Digestive Diseases and Nutrition

Upper Endoscopy

Upper EndoscopyUpper endoscopy procedure or EsophagoGastroDuodenoscopy (EGD) is a real-time visual examination of the lining of the esophagus, stomach, and upper small intestine (duodenum). The procedure is performed by board-certified gastroenterologists (stomach and liver specialists) or by their trainees (also known as Fellows) who work under their direct supervision.

The instrument used for this procedure is called the upper endoscope, a thin but long flexible tube that carries a high definition wide-angle camera, a bright light source and working channels at its tip. The endoscope allows the physician not only to take a look but also obtain tissue samples known as biopsies. Biopsies are then examined by a pathologist.

The procedure is pain free as you will receive sedatives/pain medications to ensure your comfort. A local anesthetic may also be sprayed into your mouth to suppress the cough or gag reflex when the endoscope is inserted. A plastic mouth guard will be inserted to further protect your teeth and the endoscope during the 5 – 20 minute procedure. The endoscope is inserted through the mouth and will not interfere with your breathing.

EGD helps your gastroenterologist evaluate and treat multiple gastrointestinal symptoms such as abdominal pain, nausea and vomiting, esophageal reflux, gastrointestinal hemorrhage, to name a few. It can be done on an outpatient or inpatient basis.

In preparation of the procedure, your physician may ask you to stop certain medications before your procedure. Otherwise, the only preparation for the procedure is a period of fasting ranging from 8-10 hours prior to the procedure. Detailed instruction will be provided through our staff members.

EGD is usually very safe. The risks associated with this procedure are commonly related to sedation such as transient respiratory depression (slowness of breathing) and minor change in vital signs (blood pressure and heart rate). Infection is extremely uncommon with diagnostic EGD (1-5 per 10 million); perforation (tear) risk is 3 per 10,000; and risk of death is 1 per 100,000 (to give a perspective, the risk of being randomly shot at is 6 in 100,000). Bleeding risk from diagnostic EGD is extremely rare. These risks are increased with interventions such as biopsies, dilation (stretching of tight spots), and others.

When you wake up from sedation you will be monitored for any adverse events for a period up to one hour. You may feel a little bloated from the air that is introduced through the instrument, but this will wear off in a short period of time. You will be permitted to carry on any normal activity for the remainder of the day except for driving a motorized vehicle so you will need an adult driver to pick you up that day.