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What is “EGD” (Esophagogastroduodenoscopy)?

An ENDOSCOPE is a long flexible tube that is thinner than most food you swallow. It is passed through the mouth and back of the throat into the upper digestive tract and allows the physician to examine the lining of the esophagus, stomach and duodenum (the first portion of the small intestine). Abnormalities suspected by X-ray can be confirmed or refuted and others may be detected which are too small to be seen on X-ray. If the doctor sees a suspicious area, he can pass an instrument through the endoscope and take a small piece of tissue called a biopsy for examination in the laboratory by the pathologist. Biopsies are taken for many reasons and do not necessarily imply cancer. Other instruments can also be passed through the endoscope without causing discomfort including a small brush to wipe cells from a suspicious area for examination in the laboratory (a form of pap test or cytology), a wire loop or snare to remove polyps, or a balloon to stretch a narrowed area (stricture).

Preparation

For the best possible examination, the stomach must be completely empty, so you should have nothing to eat or drink, including water, after midnight the evening before the examination. Be sure to let your doctor know if you are allergic to any drugs. A companion must accompany you to the examination because you will be given medication to help you relax. It will make you drowsy, so you will need someone to take you home. Even though you may not feel tired, your judgment and reflexes may not be normal. Please review the Preparing for your Endoscopy for instructions.

The Procedure

The endoscopy nurse will attach EKG leads to your chest, place a blood pressure cuff around your arm, place a small probe on your finger to monitor the oxygen level in your blood and start an intravenous line. Your doctor will give you medication through the vein to make you relaxed and sleepy. You may be given a topical anesthetic spray or gargle to help numb the throat. You will be asked to remove any dentures or partial plates to prevent them from being dislodged during the procedure. A small plastic rounded "bite block" will be placed between your teeth to protect the endoscope and prevent you from biting down. While you are lying in a comfortable position on your left side, the endoscope is inserted through the mouth and each part of the esophagus, stomach and duodenum is examined. The procedure is extremely well tolerated with little or no discomfort. Many patients fall asleep or remember little during the procedure. The tube will not interfere with your breathing. Gagging is usually prevented by the medication. Some patients feel a bit of pressure in the back of the throat on initial passage of the scope. The procedure itself usually lasts less than 10 minutes. You will be kept in the endoscopic area until most of the effects of the medication have worn off. Your throat may be a little sore for a couple of hours and you may feel bloated for a few minutes right after the procedure. You will be able to resume your diet after the procedure unless instructed otherwise.

Complications of EGD

Endoscopy is safe and is associated with very low risk when performed by physicians who have been specially trained and are experienced in this procedure. Complications can occur but are rare. One possible complication is perforation in which a tear through the wall of the esophagus or stomach may allow leakage of digestive fluids. This complication may be managed simply by aspiration the fluids until the tear seals or may require surgery. Unusual pain following the procedure might indicate a perforation and should be reported to our office. Bleeding may occur from the site of biopsy or polyp removal. It is usually minimal but rarely may require transfusions or surgery. Localized irritation of the vein may occur at the site of medication injection. A tender lump develops which may remain for several weeks to months but goes away eventually. Other risks include reactions to the sedatives and complications from unrelated diseases such as heart attack or stroke. Death is extremely rare, but remains a remote possibility. If a complication or question of one develops, contact the office immediately.

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