Upper Endoscopy (EGD)

What Is an Upper Endoscopy?

An upper endoscopy, also called EGD (esophagogastroduodenoscopy), is a procedure that allows your doctor to look directly at the lining of your esophagus, stomach, and the first part of the small intestine (duodenum) using a thin, flexible camera.

It is one of the best tests to evaluate reflux or heartburn, swallowing problems, abdominal pain, nausea, bleeding, anemia, and many other upper GI symptoms. It can also be used to take biopsies and sometimes treat problems during the same procedure.

Why Might I Need an Upper Endoscopy?

Upper endoscopy is commonly recommended to evaluate:

Reflux / GERD Symptoms

  • Heartburn that persists despite medication
  • Regurgitation
  • Chronic cough or hoarseness possibly related to reflux
  • Evaluation for complications such as esophagitis or Barrett’s esophagus

 

Swallowing Problems

  • Food “sticking” (dysphagia)
  • Pain with swallowing (odynophagia)

 

Upper Abdominal Symptoms

  • Persistent nausea or vomiting
  • Upper abdominal pain
  • Unexplained weight loss

 

Bleeding or Anemia

  • Black stools (melena)
  • Vomiting blood
  • Iron-deficiency anemia without a clear cause

 

Other Conditions

  • Ulcers, gastritis, or H. pylori infection
  • Celiac disease (biopsy)
  • Monitoring known conditions such as Barrett’s esophagus, ulcers, or varices (case-by-case)

 

Important: If you have trouble swallowing, bleeding, weight loss, anemia, or persistent vomiting, endoscopy is often recommended sooner.

What Can an Upper Endoscopy Diagnose?

An EGD can identify or confirm:

  • Esophagitis (inflammation from reflux)
  • Hiatal hernia
  • Barrett’s esophagus
  • Strictures (narrowing) or rings such as Schatzki ring
  • Ulcers in the stomach or duodenum
  • Gastritis
  • H. pylori infection
  • Celiac disease (via biopsy)
  • Tumors or abnormal growths (rare, but important to rule out)

 

Can an Upper Endoscopy Treat Problems Too?

Yes. In many cases, endoscopy can be both diagnostic and therapeutic, including:

  • Biopsies to evaluate inflammation, infection, Barrett’s esophagus, or celiac disease
  • Dilation of narrowed areas to improve swallowing
  • Control of certain bleeding sources
  • Removal of some polyps or foreign bodies (selected cases)

 

How the Procedure Works

During upper endoscopy:

  • You receive sedation (most patients are very comfortable and do not remember the procedure)
  • A thin camera is passed through the mouth into the esophagus, stomach, and duodenum
  • Air or CO₂ is used to gently open the GI tract for better visibility
  • If needed, biopsies are taken (you do not feel them)
  • The scope is removed and you recover in a monitored area

 

Typical procedure time: About 10–20 minutes (longer if additional treatments are performed).
Total visit time: Usually 1.5–3 hours including preparation and recovery.

Preparation: What You Need to Do

Fasting

  • No food for 6–8 hours before the procedure
  • Clear liquids may be allowed up to a few hours beforehand (exact instructions will be provided)

 

Medications

  • Tell your doctor if you take blood thinners (Warfarin, Eliquis, Xarelto, Plavix, etc.)
  • Diabetes medications may need temporary adjustment
  • Some reflux medications may be continued or temporarily held depending on the reason for the test

 

Transportation

  • You must have someone drive you home due to sedation
  • No driving, alcohol, or important decisions for the rest of the day

 

Recovery: What to Expect

After the procedure:

  • You may feel sleepy for a few hours from sedation
  • Mild sore throat, bloating, or burping can occur and usually resolves quickly
  • Most patients return to normal activities the next day

 

If biopsies are taken, results typically return within several days (timing varies by lab).

Risks and Complications

Upper endoscopy is very safe. Risks are uncommon but can include:

  • Reaction to sedation
  • Bleeding (usually minimal, more likely if biopsies or treatment are performed)
  • Infection (rare)
  • Perforation (a tear in the lining—very rare but serious)
  • Dental or throat irritation (uncommon)

 

Your overall risk depends on your medical history and whether additional procedures are performed.


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