Upper Endoscopy (EGD)

Upper endoscopy (esophagogastroduodenoscopy or EGD) uses a thin, flexible tube with a camera to examine the esophagus, stomach, and upper small intestine (duodenum). Over 7 million upper endoscopies are performed annually in the US.

EGD is performed to evaluate GERD, difficulty swallowing, persistent nausea/vomiting, upper abdominal pain, unexplained anemia, Barrett's esophagus surveillance, celiac disease diagnosis, and to treat conditions like bleeding ulcers or strictures.

Fast for 6-8 hours before the procedure. Inform your doctor about medications, especially blood thinners and diabetes drugs. Arrange for a driver. Adjust diabetes medications as directed since you will be fasting.

Under sedation, the endoscope is passed through the mouth and advanced through the upper GI tract. The doctor examines the lining and can take biopsies, dilate strictures, remove polyps, or treat bleeding. The procedure takes 15-30 minutes.

Rest for 30-60 minutes as sedation wears off. Mild sore throat and bloating are common. Resume eating within a few hours unless instructed otherwise. Take the rest of the day off. Biopsy results take 3-7 days.

Risks are low: perforation (very rare, 0.01-0.04%), bleeding (especially after biopsy or polyp removal), infection, reaction to sedation, and aspiration. Serious complications are uncommon.

Alternatives include barium swallow X-ray (less detailed, no biopsy capability), capsule endoscopy (swallowed camera pill, no treatment capability), and non-invasive H. pylori testing for suspected ulcer disease.

Covered by insurance when medically indicated. Barrett's esophagus surveillance and evaluation of significant symptoms are typically covered. Prior authorization may be required.