Esophagogastroduodenoscopy (EGD Test)

What is an esophagogastroduodenoscopy (EGD test)?

EGD stands for “esophagogastroduodenoscopy." Phew! Let’s break that down.

Working backward through the word, “scopy” means an examination with a visual instrument. A “scope” is that instrument (as in “telescope” or “microscope”). During an EGD test, medical examiners use something called an endoscope to examine the inside of your body. It’s a small, lighted camera on the end of a long, flexible tube.

After you're given medication to make you comfortable, an endoscope is passed down your throat, through your esophagus (swallowing tube) and into your stomach. The camera sends images to a computer screen showing your esophagus, stomach and duodenum (the upper part of your small intestine).

That’s where the rest of the word comes from. “Duodeno” means the duodenum, “gastro” means the stomach, and “esophago” means the esophagus.

What is the difference between an esophagogastroduodenoscopy and an endoscopy?

There are many types of endoscopy procedures. Esophagogastroduodenoscopy is just one of them. All endoscopies use the same tool — the endoscope — to examine different parts of the body. The exams are named differently to describe the different parts they are looking at.

An EGD test looks at what healthcare providers sometimes call the upper gastrointestinal (GI) tract: the esophagus, stomach and duodenum. This is the part of your digestive system that the endoscope can reach from the top down. Sometimes an EGD is also called an upper endoscopy.

Why is an esophagogastroduodenoscopy performed?

An EGD is primarily a diagnostic procedure, but it can also be used therapeutically, to treat problems that are found during the exam.

Diagnostics

Your healthcare provider might suggest an EGD test to look for possible causes of symptoms you may be experiencing related to your upper GI tract. Symptoms such as:

• Abdominal pain.
• Heartburn.
• Persistent nausea or vomiting.
• Swallowing difficulties.
• Non-cardiac chest pain.
• Chronic acid reflux.
• Unexplained weight loss.
• Vomiting blood.
• Anemia.
• Functional indigestion.

The endoscope provides a clear view of the inside lining of your upper GI tract, including the color and any abnormal textures or growths. It also allows enough visibility and access for doctors to perform small procedures during the exam.

Procedures

Sometimes an EGD can be targeted to treat a problem. Maybe you or your child swallowed something that needs to be removed. Or maybe your healthcare provider spotted something on an X-ray that needs further investigating. They might want to take a tissue sample to examine in the lab (biopsy). They can do these things with the endoscope.

By attaching tiny tools to the endoscope, EGD technicians can often fix small problems on the spot. For example:

• Stop bleeding.
• Repair holes.
• Drain abscesses.
• Remove growths.
• Open narrowed passages.
• Insert medical devices for therapy.

What does an esophagogastroduodenoscopy (EGD test) look for?

Some things they might look for include:

• Tissue damage from stomach acid, bile or chemicals.
• Cellular changes to the lining of the organs.
• Abnormal growths or ulcers on the walls.
• Bleeding and perforations (holes).
• Narrowing or blockages in the passageways.
• Inflammation and swelling.
• Varices (swollen veins).

What does an EGD test diagnose?

Abnormal test results could indicate:

• Esophagitis.
• Gastritis.
• Peptic ulcer disease.
• Stomach polyps.
• Gastroesophageal reflux.
• Esophageal strictures.
• Achalasia.
• Gastroparesis.
• Celiac disease.
• Helicobacter pylori infection.
• Gastritis.
• Intestinal metaplasia.
• Barrett’s esophagus.
• Hiatal hernia.
• Cirrhosis of the liver.
• Portal hypertension.
• Cancer of the esophagus, stomach or duodenum.

How do you prepare for an esophagogastroduodenoscopy?

EGD is a simple outpatient procedure that shouldn’t take more than an hour of your day. However, you’ll have to prepare in a few ways ahead of the appointment.

• Screening. Since the test involves sedation and sometimes general anesthesia, your healthcare provider will want to screen you in advance for any health conditions that might make these unsafe for you.
• Fasting. You’ll need to avoid eating anything within eight hours of the procedure. That’s to avoid complications from food that may still be in your stomach during the procedure. You can drink clear liquids up to two hours before the test.
• Medications. You may need to stop taking blood thinners and adjust your diabetes medications the day before the test. Your healthcare provider will instruct you.
• Driver. Because most people will be sedated for the procedure, you will be asked to have a responsible adult accompany you and take you home afterward. You will not be permitted to drive or operate heavy machinery after you receive the medications.

What happens before the test?

When you arrive for your EGD, you’ll be led to the endoscopy suite. A nurse will check your vital signs to make sure you’re in good condition for the procedure. Then your nurse will install an intravenous (IV) catheter into a vein in your arm to deliver your medicine.

If you have general anesthesia, the medication will put you completely to sleep. You won’t feel anything. However, most people will have conscious sedation instead. Sedatives will be used to make you feel sleepy and relaxed, but you may not be completely asleep. With the sedative, you’ll also have a local anesthetic sprayed into your mouth and throat. This has a numbing effect.

Your nurse will place a mouth guard in your mouth to protect your teeth and tongue. They’ll position you on your left side on the procedure table. Once you are fully sedated, the endoscope will be passed down your throat into your upper GI tract.

What happens during the test?

Some people experience mild discomfort or gagging just as the endoscope is inserted. Others don’t notice much of anything, and many don’t remember much afterward because of the effects of the sedative. It won’t interfere with your breathing and you shouldn’t feel anything once it has been placed. Your endoscopy nurse may ask you to swallow a couple of times to help guide the endoscope downward.

After placing the endoscope, your technician will pump air into the tube to help expand your esophagus, stomach and duodenum to see them better. Then they’ll use the endoscope to examine your organs. They may pass tools through the scope to take a tissue sample or make a small repair. The procedure takes about 10 minutes for just the exam and up to 30 minutes with extra steps.

What happens after the test?

Your technician will suction the air out of your stomach after withdrawing the endoscope. However, there may be some gas left in there. This will pass over the next day or so. Side effects may include bloating and passing gas (burping and farting).

You may also have a sore throat for a day or two as the numbing agent wears off. Cold foods and drinks can help soothe your throat. Your healthcare provider may recommend some more specific dietary guidelines for the days following the test.

You may not remember the test afterward. You’ll need to stay at the medical office until you are alert enough to be discharged. In some cases, your healthcare provider may be able to discuss the test results with you right away. In other cases, you may need to make a separate appointment.

What are the potential risks or complications of the procedure?

Complications from esophagogastroduodenoscopy are rare. They mainly involve:

• Adverse reactions to the sedative, such as low blood pressure and low blood oxygen.
• Internal bleeding or perforation.

When should I know the results of the test?

If you don’t have results immediately after the test, it might be because your healthcare provider needs to wait for biopsy results. This can take up to two weeks. As soon as your healthcare provider has results to share, they will be able to discuss what they found, what it means and what comes next.

A note from Cleveland Clinic
Esophagogastroduodenoscopy may have a whopper of a name, but it’s a simple procedure. Patients appreciate that it’s short and painless. Healthcare providers appreciate how well the endoscope visualizes the internal organs, and even allows them to take samples and make quick repairs. You and your healthcare provider can learn a lot from an EGD about what’s going on in your body, and sometimes even fix it.