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Digestive Health

Digestive Health

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Esophagogastroduodenoscopy

(EGD, Upper Gastrointestinal Endoscopy, Upper GI Endoscopy, Gastroscopy, Esophagoscopy)

Procedure overview

What is an esophagogastroduodenoscopy?

Esophagogastroduodenoscopy (EGD) is a diagnostic procedure that allows the physician to diagnose and treat problems in the upper gastrointestinal (UGI) tract. The doctor uses a long, flexible, lighted tube called an endoscope. The endoscope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum (first part of the small intestine). The doctor can examine the inside of these organs and detect abnormalities.

Illustration of an esophagogastroduodenoscopy procedure
Click Image to Enlarge

In addition to performing visual examination of the UGI tract with the endoscope, the doctor can insert instruments through the endoscope to obtain tissue samples for a biopsy, remove foreign objects, instill air or fluid, stop bleeding, or perform therapeutic procedures, such as endoscopic surgery, laser therapy, or dilatation (opening up). A video camera in the endoscope provides images onto a TV-like monitor.

Other related procedures that may be used to diagnose upper gastrointestinal problems are barium swallow and upper gastrointestinal series. Please see these procedures for additional information.

About the upper GI tract

Illustration of the anatomy of the digestive system, adult
Click Image to Enlarge

Digestion is the process by which food and liquid are broken down into smaller parts so that the body can use them to build and nourish cells, and to provide energy. Digestion begins in the mouth, where food and liquids are taken in, and is completed in the small intestine.

Digestion involves the mixing of food, the movement of food through the digestive tract, and the chemical breakdown of large molecules of food into smaller molecules.

In a wave-like movement, called peristalsis, muscles propel food and liquid along the digestive tract. The involvement of the upper GI tract includes the following:

  • The first major muscle movement is swallowing food or liquid. The start of swallowing is voluntary, but once it begins, the process becomes involuntary and continues under the control of the nerves.

  • The esophagus, which connects the throat above with the stomach below, is the first organ into which the swallowed food goes.

  • There is a ring-like valve that closes the passage between the esophagus and the stomach. As food nears the valve, the surrounding muscles relax and allow food to pass into the stomach.

  • The food then enters the stomach, which completes three mechanical tasks of storing and mixing the food, then emptying it into the small intestine.

  • The food is digested in the small intestine and dissolved by the juices from the pancreas, liver, and intestine and the contents of the intestine are mixed and pushed forward to allow further digestion.

Reasons for the procedure

An EGD may be performed to diagnose structural or functional abnormalities of the esophagus, stomach, and/or duodenum. These abnormalities may include, but are not limited to, the following:

  • Dysphagia (difficulty swallowing)

  • Weight loss or anorexia (loss of appetite)

  • Upper abdominal pain or chest pain of a noncardiac origin

  • Gastroesophageal reflux disease (GERD)

  • Intractable vomiting (continuous vomiting from an unknown cause)

  • Strictures (narrowing) or obstructions

  • Gastrointestinal bleeding and esophageal varices (enlarged veins in the esophagus)

  • Inflammation and ulcers

  • Tumors (benign or malignant)

  • Hiatal hernia. Upward movement of the stomach, either into or alongside the esophagus

  • Damage caused by ingestion of caustic substances (chemicals such as lye, household detergents)

An EGD may be performed therapeutically to control bleeding, remove tumors or polyps (growths), dilate narrowed areas in the upper GI tract (for example, esophagus), remove foreign objects, perform laser therapy, and place a percutaneous gastrostomy tube (a tube used for tube feeding into the stomach).

Tissue samples (biopsies) or gastrointestinal fluid samples may be obtained via an endoscope. In addition, an EGD may be used to evaluate the stomach and duodenum after a surgery.

There may be other reasons for your doctor to recommend an esophagogastroduodenoscopy.

Risks of the procedure

As with any invasive procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

  • Infection

  • Bleeding

  • Perforation (a tear in the lining) of the duodenum, esophagus, or stomach

Patients who are allergic to or sensitive to medications, contrast dyes, iodine, shellfish, or latex should notify their doctor.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Before the procedure

  • Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.

  • You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear.

  • Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).

  • You will be asked not to eat or drink liquids for eight hours before the procedure, generally after midnight. You may be given additional instructions about a special diet for one to two days prior to the procedure.

  • If you are pregnant or suspect that you are pregnant, you should notify your health care provider.

  • Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.

  • Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, ibuprofen, naproxen, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

  • Your doctor will instruct you about specific ways to prepare your bowel for the test. You may be asked to take a laxative, undergo an enema, use a rectal laxative suppository, and/or drink a special fluid that helps prepare your bowel.

  • Patients with diseases of the heart valves may be given antibiotics before the procedure.

  • You will be awake during the procedure, but a sedative will be given before the procedure. You will need someone to drive you home afterwards.

  • Based on your medical condition, your doctor may request other specific preparation.

During the procedure

An EGD may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary, depending on your condition and your doctor’s practices.

Generally, an EGD follows this process:

  1. You will be asked to remove any clothing, jewelry, or other objects that may interfere with the procedure. If you wear dentures, you will be asked to remove them until the procedure has been completed.

  2. If you are asked to remove clothing, you will be given a gown to wear.

  3. An intravenous (IV) line will be inserted in the arm or hand. A sedative will be injected into the IV.

  4. Your heart rate, blood pressure, respiratory rate, and oxygen level will be monitored during the procedure.

  5. You will lie on your left side on the X-ray table with your head bent forward.

  6. Numbing medication will be sprayed into the back of your throat to prevent gagging as the endoscope is passed down your throat into your stomach. The spray may have a bitter taste to it. Holding your breath while the doctor sprays your throat may decrease the taste.

  7. You will not be able to swallow the saliva that may collect your mouth during the procedure due to the endoscope in your throat. The saliva will be suctioned from your mouth from time to time.

  8. A mouth guard will be placed in your mouth to keep you from biting down on the endoscope and to protect your teeth.

  9. Once your throat is numbed and you are sufficiently relaxed from the sedative, the physician will ask you to swallow the endoscope. By using the endoscope’s camera system, the doctor will guide the endoscope down the esophagus, through the stomach, and into the duodenum.

  10. You may experience a sensation of pressure or bloating as the endoscope is being advanced.

  11. If needed for your specific situation, samples of fluid and/or tissue may be taken at any time during the procedure. Other procedures, such as the removal of an obstruction, may be performed while the endoscope is in place.

  12. After the examination and procedures have been completed, the endoscope will be withdrawn.

After the procedure

After the procedure, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If this procedure was performed as an outpatient, you should plan to have another person drive you home.

You will not be allowed to eat or drink anything until your gag reflex has returned. You may notice some soreness of your throat and pain with swallowing for a few days. This soreness is normal.

You may resume your usual diet and activities after the procedure, unless your doctor decides otherwise.

Notify your doctor to report any of the following:

  • Fever and/or chills

  • Redness, swelling, or bleeding or other drainage from the IV site

  • Abdominal pain, nausea, and/or vomiting

  • Black, tarry, or bloody stools

  • Swallowing difficulties

  • Throat or chest pain that worsens

Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care professional with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful. But please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American Cancer Society

American Gastroenterological Association

National Cancer Institute (NCI)

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

National Institutes of Health (NIH)

National Library of Medicine

With state-of-the-art equipment and a high definition video system, our focus at Broward Health Imperial Point’s Center for Digestive Health is on preventive screening, accurate diagnosis of disease and effective treatment to restore or maintain your digestive health.

Highly-skilled physicians, nurses and technologists are here to guide you through your test or procedure and keep you as comfortable as possible. Light sedation anesthesia for procedures will help you get back to normal, fast.

Broward Health Imperial Point’s Center for Digestive Health provides the most advanced care for the following conditions:

Barrett’s Esophagus
Barrett’s esophagus is a disorder in which the lining of the esophagus (the tube that carries food from the throat to the stomach) is damaged by stomach acid and changed to a lining similar to that of the stomach.

GERD/Heartburn
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach to the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

Radiation Proctitis
Radiation proctitis, which involves the lower intestine, is inflammation and damage to the lower parts of the colon after exposure to x-rays or other radiation as part of radiation therapy. Radiation proctitis most commonly occurs after treatment for prostate, colon and cervical cancers.

Procedures performed at the Center for Digestive Health include:

TIF Incisionless Surgery for Heartburn/GERD
Transoral Incisionless Fundoplication (TIF) represents a huge advance in the evolution of surgery. Performed with the new EsophyX® surgical device that is placed through the patient’s mouth, this technique reconstructs a durable anti-reflux valve and tightens the LES (lower esophageal sphincter), re-establishing a barrier to reflex and restoring the competency of the gastroesophageal junction. This advanced procedure results in the effective elimination of GERD symptoms, leaves no visible scarring and allows patients to recover quickly.

Barrx Esophagus Ablation
The Barrx Esophagus Ablation is an incisionless, proactive outpatient procedure that typically takes less than 30 minutes. By using advanced BARRX HALO System technology, we are able to remove the diseased layer of cells from the esophagus without injury to underlying healthy tissue. Patients can expect a re-growth of their normal cells within three to four weeks.

Capsule Endoscopy
Capsule Endoscopy is a procedure using a tiny wireless camera that sits inside of a vitamin-sized capsule that you swallow. This allows the camera to take pictures of your digestive tract. The camera takes thousands of pictures that are transmitted to a recorder you wear on a belt around your waist as the capsule travels throughout your digestive tract.

Small Bowel Enteroscopy
A small bowel enteroscopy is a procedure used to examine the gastrointestinal bleeding, small bowel tumors, polyps, or other small bowel diseases.

During the procedure, a doctor inserts a thin, flexible tube called an endoscope into a patient’s mouth to examine the lining of the esophagus, stomach and portions of the small intestine (small bowel). If growths or other abnormalities are found during the test, the physician may remove the abnormal tissue for further examination or biopsy.

Halo Procedure/Barrett’s Esophagus Ablation
The HALO procedure consists of ablative therapy to the patient’s esophagus. The HALO ablation technology is designed specifically to remove the diseased tissue and allow new, healthy tissue to re-grow. This allows for large areas of Barrett’s esophagus to be effectively treated. More importantly, this procedure can remove precancerous lesions from the esophagus and alleviate the patient’s wait-time and anxiety that often accompany this diagnosis.

For more information about our services or to find a doctor, call the Broward Health Line at 954-759-7400.

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