Esophagogastroduodenoscopy

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Esophagogastroduodenoscopy (/ɪˌsɒfəɡoʊˌɡæstroʊˌduːoʊdɪˈnɒskoʊpi/), also called by various other names, is a diagnosticendoscopic procedure that visualizes the upper part of the gastrointestinal tract down to the duodenum. It is considered a minimally invasive procedure since it does not require an incision into one of the major body cavities and does not require any significant recovery after the procedure (unless sedation or anesthesia has been used). However, a sore throat is common.

Why an EGD test is performed

Your doctor may recommend an EGD test if you have certain symptoms, including:

  • severe, chronic heartburn
  • vomiting blood
  • black or tarry stools
  • regurgitating food
  • pain in your upper abdomen
  • unexplained anemia
  • persistent nausea or vomiting
  • unexplained weight loss
  • a feeling of fullness after eating less than usual
  • a feeling that food is lodged behind your breastbone
  • pain or difficulty swallowing

Your doctor may also use this test to help see how effectively a treatment is going or to track complications if you have:

PREPARATION

Preparing for the EGD test

Your doctor will advise you to stop taking medications such as aspirin (Bufferin) and other blood-thinning agents for several days before the EGD test.

You won’t be able to eat anything for 6 to 12 hours before the test. People who wear dentures will be asked to remove them for the test. As with all medical tests, you’ll be asked to sign an informed consent form before undergoing the procedure.

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PROCEDURE

Where and how the EGD test is administered

Before administering an EGD, your doctor will likely give you a sedative and a painkiller. This prevents you from feeling any pain. Usually, people don’t even remember the test.

Your doctor may also spray a local anesthetic into your mouth to stop you from gagging or coughing as the endoscope is inserted. You’ll have to wear a mouth guard to prevent damage to your teeth or the camera.

The doctor then inserts an intravenous (IV) needle into your arm so that they may give you medications throughout the test. You’ll be asked to lie on your left side during the procedure.

Once the sedatives have taken effect, the endoscope is inserted into your esophagus and passed down into your stomach and the upper part of your small intestine. Air is then passed through the endoscope so that your doctor can clearly see the lining of your esophagus.

During the examination, the doctor might take small tissue samples using the endoscope. These samples can later be examined with a microscope to identify any abnormalities in your cells. This process is called a biopsy.

Treatments can sometimes be done during an EGD, such as widening any abnormally narrow areas of your esophagus.

The complete test lasts between 5 and 20 minutes.

RISKS AND COMPLICATIONS

Risks and complications of an EGD test

In general, an EGD is a safe procedure. There’s a very slight risk that the endoscope will cause a small hole in your esophagus, stomach, or small intestine. If a biopsy is performed, there’s also a small risk of prolonged bleeding from the site where the tissue was taken.

Some people also may have a reaction to the sedatives and painkillers used throughout the procedure. These could include:

  • difficulty breathing or an inability to breathe
  • low blood pressure
  • slow heartbeat
  • excessive sweating
  • a spasm of the larynx

However, less than one out of every 1,000 people experience these complications.

RESULTS

Understanding the results

Normal results mean that the complete inner lining of your esophagus is smooth and shows no signs of the following:

  • inflammation
  • growths
  • ulcers
  • bleeding

The following may cause abnormal EGD results:

  • Celiac disease results in damage to your intestinal lining and prevents it from absorbing nutrients.
  • Esophageal rings are an abnormal growth of tissue that occurs where your esophagus joins your stomach.
  • Esophageal varices are swollen veins within the lining of your esophagus.
  • A hiatal hernia is a disorder that causes a portion of your stomach to bulge through the opening in your diaphragm.
  • Esophagitis, gastritis, and duodenitis are inflammatory conditions of the lining of your esophagus, stomach, and upper small intestine, respectively.
  • Gastroesophageal reflux disease (GERD) is a disorder that causes liquid or food from your stomach to leak back into your esophagus.
  • Mallory-Weiss syndrome is a tear in the lining of your esophagus.
  • Ulcers can be present in your stomach or small intestine.

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AFTER THE TEST

What to expect after the test

A nurse will observe you for about an hour following the test to make sure that the anesthetic has worn off and you’re able to swallow without difficulty or discomfort.

You may feel slightly bloated. You may also have slight cramping or a sore throat. These side effects are quite normal and should go away completely within 24 hours. Wait to eat or drink until you can swallow comfortably. Once you do begin eating, start with a light snack.

You should seek immediate medical attention if:

  • your symptoms are worse than before the test
  • you have difficulty swallowing
  • you feel dizzy or faint
  • you’re vomiting
  • you have sharp pains in your abdomen
  • you have blood in your stool
  • you’re unable to eat or drink
  • you’re urinating less than usual or not at all

Your doctor will go over the results of the test with you. They may order more tests before they give you a diagnosis or create a treatment plan.

What are the risks of the exam?

In general, esophagogastroduodenoscopy is a very safe procedure. Overall, complications occur in less than 1% of patients. Most complications are not life-threatening, however, if a complication occurs, it may require hospitalization and surgery. Prior to the exam, a consent form will be reviewed with the patient by the nursing staff. Should any questions or concerns arise, these can be discussed with your physician prior to beginning the procedure.

Medication reactions associated with the sedation can occur. These can include but are not limited to allergic reactions, difficulty breathing, affects on the heart and blood pressure, and irritation of the vein used to give the medication.

Bleeding can occur with biopsies, removal of polyps, and with dilating strictures. Again, significant bleeding which might require a blood transfusion or hospitalization is very uncommon.

Perforation or puncture of the esophagus, stomach, or small intestine can occur. This may be recognized at the time of the exam, or it may not be apparent until later in the day. In most cases, a perforation will require a surgery and hospitalization. This is still an uncommon complication, even when biopsies are taken or a dilation is performed.

It is very important that the patient contact the doctor’s office immediately if symptoms arise after the procedure such as worsening abdominal pain, bleeding, or fever.

Like any other test, an esophagogastroduodenoscopy is not perfect. There is a small, accepted risk that abnormalities including cancers can be missed at the time of the exam. It is important to continue to follow-up with your doctors as instructed and inform them of any new or persistent symptoms.

What are alternatives to an esophagogastroduodenoscopy?

To an extent, the alternatives to the exam will depend on the reason for needing to undergo the esophagogastroduodenoscopy in the first place. In most cases, the esophagogastroduodenoscopy is the best method to evaluate and treat abnormalities in the upper GI tract. However, an x-ray called an upper GI/barium swallow can evaluate the upper GI tract as well. This is however only a diagnostic exam. Treatment of abnormalities will require an esophagogastroduodenoscopy or surgery.

https://www.tddctx.com/procedures/egd-esophagogastroduodenoscopy

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