To view ASGE’s patient education video for Upper Endoscopy, click here.

What is upper endoscopy?

Upper endoscopy is sometimes referred to as upper GI endoscopy or esophagogastroduodenoscopy (EGD). Your doctor will use a thin, flexible tube called an endoscope to examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). A tiny video camera at the tip of the tube allows the doctor to carefully examine the lining of your gastrointestinal tract.

Why is upper endoscopy done?

Upper endoscopy is done for a variety of reasons. It is used to evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It is the best test for detecting the cause of upper gastrointestinal tract bleeding and is more accurate than x-rays to detect inflammation, ulcers and tumors in this area.

Upper endoscopy may also be performed to take small tissue samples (biopsies). Biopsies are used to help your doctor test for different conditions found in the upper gastrointestinal tract as well as distinguish between benign (noncancerous) and malignant (cancerous) tissue.

Your doctor can pass instruments through the endoscope to directly treat many conditions of the upper gastrointestinal tract. Your doctor may be able to stretch (dilate) a narrowed area, remove polyps (usually benign growths) or treat bleeding. These treatments will cause you little or no discomfort.

What preparations are required?

An empty stomach is required for the best and safest examination. You will be instructed to have no solid foods after midnight and clear liquids only on the day of your procedure. Depending on the time of your exam, you will be instructed when to stop clear liquids and start fasting.

Can I take my current medications?

Notify the doctor of all the medications you are taking. Most medications can be continued as usual, but some medications may need to be adjusted or stopped temporarily prior to the exam. The doctor’s office will discuss any medication changes with you prior to the upper endoscopy.

What happens during upper endoscopy?

Right before your exam, a nurse will have you change into a gown. Your medical history will be reviewed, vital signs taken, and an IV will be started for sedation purposes. You will speak with a nurse anesthetist about your sedation options.

Once you enter the procedure room, the physician will speak with you regarding your procedure, any concerns you have, and have you sign a procedure consent. Sedation will be given after all your questions have been answered and you have signed your consent.

You will lie on your left side and the nursing staff will insert a bite block between your teeth for protection during the procedure. The doctor will pass the endoscope through your mouth and into the esophagus, stomach, and duodenum. The endoscope doesn’t interfere with your breathing. Many patients fall asleep during the procedure.

What happens after upper endoscopy?

After the exam you will be taken back to the recovery area. The doctor will give you and your driver (if authorization given) a report of the procedure. You will have to wait for the results of any biopsies taken. Because you will still be sleepy from the sedation, you may not remember talking with the doctor. The nurse will go over your results and any home instructions with you and your driver.

Your throat might be a little sore and you may have some abdominal bloating from the air introduced into your stomach during the procedure. Unless the doctor instructs otherwise, you may resume a regular diet after you leave.

It can take up to a full day for the effects of the sedation to wear off. Because of the sedation, you will need to have someone to take you home and you are not to go back to work for the rest of the day. If you do not have a driver or a responsible adult to accompany you home, your procedure will be cancelled.

What are the possible complications of upper endoscopy?

Upper endoscopy is generally safe when performed by doctors who have been specially trained and are experienced in the procedure. Although complications are uncommon, they do occur and can include:

  • Bleeding at a biopsy or polyp removal site (usually minimal and rarely requires follow-up)
  • Perforation (very rare but may require surgery)
  • Reactions to sedation
  • Complications from underlying conditions.

Your doctor will discuss the risks of upper endoscopy with you. It is important to recognize early signs of possible complications. Contact your doctor immediately if you develop a fever, trouble swallowing or increasing throat, chest or abdominal pain, or bleeding, including black stools. It should be noted bleeding can occur several days after the procedure.