Esophagogastroduodenoscopy: Purpose, Preparation, Risks – Complications and Results

What is it? An esophagogastroduodenoscopy (EGD) is a test to examine the lining of your esophagus, stomach, and duodenum.

The esophagus is the muscular tube that connects the throat to the stomach and the duodenum, the upper part of the small intestine.

An endoscope is a small camera in a tube. An EGD test involves passing an endoscope through the throat and your esophagus.

Purpose

Your doctor may recommend an esophagogastroduodenoscopy test if you have specific symptoms, which include:

  • Severe and chronic heartburn.
  • Vomiting of blood.
  • Black or tarry stools
  • Regurgitation of food.
  • Pain in the upper part of the abdomen.
  • Anemia inexplicable.
  • Persistent nausea or vomiting
  • Unexplained weight loss
  • A feeling of fullness after eating less than usual (stuffed with food).
  • A feeling that food is lodged behind the sternum.
  • Pain or difficulty swallowing.

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

  • Crohn’s disease.
  • Peptic ulcers
  • Cirrhosis.
  • Swollen veins in the lower esophagus.

Preparation before the esophagogastroduodenoscopy

  • Your doctor will advise you to stop taking medications such as aspirin and other anticoagulants for several days before the EGD test.
  • You will not 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 exams, you will be asked to sign an informed consent form before undergoing the procedure.

The procedure of the esophagogastroduodenoscopy

Before administering an EGD, your doctor will probably give you a sedative and an analgesic. This prevents me from feeling pain. Usually, people do not even remember the test.

Your doctor may also spray a local anesthetic on your mouth to prevent it from burning or coughing when the endoscope is inserted. You will have to wear a mouth guard to avoid damage to your teeth or the camera.

 

The doctor then inserts an intravenous needle into your arm so they can give you medication throughout the exam. You will be asked to lie on the left side during the procedure.

Once the sedatives have taken effect, the endoscope is inserted into the esophagus and passed into the stomach and upper part of the small intestine. The air passes through the endoscope so your doctor can see the lining of your esophagus.

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

Treatments can sometimes be performed during an EGD, such as widening any abnormally narrow esophagus area.

The complete test lasts between 5 and 20 minutes.

Risks and complications of an esophagogastroduodenoscopy

In general, an EGD is a safe procedure. There is a minimal risk of the endoscope causing a small hole in the esophagus, stomach, or small intestine.

If a biopsy is performed, there is also a small risk of prolonged bleeding at the site where the tissue was taken.

Some people may also react to the sedatives and analgesics used throughout the procedure. These could include:

  • Difficulty breathing or inability to breathe.
  • Low blood pressure.
  • Slow heartbeat.
  • Excessive sweating
  • A spasm of the larynx.

However, less than one in 1,000 people experience these complications.

Results

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

  • Inflammation.
  • Ulcers.
  • Bleeding

The following may cause abnormal EGD results:

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

What to expect after the test

A nurse will observe you for about an hour after the test to ensure that the anesthesia is gone and you can swallow without difficulty or discomfort.

It may feel slightly swollen. You may also have mild cramping or a sore throat. These side effects are pretty standard and should disappear entirely within 24 hours.

Wait to eat or drink until you can swallow comfortably. Once you start 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 weak.
  • You are vomiting.
  • You have sharp pains in your abdomen.
  • You have blood in your stool.
  • You can not eat or drink.
  • You are urinating less than usual, or you are not at all.

Your doctor will review the results of the Esophagogastroduodenoscopy test with you. They can request more tests before they give a diagnosis or create a treatment plan.