Upper Endoscopy (EGD) & Procedure Instructions

Upper endoscopy (EGD) is the examination of the upper gastrointestinal tract using a long, flexible scope. This procedure allows your physician to observe all parts of the upper gastrointestinal tract – the esophagus, the stomach, and the first part of your small intestine. Upper endoscopy (EGD) can be used to investigate symptoms, diagnose or biopsy for diseases, or treat digestive system problems. It is sometimes ordered to test for anemia, bleeding, inflammation, diarrhea or cancers of the digestive system. Patients experience little or no discomfort during the procedure and it typically takes 30 minutes or less.

Upper endoscopy (EGD) is the examination of the upper gastrointestinal tract using a long, flexible scope. The procedure allows your physician to observe all parts of the upper gastrointestinal tract. The instrument used is an upper endoscope. It is a long, thin, flexible tube about twice the diameter of a pencil. There are approximately four channels within the “scope” through which the physician may illuminate, wash, suction, photograph and biopsy the upper gastrointestinal tract. These channels provide the make it possible to biopsy abnormal tissue, remove polyps, cauterize blood vessels to stop active bleeding, or to prevent re-bleeding. In addition, sclerosing agents can be injected into varices, (dilated vessels seen in the upper portion of the stomach or esophagus in patients with cirrhosis of the liver), or these varices can be banded with small rubber bands. Strictures (narrowed areas in the upper GI tract secondary to scarring from reflux or ulcer disease), can be dilated utilizing several different types of dilators.

Your upper endoscopy (EGD) procedure will be performed by a Eugene Gastroenterology Physician at the Oregon Endoscopy Center, adjacent to our office. It’s extremely important that you follow the procedure preparation instructions carefully to minimize the risk of aspirating stomach contents into your lungs.

Upon admission, you will be asked a series of medically related questions. You will change into a hospital gown and be shown to a bed. You will be awake during the procedure, but you will be given medicine to relax you (a sedative) before the test.

Once you’ve completed the admission process, you will have an intravenous line started in your arm or hand. This makes it possible for your physician can administer sedation and any pain medication before and during the procedure. If you have any history of drug reactions or allergies, heart or lung condition, artificial joints (e.g., artificial hip or knee), inform your nurse and doctor before the procedure begins.

Once the inspection is complete, the upper endoscope will be removed. The entire examination takes 10 and 30 minutes. You will then be taken to the postoperative area for recovery. It is very common, due to the nature of the medications used for sedation, for patients to remember little or nothing of the procedure. You may experience some abdominal discomfort due to the presence of gas that may last 20 to 30 minutes, but this is normally minimal.

Forgetfulness is normal immediately after the procedure and is due to the use of a sedative during the endoscopy (EGD). Due to the amnesia-like effects of the sedation used for upper endoscopy (EGD), it is likely you will not remember the information given to you immediately following your procedure. Therefore, your doctor will have the discharge nurse/clinician speak with you and your family approximately 30 minutes after the completion of your procedure. At that time, the procedure findings will be explained to you. You will be scheduled for any follow-up procedures that might be necessary, and any questions you and your family might have will be answered. In our experience, most patients want to go home as soon as possible after their procedure. However, if you wish to speak to your physician, he/she will be happy to accommodate your request.

Due to the nature of the medications used during the procedure, you must have someone drive you home after your procedure. Once you have returned home, do not operate machinery and do not to drive for at least 24 hours, as the effects of the drugs may persist.

Forgetfulness is normal immediately after the procedure and is due to the use of a sedative during the endoscopy (EGD). Due to the nature of the medications used during the procedure, you must have someone drive you home after your procedure. Once you have returned home, do not operate machinery and do not to drive for at least 24 hours, as the effects of the drugs may persist.

Gas

Abdominal gas or bloating caused by the introduction of air into the stomach may cause some discomfort for a short time after the procedure. Belching or passing gas will help to relieve this symptom. Refrain from eating large amounts of food until you have returned to your normal state of comfort.

Nausea

Uncommonly, nausea my result from the abdominal gas and/or the medications used during the procedure. It is recommended that you remain on clear fluids until the nausea subsides. Should vomiting occur for an extended period (more than 6 hours), notify your physician. Bedrest is recommended.

Sore throat

Occasionally, a sore throat may be present following the procedure due to the passage of the scope through the oropharynx into the esophagus. If this occurs, it is generally mild and lasts up to 2 days. Once your swallowing reflex has returned, you will find warm drinks very soothing. You may also take Tylenol for minor discomfort but inform your physician if the symptoms worsen. Topical therapy with throat lozenges or sprays usually help to relieve this symptom; gargling with saltwater may help to decrease inflammation. If a severe sore throat is present or this symptom persists longer than 3 days, call your physician.

Notify Your Physician If You Experience Any Worrisome Symptoms

  • Fever, severe pain or excessive bleeding should be reported to your doctor immediately.
  • Localized irritation of the vein (phlebitis) at the I.V. site may occur at the site of medication injection. A tender lump develops which may remain for several weeks to several months, but it goes away eventually. Elevation of the arm and warm set compresses applied to the site several times per day should help. If a red streak should form that appears to follow the route of a vein and extends up your arm, notify your doctor immediately.
  • Should you have any questions after your procedure, please call our office and your call will be directed to your physician’s triage nurse. Phone: 541-868-9500 or Toll-Free: 877-484-4501

Your Test Results

A pathology report of any biopsied tissue should be received by our office in 14 days. If you have not heard from us after 14 days, please call our office and your call will be directed to your physician’s triage nurse.

It is your right to be thoroughly informed of the risks and possible complications before deciding to undergo a recommended upper endoscopy (EGD) procedure.

Although any medical test has some risk associated with it, serious problems associated with upper endoscopy (EGD) are very uncommon. When they occur, they are very treatable. Because of its acceptability, low risk, accuracy, and the variety of tasks it can accomplish, upper endoscopy (EGD) is well recognized as an important test in appropriate situations.

There is a 1 in 100 chance of some complications when upper endoscopy (EGD) is used to diagnose issues, but most minor; serious problems are uncommon.

There is a risk of bleeding in about 1 of 3,000 procedures. Any persistent bleeding that is manifested by vomiting blood or passing black bowel movements should be reported to your physician.

There is a risk of perforating the upper gastrointestinal tract with the scope in about 1 of 4,000 procedures.

There is a risk of temporary irregularity of the heart. For this reason, if you have a history of heart disease, your heart may be monitored with an electrocardiogram to minimize risk to you.

There is a risk of an allergic or other reaction to the drugs administered during the procedure.

These are rare, and the effects of the drugs can be reversed with other drugs.

There is a risk of aspiration (vomiting stomach contents and going into the lungs). This is rare, and the stomach should be empty at the time of the procedure.

There is a slightly higher risk of complications if dilation or sclerotherapy is performed during your procedure.

Death is extremely rare but remains a possibility.

The most common alternative to upper endoscopy (EGD) is an upper GI X-ray examination utilizing barium. This examination requires that you swallow barium (a chalky liquid), and X-rays are taken. Some abnormalities of the upper gastrointestinal tract can be detected by studying these films; however, the procedure is generally recognized as not being as accurate as an upper endoscopy (EGD) and does not allow for biopsy and removal of tissue.

Other procedures that may be done prior to upper endoscopy (EGD) (but are not considered alternatives to the procedure) are CAT scan, ultrasound, and nuclear medicine scans. These studies are utilized to assess other structures but may complement the findings of endoscopy (EGD).

Note: The information in this section is provided as a supplement to information discussed with your healthcare provider. It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.