Esophagogastroduodenoscopy, or EGD for short, is a procedure used by your doctor to gain more information about your esophagus, stomach, and small intestine. Your doctor can look at the insides of these structures by placing an endoscope, which is a small, bendable tube that acts like a video camera, into your throat. If any unusual growths or foreign bodies are found by your doctor, the endoscope may also be used to treat them.
Understanding the Digestive System
Before we discuss the EGD, it may be helpful for you to understand the normal anatomy of the
digestive system or food pathway.
When you eat or drink, food or liquid travels from the mouth through a hollow tube called the esophagus into your stomach.
In your stomach, acids and enzymes break down the food. From the stomach, the food enters the small intestine, another hollow organ that functions to digest and absorb certain parts of the food.
After the remaining food leaves the small intestine, it enters the
colon. The colon has almost nothing to do with digestion. Its main function is to remove water from the stool and store it so that you can have a bowel movement and clear the colon of waste.
During the EGD, your doctor will only look at the upper digestive tract. This includes the esophagus, stomach, and the first part of the small intestine (duodenum).
Upper Digestive Tract Problems Seen During EGD
Now that you have a better understanding of the normal anatomy, let's look at some of the common problems that can occur in the upper digestive tract.
Many times a day, some of the acidic contents of the stomach go up into the esophagus. In most people, this never produces any problems because the esophagus has a defense system against the acid. However, when this defense system fails, the acid can damage the esophagus. This is called gastroesophageal reflux disease (
GERD for short), which is a condition that produces
heartburn, chest pain,
asthma, or an acidic taste in the mouth. If this damage continues for many years, it can eventually lead to bleeding, narrowing, or a tear in your esophagus. Narrowing of the esophagus may cause difficulty in swallowing.
Peptic ulcers are another upper digestive tract problem. A peptic ulcer occurs when the stomach or duodenum becomes damaged. Because the inside of the stomach is so acidic, it has developed several defense systems to protect it from acid damage, just like the esophagus. However, when the normal protective barrier and defenses weaken or are overpowered by certain conditions, ulcers can develop.
This imbalance can occur for many reasons, including having too much acid produced in the stomach, having a bacterial infection, or overusing anti-inflammatory medicine like
Motrin® or Advil
®. Several problems can occur because of ulcers. These include bleeding and perforations (when a hole is created in the stomach or duodenum).
Abnormal growths are another digestive tract problem that can occur anywhere along the digestive pathway. These growths can be many different shapes and sizes, and sometimes they can be cancerous. Cancer can occur throughout the digestive tract, including the areas of the esophagus, stomach, and small intestine. However, having an abnormal growth does not necessarily mean that you have cancer.
These examples represent some of the more common problems that can develop in the upper digestive tract. However, there are many other problems that can occur in this area. Your doctor will be able to describe what might be causing your symptoms and the abnormal findings associated with them.
Your stomach and duodenum must be empty in order for the EGD to be thorough and safe, so you will not be able to eat or drink anything for at least six hours beforehand. Also, you must arrange for someone to take you home -- you will not be allowed to drive after the procedure because of the sedatives. Your physician may give you other special instructions.
EGD: The Procedure Itself
For the EGD procedure, you will swallow a thin, flexible, lighted tube called an endoscope. Right before the procedure, the physician will spray your throat with a numbing agent that may help prevent gagging. You may also receive pain medicine and a sedative to help you relax during the exam. The endoscope transmits an image of the inside of the esophagus, stomach, and duodenum, so the physician can carefully examine the lining of these organs. The scope also blows air into the stomach; this expands the folds of tissue and makes it easier for the physician to examine the stomach.
Through the endoscope, the physician can see abnormalities, like inflammation or bleeding, that do not show up well on x-rays. The physician can also insert instruments into the scope to treat bleeding abnormalities or remove samples of tissue (biopsy) for further tests. If your doctor discovers a stricture (narrowed area) during
upper endoscopy, he or she may perform dilation. Dilation stretches the narrowed area and may improve your difficulty or pain with swallowing. It may also help if you have a problem with regurgitating food.
The procedure takes 20 to 30 minutes. Because you will be sedated, you will need to rest at the endoscopy facility for one to two hours until the medication wears off.
Possible complications of an EGD include bleeding and puncture of the stomach lining. However, such complications are rare. Most people will probably have nothing more than a mild sore throat after the procedure.
An EGD is a procedure that allows your doctor to look at the lining of the esophagus, stomach, and the first part of the small intestine. It has been used for many years with limited complications to help diagnose conditions of the upper digestive tract.
For a better understanding of an EGD, including its risks, benefits, and alternatives, click on any of the links below.
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