An esophagogastroduodenoscopy (EGD) test is performed to examine the lining of your esophagus. The esophagus is the muscular tube that connects your throat to your stomach and the duodenum - the upper part of the small intestine.
An EGD test is administered by passing a small camera on a tube (called an endoscope) down the throat and along the length of your esophagus.
Your doctor may recommend an EGD test if you have certain symptoms that are not responding to treatment. These symptoms include:
- severe chronic heartburn
- vomiting blood
- black or tarry stools
- regurgitating food
- pain in the 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 the 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 suffer from:
- Crohn’s disease
- cirrhosis of the liver
- swollen veins in your lower esophagus
Before administering an EGD, your doctor will give you a sedative and a painkiller. This will prevent you from feeling any pain. Usually, people do not even remember the test.
The doctor may also spray a local anesthetic into your mouth to stop you from gagging or coughing as the endoscope is inserted. You will also have to wear a mouth guard to prevent damage to your teeth or the camera.
The doctor will insert an intravenous (IV) needle into your arm so that he or she may give you medications throughout the test. You will be asked to lie on your left side during the procedure.
Once the sedatives have taken effect, the endoscope will be inserted into your esophagus and passed down into your stomach and the upper part of your small intestine. Air will then be passed through the endoscope so that the doctor can clearly see the lining of your esophagus.
During the examination, the doctor might take biopsies (or small tissue samples) using the endoscope. These can later be examined under a microscope to identify any abnormalities in your cells.
If necessary, certain treatment can be done during the EGD, such as widening any abnormally narrow areas of your esophagus.
The complete test lasts between five and 20 minutes.
Your doctor will advise you to stop taking medications such as aspirin and other blood-thinning agents for several days before the test.
You will not be able to eat anything for six to 12 hours before the test. If you wear dentures, they must be removed before starting the EGD. As for all medical test and procedures, you’ll be asked to sign an informed consent form before undergoing the procedure.
A nurse will observe you for about an hour following the test to make sure that the anesthetic has worn off and you are able to swallow without difficulty or discomfort.
You may feel slightly bloated, or experience 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 are vomiting
- you have sharp pains in your abdomen
- you have blood in your stool
- you are unable to eat or drink
- you are urinating less than usual or not at all
If your results are normal it means that the complete inner lining of your esophagus was smooth and showed no signs of inflammation, growths, ulcers, or bleeding.
Abnormal results may be caused by:
- Celiac disease: a disease that causes damage to the intestinal lining and prevents it from absorbing nutrients.
- Esophageal rings: an abnormal growth of tissue that occurs where the esophagus joins the stomach.
- Esophageal varices: swollen veins within the lining of the esophagus.
- Hiatal hernia: a disorder causing a portion of the stomach to bulge through the opening in the diaphragm.
- Gastritis: inflammation of the lining of the stomach or upper small intestine.
- Gastroesophageal reflux disease (GERD): a disorder that causes liquid or food from the stomach to leak back into the esophagus.
- Ulcers: ulceration of the stomach or small intestine.
- Mallory-Weiss syndrome: a tear in the lining of the esophagus.
In general, an EGD is a safe procedure. There is a very slight risk that the endoscope will cause a small hole in the esophagus, stomach, or small intestine. There is also a small risk of bleeding from the location of the biopsy.
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.