In an esophagogastroduodenoscopy (EGD), a doctor looks at the lining of your esophagus, stomach, and duodenum. They may do this test to help diagnose problems in these body regions.

Illustration of endoscope being passed down throat and along the esophagus.Share on Pinterest
Illustration by Sophia Smith

Read on to learn more about the EGD test, the reasons to do it, the risks, and what to expect.

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

An endoscope is a small camera on a tube. An EGD test involves passing an endoscope down your throat and along the length of your esophagus.

You may need an EGD test if you experience certain symptoms, including:

  • severe, chronic heartburn
  • vomiting blood
  • black or tarry stools
  • regurgitating food
  • pain in your 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 your breastbone
  • pain or difficulty swallowing

Your doctor may also use this test to help see how effectively a treatment is working or to track complications if you have:

Your doctor will give you specific instructions to prepare for your EGD test. You may also want to:

  • Talk with your doctor about medications. Tell your doctor about any over-the-counter or prescription medications, vitamins, or supplements you take. You may need to adjust or stop taking certain medications before the procedure.
  • Discuss your medical history. Let your doctor know about any health conditions, symptoms, or allergies you have.
  • Arrange for transportation home. You will likely be given sedatives during the test, and you won’t be able to drive until they wear off. Ask a family member or friend if they can help you get home after the test.
  • Take the day off. You may experience slight discomfort after the test, and it may take a while for the sedatives to wear off. Take the day off from work if you can and plan to rest at home.
  • Fast. You won’t be able to eat or drink anything for 6 to 12 hours before the test.
  • Sign the necessary forms. As with all medical tests, you’ll be asked to sign an informed consent form before undergoing the procedure. Bring any additional paperwork your doctor asks for.

An EGD is performed in a hospital or medical center. Here’s what to expect during the test:

  1. You will need to remove any clothing or jewelry that may interfere with the test. If you wear dentures, you will be asked to remove them.
  2. Your doctor will attach monitors to your body to check your breathing, heart rate, blood pressure, and oxygen level during the test.
  3. Your doctor will give you a sedative and pain reliever through an intravenous (IV) needle in your arm. This prevents you from feeling pain. Usually, people don’t even remember the test.
  4. Your doctor may spray a local anesthetic into your mouth to stop you from gagging or coughing as the endoscope is inserted.
  5. You’ll be given a mouth guard to wear. This helps prevent damage to your teeth or the camera.
  6. You’ll be asked to lie on your left side on the exam table.
  7. Your doctor will pass an endoscope down your esophagus and into your stomach and upper part of your intestine. You may feel some pressure as the endoscope goes down your throat.
  8. A camera on the endoscope sends a video image to a monitor. This allows your doctor to examine your digestive tract.
  9. Air is passed through the endoscope to make it easier for your doctor to see.
  10. Your doctor might take small tissue samples using the endoscope. These samples can later be examined with a microscope to identify anything unusual in your cells. This process is called a biopsy.
  11. Your doctor may perform certain treatments during an EGD, such as widening any unusually narrow areas of your esophagus.

When the test is over, your doctor will remove the endoscope. The complete EGD test usually lasts about 15 to 30 minutes.

In general, an EGD is a safe procedure. There’s a very slight risk that the endoscope will cause a small hole in your esophagus, stomach, or small intestine. If a biopsy is performed, there’s also a small risk of prolonged bleeding from the site where the tissue was taken.

Some people also may have a reaction to the sedatives and pain relievers 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

Your doctor can treat a reaction to sedatives with medication or IV fluids during or after the EGD test, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

While EGD tests have very few serious risks, seek immediate medical attention if:

  • your symptoms are worse than before the test
  • you have difficulty swallowing
  • you feel dizzy or faint
  • you’re vomiting
  • you have sharp pains in your abdomen
  • you have blood in your stool
  • you’re unable to eat or drink
  • you’re urinating less than usual or not at all

“Normal” results mean that the complete inner lining of your esophagus is smooth and shows no signs of:

  • inflammation
  • growths
  • ulcers
  • bleeding

“Abnormal” EGD results may be due to:

  • Celiac disease. This digestive disorder is caused by an atypical immune reaction to gluten that can damage your intestinal lining and prevent it from absorbing nutrients.
  • Esophageal rings. These unusual growths of tissue occur where your esophagus joins your stomach.
  • Esophageal varices. These are swollen veins within the lining of your esophagus.
  • Hiatal hernia. A hiatal hernia occurs when a portion of your stomach bulges through the opening in your diaphragm.
  • Inflammatory conditions. Esophagitis, gastritis, and duodenitis are inflammatory conditions of the lining of your esophagus, stomach, and upper small intestine, respectively.
  • Gastroesophageal reflux disease. Also known as GERD, this condition causes liquid or food from your stomach to leak back into your esophagus.
  • Mallory-Weiss syndrome. This is a tear in the lining of your esophagus. It may be due to severe or prolonged vomiting.
  • Ulcers. These painful sores may be present in your stomach or small intestine.
  • Tumors. Cancerous or noncancerous tumors may be found in your esophagus, stomach, or small intestine.

A nurse will observe you for about 1 hour following the test to make sure that the sedative has worn off and you’re able to swallow without difficulty or discomfort.

When you’re ready to leave the hospital, your doctor will give you instructions to care for yourself at home. Ask a friend or family member to help you get home, and plan to relax for the rest of the day.

You may experience some uncomfortable symptoms after an EGD test, such as:

  • gas or bloating
  • slight cramping
  • sore throat

These side effects are quite common 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.

Your doctor will follow up with you to go over the results of the EGD. Some results may be ready immediately. Biopsy results may take several days or longer. Your doctor may order more tests before they give you a diagnosis or create a treatment plan.