Esophagogastroduodenoscopy

Esophagogastroduodenoscopy (EGD) is a procedure that uses a flexible endoscope to inspect the lining of the esophagus, stomach, and duodenum. It serves diagnostic and, in many cases, therapeutic purposes. A trained clinician, typically a gastroenterologist, performs EGD under sedation. The patient is placed in the left lateral position. A topical anesthetic is sprayed in the throat and intravenous sedation or anesthesia is provided as needed. The endoscope is advanced through the mouth into the upper gastrointestinal tract, and the interior surfaces are examined while the lumen is gently insufflated with air or carbon dioxide to improve visibility. During the procedure, biopsies may be taken, polyps removed, and minor therapeutic maneuvers such as dilation of strictures, hemostasis for bleeding, foreign body removal, or stent placement may be performed.

Indications include evaluation of dysphagia, odynophagia, chronic upper abdominal pain or reflux symptoms, suspected upper gastrointestinal bleeding, iron deficiency anemia, and surveillance of premalignant conditions such as Barrett’s esophagus. EGD also allows targeted biopsies for histologic diagnosis and, with adjunct techniques like chromoendoscopy or narrow-band imaging, enhanced mucosal assessment.

Risks are generally low but include bleeding, perforation, infection, and adverse reactions to anesthesia. Contraindications include inability to cooperate or provide informed consent, uncorrected coagulopathy, severe cardiopulmonary disease, or suspected perforation or obstruction that makes safe endoscope passage unlikely.

Preparation usually involves fasting for several hours and medication adjustments as advised by the clinician. Afterward, patients may experience a sore throat and are typically advised not to drive for 24 hours following sedation.