EgdEdit
EGD, short for esophagogastroduodenoscopy, is a medical procedure that employs a flexible endoscope to inspect the mucosal lining of the esophagus, stomach, and duodenum. It is commonly referred to in clinical practice as an upper endoscopy and is a staple tool in modern gastroenterology. The procedure is typically performed by gastroenterologists, though surgeons with endoscopy training may also perform it in some settings. In most cases it is outpatient and involves mild to moderate sedation to minimize discomfort.
The reach of an esophagogastroduodenoscopy goes beyond visualization. The same instrument can be used to obtain tissue samples (biopsies), identify sources of bleeding, dilate strictures, remove foreign bodies, and perform therapeutic interventions such as polyp removal or laser/clip-based hemostasis. Because it visualizes the inner lining directly, EGD is indispensable for diagnosing conditions that affect the upper digestive tract, including reflux-related changes, ulcers, tumors, infections, and inflammatory diseases. See esophagogastroduodenoscopy and Upper endoscopy for broader context and related techniques.
Indications and scope
- Diagnostic indications: persistent dysphagia or odynophagia, unexplained upper abdominal pain, gastrointestinal bleeding, gastroesophageal reflux symptoms with alarm features, suspicion of Barrett’s esophagus or peptic disease, and investigation of weight loss or anemia when upper GI disease is suspected. For many of these conditions, tissue samples can clarify whether inflammation, infection, or cancer is present. See dysphagia, Barrett's esophagus, and peptic ulcer disease.
- Therapeutic indications: dilation of esophageal or pyloric strictures, removal of polyps or foreign bodies, control of nonvariceal or variceal bleeding, stent placement in certain obstructive lesions, and treatment of early cancers or premalignant areas with endoscopic mucosal therapy. See polypectomy, hemostasis, and endoscopic mucosal therapy.
- Preoperative assessment and surveillance: some patients undergo EGD as part of broader surgical planning or as surveillance for certain chronic conditions. See surveillance endoscopy.
Procedure and technique
- Preparation: patients are typically instructed to fast for several hours before the procedure. Pre-procedure assessment covers prior medical history, medications (notably anticoagulants), and allergies.
- Sedation: most EGDs are performed under sedation, ranging from moderate to deep anesthesia. The choice of sedation is tailored to the patient and setting, with involvement from an anesthesiologist when deeper sedation is anticipated. See anesthesia and sedation.
- Insertion and inspection: a lubricated endoscope is gently passed through the mouth and advanced into the esophagus, stomach, and duodenum. The camera provides real-time images, and the physician can insufflate air to improve visibility.
- Interventions: biopsies are often taken with small forceps (see biopsy). Therapeutic maneuvers—such as dilation of strictures, removal of polyps, or hemostasis for bleeding—may be performed through auxiliary channels on the scope. See biopsy and hemostasis.
- Recovery: after completion, the patient is monitored as the sedative effects wear off. Most people resume ordinary activities within a day or two, depending on the extent of the procedure and the sedation used.
EGD equipment has evolved considerably since the mid-20th century, with advances in optics, video display, and miniaturized channels that enable a wider range of diagnostic and therapeutic capabilities. The modern practice relies on standards and guidelines from professional organizations such as the American Society for Gastrointestinal Endoscopy and national health authorities to ensure safety, quality, and appropriate use. See gastroenterology for broader context about the specialty and its practice standards.
Safety, risks, and alternatives
- Safety profile: EGD is generally well tolerated, with a low risk of serious complications when performed by trained professionals. Common issues include transient sore throat, mild abdominal discomfort, and the usual risks associated with sedation. Serious complications such as perforation, significant bleeding, infection, or adverse reactions to anesthesia are uncommon but real possibilities and are discussed pre-procedure as part of informed consent. See perforation and sedation.
- Contraindications: active perforation or severe, unstable cardiopulmonary status may preclude the procedure. In such cases, alternative diagnostic approaches may be considered.
- Alternatives and complements: less invasive tests such as a barium swallow can visualize certain structural problems but do not permit biopsy or immediate therapy. For evaluation of the small intestine, newer approaches like capsule endoscopy may be used, though they do not allow intervention. In some scenarios, imaging studies (CT or MRI) or non-endoscopic tests provide complementary information. See capsule endoscopy and barium swallow.
History and context
The development of flexible endoscopy in the 1950s–1960s, culminating in practical techniques for visualizing the upper GI tract, laid the groundwork for the modern esophagogastroduodenoscopy. Early pioneers contributed to improvements in safety, image quality, and the ability to perform targeted biopsies and therapeutic maneuvers through the same instrument. Since then, the procedure has become a routine component of patient care in gastroenterology, emphasized in clinical guidelines and training across health systems. See history of endoscopy for a broader look at the field’s evolution.