In upper endoscopy, also referred to as esophagogastroduodenoscopy or EGD, patients fast prior to the test and then receive mild sedation.  The gastroenterologist inserts a scope of about the thickness of a pencil into the mouth and advances it down the esophagus (including its juncture with the top of the stomach which is an area of focus when GERD is suspected), to the stomach, and sometimes to the small intestine (see video).

This test  is commonly used to evaluate patients experiencing persistent esophageal reflux, dysphagia (difficulty swallowing), chronic indigestion or stomach pain, nausea, vomiting, and other symptoms. Upper endoscopy is a safe and widely used procedure requiring a stay of just a couple hours at an endoscopy facility (see video).

The physician can inspect for any visual signs of inflammation, infection, bleeding, cancer, or precancerous cell changes. The doctor can also identify anatomical changes such as constricted areas or hiatal hernia. For tissue areas of interest or concern, the specialist may take a biopsy (small sample of cells) with the endoscope for evaluation microscopically in the lab. These samples help confirm that tissue is healthy or that it has cancerous, precancerous, or infected characteristics.

Upper endoscopy has also found increasing use as a treatment modality. Trained specialists can use it to expand narrowed areas, remove benign growths such as polyps, retrieve swallowed objects, and repair bleeding from ulcers or lining tears. These capabilities can spare patients surgical procedures.

The endoscopist will often inform patients of the preliminary findings of the upper endscopy while they are in the recovery area. A full report, including biopsy results, may take several more days.

Possible complications of upper endoscopy 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.  The procedure takes 15 to 20 minutes. Because you will be sedated, you will need to rest at the physician's office for 1 to 2 hours until the medication wears off.

Preparation
Your stomach and duodenum must be empty for the procedure to be thorough and safe, so you will not be able to eat or drink anything for at least 6 hours beforehand. Also, you must arrange for someone to take you home—you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions.

EGD instructions