Endoscopic Ultrasound (EUS)

What is Upper Endoscopy (EGD)?
An esophago-gastro-duodenoscopy (EGD) is a procedure that allows your physician to examine the lining of the upper part of your gastrointestinal tract, including the esophagus, stomach and the duodenum (the beginning part of your small intestines).  Your doctor will use a thin, flexible tube called an endoscope, which has its own lens and light source, and will view the images on a video monitor to look for inflammation, bleeding ulcers or tumors.  

There are different types of EGD procedures that are used for different reasons to provide a better look at your upper gastrointestinal tract, including:

  • EGD with esophageal dilation in which your doctor dilates, or stretches, the narrow part of your esophagus to get a better look at the lining. Dilation is indicated when there is a blockage or stricture in the esophagus usually caused by tumors, acid reflux, ingestion of harmful agents, or the inability of food to move down the esophagus properly. In order to fix this, your doctor will pass a tapered dilating instrument through your mouth and guide it into the esophagus. This instrument will open the narrowing in the esophagus.
  • EGD with confocal microendscopy in which a laser is used to image the lining of the esophagus
  • EGD with radiofrequency ablation

Reasons for EGD

  • Unexplained, persistent abdominal pain
  • Persistent nausea, vomiting or difficulty swallowing
  • Upper GI bleed ( may be treated by endoscopy)
  • Removal of  a foreign body
  • Abnormal or unclear findings on imaging
  • Biopsy (small tissue sample)
  • Follow up of previously noted polyps, tumors or ulcers

EGD Preparation
An empty stomach allows for the best and safest examination.  You will be asked to refrain from eating or drinking for up to eight hours prior to the exam.  You may need to make adjustments to your medications.  It is important to discuss your medications with your physician prior to the endoscopy.  

During Your EGD
The procedure typically takes between 10 – 30 minutes to complete.  The endoscopy is performed while you lie on your left side.  A plastic mouth guard is placed between the teeth to prevent damage to the teeth and endoscope.  You will have an IV in your arm through which you will be given anesthesia (Propofol) to put you to sleep during the procedure.    Air is gently passed through the endoscope to open the esophagus, stomach and intestine, allowing the endoscope to be passed through these areas and to improve the endoscopist’s ability to see a full and complete picture.  The endoscope does not interfere with breathing.  

After Your EGD
After the endoscopy you will be observed while the sedation wears off.  It is normal to feel tired temporarily after receiving the sedative medication.  You must have someone to escort you home after the procedure and you will be instructed not to drive or return to work for the remainder of the day.
The endoscopist can describe the results of the exam before you leave the endoscopy facility.  If biopsies have been taken, you should call for results within two weeks after your endoscopy.

Possible Complications
Upper endoscopy is a safe procedure and complications are rare.  Possible complications include:

  • Aspiration of food/fluid into the lungs: This is minimized by following the dietary restrictions prior to the procedure.
  • Reaction to the sedative medication
  • Bleeding from biopsies or polyp removal (Typically minimal and controlled).
  • The endoscope can cause a tear in the area being examined.  (Serious but rare occurrence).

The following signs/symptoms should be immediately reported:

  • Severe abdominal pain
  • Firm distended abdomen
  • Vomiting
  • Elevated temperature
  • Difficulty swallowing or severe throat pain
  • Crunching feeling under skin of the neck