how to prepare for upper endoscopy (EGD)

To prepare for an upper endoscopy, you need to stop solid food for eight hours or more. You may need to stop blood thinners up to 7 days before the test. You can take your essential medications like those for blood pressure the morning of your test.

What is an upper endoscopy (EGD)?

An upper endoscopy is otherwise known as an esophagogastroduodenoscopy or EGD for short. This is an examination of the inside of your esophagus (food pipe), stomach, and duodenum using a fiber optic flexible tube (gastroscope or endoscope) that has light and camera at the end.

Why do you need an upper endoscopy?

An EGD is the best way to examine the esophagus, stomach and duodenum. EGD prevents hospitalization and saves lives. It is helpful in the following instances.

  • Evaluate upper abdominal symptoms such as pain, bloating, nausea, vomiting. .
  • Difficulty swallowing or painful swallowing.
  • Heartburn and regurgitation.
  • Diagnose H.pylori.
  • Gastrointestinal bleeding such as vomiting blood and blood in the stool.
  • Diagnose and treat Barrett’s esophagus.
  • Evaluate iron deficiency anemia.
  • Diagnose and remove polyps.
  • Before weight loss surgery.
  • Diagnose cancer of the esophagus, stomach and duodenum.
  • Treat bleeding from the esophagus, stomach or duodenum from things like ulcer, inflammation, abnormal blood vessels, cancer.
  • Relieve obstruction in the esophagus, stomach or duodenum.
  • Remove foreign body.
  • Diagnose and treat varices.
  • Treat leaks and fistula.
  • Manage achalasia by balloon dilation or injection of Botox.
  • Assess injury caused by ingesting caustic material.
  • Place a feeding tube.
  • Treat obesity.

 

What are the risks of upper endoscopy

Complications rarely occur with an EGD. The rate of occurrence varies between 1 in 200 patients to 1 in 10,000 patients. Risks of upper endoscopy include reaction to sedation, breathing problems, nausea, vomiting, abdominal pain, headaches, heart problems, bleeding, perforation, and death. The risks and benefits are discussed during consent before the test.

What are the alternatives to an upper endoscopy?

Few things can replace an EGD. X-ray, CT scan, MRI, medications, surgery are alternatives depending on the circumstances.

How do I prepare for my test

What do I do 1 week before the EGD?

  • Discuss all your medications with your provider.
  • You may need to stop your antiplatelet or anticoagulants such as Coumadin, Plavix.
  • You may continue to take your aspirin.
  • Arrange for a driver to take you home after the procedure.

What do I do 2-3 days before the EGD?

  • You may need to stop anticoagulants like Eliquis, Pradaxa, and Xarelto 2-3 days before your EGD.

What do I do a day before the EGD?

  • Confirm your transportation with a responsible adult driver.
  • No solid food 8 hours prior to your procedure.

What do I do on the day of the EGD?

  • You may take your essential morning medications with a few small sips of water, at least 4 hours before your procedure, unless as directed by your physician.
  • Nothing by mouth at least 4 hours prior to your procedure including gum, hard candies, mints, tobacco.
  • Leave your valuables at home.
  • Bring your ID, insurance cards, and any co-pay with you.

 

What to expect during the procedure

You will be given medicines to make you sleepy. Most people do not remember the test. You will be given oxygen and monitored throughout the test. Your doctor will insert the gastroscope or endoscope through your mouth and examine the lining of your esophagus, stomach and small intestine. Other tools be may passed into your upper gastrointestinal tract via the endoscope. For most people, the procedure only last about 15-30 minutes.

What to expect after the procedure

You will be monitored until you are awake. You may eat or drink once you are awake. Your doctor may discuss your result with you and whomever came with you. You may be given a copy of your report. If biopsies are taken, it may take a few days for those results to come from the pathologist. Someone should drive you home.

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