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Esophagogastroduodenoscopy (EGD)

Esophagogastroduodenoscopy (EGD): Procedure, Preparation, and Clinical Use

Esophagogastroduodenoscopy (EGD), also called upper endoscopy, is a minimally invasive procedure to visualize the esophagus, stomach, and duodenum (first part of the small intestine). Below is a detailed overview of its methodology, applications, and recovery.

Procedure Overview

1. Preparation:
   • Fasting: No food/drink for 6–8 hours to reduce aspiration risk.
   • Medications: Discontinue blood thinners (e.g., warfarin) or diabetes drugs as advised.
2. Steps During EGD:
   • Sedation: Conscious sedation (e.g., midazolam) or general anesthesia to relax the patient12.
   • Local anesthesia: Throat spray to numb the gag reflex16.
   • Mouthguard: Protects teeth and the endoscope14.
   • Positioning: Patient lies on their left side to facilitate scope insertion14.
   • Scope insertion: The endoscope is guided through the mouth, esophagus, stomach, and duodenum. Air is pumped to inflate the stomach for better visualization127.
   • Biopsies/treatments: Tissue samples are collected, or interventions (e.g., bleeding control) are performed37.

Duration: 5–60 minutes, depending on complexity12.

Clinical Applications

EGD is used for diagnosis and treatment:

Diagnostic Use	Therapeutic Use
Gastroesophageal reflux disease (GERD)	Bleeding control (e.g., ulcers, varices).
Peptic ulcers	Dilation of strictures (e.g., esophageal narrowing).
Gastric cancer screening	Foreign body removal (e.g., swallowed objects).
Celiac disease	Polyp removal.

Preparation and Recovery

1. Preparation:
   • Avoid medications: NSAIDs, anticoagulants, or certain diabetes drugs may be paused38.
   • Transport: Arrange a driver post-procedure due to sedation effects38.
2. Recovery:
   • Gag reflex: Avoid eating/drinking until it returns (typically within 1–2 hours)13.
   • Side effects: Sore throat, bloating, or gas (resolves within 24 hours)23.
   • Activity: Resume normal diet and activities the next day38.

Risks and Complications

• Common: Sore throat, temporary bloating.
• Rare:
  • Perforation (tear in the GI tract).
  • Bleeding from biopsy sites.
  • Sedation-related complications (e.g., respiratory depression)37.

Conclusion
EGD is a safe, versatile tool for diagnosing and treating upper GI disorders. Proper preparation and adherence to post-procedure guidelines minimize risks.

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References

1. MedlinePlus: EGD
2. Cleveland Clinic: EGD
3. Medical News Today: EGD
4. Johns Hopkins: Upper Endoscopy
5. StatPearls: EGD
6. RAMA: EGD
7. Medscape: EGD Technique
8. Michigan Medicine: EGD Prep