Alternative names
EGD - esophagogastroduodenoscopy; Upper endoscopy; Gastroscopy


Esophagogastroduodenoscopy (EGD) is an examination of the lining of the esophagus, stomach, and upper duodenum with a small camera (flexible endoscope) which is inserted down the throat.

How the test is performed

You will be given a sedative and an analgesic. A local anesthetic will be sprayed into your mouth to suppress the need to cough or gag when the endoscope is inserted. A mouth guard will be inserted to protect your teeth and the endoscope. Dentures must be removed.

In most cases, an intravenous line will be inserted into your arm to administer medications during the procedure.

You will be instructed to lie on your left side.

After the gag reflex has been suppressed by the anesthetic, the endoscope will be advanced through the esophagus to the stomach and duodenum. Air will be introduced through the endoscope to enhance viewing. The lining of these organs is examined and biopsies can be obtained through the endoscope. Biopsies are tissue samples that are reviewed under the microscope.

After the test is completed, food and liquids will be restricted until your gag reflex returns.

The test lasts about 30 to 60 minutes.

How to prepare for the test
Fasting is required overnight (6 to 12 hours before the test). An informed consent form must be signed. You may be told to stop aspirin and other blood-thinning medications for several days before the test.

Infants and children:
The preparation you can provide for this test depends on your child’s age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:

  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel

The local anesthetic makes swallowing difficult. This wears off shortly after the procedure. The endoscope may stimulate some gagging in the back of the throat. There may be a sensation of gas, and the movement of the scope may be felt in the abdomen. Biopsies cannot be felt. Because of the intravenous sedation, you may not feel any discomfort and may have no memory of the test.

Why the test is performed

This test is helpful in determining:

  • The cause of upper GI (gastrointestinal) bleeding  
  • The cause of swallowing difficulties  
  • The presence of ulcerations or inflammation  
  • The cause of abdominal pain  
  • The condition of the stomach and duodenum after an operation  
  • The presence of tumors or other abnormalities of the upper GI tract  
  • Inflammation, narrowing, or tumors of the esophagus

Normal Values

The esophagus, stomach, and duodenum should be smooth and of normal color. There should be no bleeding, growths, ulcers or inflammation.

What abnormal results mean

An EGD may indicate:

  • Ulcers (acute or chronic)  
  • Tumors  
  • Inflammation of the stomach and duodenum  
  • Diverticula  
  • Mallory-Weiss syndrome (tear)  
  • Esophageal rings  
  • Esophagitis  
  • Strictures  
  • Gastric masses  
  • Obstruction  
  • Gastric erosion

What the risks are

There is a small chance of perforation (hole) of the stomach, duodenum, or esophagus or bleeding at the biopsy site. A patient could have an adverse reaction to the anesthetic, medication, or tranquilizer. This could cause:

  • Respiratory depression (difficulty breathing)  
  • Apnea (not breathing)  
  • Hypotension (low blood pressure)  
  • Excessive sweating  
  • Bradycardia  
  • Laryngospasm (spasm of the larynx)

The overall risk is less than 1 out of 1,000 people.

Special considerations

If any of these conditions arise after the test, contact the health care provider:

  • Difficulty swallowing  
  • Pain  
  • Fever  
  • Black stools  
  • Blood in vomit


Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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