An upper GI endoscopy or EGD (esophagogastroduodenoscopy) is a procedure to diagnose and treat problems in your upper GI (gastrointestinal) tract. The upper GI tract includes your food pipe (esophagus), stomach, and the first part of your small intestine (the duodenum).

Symptoms:

• Heartburn or acid reflux: A burning sensation in the chest or throat, especially after eating.
• Dysphagia (difficulty swallowing): A feeling of food being stuck in the throat or chest.
• Unexplained weight loss: Can be associated with chronic conditions like esophageal cancer, ulcers, or gastric diseases.
• Upper abdominal pain: Discomfort or pain in the upper part of the stomach that might indicate ulcers, gastritis, or inflammation.
• Nausea and vomiting: Could be caused by gastric or duodenal ulcers, gastritis, or a blockage.
• Bloody vomit (hematemesis): Vomiting blood could indicate active bleeding from ulcers, varices, or tumors.
• Black or tarry stools (melena): Indicative of digested blood, often from bleeding higher in the GI tract, such as from an ulcer.

Purpose:

• Diagnostic tool: Used to visually examine the upper GI tract (esophagus, stomach, and duodenum) to identify abnormalities or disease.
• Therapeutic purposes: Allows the physician to treat certain conditions directly (e.g., removing foreign bodies, controlling bleeding, or dilating strictures).
• Prevention: Helps detect conditions such as precancerous lesions or infections (e.g., H. pylori) early.

Indications:

• Chronic GERD: To assess the esophageal lining for damage such as ulcers or Barrett’s esophagus.
• Unexplained weight loss or anemia: Often suggests a GI malignancy or chronic bleeding.
• Abnormal imaging findings: If a CT scan or ultrasound reveals an issue in the upper GI tract, an endoscopy can provide more detailed visualization.
• Bleeding in the upper GI tract: To identify the source of blood and potentially treat it.
• Persistent nausea/vomiting: When other causes are suspected, especially in the context of ulcers, tumors, or strictures.

Procedure:

• Preparation: Patients are asked to fast for 6-8 hours before the procedure to ensure an empty stomach.
• Sedation: Mild sedatives or anesthesia are administered to relax the patient and reduce discomfort.
• Endoscope insertion: A flexible tube (endoscope) with a camera is passed through the mouth into the esophagus, stomach, and duodenum.
• Inspection: The physician examines the mucosal lining for any signs of inflammation, ulcers, tumors, or bleeding.
• Interventions: If needed, the doctor may perform therapeutic interventions such as:
  • Biopsy: To diagnose infections, cancer, or other conditions.
  • Treatment of bleeding: Using cauterization, clips, or injection of medications.
  • Foreign body removal: If a foreign object is present in the stomach or duodenum.
  • Stricture dilation: Using a balloon or dilator to widen a narrowed esophagus or stomach.

Treatment:

• Biopsy: A small tissue sample can be taken for further analysis (e.g., for H. pylori, cancer, or infection).
• Cauterization or clipping: To stop active bleeding.
• Polyps removal: If any are found during the examination.
• Dilation of strictures: Using a balloon or bougie to open up narrowed areas.
• Removal of foreign bodies: If a foreign object is lodged in the upper GI tract.