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Upper Endoscopy (EGD)

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This guide is for patients who are going to have an upper endoscopy, also called esophagogastroduodenoscopy, or EGD. It answers some of the most commonly asked questions. Please don’t hesitate to ask your doctor or nurse for more information.


What is an EGD?
An EGD is a procedure involving the use of an endoscope, a lighted, flexible tube, about the thickness of your finger. The doctor will pass the tube through the mouth and back of the throat into the esophagus, stomach and duodenum (the first part of the small intestine). The procedure checks for ulcers and other abnormalities. If necessary, an instrument can be passed through the tube to take a small piece of tissue (a biopsy) for examination in the laboratory. Biopsies are done for many reasons and don’t necessarily imply cancer.

Preparing for your procedure
Because you will be sedated, you will not be able to drive after your EGD. You must arrange for a responsible adult (over 18) who can drive or otherwise accompany you to and from the endoscopy unit. Your procedure cannot begin until a responsible adult driver is in the unit. This person should remain in the unit during your entire visit so that they are available as soon as you are ready to be discharged. You will not be discharged unless that person is in the unit. Because your judgment may be impaired after this procedure, you will not be released to take public transportation, a taxicab, or even walk home without another responsible adult present to accompany you.

Please contact your primary care physician or insurance company if prior referral is needed.

The procedure will take about 30 minutes, but expect the visit to the endoscopy suite to last two to three (2-3) hours to allow for preparation and recovery.

Because you will be sedated, you MUST arrange for a responsible adult (age 18 years or older) to accompany you from the endoscopy unit after your procedure.  This person should remain near the unit during your entire visit.  That person needs to be available as soon as you are ready to be discharged.  You will not be discharged until that person is in the endoscopy unit.  You may not travel by taxi or public transportation after your procedure unless you have a responsible adult to accompany you. 

You may eat your normal diet the day before the procedure. Do not eat any solid food or non-clear liquids, such as milk or orange juice,  for six (6) hours prior to your scheduled appointment time.  You may drink clear liquids such as water or black coffee up to two (2) hours before your test. Take your medications with a few sips of water no later than four (4) hours before your appointment.  If you are taking pain medication, you may do so up to four (4) hours before the procedure. 

If you are on any anticoagulant medications (blood thinners), including aspirin or non-steroidal anti-inflammatory drugs, please notify the physician that ordered your test.  Your medication may have to be adjusted the week before your test.

If a dilation or polyp removal is planned during your procedure you should not take anti-platelet drugs for one (1) week days prior to your appointment as all of these drugs may increase bleeding.

A few of these products include:

Be sure to tell the doctor that ordered your test if you are on Coumadin or other blood thinners.  You will need special instructions.

If you have an implanted cardiac defibrillator (ICD), please call 734-936-9250 option 1 as soon as possible with the ICD name and manufacturer. 

The day of the test — important information

1. Your procedure is scheduled for:

Date:______________________ Time:________________________
If you are unable to keep your appointment, please call the endoscopy scheduling center  at 734-936-9250, option 1, as soon as possible.

2.  A map guiding you the endoscopy unit where your procedure will be performed has been mailed to you or is available on-line.  If you are uncertain at which site your procedure is scheduled, please call the endoscopy scheduling call center at 734-963-9250 option 1.
 
3.  Please bring the following with you on the day of your EGD:

Your procedure will not begin until the nursing staff speaks with the responsible adult who will take you home.  You will not be discharged until that person is in the unit to escort you from the endoscopy suite. You will not be able to drive for at least 12 hours.

4. If you take oral diabetes medications (pills):  Do not take the medication the morning of your test.  Bring your diabetes medication with you. If you take insulin (one or two injections per day):  Take one-half of your usual morning dose of NPH, Lente, Novolin 70/30 or Lantus insulin and NO Regular or Humalog insulin the morning of your test.  If you take Ultralente insulin or are on three or more injections per day, please contact the health care provider who manages your diabetes.

Please refer to the handout, “Instructions for Patients with Diabetes Having Outpatient Procedures”.

 5. Please leave jewelry at home.

 6. Small children will be more comfortable at home.  

The procedure

In the reception or preparation area you will answer questions about your health history, current medicines and allergies. You will sign a consent form. After you change into a hospital gown, a nurse will start an intravenous line (IV). The IV is used to give you medication to make you more comfortable during the procedure. The procedure is performed in a room specially designed for endoscopic procedures. Equipment that will help the nurse and doctor monitor your heartbeat and breathing will be connected to you. Your throat will be numbed with a spray and you will be sedated before the doctor passes the tube through your mouth into your stomach. You will be able to breathe normally and burp if needed during the test. There usually is no pain associated with this test, even if a biopsy is done. 

Potential complications

Complications are extremely rare. However, there are potential complications
associated with all medical procedures. These will be explained to you at the time you sign your consent for the procedure.

Your doctor

A doctor specially trained in gastrointestinal procedures will perform the test. The doctor who ordered your procedure will make decisions regarding your plan of care. 

Recovery

After your procedure you will be taken to the recovery area. One adult person who came with you to your procedure may join you there, if you wish.  When you are ready to go home the nurse will discuss discharge instructions and answer your questions. You will be given a summary of findings for your procedure.  You may NOT drive yourself home.  Be sure to bring a responsible adult licensed driver with you.  A responsible adult will need to be with you when you are discharged from the recovery area.  You may want  a family member or friend to stay with you for the remainder of the day.

At-home instructions

You will be given specific written instructions about resuming your activity, medications and diet.

U-M Health System Related Sites:
Department of Internal Medicine Division of Gastroenterology
Directions to the Medical Procedures Unit
Instructions for Patients with Diabetes Having Outpatient Tests (on insulin)
Instructions for Patients with Diabetes Having Outpatient Tests (no insulin)

Other Related Web Sites:
National Institute of Digestive Diseases - Upper Endoscopy
Your Digestive System and How it Works

Information provided by UMHS Medical Procedures Unit staff
Last update 05/08/08