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Upper Endoscopy
(Esophagogastroduodenoscopy, EGD)

Medical Author: Jay W. Marks, M.D.
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

What is upper endoscopy?

Upper endoscopy is a procedure that enables the examiner (usually a gastroenterologist) to examine the esophagus (swallowing tube), stomach, and duodenum (first portion of small bowel) using a thin, flexible tube through which the lining of the esophagus, stomach, and duodenum can be viewed using a TV monitor.

How do I prepare for endoscopy?

To accomplish a safe and complete examination, the stomach should be empty. The patient will most likely be asked to have nothing to eat or drink for six hours or more prior to the procedure.

Prior to scheduling the procedure, the patient should inform his or her physician of any medications they are currently taking, any allergies, and all of their health problems. This information will remind the doctor whether the patient may need antibiotics prior to the procedure, what potential medications should not be used during the exam because of the patient's allergies, and will provide the individual scheduling the procedure an opportunity to instruct the patient whether any of the medications they are taking should be held or adjusted prior to the endoscopy.

Knowledge whether the patient has any major health problems, such as heart or lung diseases, will alert the examiner of possible need for special attention during the procedure.

Why have you been scheduled for an endoscopy?

Upper endoscopy usually is performed to evaluate possible problems with the esophagus, stomach or duodenum, and evaluate symptoms such as upper abdominal pain, nausea or vomiting, difficulty in swallowing, intestinal bleeding anemia, etc.. Upper endoscopy is more accurate than X-ray for detecting inflammation or smaller abnormalities such as ulcers or tumors within the reach of the instrument. Its other major advantage over X-ray is the ability to perform biopsies (obtain small pieces of tissue) or cytology (obtain some cells with a fine brush) for microscopic examination to determine the nature of the abnormality and whether the abnormality is benign or malignant (cancerous).

Biopsies are taken for many reasons and may not mean that cancer is suspected. Upper endoscopy also can be used to treat many conditions within its reach. The endoscope's channels permit passage of accessory instruments enabling the examiner to treat many of the conditions such as stretching areas of narrowing (strictures), removal of benign growths such as polyps, accidentally swallowed objects, or treating upper gastrointestinal bleeding as seen in ulcers tears of the lining. These capabilities have markedly reduced the need for transfusions or surgery.



Next: What can I expect during the endoscopy? »

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Endoscopy (Esophagogastroduodenoscopy, EGD)

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A duodenal diverticulum (the plural of which is diverticula) is a pouch attached to the duodenum, the first part of the small intestine just past the stomach.

There are two types of duodenal diverticula. The common type which is present in at least 6% of individuals, is one that sticks out from the duodenum, similar to the more common colonic diverticula. This is referred to as an "extramural" diverticulum. Extramural diverticula may vary in size from a few millimeters to a few centimeters. They usually are located in the area around the Papilla of Vater where the bile and pancreatic ducts enter the duodenum.

A second, rare type of diverticulum is referred to as an "intramural" diverticulum. It does not protrude from the duodenum. Rather, it protrudes into the duodenal lumen (the hollow inside of the duodenum through which digesting food flows). Both types of diverticula, extramural and intramural, comm...

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