EGD Procedure - Upper GI Endoscopy

There are many diseases and conditions that an individual can experience that relates to their stomach, esophagus, or intestines. For example, a patient may suffer from chronic heartburn or have unexplained long-term nausea or vomiting, and doctors want to determine what is causing these symptoms. 

They may order an esophagogastroduodenoscopy or upper GI endoscopy or EGD (the medical abbreviation) which is a test to help them diagnose these issues.

What is an EGD Procedure?

An upper GI endoscopy (EGD) is a procedure that is performed by a doctor with an endoscope to visualize and closely examine the lining of your upper GI tract. An endoscope is a special flexible tube with a camera and a light mounted on its end.

The doctor can examine the patient’s entire upper gastrointestinal tract beginning at the mouth all the way to the duodenum, i.e. the small bowel.

Play Video about EGD Procedure

Why would an Individual need an Upper GI Endoscopy?

A doctor would use EGD to help locate the cause of unexplained symptoms that may be definitive of disease or infection such as:

As with any surgery, there are risks involved. Risks associated with single anastomosis sleeve ileal bypass can include:

Who is a Candidate for EGD?

Do you have difficulty swallowing, pain in the upper abdomen, or unexplained heartburn? 

Individuals who are having chronic digestive issues, unexplained weight loss, and continuing symptoms of reflux are good candidates for upper GI endoscopy.

What do I need to do to Prepare for an Upper GI Endoscopy?

EGD prep is important and necessary to ensure patient safety during the procedure. Each patient’s doctor will provide them with specific instructions regarding the use of medications they normally take (blood thinners or high blood pressure medications) before their procedure. 

In general, no eating or drinking at all is allowed for at least eight hours before the procedure.

How is an Upper GI Endoscopy performed?

EGD is normally performed as an outpatient procedure and does not require a hospital stay. Knowing what to expect from the EGD procedure should help alleviate some anxiety and make the process go more smoothly.

While the patient is under mild sedation, a gastroenterologist or surgeon carefully lowers the endoscope down the patient’s throat and into the upper GI tract.

The tiny endoscopic camera sends a video image to a monitor that is located next to the doctor allowing a direct examination of the upper GI tract lining. Air is pumped in through the endoscope to widen these areas so the doctor can easily access and inspect for abnormalities.

If necessary, the doctor will take a small tissue sample from the lining to send to a lab for review but the patient will not feel anything (EGD with biopsy). Polyps and tumors can also be removed during the upper GI procedure.

EGD

How long does an EGD Procedure take?

There are no incisions involved and the entire process is carried out as an outpatient procedure in less than 30 minutes and offers a quick recovery.

What can I Expect after an EGD Procedure?

You may be groggy due to the sedative after the procedure and will need a friend or family member to drive you home. Driving an automobile is not allowed after the procedure. Even though you may not feel tired, your judgment and reflexes will most likely be impaired. (make sure you have someone with you!)

Overall, EGD has minimal recovery or discomfort. You may experience a sore throat for 1–2 days, have difficulty swallowing, feel bloated, or maybe be sore in the location where the IV sedation was administered (if used). These mild side effects should dissipate within 48 hours.

When will I get the Results?

The physician may explain the results after the exam or may suggest an appointment for a later date when the patient can fully understand and remember the results. Often, a side effect of sedation causes patients to not remember anything about the procedure or directly afterward. If a biopsy has been performed or a polyp removed, the results will not be available for three to seven days.

What are the Risks of an Upper GI Endoscopy?

Generally, EGD is a very safe procedure with no associated major risks or complications. Sometimes, patients experience a temporary, mild sore throat after the exam but this normally resolves within a few days.

Serious risks are rare with upper GI endoscopy and may include excessive bleeding, especially with the removal of a polyp. In extremely rare instances, a perforation, or tear, in the esophagus or intestinal wall can occur requiring hospitalization or surgery. In very rare circumstances, a diagnostic error or oversight may occur.

How much does EGD cost?

The average cost of an upper GI endoscopy is between $787 to $3,382 in the United States and will vary depending on many factors. These factors may include, patient-specific criteria, any additional testing that may be necessary during the procedure, geographic location, medical insurance coverage, etc.

Some or all of the costs of the upper GI endoscopy (CPT code for EGD 43235) may be covered under medical insurance. It is important that patients check the coverage that is available on their plan before scheduling the procedure.

EGD with biopsy (CPT code 43238) and EGD with dilation (CPT code differs depending on the dilation technique) may also require pre-authorization.

Many insurance companies require a detailed history of symptoms and documentation of treatments before they will approve the procedure.

What is an EGD with Biopsy?

Sometimes a small sample of tissue is gathered during the upper GI procedure and is used to diagnose or confirm the presence of conditions such as cancer, celiac disease, gastritis, etc.

What is an EGD with Dilation?

Sometimes, scarring from chronic reflux (acid repeatedly backing up into the lower portion of the esophagus) can cause the tube to become constricted making it hard for the patient to swallow. When they eat, their food feels “stuck” around their upper chest causing discomfort or pain. Though less common, thin layers of excess tissue caused by cancer or as a result of radiation treatment can cause narrowing.

Esophageal dilation or EGD with dilation is a procedure that is performed to stretch or dilate a narrowed portion of a patient’s esophagus (the tube that you use to swallow). There are different techniques used to perform dilation of the esophagus.

What is the difference between EGD and a Colonoscopy?

Both an upper GI and a Colonoscopy are procedures that utilize endoscopic technology to examine sections of the digestive system. EGD examines the upper portion of the digestive tract through the mouth and a colonoscopy is performed through the rectum to examine the lower part of the GI tract.

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