Esophagogastroduodenoscopy (EGD) is a procedure used to examine the upper digestive tract, including the esophagus (the muscular tube connecting the mouth to the stomach), the stomach, and the duodenum (the first part of the small intestine). EGD is performed using an endoscope, a long, flexible instrument with a light and camera on the end. The endoscope is inserted through the mouth and passed along the digestive tract, allowing the doctor to view the tissues directly.

EGD is typically performed in an outpatient surgery clinic. Patients receive sedative medications and are not fully awake during the procedure; they also generally do not remember it afterward. In some cases, general anesthesia may be used.

EGD can be used for diagnostic purposes, such as identifying conditions affecting the digestive tract, or for treatment. Specialized surgical instruments can be passed through the endoscope, enabling procedures to be performed inside the digestive tract without requiring abdominal incisions.

Various procedures can be performed during EGD. For example, a foreign body (an object that was swallowed) can be removed. Tumors or polyps can also be excised, often using a snare, an electrified wire tightened around the base of the tissue to remove it. A biopsy may be taken by removing a small tissue sample for laboratory analysis to determine if it is cancerous or indicative of another disease. Submucosal injections, which involve injecting fluid beneath the lining of the digestive tract, can also be performed to separate an area and facilitate tissue removal.

In some cases, an ultrasound is performed during EGD, known as a transendoscopic ultrasound (TUS). This procedure can assess how deeply cancer or another disease has penetrated tissue and evaluate nearby structures, such as the pancreas. TUS can also guide biopsies or fine-needle aspirations (FNA), a technique that uses a needle and syringe to collect cells for laboratory analysis.

Strictures, or narrowed areas of the digestive tract caused by scar tissue, can interfere with food passage. Dilation (also called dilatation) is a procedure used to widen these areas. This can be accomplished with a balloon inflated inside the narrowed area or guide-wire dilation, where a wire guides a tapered tube to gradually expand the passage.

A gastrostomy tube, or feeding tube, can also be placed during EGD. This tube passes through the skin into the stomach, allowing food to be delivered directly to the stomach, bypassing chewing and swallowing. Varices—swollen veins that may cause bleeding—can also be treated during EGD through ligation, which involves clamping off the swollen veins to stop the bleeding.