Esophagogastroduodenoscopy (EGD) is an endoscopic procedure that utilizes a small, flexible camera called an endoscope that’s passed down the throat, allowing doctors to view the esophagus, stomach and duodenum, which is the initial portion of the small intestine.
When used as a tool to help diagnose and treat chronic liver disease, EGD is useful in locating the source of gastrointestinal bleeding that may be caused by portal hypertension. Portal hypertension is a potentially life-threatening condition involving elevated blood pressure within the portal vein, which carries blood to the liver from the intestines, spleen, pancreas and stomach. This increase in pressure is usually caused by a blockage in blood flow through the liver. Read more about portal hypertension and its symptoms and causes.
Though portal hypertension can develop due to issues like a tumor or blood clot in the portal vein, the condition is most often caused by cirrhosis, which is advanced scarring of the liver due to tissue damage. This damage can be due to different causes, including alcohol abuse, chronic hepatitis or nonalcoholic fatty liver disease.
In response to portal hypertension, the body often attempts to divert blood flow through other veins. The extreme pressure can make those veins dangerously expand, which thins, stretches and weakens their walls. If left untreated, these weakened veins — called “varices” — can leak blood or even rupture, potentially causing life-threatening internal bleeding.
In addition to locating gastrointestinal bleeding, EGD can also be used to facilitate endoscopic variceal ligation (EVL) in which rubber bands are placed to choke off the blood supply to the varices.
As with other endoscopic procedures, EGD is often performed while the patient is sedated. It’s usually an outpatient procedure.
With the patient lying on their back or side, the endoscopic specialist feeds the endoscope down the patient’s throat, through the stomach and into the duodenum, with the endoscopist looking for any sources of bleeding. The procedure usually takes around a half hour, though it may take longer depending on what the endoscopist finds and other procedures that might be done.