Esophagogastroduodenoscopy with intravenous anesthesia

Esophagogastroduodenoscopy (EGD), also known as gastroscopy or upper gastrointestinal endoscopy, allows a detailed assessment of the mucosal lining of the esophagus, stomach, and duodenum. The examination is performed in cases of unexplained upper abdominal pain, heartburn, difficulty swallowing, nausea, vomiting, or suspected gastrointestinal bleeding. During the procedure, inflammation, ulcers, polyps, and tumors can be detected. If necessary, a biopsy or polyp removal (polypectomy) can be performed during the same procedure, helping to avoid an additional intervention. The examination is most commonly performed under intravenous sedation, during which the patient remains drowsy but continues to breathe independently. Vital signs, including breathing, heart rate, and blood pressure, are continuously monitored throughout the procedure to ensure maximum safety. Sedation helps minimize discomfort and allows the examination to proceed smoothly.

Preparation for Esophagogastroduodenoscopy

To ensure the accuracy and safety of the examination, it is important to:

• Do not eat or drink (including water) for at least 6–8 hours before the procedure;
• Inform your doctor about any medications you are taking, especially anticoagulants, insulin, or other important medications;
• If necessary, additional blood tests (e.g., coagulation tests such as INR and APTT) may be performed if a biopsy or polyp removal is planned;
• If sedation is planned, arrange for someone to accompany you home after the procedure.

How is Esophagogastroduodenoscopy Performed Under Intravenous Sedation?

Before the procedure, an intravenous catheter is inserted, and sedative medication (most commonly midazolam) is administered. Throughout the examination, vital signs, including breathing, heart rate, blood oxygen saturation, and blood pressure, are continuously monitored. The procedure is performed as follows:

• The patient is positioned on their left side;
• A mouthguard is placed to protect both the teeth and the endoscope;
• A thin, flexible endoscope equipped with a video camera is inserted through the mouth;
• Air or carbon dioxide is introduced into the gastrointestinal tract to improve visualization of the mucosa;
• The condition of the mucosal lining is assessed using the transmitted video images.

The examination usually takes approximately 10–20 minutes. If suspicious abnormalities are identified, a biopsy may be performed, during which a small tissue sample is collected for histological analysis. In some cases, additional therapeutic interventions, such as polyp removal or control of bleeding, may also be carried out. In selected situations, esophagogastroduodenoscopy can help avoid open surgery or additional diagnostic procedures.

After Esophagogastroduodenoscopy

Following the procedure, the patient is observed in the healthcare facility until the effects of sedation have worn off. Temporary symptoms such as a sore throat, discomfort when swallowing, mild abdominal bloating, drowsiness, or slowed reaction times may occur. It is important not to rush back to normal activities in the hours following the examination. Food and fluids are generally avoided for the first two hours after the procedure to reduce the risk of aspiration. For the remainder of the day, patients are usually advised to avoid driving, operating machinery, consuming alcohol, or taking sedative substances. For your safety, monitor your condition carefully. Severe abdominal or chest pain, bloody vomiting, fever, breathing difficulties, or swallowing problems may indicate serious complications and require immediate medical attention. Follow-up appointments are an important part of the process. During these visits, the examination findings, biopsy results, and further treatment or surveillance plans are discussed. The full benefit of the procedure is achieved only after comprehensive evaluation of the collected information and its application to clinical decision-making.

What Conditions Can Be Diagnosed and Treated with Esophagogastroduodenoscopy?

• Gastric and duodenal ulcers;
• Gastroesophageal reflux disease (GERD);
• Gastritis and esophagitis;
• Hiatal hernia;
• Celiac disease;
• Mucosal polyps and tumors (precancerous or malignant);
• Sources of gastrointestinal bleeding;
• Foreign bodies and strictures (narrowings).

Esophagogastroduodenoscopy is a highly informative and safe procedure that enables accurate assessment of the mucosal lining of the upper gastrointestinal tract, detection of pathological changes, and planning of further treatment. It plays an important role in both the diagnosis and prevention of inflammatory, precancerous, and malignant conditions by allowing timely detection of abnormalities. For more information about the examination, its procedure, or preparation requirements, please consult a gastroenterologist.