Upper endoscopy, also called esophagogastroduodenoscopy (EGD), is a procedure that lets doctors look directly at the lining of the esophagus, stomach, and first part of the small intestine (duodenum), using a flexible tube with a camera. Most people tolerate upper endoscopy well, and it is considered very safe. The procedure helps diagnose and treat many digestive problems related to the upper intestinal tract.

Upper endoscopy is a procedure in which a doctor uses a thin, flexible tube called an endoscope to examine the upper digestive tract. The endoscope is equipped with a light and a camera that sends video images to a monitor during the procedure.

During upper endoscopy, the doctor can see the lining of the esophagus (food pipe), stomach, and the first part of the small intestine. Doctors may also use upper endoscopy to take small tissue samples called biopsies, treat bleeding, or remove growths.

Upper endoscopy is used to diagnose and treat a wide range of digestive symptoms and conditions. The procedure helps doctors find the cause of unexplained symptoms and manage certain conditions.

Common reasons for upper endoscopy include:

• Ongoing pain in the upper part of the abdomen, especially with weight loss, loss of appetite, or signs of bleeding, to check for ulcers or other problems
• Ongoing nausea or vomiting that does not improve, to look for blockages or inflammation
• Difficulty swallowing or pain with swallowing, to check for narrowed areas or growths in the esophagus or stomach
• Chronic acid reflux (heartburn) that does not improve with medicine, to look for damage or changes in the esophagus
• An unexplained low blood count (anemia), to look for hidden bleeding or problems absorbing nutrients
• Black or tarry stools, vomiting blood, or other signs of bleeding in the upper digestive tract, to find and treat the source
• Screening and follow-up for Barrett’s esophagus, a condition in which the lining of the esophagus changes and is linked to a higher risk of cancer
• Checking for swollen veins (varices) in people with liver disease to prevent or treat bleeding
• Checking whether inflammation of the esophagus, ulcers, or other conditions are healing
• Taking biopsies to check for celiac disease, which damages the lining of the small intestine in response to gluten, or to check for cancer or infections
• Removing polyps or foreign objects or stretching narrowed areas (strictures)
• Placing feeding tubes

Doctors may also use upper endoscopy to follow up on abnormal imaging test results or to guide treatment for specific digestive diseases.

Some people may not be able to have upper endoscopy safely. For example, it may not be recommended for people who have serious heart or lung problems that increase the risk of anesthesia, severe bleeding disorders, or an inability to cooperate during the procedure.

Tests are not routinely needed before upper endoscopy. Doctors may recommend certain tests based on a person’s health history, physical exam, and the risks of the procedure.

A medical history and physical exam help identify conditions that could affect sedation or increase the risk of the procedure. Doctors also review medicines, allergies, and past procedures.

Tests that may be needed before upper endoscopy include:

• Blood tests to check for anemia or bleeding problems, particularly if biopsies or treatment are planned
• Tests to check how well the blood clots, especially for people who take blood thinners or have bleeding disorders
• Pregnancy testing for women of childbearing age if the procedure involves certain medicines or imaging
• A chest X-ray for people with new breathing symptoms or heart problems, to check whether sedation can be given safely
• Other tests for specific health concerns, such as kidney or liver problems

Preparation for upper endoscopy helps keep the procedure safe and allows doctors to see the upper digestive tract clearly. Doctors provide specific instructions based on the timing and reason for the procedure.

Key steps in preparation include:

• Fasting: Most people are asked not to eat or drink for six to eight hours before the procedure. This keeps the stomach empty and reduces the risk of stomach contents entering the lungs.
• Medication review: Doctors discuss which medicines can be continued and which may need to be stopped or adjusted. Blood thinners, diabetes medicines, and iron supplements may require special instructions.
• Allergy and health history: The care team needs to know about any allergies, heart or lung problems, or past reactions to sedation.
• A ride home: Because sedatives are used, people who have an upper endoscopy with sedation should not drive until the following day. A friend or family member should be available to help.
• Informed consent: Doctors explain the procedure, its risks and benefits, and other options. They also answer questions before asking for written agreement.

In emergencies or when the stomach empties slowly, doctors may adjust the preparation or take extra steps during anesthesia to protect the airway.

Upper endoscopy is performed by a specially trained doctor, often a gastroenterologist, with support from nurses and anesthesia staff. The procedure is usually done in a hospital or outpatient center.

During upper endoscopy:

• People lie on their left side or back on an exam table.
• A sedative is given through an IV to help people relax and prevent discomfort. Sometimes, a local anesthetic spray is used to numb the throat. The team monitors vital signs throughout the procedure and is ready to manage any problems.
• A mouth guard is placed to protect the teeth and the endoscope.
• The doctor gently passes the endoscope through the mouth and esophagus and into the stomach and small intestine. The procedure does not interfere with breathing.
• Air (or carbon dioxide) is introduced through the endoscope to gently inflate the stomach and first part of the small intestine, making the lining easier to examine.
• The doctor examines the lining for signs of inflammation, ulcers, growths, or bleeding.
• Small forceps passed through the endoscope may be used to take biopsies. Taking a biopsy does not cause pain.
• The doctor may also stop bleeding, remove polyps, and stretch narrowed areas. The procedure usually lasts 10 to 20 minutes. Many people fall asleep during the procedure or remember little of the procedure.

Upper endoscopy is very safe, but like any procedure, it has some risks and possible complications. Most complications are rare and can be managed quickly.

Risks and complications include:

• Bleeding, usually related to a biopsy or polyp removal. It typically stops without treatment, although bleeding can sometimes occur several days after the procedure.
• Perforation (hole or tear in the digestive tract lining). This is rare but may require surgery.
• A reaction to sedatives, which may cause breathing or heart problems, low blood pressure, or a slow heartbeat.
• Infection, which is uncommon.
• A sore throat, bloating, or mild discomfort, which usually goes away quickly.
• Heart or breathing problems related to anesthesia, such as low oxygen levels or an irregular heartbeat, especially in people with other health problems.
• Rare allergic reactions to medicines or anesthetics.

Recovery after upper endoscopy is usually quick and straightforward. Most people stay at the hospital or center for about an hour while the sedatives wear off. Some may need to stay longer if there are special concerns. People need a ride home after the procedure.

Common recovery experiences include:

• A mild sore throat or bloating may occur and usually fades within a few hours.
• Sedation may cause sleepiness or grogginess. Rest is recommended for the remainder of the day. People who receive sedatives should not drive or make important decisions until the following day because their judgment may be impaired.
• Eating and drinking can usually resume shortly after the procedure and once swallowing feels normal, unless the doctor provides other instructions.
• Some results from the procedure may be available right away, but biopsy results typically take a few days.

This article was medically reviewed in August 2026.