upper endoscopy

EGD involves passing a flexible endoscope through the mouth into the esophagus, stomach, and first/second portion of the duodenum under sedation. It allows direct visualization, biopsy for histopathology (e.g., H. pylori testing, Barrett's esophagus surveillance, celiac disease), and therapeutic maneuvers such as band ligation of esophageal varices, hemostasis of bleeding ulcers (injection, thermal, or mechanical clipping), foreign body removal, dilation of strictures, and stent placement. Indications include upper GI bleeding, iron deficiency anemia workup, dysphagia, odynophagia, refractory GERD, unexplained weight loss, and surveillance in high-risk conditions (Barrett's esophagus, prior gastric ulcers, hereditary polyposis syndromes). Contraindications include suspected perforation, unstable cardiopulmonary status, and severe coagulopathy (relative). Complications, though rare, include perforation, aspiration, bleeding, and adverse reactions to sedation. Clinically, EGD is often paired with pathology (e.g., biopsies for Helicobacter pylori, dysplasia grading in Barrett's esophagus) and plays a central role in the diagnostic algorithm for upper GI symptoms, especially alarm features (weight loss, anemia, dysphagia, GI bleeding) in patients over 60 or with red-flag symptoms regardless of age.