Oesophagogastroduodenoscopy (OGD/EGD)
Related Subjects:
|Upper Gastrointestinal Bleed
|Oesophageal Variceal Bleeding
|Dieulafoy Lesion
|Mallory-Weiss Tear
|Gastric Cancer
|Peptic Ulcer Disease
|Oesophagogastroduodenoscopy (OGD/EGD)
|Hereditary Haemorrhagic Telangiectasia
|Hypovolaemic or Haemorrhagic Shock
📖 About Oesophagogastroduodenoscopy (OGD/EGD)
- ⏳ Patients must fast for at least 6 hours to reduce aspiration risk.
- 📝 Consent: Explain procedure, risks (bleeding, perforation, sedation), and aftercare restrictions.
- 📹 A flexible fibreoptic endoscope is passed via the mouth → oesophagus → stomach → duodenum.
- 💨 Local anaesthetic throat spray reduces gag reflex; light IV sedation (e.g., midazolam) may be given.
- 🌬️ Nasal oxygen is used if sedated or hypoxic.
- 🧒 Children/severe anxiety → may need general anaesthesia.
- 🔍 Visualises oesophagus, stomach, and proximal duodenum for ulcers, inflammation, varices, or malignancy.
🎯 Indications
- 🍽️ Dyspepsia with alarm features (weight loss, anaemia, vomiting).
- 🩸 Unexplained iron deficiency anaemia.
- 🌾 Suspected Coeliac disease (duodenal biopsy).
- 🥤 Dysphagia or odynophagia.
- ⚠️ Upper GI bleeding (melaena, haematemesis).
- 🛠️ Therapeutic uses → stents, variceal banding, PEG insertion.
🚨 Urgent Indications
- ⏱️ 2-week referral: Dysphagia or age >55 with weight loss + abdominal pain/reflux/dyspepsia.
- 🔔 Suspicion of GI malignancy or persistent/worsening GI symptoms despite therapy.
🛠️ Interventions During OGD
- 🧪 Biopsies: For malignancy, inflammation, or H. pylori.
- 🌾 Duodenal biopsy: Villous atrophy/crypt hyperplasia → Coeliac disease.
- 🩸 Bleeding control: Adrenaline injection, variceal banding, or sclerosant.
- 🧱 Stenting: For oesophageal or gastric outlet obstruction.
- 🥤 PEG tube: For long-term enteral feeding.
🩺 Post-Procedure Care
- 🚫 Nil by mouth ~4 hrs after to avoid aspiration.
- 🚗 Do not drive/operate machinery for 24 hrs if sedated.
- 👀 Monitor for red flags: severe abdominal pain, haematemesis, melaena, fever.
- ⚠️ Persistent dysphagia, chest pain, or breathlessness may indicate perforation → urgent review.
