EGDs for Chronic Liver Disease

Bleeding is often a source of serious ailment and even death in patients with advanced liver disease. Knowing the source of the bleed is critical when trying to save a patient's life. 

A study published by senior author Eric Goldberg, MD, in the Clinical Liver Disease Journal explains how EGDs (esophagogastroduodenoscopy) can be used to diagnose the source of bleeding in patients with advanced liver disease and help manage their condition.  

Patient Guide to EGDs

  • What is an EGD?
    • EGDs are endoscopic procedures that allow doctors to see inside the area surrounding a patient's liver, like the esophagus and stomach. 
  • Why is this test done? 
    • This test allows the doctor to look in your upper digestive tract for active or potential sources of bleeding. 
    • Areas of concern will be treated accordingly with various maneuvers (bands, clips, cautery, etc.) to stop current bleeding or prevent future bleeding.
    • Areas of concern (ulcers, growths, etc) may be sampled with biopsy to rule out certain diseases (malignancy, inflammation, infection with certain bacteria, etc.).
  • How should I prepare for my procedure? 
    • Your stomach should be completely empty. Do not eat or drink after midnight on the night before your procedure.
    • Tell your doctor about your medications prior to scheduling the procedure. Some of these (blood thinners, anticoagulation, etc.) may need to be held for several days prior to the procedure.
    • Tell your doctor or nurse about any allergies to medications.
    • Tell your doctor if you have a pacemaker, defibrillator, or other cardiac devices.
    • You will be asked to wear a hospital gown and remove dentures, contact lenses, or eyeglasses at the time of the procedure.
  • What do I do during the procedure?
    • Vital signs will be taken and an IV placed for medication administration.
    • You will be asked to lie on your left side, and a ‘‘bite-blocker’’ will be used to protect your teeth.
    • After sedation, the scope will be passed through your mouth, down your esophagus, and into the stomach and beginning of your small intestine.
    • The scope will not be placed in your airway, and you will still be able to breathe during the EGD. Treatment of bleeding sites and biopsies may then occur.
    • The procedure typically lasts 20-30 minutes.
  • What happens after the procedure? 
    • You will be monitored while anesthesia and sedation wear off.
    • You may feel drowsy afterward and will need an escort home. Do not operate machinery for 24 hours. This includes driving.
    • You may notice a sore throat and bloating after the procedure. This is not uncommon and will get better.
    • Call your doctor immediately if you have any complications (see below).
  • Are there risks involved? 
    • Complications are rare but can occur. These include but are not limited to:
      • Bleeding and requiring blood transfusions
      • Adverse reaction to sedatives
      • Breathing, respiratory, or cardiac complications
      • A tear in the lining (perforation) of the digestive tract
      • Need for emergency surgery
  • When should I contact my doctor? 
    • Call with any questions or if you experience the following:
      • Fever of 100.4F or higher
      • Trouble swallowing
      • Difficulty breathing
      • Blood in vomit or stool
      • Increasing throat, chest, or abdominal pain
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