Upper Endoscopy (EGD) in Dallas & Sachse, TX

Medically reviewed by Jaison John, MD — Board-Certified Gastroenterologist
Last updated: March 2026

What Is an Upper Endoscopy (EGD)?

An upper endoscopy, formally known as an esophagogastroduodenoscopy (EGD), is a medical procedure that allows a gastroenterologist to directly examine the lining of the upper gastrointestinal (GI) tract — specifically the esophagus, stomach, and duodenum (the first portion of the small intestine). The procedure is performed using a thin, flexible tube called an endoscope, which is equipped with a small high-definition camera and a light at its tip. As the endoscope is gently advanced through the mouth, it transmits real-time video to a monitor, giving the physician a detailed view of the mucosal tissue throughout the upper digestive system.

Upper endoscopy is one of the most commonly performed procedures in gastroenterology. According to the American Society for Gastrointestinal Endoscopy (ASGE), more than 6 million upper endoscopies are performed annually in the United States. The procedure serves both diagnostic and therapeutic purposes: it can identify the cause of persistent upper GI symptoms, detect abnormalities such as ulcers, inflammation, or precancerous tissue changes, and allow the physician to take biopsies or perform treatments during the same session.

At Texas Gut Health in Sachse, TX, Dr. Jaison John performs upper endoscopies using state-of-the-art endoscopic equipment in a comfortable outpatient setting. Dr. John completed his gastroenterology fellowship at UT Medical Branch, where he served as Chief Fellow, and his internal medicine residency at UT Austin Dell Medical School, where he served as Chief Resident. He holds dual board certifications from the American Board of Internal Medicine (ABIM) in both internal medicine and gastroenterology, ensuring that every procedure is performed with the highest level of clinical expertise.

Who Needs an Upper Endoscopy?

Your gastroenterologist may recommend an upper endoscopy to investigate a wide range of upper gastrointestinal symptoms or to monitor known conditions. The American College of Gastroenterology (ACG) and the American Gastroenterological Association (AGA) have established clinical guidelines that outline the most common indications for EGD. You may be a candidate for an upper endoscopy if you experience any of the following:

• Persistent gastroesophageal reflux disease (GERD) symptoms — Chronic heartburn, acid regurgitation, or chest pain that does not respond adequately to proton pump inhibitors (PPIs) or other acid-reducing medications may warrant an EGD to evaluate the esophageal lining for erosive esophagitis, strictures, or Barrett's esophagus.
• Difficulty swallowing (dysphagia) — Trouble swallowing solids or liquids, or the sensation of food getting stuck in the chest or throat, is an important indication for upper endoscopy. EGD can identify structural causes such as esophageal strictures, eosinophilic esophagitis, rings, webs, or tumors. When a narrowing is found, esophageal dilation can often be performed during the same procedure.
• Unexplained upper abdominal pain — Persistent or recurrent pain in the upper abdomen, epigastric region, or beneath the breastbone that has not been explained by imaging studies or laboratory tests may require direct visualization of the stomach and duodenal lining.
• Unexplained anemia or iron deficiency — Iron-deficiency anemia without a clear dietary or menstrual cause may indicate occult (hidden) bleeding from the upper GI tract. An EGD can identify sources of bleeding such as ulcers, erosive gastritis, vascular malformations, or tumors.
• Celiac disease screening and diagnosis — When blood tests suggest celiac disease (elevated tissue transglutaminase antibodies), an upper endoscopy with duodenal biopsies is required to confirm the diagnosis by demonstrating characteristic villous atrophy in the small intestinal lining. The ACG considers duodenal biopsy via EGD the gold standard for celiac disease diagnosis.
• Barrett's esophagus surveillance — Patients with a prior diagnosis of Barrett's esophagus require periodic surveillance EGDs with biopsies to monitor for dysplasia (precancerous cellular changes) that could progress to esophageal adenocarcinoma. The ACG recommends surveillance intervals of every 3 to 5 years for non-dysplastic Barrett's esophagus.
• Persistent nausea, vomiting, or unexplained weight loss — Chronic nausea, recurrent vomiting, or significant unintended weight loss may indicate an underlying upper GI condition that requires endoscopic evaluation.
• Upper gastrointestinal bleeding — Vomiting blood (hematemesis) or passing black, tarry stools (melena) are signs of upper GI bleeding that often require urgent endoscopy to identify and potentially treat the source.

If you live in Sachse, Murphy, Wylie, Plano, Garland, Rowlett, Richardson, or anywhere in the Dallas-Fort Worth metroplex and are experiencing any of these symptoms, Dr. John and the team at Texas Gut Health can evaluate whether an upper endoscopy is right for you.

What to Expect

Knowing what happens before, during, and after an upper endoscopy can help you feel confident and prepared. Here is a detailed overview of the entire experience at Texas Gut Health.

Before Your Upper Endoscopy

Preparation for an upper endoscopy is significantly simpler than preparation for a colonoscopy — no bowel prep is required. The key requirement is fasting to ensure your stomach is empty, which allows your gastroenterologist a clear view of the upper GI lining and reduces the risk of aspiration during sedation. Preparation guidelines include:

• Fasting: You must not eat or drink anything for at least 6 to 8 hours before the procedure. For a morning procedure, this typically means nothing by mouth after midnight the night before. Your doctor may allow small sips of water with essential medications up to 2 hours before your appointment.
• Medication adjustments: Inform Dr. John about all medications, supplements, and over-the-counter drugs you take. Blood thinners such as warfarin, clopidogrel, or direct oral anticoagulants may need to be temporarily stopped or adjusted before the procedure. Diabetes medications may also need dosing modifications on the day of the procedure. You will receive specific instructions from our office.
• Transportation: Because you will receive intravenous sedation, you must arrange for a responsible adult to drive you home after the procedure. You will not be permitted to drive, operate heavy machinery, or make important legal or financial decisions for the remainder of the day.
• What to wear: Wear comfortable, loose-fitting clothing. You will be given a hospital gown to change into before the procedure. Leave jewelry and valuables at home.

During the Procedure

An upper endoscopy typically takes only 15 to 20 minutes from start to finish, making it one of the shorter outpatient procedures in gastroenterology. Here is what happens once you arrive:

• Check-in and preparation: A nurse will review your medical history, confirm your medications, check your vital signs, and place an intravenous (IV) line in your arm or hand.
• Throat spray: A topical anesthetic spray may be applied to the back of your throat to minimize the gag reflex and improve comfort as the endoscope is passed.
• Sedation: You will receive sedation through your IV, which produces a comfortable, relaxed, twilight-like state. Most patients fall asleep within seconds and do not feel or remember the procedure.
• The examination: With you lying on your left side, Dr. John will gently guide the endoscope through your mouth, down the esophagus, through the stomach, and into the duodenum. Air or carbon dioxide is introduced through the scope to gently inflate the GI tract, providing a clear view of the mucosal surfaces. Dr. John carefully inspects the tissue as the scope is advanced and withdrawn, looking for signs of inflammation, ulceration, structural abnormalities, or suspicious lesions.
• Biopsies and therapeutic interventions: If abnormal tissue is observed, Dr. John will take small biopsy samples using tiny forceps passed through the endoscope. This is completely painless. Biopsies are routinely taken to test for conditions such as celiac disease, Helicobacter pylori (H. pylori) infection, Barrett's esophagus, eosinophilic esophagitis, and gastritis. In certain cases, therapeutic interventions such as esophageal dilation (stretching a narrowed area) or hemostasis (stopping a bleeding site) can be performed during the same procedure.

After Your Upper Endoscopy

After the procedure, you will be moved to a recovery area where nurses will monitor your vital signs for approximately 30 to 45 minutes as the sedation wears off. Most patients begin to feel alert relatively quickly.

• Preliminary results: Dr. John will speak with you and your companion before you leave to share his initial findings from the visual examination. If biopsies were taken, pathology results are typically available within 1 to 2 weeks, at which point our office will contact you to discuss the results and any recommended next steps.
• Throat discomfort: You may experience a mild sore throat or a sensation of fullness for a few hours after the procedure. This is normal and resolves on its own. Warm liquids, throat lozenges, and soft foods can help ease any discomfort.
• Bloating: Mild bloating from the air used during the procedure is common and passes quickly, usually within a few hours.
• Resuming eating: You may begin drinking clear liquids once the numbness in your throat has worn off, typically within 30 to 60 minutes. Soft foods can be introduced within a few hours, and most patients return to their normal diet by the following day.
• Activity restrictions: Plan to rest for the remainder of the day. Do not drive, consume alcohol, or sign legal documents for 24 hours after receiving sedation. Most patients return to normal activities, including work, the next day.

Conditions Diagnosed or Treated

An upper endoscopy is a versatile diagnostic and therapeutic tool that can identify, evaluate, or manage a broad range of upper gastrointestinal conditions. The most common conditions diagnosed or assessed through EGD include:

• Gastroesophageal reflux disease (GERD) — EGD allows direct visualization of the esophageal lining to assess for erosive esophagitis, the hallmark of GERD. It can also identify complications of chronic reflux, including strictures and Barrett's esophagus. The ACG recommends EGD for patients with GERD alarm symptoms or those who do not respond to standard medical therapy.
• Barrett's esophagus — This condition occurs when chronic acid reflux causes the normal squamous lining of the lower esophagus to be replaced by specialized intestinal-type epithelium (intestinal metaplasia). Barrett's esophagus is a precancerous condition that increases the risk of esophageal adenocarcinoma. EGD with systematic four-quadrant biopsies is the standard method for diagnosis and surveillance.
• Celiac disease — An upper endoscopy with duodenal biopsies is the gold standard for confirming a diagnosis of celiac disease. During the procedure, the gastroenterologist obtains multiple tissue samples from the duodenum, which are examined by a pathologist for villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes — the histologic hallmarks of celiac disease.
• Peptic ulcers — EGD can identify gastric ulcers (in the stomach) and duodenal ulcers (in the first part of the small intestine). The procedure also allows the physician to test for H. pylori, the bacterium responsible for the majority of peptic ulcers, and to treat actively bleeding ulcers endoscopically.
• Gastritis — Inflammation of the stomach lining (gastritis) can be caused by H. pylori infection, chronic NSAID use, autoimmune conditions, or other factors. EGD with biopsy helps determine the cause and severity of gastritis so that appropriate treatment can be initiated.
• Esophageal strictures — Narrowing of the esophagus can result from chronic acid reflux, radiation therapy, eosinophilic esophagitis, or scarring from previous injury. EGD both diagnoses the stricture and allows for esophageal dilation during the same procedure, providing immediate symptom relief for patients with difficulty swallowing.
• Eosinophilic esophagitis (EoE) — This chronic immune-mediated condition causes inflammation and elevated eosinophil levels in the esophageal tissue. EGD with esophageal biopsies is required for diagnosis, and characteristic findings such as rings, furrows, or white plaques may be visible during the examination.
• Upper GI bleeding — EGD is the primary tool for evaluating and treating acute upper gastrointestinal bleeding. The endoscopist can identify bleeding sources — such as ulcers, varices, Mallory-Weiss tears, or vascular malformations — and apply hemostatic therapies including cauterization, clipping, or banding during the same procedure.

Risks and Benefits

Upper endoscopy is considered a very safe procedure with a well-established safety profile. As with any medical procedure, patients should be aware of both the benefits and the small risks involved.

Benefits

• Direct visualization: EGD provides a real-time, high-definition view of the esophagus, stomach, and duodenum, allowing the gastroenterologist to detect abnormalities that may not be visible on imaging studies such as X-rays or CT scans. Studies published in Gastrointestinal Endoscopy demonstrate that EGD has a diagnostic sensitivity exceeding 90% for most upper GI conditions.
• Tissue sampling: The ability to take biopsies during the procedure is critical for confirming diagnoses such as celiac disease, Barrett's esophagus, H. pylori infection, and eosinophilic esophagitis. Biopsy results guide treatment decisions and help avoid unnecessary empiric therapies.
• Simultaneous treatment: Unlike imaging-only tests, EGD allows the physician to perform therapeutic interventions during the same session, including esophageal dilation, polyp removal, hemostasis for bleeding lesions, and foreign body retrieval. This dual diagnostic-therapeutic capability reduces the need for additional procedures.
• Quick procedure with rapid recovery: At only 15 to 20 minutes, EGD is one of the shortest endoscopic procedures. Most patients recover quickly, resume eating within hours, and return to normal activities the following day.
• No bowel preparation: Unlike a colonoscopy, EGD requires only a brief fasting period — no laxative bowel prep is necessary, which most patients find significantly more convenient and tolerable.

Risks

Serious complications from upper endoscopy are rare. According to large-scale studies cited by the ASGE, the overall complication rate for diagnostic EGD is approximately 1 in 1,000 procedures, and the mortality rate is extremely low at approximately 1 in 10,000. The most significant risks include:

• Bleeding: Minor bleeding may occur at a biopsy site or after polyp removal, but it almost always stops on its own. Clinically significant bleeding requiring intervention occurs in fewer than 1 in 1,000 diagnostic EGDs, though the risk is slightly higher when therapeutic interventions such as dilation or polypectomy are performed.
• Perforation: A tear in the wall of the esophagus, stomach, or duodenum is the most serious potential complication but is extremely rare, occurring in approximately 1 in 2,500 to 1 in 11,000 diagnostic procedures. The risk increases modestly with therapeutic interventions such as dilation of strictures. If a perforation occurs, it may require hospitalization and, in some cases, surgical repair.
• Adverse reaction to sedation: Sedation-related complications, such as respiratory depression, a drop in blood pressure, or an allergic reaction, are uncommon and are carefully monitored by the clinical team throughout the procedure with continuous pulse oximetry and blood pressure monitoring.
• Aspiration: There is a very small risk that stomach contents could enter the lungs during the procedure, which is why fasting beforehand is critically important. Following the prescribed fasting guidelines virtually eliminates this risk.
• Sore throat: While not a true complication, mild throat discomfort lasting 1 to 2 days is common and resolves without treatment.

Dr. John discusses all risks and benefits with each patient during the pre-procedure consultation and answers any questions to ensure you feel fully informed. The medical consensus from the ACG, AGA, and ASGE affirms that the diagnostic and therapeutic benefits of upper endoscopy far outweigh its small risks when the procedure is clinically indicated.

Frequently Asked Questions