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Esophagogastroduodenoscopy

Esophagogastroduodenscopy is a diagnostic endoscopic procedure that allows visualization of the upper digestive tract, including the esophagus, stomach, and duodenum.
It is commonly used to evaluate symptoms such as dysphagia, abdominal pain, and gastrointestinal bleeding.
The procedure involves inserting a flexible, lighted tube (endoscope) through the mouth and down the throat to examine the interior lining of these organs.
Esophagogastrodudenoscopy can also be used to obtain tissue samples for biopsy and to treat certain conditions, such as bleeding ulcers.
It is considered a safe and effective tool for the diagnosis and management of upper gastrointestinal disorders.

Most cited protocols related to «Esophagogastroduodenoscopy»

1
Retrospective Cohort Analysis of EoE Therapies
We performed a retrospective cohort analysis of patients at University of North Carolina (UNC) Hospitals from 2006–2013. Patients of any age with EoE were identified from the UNC EoE Clinicopathologic Database.[12 (link), 13 (link)] For inclusion, patients had to have EoE by consensus guidelines, including failure to respond to a PPI trial;[1 (link)–3 (link)] undergo treatment with swallowed topical corticosteroids (tCS) or dietary therapy; and have a follow up endoscopy with biopsy. Treatment with tCS consisted of either budesonide (0.5–1 mg twice daily, depending on patient age)[14 (link), 15 (link)] or fluticasone (440–880 mcg twice daily, depending on patient age).[16 (link)–18 (link)] Dietary therapy consisted of six food elimination diets or targeted elimination diets.[19 (link)–21 (link)] Patients were treated with either tCS or dietary elimination for approximately 8 weeks prior to reassessment with esophagogastroduodenoscopy (EGD). For patients undergoing serial therapeutic trials of pharmacologic treatment modalities (for example fluticasone followed by budesonide), the results from the trial resulting in the lowest post-treatment eosinophil count were used for analysis. For patients undergoing sequential trials of dietary and steroid therapy (for example, dietary therapy after steroid therapy had failed), each therapeutic outcome was included. When a patient had outcomes for both dietary and steroid therapy, the eosinophil count from the diagnostic pre-treatment EGD was used to determine the percentage change in eosinophils.
Data were abstracted from the UNC electronic medical record. Using standardized data collection tools, we recorded patient demographics, symptoms, comorbidities, baseline and follow-up endoscopy findings, baseline and follow-up eosinophil counts on esophageal biopsy, and therapeutic regimen. Pre- and post-treatment eosinophil counts were recorded as the maximum number of eosinophils per high-power field (eos/hpf; hpf size = 0.24mm2) from pathologist review. Treatment outcomes were defined as follows: symptom response (dichotomous patient-reported subjective improvement [yes/no]); endoscopic response (dichotomous endoscopist-reported assessment of improvement [yes/no]), and both symptom and endoscopic response.
Wolf W.A., Cotton C.C., Green D.J., Hughes J.T., Woosley J.T., Shaheen N.J, & Dellon E.S. (2015). Evaluation of Histologic Cutpoints for Treatment Response in Eosinophilic Esophagitis. Journal of gastroenterology and hepatology research, 4(10), 1780-1787.
Publication 2015
Administration, Topical Adrenal Cortex Hormones Biopsy Budesonide Diagnosis Diet Elimination Diets Endoscopy Eosinophil Esophagogastroduodenoscopy Fluticasone Food Pathologists Patients Steroids Treatment Protocols
2
Retrospective Case-Control Study of EoE at UNC Hospitals

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Publication 2009
Acids Barrett Esophagus Biopsy Deglutition Disorders Endoscopy, Gastrointestinal Eosinophil Eosinophilia Esophageal Diseases Esophagogastroduodenoscopy Failure to Thrive Food Gastroesophageal Reflux Disease Heartburn Impacted Tooth Inflammation Pain Patients Reading Frames
3
Prognostic Factors in Oncology Patients
The peripheral venous blood was collected in fasting state within one week before chemotherapy in all patients. The counts of peripheral neutrophils, lymphocytes, and platelets were measured and analyzed by an automatic blood analyzer (Beckman Coulter LH750), and the levels of peripheral albumin were measured and analyzed by an automatic blood analyzer (Beckman Coulter AU5800). The definitions of PNI and SII were shown as follows: PNI= albumin (g/L) + 5×total lymphocyte counts(109/L) (26 (link)); SII= platelet × neutrophil/lymphocyte counts (27 (link)).
All patients were recommended to have a follow-up visit every 3 months in the first 2 years, and every 6 months after 2 years. Follow-up methods mainly include telephone encounter, outpatient visits, and hospitalization. The hospital examination items included CT of chest, abdomen, and pelvis, as well as esophagogastroduodenoscopy (EGD) and tumor markers. In this study, the deadline for follow-up was September, 1st, 2021. Overall survival (OS) was defined as the time interval from treatment to cancer-related death or final contact, and OS was the preferred destination. And progression-free survival (PFS) was measured from the time of treatment initiation to clinical or radiographic progression or death from any cause.
Ding P., Yang P., Sun C., Tian Y., Guo H., Liu Y., Li Y, & Zhao Q. (2022). Predictive Effect of Systemic Immune-Inflammation Index Combined With Prognostic Nutrition Index Score on Efficacy and Prognosis of Neoadjuvant Intraperitoneal and Systemic Paclitaxel Combined With Apatinib Conversion Therapy in Gastric Cancer Patients With Positive Peritoneal Lavage Cytology: A Prospective Study. Frontiers in Oncology, 11, 791912.
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Publication 2021
Abdomen Albumins BLOOD Blood Platelets Chest Disease Progression Esophagogastroduodenoscopy Hospitalization Lymphocyte Lymphocyte Count Neutrophil Outpatients Patients Pelvis Pharmacotherapy Platelet Counts, Blood Therapy-Associated Cancers Tumor Markers Veins X-Rays, Diagnostic
4
Prospective Cohort Study of Eosinophilic Esophagitis
We conducted a prospective cohort study at University of North Carolina from July, 2011 through December, 2013. Consecutive adult patients (age 18-80 years) undergoing routine outpatient esophagogastroduodenoscopy (EGD) were approached if they had upper GI symptoms suggestive of esophageal dysfunction (e.g. dysphagia, food impaction, heartburn, reflux, chest pain). Subjects provided informed consent, including consent for future use of stored specimens, and were enrolled prior to the endoscopy. Subjects were excluded if they had a known (prevalent) diagnosis of EoE or a different eosinophilic gastrointestinal disorder (EGID), GI bleeding, active anticoagulation, known esophageal cancer, prior esophageal surgery, known esophageal varices, medical instability or multiple comorbidities precluding enrollment in the clinical opinion of the endoscopist, or inability to read or understand the consent form. This study was approved by the UNC Institutional Review Board and registered on clinicaltrials.gov (NCT 01988285).
Cases were diagnosed with EoE if they met consensus guidelines (1 (link)-3 (link)). Specifically, they were required to have at least one typical symptom of esophageal dysfunction; at least 15 eosinophils per high-power field (eos/hpf) on esophageal biopsy persisting after an 8 week PPI trial (20-40 mg twice daily of any of the available agents, prescribed at the discretion of the clinician); and other causes of esophageal eosinophilia excluded. Of note, baseline data for the EoE cases were obtained after the PPI trial, at the time of the confirmatory EGD, but prior to receiving the histologic results confirming the diagnosis or provision of EoE-specific treatment, so as to minimize potential recall bias. Controls were subjects who, after endoscopy and biopsy, did not meet clinical or histologic criteria for EoE. Subjects with PPI-responsive esophageal eosinophilia (PPI-REE) were not included in this study.
Clinical data were collected using a standardized case report form. Items recorded included demographics, symptoms, concomitant atopic diseases, indications for endoscopy, and endoscopic findings. Food allergy data was collected by patient self-report on a prospectively administered questionnaire, and could therefore include both food allergies and sensitizations. Systematic allergy testing was not a component of this study. During endoscopy, research-protocol esophageal biopsies were obtained (two from the proximal, one from the mid, and two from the distal esophagus) to maximize EoE diagnostic sensitivity (30 (link), 31 ). Gastric and duodenal biopsies were also collected for research purposes to exclude concomitant eosinophilic gastroenteritis. Additional clinical biopsies were taken as indicated at the discretion of the endoscopist. Esophageal eosinophil counts were quantified by the study pathologists using our previously validated methods (32 (link)). In brief, slides were masked to case/control status, digitized, and reviewed with Aperio ImageScope (Aperio Technologies, Vista, CA). Five microscopy fields from each of the five biopsies were examined to determine the maximum eosinophil density (eosinophils/mm2 [eos/mm2]). So results could be compared to prior studies, eosinophil density was converted to an eosinophil count (eos/hpf) using a hpf size of 0.24 mm2, the most commonly reported field size in the literature (33 (link)).
EoE cases were treated for 8 weeks as clinically indicated with topical corticosteroids (either oval viscous budesonide 1 mg twice daily or fluticasone from a multi-dose inhaler, 880 mcg twice daily) (34 (link)-36 (link)). At the end of the treatment period, repeat upper endoscopy with biopsy was performed, with collection of a second set of blood and tissue samples as noted above. A second blood sample was also collected for a subset of control subjects at least 2 months after baseline samples were collected to assess for stability in biomarkers over time.
Dellon E.S., Rusin S., Gebhart J.H., Covey S., Higgins L.L., Beitia R., Speck O., Woodward K., Woosley J.T, & Shaheen N.J. (2015). Utility of a non-invasive serum biomarker panel for diagnosis and monitoring of eosinophilic esophagitis: A prospective study. The American journal of gastroenterology, 110(6), 821-827.
Publication 2015
Adrenal Cortex Hormones Adult Biological Markers Biopsy BLOOD Budesonide Chest Pain concomitant disease Deglutition Disorders Diagnosis Duodenum Endoscopy Endoscopy, Gastrointestinal Eosinophil Eosinophilia Eosinophilic gastroenteritis Esophageal Diseases Esophageal Neoplasms Esophageal Varices Esophagogastroduodenoscopy Esophagus Ethics Committees, Research Fluticasone Food Food Allergy Heartburn Hypersensitivity Impacted Tooth Inhaler Mental Recall Microscopy Operative Surgical Procedures Outpatients Pathologists Patients Stomach Tissues Viscosity
5
Pediatric Ulcerative Colitis Prospective Study

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Publication 2019
Biopsy Child Diagnosis Esophagogastroduodenoscopy Ethics Committees, Research Feces Gene Expression Immunologic Adjuvants Leukocyte L1 Antigen Complex Mesalamine Microbiome North American People Pediatric ulcerative colitis Pentasa Pharmaceutical Preparations Rectum RNA, Ribosomal, 16S Safety Therapeutics Tumor Necrosis Factor-alpha

Most recents protocols related to «Esophagogastroduodenoscopy»

1
Efficacy of FED Monotherapy in EoE
We conducted a mixed methods study in two phases. Phase 1 was a retrospective study aimed at identifying the efficacy of FED monotherapy in EoEPPI+ patients. Phase 2 was a prospective cohort study that investigated patient outcomes after trialing both PPI monotherapy and FED monotherapy using both quantitative and qualitative outcomes. This study has received Institutional Review Board approval.
In Phase 1, we performed a chart review where EoEPPI+ patients who trialed FED monotherapy were identified using the International Classification of Diseases, Tenth Revision (ICD-10), code K20.0 (eosinophilic esophagitis) at a single center from January 2013 until September 2021. From 405 patients identified with the ICD-10 code K20.0, patients were included for chart review and subsequent analysis if they met the following criteria: 1) Diagnosis of EoE was histologically confirmed while not on any treatments for EoE, 2) Achievement of histologic remission of EoE while on at least 8 weeks of PPI monotherapy, and 3) Had repeat esophageal biopsies after trialing FED monotherapy for at least 8 weeks. In our study, histologic diagnosis of EoE was defined by ≥ 15 eos/hpf in esophageal biopsies taken during EGDs. Histologic remission of EoE was our primary endpoint and was defined by ≤ 10 eos/hpf in proximal, middle, and distal esophageal biopsies from EGDs after at least 8 weeks of respective monotherapy treatment. Histoclinical features such as symptoms and peak eosinophil counts were extracted from the electronic medical record. Symptoms were recorded as binary outcomes. Endoscopic reference scores (EREFS) were unavailable for many of the patients, so they were not included in our analysis.
During Phase 2 of our study, patients were enrolled into a prospective cohort on a voluntary basis until September 2021. EoEPPI+, FED− patients resumed PPI monotherapy, while EoEPPI+, FED+ patients could revert to PPI monotherapy, continue FED monotherapy, or switch to FED monotherapy with PPI on an as needed basis. The exploratory option of FED monotherapy with PPI on an as needed basis was offered because these patients were responsive to both PPI monotherapy and FED monotherapy. Therefore, it was plausible that their EoE would remain in histologic remission with this regimen. We measured patient health-care utilization during this follow-up period by recording the number of patients with food impactions requiring urgent EGD and the number of patients who suffered from symptom exacerbation requiring urgent follow-up visit while on their maintenance treatment plan. We also recorded the number of patients that had repeat EGDs for routine monitoring of histologic recurrence of EoE while on maintenance treatment plan, and the number of patients who underwent repeat EGDs for histologic evaluation after trialing other treatment plans.
Sia T., Cunningham E., Miller M., Nitschelm R., Tanaka R., Epstein T., Garrett K., Huang A., Pak D., Scheve A, & Leung J. (2023). Food elimination diet is a viable alternative therapy for eosinophilic esophagitis responsive to proton pump inhibitors. BMC Gastroenterology, 23, 60.
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Publication 2023
Biopsy Diagnosis Endoscopy Eosinophil Esophagogastroduodenoscopy Ethics Committees, Research Follow-Up Care Food Impacted Tooth Infantile Neuroaxonal Dystrophy Patients Recurrence Treatment Protocols
2
Genetic Factors in Upper Gastrointestinal Bleeding
Patients over 18 years old admitted to the hospital complex with signs and symptoms of UGIB and diagnosed by upper digestive endoscopy (UDE) or surgical intervention (laparoscopy) were determined as our study group.
UGIB was defined as: i) presence of endoscopically proven ulcers, perforation, or hemorrhagic erosions and ii) presence of dark or “coffee grounds” vomiting, melena, hematemesis, hematochezia, epidegastric pain, sudden loss, heavy sweating, and/or pallor.
Patient exclusion criteria were (i) bleeding from gastric or esophageal varices or neoplasm; (ii) presence of cirrhosis, Mallory-Weiss tears, and/or Dieulafoy lesions; (iii) serious health condition; (iv) UDE performed after 48 h of hospital admission; (v) hospitalization within 15 days prior to the current hospital admission; and (vi) in-hospital UGIB.
For each recruited case participant, controls were matched by sex, age (±5 years), and recruitment data (3 months). Control participants were admitted to preoperative units of the same hospital complex for mild surgery unrelated to gastrointestinal disorders (i.e., inguinal/umbilical hernia correction; plastic surgery; phacectomy (eye cataract); and prostatectomy).
Participants were recruited regardless of the use of NSAIDs and LDA in order to verify whether the proposed genetic variants are associated with the risk of UGIB or whether there is synergism between the variants and the use of these drugs in the risk of UGIB. Hence, it is essential that both case and control groups include NSAIDs or LDA-exposed and NSAIDs or LDA-unexposed individuals to assess the likely direct effect of functional variants on risk of suffering UGIB (7 (link)).
In order to reduce possible bias, only biologically unrelated participants were included. Participants with history of neoplasia, immunodeficiency syndrome, coagulopathies, nasogastric or percutaneous tube holders; patients who use narcotics; and non-residents of the study region for at least 3 months were excluded.
The inclusion and exclusion criteria for the participants are described in detail in our three previous studies (4 (link), 10 (link), 11 (link)).
Forgerini M., Urbano G., De Nadai T.R., Batah S.S., Fabro A.T, & De Carvalho Mastroianni P. (2023). The role of CYP2C9*2, CYP2C9*3 and VKORC1-1639 variants on the susceptibility of upper gastrointestinal bleeding: A full case-control study. Journal of Pharmacy & Pharmaceutical Sciences, 26, 11136.
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Publication 2023
Anti-Inflammatory Agents, Non-Steroidal Blood Coagulation Disorders Cataract Coffee Esophageal Varices Esophagogastroduodenoscopy Exomphalos Gastrointestinal Diseases Genetic Diversity Groin Hematemesis Hematochezia Hernia, Inguinal Hospitalization Immunologic Deficiency Syndromes Laparoscopy Liver Cirrhosis Mallory-Weiss Syndrome Melena Narcotics Neoplasms Operative Surgical Procedures Pain Patients Pharmaceutical Preparations Plastic Surgical Procedures Prostatectomy Stomach Ulcer Umbilicus
3
Retrospective Analysis of Gastric Biopsies
We retrospectively reviewed patients undergoing esophagogastroduodenoscopy (EGD) with gastric biopsies or H. pylori breath test at Renmin Hospital of Wuhan University (RHWU) between June 2020 and July 2021. We included 1826 patients (881 H. pylori positive and 945 H. pylori negative) for the development of EADHI. Table 1 shows the patient characteristics. Exclusion criteria include (1) patients with a history of GC, peptic ulcer, gastric surgery, or submucosal tumor and (2) patients who received H. pylori eradication or administered antibiotics within a month or proton pump inhibitor within 2 weeks of H. pylori breath test.
EGD was performed using a standard endoscope (GIF-HQ290, GIF-H260; Olympus, Tokyo, Japan; EG-L590ZW; Fujifilm, Tokyo, Japan) and the images were captured during high-definition, white-light examination of the antrum, angularis (retroflex), body (forward and retroflex), and fundus (retroflex). Gastric biopsies were performed in the antrum and body at the endoscopist’s discretion.
Zhang M., Pan J., Lin J., Xu M., Zhang L., Shang R., Yao L., Li Y., Zhou W., Deng Y., Dong Z., Zhu Y., Tao X., Wu L, & Yu H. (2023). An explainable artificial intelligence system for diagnosing Helicobacter Pylori infection under endoscopy: a case–control study. Therapeutic Advances in Gastroenterology, 16, 17562848231155023.
Publication 2023
Antibiotics, Antitubercular Antral Biopsy Breath Tests Endoscopes Esophagogastroduodenoscopy Helicobacter pylori Human Body Light Neoplasms Operative Surgical Procedures Patients Peptic Ulcer Proton Pump Inhibitors Stomach
4
Evaluating Endoscopist Accuracy in H. pylori Detection
A separate testing dataset was developed to evaluate the diagnostic accuracy of EADHI, and compare it with endoscopists. In August 2021, the EGD images (about 24 images per case) of 168 patients (84 H. pylori positive and 84 H. pylori negative) were included as the testing dataset and 71 patients were excluded using the exclusion criteria (Figure 3). Table 1 shows the patient demographics, and there was no overlap between the testing and the development datasets. In all, 10 endoscopists, trained on the Kyoto classification of gastritis16 (link) before assessing cases using PowerPoint presentation, of varying experience blinded to the patients’ H. pylori infection status were independently asked whether a patient was H. pylori positive or H. pylori negative. Four of the 10 endoscopists were classified as follows: ‘expert group’, with EGDs > 5000. The other endoscopists were further classified as the ‘relatively experienced group’, EGDs > 1000 (n = 3); and the ‘beginner group’, EGDs < 1000 (n = 3). All 10 endoscopists were not involved in the selection of the data.
Zhang M., Pan J., Lin J., Xu M., Zhang L., Shang R., Yao L., Li Y., Zhou W., Deng Y., Dong Z., Zhu Y., Tao X., Wu L, & Yu H. (2023). An explainable artificial intelligence system for diagnosing Helicobacter Pylori infection under endoscopy: a case–control study. Therapeutic Advances in Gastroenterology, 16, 17562848231155023.
Publication 2023
Diagnosis Esophagogastroduodenoscopy Helicobacter pylori Infection Patients
5
Evaluating Healthcare Costs in GERD-to-EAC Progression
Patient demographic and clinical characteristics, and all-cause and disease-related HRU and direct healthcare costs, were measured by EAC risk/diagnosis cohort from GERD to EAC. Disease-related outcomes were identified using claims with a diagnosis code, procedure code for a diagnostic test or treatment, or National Drug Code for a treatment for GERD, NDBE, IND, LGD, HGD, or EAC. Healthcare resource utilization included IP admissions, emergency department (ED) visits, and days with OP services (including laboratory tests, imaging, mental health services, drug administration, skilled nursing facilities, and home care/hospice services in addition to office visits [day with office visits excluded other type of OP services during that day]). Direct healthcare costs included total (medical and pharmacy), medical (IP, ED, OP), and pharmacy costs, as well as costs associated with disease-related esophagogastroduodenoscopy (EGD). Costs were evaluated from a payer perspective (ie, amounts reimbursed by the health plan and coordination of benefit), adjusted for inflation using the US Medical Care component of the Consumer Price Index, and reported in 2020 US dollars.19
Sharma P., Falk G.W., Bhor M., Ozbay A.B., Latremouille-Viau D., Guerin A., Shi S., Elvekrog M.M, & Limburg P. (2023). Healthcare Resource Utilization and Costs Among Patients With Gastroesophageal Reflux Disease, Barrett’s Esophagus, and Barrett’s Esophagus-Related Neoplasia in the United States. Journal of Health Economics and Outcomes Research, 10(1), 51-58.
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Publication 2023
Diagnosis Esophagogastroduodenoscopy Gastroesophageal Reflux Disease Health Planning Hospice Care Mental Health Services Office Visits Patients Pharmaceutical Preparations Tests, Diagnostic

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1
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More about "Esophagogastroduodenoscopy"

Esophagogastroduodenoscopy (EGD) is a diagnostic and therapeutic endoscopic procedure that allows for the comprehensive examination of the upper gastrointestinal (GI) tract, including the esophagus, stomach, and duodenum.
This minimally invasive procedure involves the insertion of a flexible, lighted tube called an endoscope through the mouth and down the throat to visually inspect the interior lining of these organs.
EGD is commonly used to evaluate a variety of upper GI symptoms, such as difficulty swallowing (dysphagia), abdominal pain, and gastrointestinal bleeding.
It is a safe and effective tool for the diagnosis and management of numerous upper GI disorders, including gastroesophageal reflux disease (GERD), peptic ulcers, Barrett's esophagus, and upper GI cancers.
In addition to diagnostic capabilities, EGD can also be utilized for therapeutic purposes, such as the treatment of bleeding ulcers, removal of polyps, and the placement of stents or feeding tubes.
Advancements in endoscopic technology, including the EVIS LUCERA SPECTRUM, GIF-H290, and GIF-H290Z models, have enhanced the quality and versatility of EGD procedures.
Patients undergoing EGD are typically given a sedative or anesthetic to ensure comfort and minimize discomfort during the procedure.
The entire process generally takes less than an hour, and most patients are able to return to their normal activities shortly after the procedure is completed.
If you or a loved one are experiencing any upper GI symptoms, consult with your healthcare provider to determine if an EGD may be a appropriate diagnostic or treatment option.
With its ability to provide detailed visualization and facilitate targeted interventions, EGD remains a vital tool in the management of upper gastrointestinal conditions.