Upper endoscopy or EGD (esophagogastroduodenoscopy) is the diagnostic modality of choice for upper abdominal symptoms that suggest ulcer, stomach inflammation or reflux. These procedure allows the doctor to look into the esophagus, stomach and duodenum. Biopsies can be taken if necessary. It is done as outpatient using some type of sedation.  Gastritis, esophagitis, duodenitis or ulcers are the most common diagnoses encountered.  Also tumors in these areas can be diagnosed and biopsied.

Stomach surgery is done mainly for a tumor.  Now a days patients are less likely to require surgery for ulcer disease due to the broad use of PPI (proton pump inhibitors) and anti acids that treat ulcers so well. Another surgery that is done in the stomach is the Nissen fundoplication. Thi consists of a wrap around the esophagus. It is an operation used to prevent reflux that is refractory to medical therapy. This operation can be done laparoscopically or robotically (small cuts) also which is the preferred method today. The operation is done under anesthesia and the pt is required to stay in the hospital a few days.  See the reflux section.

The risks of upper endoscopy are bleeding, infection and perforation.

The risks of stomach surgery are bleeding, infection, perforation, leak of anastomosis if a resection of the stomach is done.

The risks of Nissen fundoplication are the same as stomach surgery and also narrowing of the esophagus, break down of the wrap, difficulty swallowing and recurrence of symptoms.