Upper Endoscopy (EGD)

What is an upper endoscopy?

Upper endoscopy (EGD) examines the esophagus, stomach, and duodenum to diagnose and treat upper GI tract disorders. It investigates symptoms like abdominal pain, difficulty swallowing, prolonged nausea & vomiting, heartburn, unexplained weight loss, anemia, or blood in your bowel movements. Discuss your doctor’s reasons for performing the test, which should be conducted by specially trained doctors, nurses, and technicians.

Anesthesia Conscious sedation is typically used. This involves a combination of a sedative to help you relax and a local anesthetic to numb the throat. This allows you to remain comfortable and drowsy during the procedure without experiencing significant pain or discomfort.
Duration Procedure typically takes between 10 to 30 minutes to complete.
Treatment Ambulatory
Covered by insurance Yes                                                                         
Work stopping None
sports stop A few days
Post-operative follow-up Limit physical activities. Massage of the area and wearing of compression garments recommended for 1 week
Risks EGD risks, although rare, include sedation reactions, bleeding, infection, and gastrointestinal perforation. There is also a small chance of aspiration and temporary sore throat or discomfort. Discuss these risks with your healthcare provider before the procedure.

Before Procedure

Your doctor will review the procedure, address questions, and inquire about allergies or health issues before you sign a consent form. Avoid food, drink, antacids, aspirin, and ibuprofen for 24 hours before the test. “Conscious sedation” is used, causing relaxation and amnesia. Avoid driving and signing legal documents until the next day; arrange a ride home.


After signing consent, you’ll wear a hospital gown, remove eyewear and dentures, and receive an IV. In the procedure room, you’ll lie on your right side, and a numbing anesthetic will be sprayed in your mouth. Monitors track vital signs during the procedure.


Once sedated, the doctor inserts the endoscope with a camera through a mouthguard. The doctor maneuvers the scope, examining the esophagus, stomach, and duodenum, using air and instruments as needed. Gagging is brief, and you won’t feel diagnostic or treatment actions.


The entire procedure lasts 10-30 minutes.

After the Procedure

Endoscopic advances enable the non-surgical treatment of gut diseases. During EGD, varices, ulcers, and abnormal blood vessels causing bleeding can be treated by injection, cauterization, or banding. Foreign objects, strictures, and blockages can be removed, dilated, or bypassed with stents. In some cases, a percutaneous endoscopic gastrostomy (PEG) tube is placed for feeding. Discuss other possible therapies with your doctor before the procedure.

Diagnosis at EGD

Diagnosis often comes from observing upper GI tract abnormalities, but biopsies or cell samples may be necessary to confirm or determine causes. Biopsies help identify inflammation, ulcers, bacteria, nodules, masses, or tumors, and can distinguish between benign and malignant growths. Some biopsies are taken for microscopic evidence of gut diseases, even if the lining appears normal.

Adverse Effects

Reaction to sedation. Patients may experience side effects from the sedative medication used, such as drowsiness, dizziness, or allergic reactions.


Bleeding may occur, especially if biopsies or therapeutic interventions are performed during the procedure.


Infection. There is a low risk of infection from the procedure, but it can still occur.


Perforation. In rare cases, a tear or perforation may occur in the gastrointestinal tract, which may require surgery to repair.


Aspiration. There is a small risk of food or saliva entering the lungs during the procedure, potentially causing aspiration pneumonia.


Sore throat or discomfort. Patients may experience a sore throat or mild discomfort in the throat following the procedure.


It’s important to note that complications from EGD are rare, and the procedure is generally considered safe. However, if you experience severe pain, fever, persistent vomiting, or difficulty breathing after an EGD, contact your healthcare provider immediately.

Physician Ownership Disclosure

Physician Ownership Closure

The partners listed below make up the partnership of The Center for Special Surgery. An interest in this facility enables them to have a voice in the Administration and Medical Policy of this health care institution. This involvement helps to ensure the finest quality surgical care for their patients.

  • Dr. Ronald A. Ahloy

Some of the physicians also perform surgery at other surgical facilities in North Hawaii Community Hospital. If you have a preference of where your ambulatory procedure is performed, please let us know. Special emphasis is place on patient feedback so that we can treat you professionally and courteously at all times


Patient Rights and Responsibilities

Patient Rights and Responsibilities

You have the right…

  1. To have The Center for Special Surgery at TCA respond to your requests and needs for treatment or service provided that the space is available, and to receive the care that reflects your interests and that has been determined by your physician, and respects your advance directives or your rights to formulate advance directives.
  2. To be informed of the right to care that is respectful, recognizes dignity and is private to the extent possible.
  3. To have patient information treated confidentially, based on applicable laws and regulations.
  4. To be involved in making decisions regarding your care, including assessment and management of pain.
  5. To be given information in the language you understand or to have information interpreted.
  6. To give informed consent, that is, to make decisions in collaboration with your physician that involve your health care. Consent may be given by the patient or the patient’s legal representative. In order to give consent, the patient will be provided information to include:
    1. An explanation of recommended treatments or procedures in terms that are understandable.
    2. An explanation of the risks and benefits of treatment, including the chance of success, mortality risk and serious side-effects.
    3. An explanation of the alternatives and the risks and benefits of such.
    4. An explanation of the likely consequences if no treatment is pursued.
    5. An explanation of the recuperative period, including anticipated problems and anticipated length of recuperation.
    6. An explanation that the patient or his/her legal representative is free to withdraw consent and discontinue participation in treatment.
    7. A disclosure statement that the patient’s physician is participating in teaching, research, experimental or education projects relating to the patient’s case.
  7. To an explanation of admission procedures, which shall include disclosure upon admission, of the facility’s policy statement on patient rights, which shall include:
    1. The right to participate in all decisions involving care or treatment, consistent with state and federal statutes.
    2. . The right to refuse any drug, test, treatment, procedure or treatment consistent with the state and federal statutes, including likely medical consequences of such refusal.
    3. The right to receive considerate and respectful care in a clean and safe environment, free of unnecessary restraint.
    4. The right to be informed of the facility’s rules and regulations applicable to the patient.
    5. The right to be informed of the facility’s grievance procedure. The Administrator may be reached by calling 210-858-7066.
    6. The right to file a grievance with the appropriate state agency *, accrediting body**, or CMS (Medicare)***.
  8. To know name, professional status and experience of the staff providing care or treatment.
  9. To be informed prior to the initiation of general billing procedures.
    1. Prior to the initiation of non-emergency treatment, upon request, the patient has the right to be informed of routine, usual and customary charges or estimated charges for service based on an average patient with diagnosis similar to the tentative admission diagnosis of the patient.
    2. If you have questions, please call 210-858-7083 for medical cost information between the hours of 8:00am and 5:00pm on weekdays.
    3. Based upon insurance information provided by the patient, the facility shall provide assistance as needed with estimates of co-payments, deductibles or other charges that must be paid by the patient. Such assistance may be obtained weekdays between 8:00am and 5:00pm by calling the facility business office manager.
    4. The facility may include a disclaimer with the disclosure of any charges. Such disclaimer may include further variables, which may alter any disclosed charge. Any charges prohibited by law or third party payor contract will include a no charge disclaimer in the disclosure.
  10. To be provided with information regarding teaching, research, educational or experimental projects related to your care. You have the right to refuse to participate in such projects.
  11. To have your medical records maintained in confidence and in accordance with the medical staff bylaws, rules and regulations. You have the right to have access to your medical record by contacting the facility.

*Texas Department of State Health Services – Facility Licensing Group – (888) 973-0022

**Accreditation Association for Ambulatory Health Care – (847) 853-6060

*** Medicare Beneficiary Ombudsman – CMS website


You have the responsibility…

  1. To provide the facility with accurate and complete information about your present complaints and your past health history.
  2. To be considerate of other patients, physicians and facility personnel. To show respect for the belongings of others and facility property.
  3. To discuss your health problems with only those involved in your care.
  4. To request your records through the facility.
  5. To inquire as to the name and purpose of any personnel caring for you.
  6. To say whether or not you understand a contemplated course of treatment and your obligations in the administration of the treatment.
  7. To cooperate with any research or experimental project in which you consent to participate.
  8. To inform the staff that translation is required.
  9. To provide the facility with the necessary information for insurance processing and to be prompt in payment of facility bills.
  10. To be cooperative during recommended treatment.

After the Procedure

Diagnosis often comes from observing upper GI tract abnormalities, but biopsies or cell samples may be necessary to confirm or determine causes. Biopsies help identify inflammation, ulcers, bacteria, nodules, masses, or tumors, and can distinguish between benign and malignant growths. Some biopsies are taken for microscopic evidence of gut diseases, even if the lining appears normal.


Ron Ahloy

Dr. Ron Ah Loy, M.D., AFAG, FACP, a Big Island native, is the owner and CEO of Big Island Gastroenterology and Endoscopy Center. Graduating from the University of Hawaii’s John A. Burns School of Medicine in 1978, he completed his residency and fellowship before returning to Hilo to practice Internal Medicine and Infectious Diseases.


In 1990, he shifted his focus to Gastroenterology after completing a two-year fellowship at the University of California, San Diego.

Dr. Ah Loy has practiced on the Big Island since 1983, specializing in Gastroenterology since 1992. He holds board certifications in Internal Medicine, Infectious Disease, and Gastroenterology and is a member of numerous professional associations. Dr. Ah Loy and his wife Marva have seven children and thirteen grandchildren, and he enjoys surfing, swimming, guitar, ranch work, and spending time with his grandkids.

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