An upper gastrointestinal endoscopy (EGD) uses a flexible tube passed through the mouth to examine the esophagus, stomach, and small intestine. Since the endoscope enters through the mouth and throat, patients often wonder if a stuffy nose or seasonal allergies will interfere with the process. A mild, uncomplicated stuffy nose usually does not require cancellation, but the decision to proceed is always medical, as the procedure involves sedation that affects breathing.
Minor Congestion Versus Severe Illness
The distinction between a manageable symptom and a reason for rescheduling lies in the severity and nature of the illness. A minor head cold, characterized by a clear, runny nose and mild throat irritation without a fever, is often safe enough to proceed. These symptoms are not associated with increased complications during sedation.
However, signs of a systemic illness or a lower respiratory tract infection necessitate rescheduling. Symptoms requiring cancellation include a fever above 100.4°F, a deep chest cough, or thick, colored mucus. These signs suggest an active infection and introduce risk of aspiration pneumonia or respiratory compromise under sedation.
How Nasal Congestion Affects Sedation and Airway Management
Most upper endoscopies are performed under conscious or deep sedation, utilizing medications like Propofol that suppress the respiratory drive. Since a bite block is placed in the mouth and the endoscope occupies the oropharynx, the patient must rely on their nose for effective breathing. The medical team delivers supplemental oxygen via a nasal cannula to prevent oxygen desaturation (hypoxia) during sedation.
Nasal congestion compromises this delivery, as a blocked passage prevents oxygen flow into the lungs. Sedation also relaxes upper airway muscle tone, increasing the risk of airway collapse compounded by thick mucus. This combination significantly increases the chance of a dangerous drop in blood oxygen saturation levels during the procedure.
Essential Pre-Procedure Communication
If you wake up with any symptoms of a cold or congestion, you must contact the facility or physician’s office before the day of the procedure. Do not wait until your appointment time to inform the staff, as this may lead to immediate cancellation. When you call, be prepared to provide details about the onset of symptoms, the presence of a fever, and the nature of any cough or mucus.
The medical team may approve the use of certain, non-sedating decongestants to help clear nasal passages. Simple saline nasal sprays are often well-tolerated and can improve nasal patency without medical risk. However, you must get explicit permission before taking any over-the-counter decongestants, including sprays like oxymetazoline, as some ingredients can interact with sedation medications or affect blood pressure.