An upper endoscopy (EGD) uses a flexible tube with a camera to examine the lining of the esophagus, stomach, and the first part of the small intestine. This procedure requires the upper digestive tract to be completely empty for a clear view and patient safety. Following preparation guidelines, especially regarding consumption the night before, is necessary for accurate results. Adhering to dietary restrictions also reduces the risk of complications associated with sedation.
The Final Solid Meal
The last solid food you consume must be timed carefully, typically 8 to 12 hours before your scheduled procedure. This meal should be light and low in both fat and fiber to ensure rapid clearance from the stomach. Easily digestible options include simple starches like white toast or crackers, plain white rice, or a small portion of lean protein such as baked or grilled chicken or fish.
Consuming a heavy or fatty meal can slow down gastric emptying, potentially leaving residual food that obstructs the endoscopist’s view. Strictly avoid high-fiber foods, including nuts, seeds, raw fruits, and vegetables, as these take longer to digest. Red meat and fried foods should also be avoided due to their high-fat content.
Navigating the Clear Liquid Phase
After the final solid meal cutoff, you must switch exclusively to a clear liquid diet, which typically lasts until a few hours before the procedure. A clear liquid is defined as any liquid you can see through that leaves no solid residue in the digestive tract. This phase maintains hydration while ensuring the gastrointestinal tract remains empty for optimal visualization.
Acceptable clear liquids include:
- Plain water.
- Clear fruit juices without pulp (e.g., apple or white grape).
- Clear broth (e.g., chicken or beef bouillon).
- Clear sodas (e.g., ginger ale or Sprite).
- Plain gelatin.
- Popsicles (without fruit pieces or dairy).
- Black coffee or tea (no milk, creamer, or non-dairy substitutes).
It is crucial to avoid any liquids with red, purple, or blue food dyes, as these pigments can stain the digestive lining and be mistaken for blood during the examination.
Strict Fasting Requirements
The final phase of preparation is the absolute cessation of all intake, known as the NPO (“nothing by mouth”) period. This strict fasting is mandatory for patient safety and typically begins six to eight hours before the scheduled endoscopy time. Even water must be stopped within a few hours of the exam.
The primary reason for strict fasting is preventing pulmonary aspiration, a serious complication that occurs when stomach contents enter the lungs during sedation. Since anesthesia temporarily suppresses the protective gag reflex, any remaining fluid or food can be regurgitated and inhaled. Patients should only take necessary prescription medications (e.g., for heart or blood pressure) with a minimal sip of water, and only after specific instruction from their physician.