Gastroenterology Associates of Central Pennsylvania, PC

1421 Fishburn Road, Hershey PA 17033

Phone: 717-533-2224 Fax: 717-533-2164


PATIENT NAME: __________________________________

Your UPPER ENDOSCOPY (egd) is scheduled for__________________.




An upper endoscopy (also called an esophagogastroduodenoscopy) (egd) is a procedure that allows your physician to examine the lining of your esophagus and stomach. In order for the upper endoscopy (egd) to be thorough and safe it is important that you follow the directions listed below. If you have any questions, please call our office at 533-2224.


1. After midnight, NOTHING TO EAT OR DRINK.

     No smoking

     No hard candy, breathe mints, lozenges, chewing gum


2. Medications:

     Prescribed cardiac and anti-hypertensive (blood pressure) medications should be taken with a sip of water the morning of the procedure

     Diabetics-hold morning oral hypoglycemic agents and only self-administer of the usual morning insulin dose

     If taking Coumadin, ask for special instructions

3. Transportation: You MUST have a responsible person drive you home after the test is completed. You MAY NOT walk, take a taxi, bus or any other form or public transportation.

4. Special Instructions: _________________________________________________________________

Reviewed w/patient ____________________________________ Date ________________