The need for rapid, accurate, and cost-effective diagnosis of common complaints that arise from the upper gastrointestinal (GI) tract has caused many primary care physicians to add diagnostic esophagogastroduodenoscopy (EGD) to the armamentarium of procedures that they offer in their offices.

The use of a scope to visualize the upper GI tract began with Kussmaul's passage of a rigid tube into the stomach of a sword swallower in 1868. From that time until the 1930s rigid esophagogastroscopy provided the only available nonsurgical method of viewing parts of the upper GI tract. The rigid procedure had a high risk of perforation and other complications. In 1932 Schuidder and Wolfe introduced a semiflexible gastroscope that substantially decreased the risk of esophageal perforation. By the late 1950s several companies had developed a fully flexible fiberoptic upper GI endoscope that provided much better visibility of a larger portion of the GI anatomy. Finally, during the past 25 years, better illumination techniques and high-quality video cameras have been added to the equipment, making EGD a highly effective diagnostic procedure.<sup>6 Coleman W.H. Introduction to EGD Esophagogastroduodenoscopy: A Syllabus for the Family Physician Interested in Performing This Procedure Kansas City: American Academy of Family Physicians (1994).  1-3

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