What is upper gastrointestinal (GI) endoscopy?
Upper GI endoscopy is a procedure in which a gastroenterologist uses an endoscope—a flexible tube with a camera—to diagnose and treat conditions that affect the lining of your upper GI tract– the esophagus, stomach, and first part of the small intestine (duodenum).
Upper endoscopy is more accurate than X-rays for detecting abnormal growths such as cancer and for examining the inside of the upper digestive system. In addition, abnormalities can be treated through the endoscope. For example:
- Polyps (growths of tissue in the stomach) can be identified and removed, and tissue samples (biopsies) can be taken for analysis.
- Narrowed areas (strictures) of the esophagus, stomach, or duodenum from cancer or other diseases can be dilated or stretched using balloons or other devices. In some cases, a stent (a wire or plastic mesh tube) can be put in the stricture to prop it open.
- Objects stuck in the esophagus or stomach can be removed.
- Bleeding due to ulcers, cancer, or varices can be treated.
Why do doctors use upper GI endoscopy?
The endoscopy will be performed as an outpatient procedure, and it is commonly used to help identify and sometimes treat:
- Abdominal or chest pain
- Nausea and vomiting
- Persistent heartburn
- Swallowing problems
- Unexplained weight loss
- To diagnose Achalasia
How Do I Prepare for an Upper Endoscopy?
Prior to your procedure, you should talk with your doctor about your medical history, including medical conditions and symptoms you have, allergies, and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including medicines for:
- Blood pressure
- Blood thinners (including aspirin or medicines that contain aspirin)
- Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen
Also, tell your doctor if you have:
- Ever been told you need to take antibiotics before a dental or surgical procedure
- Ever had endocarditis (an infection of the heart valves)
- An artificial heart valve
- Rheumatic heart disease
If you have any of these conditions or devices, you may need to take antibiotics before the upper endoscopy.
Arrange for a ride home
For safety reasons, you can’t drive for 24 hours after the procedure, as the sedatives used during the procedure need time to wear off. You will need to make plans for getting a ride home after the procedure.
Do not eat or drink before the procedure
To see your upper GI tract clearly, your doctor will most likely ask you not to eat or drink up to 8 hours before the procedure.
What Happens During an Upper Endoscopy?
Your gastroenterologist will perform the upper GI endoscopy in an outpatient surgery center. Before your gastroenterologist performs an upper endoscopy, he or she will explain the procedure in detail, including possible complications and side effects. The doctor will also answer any questions you may have. You will likely get a sedative through an intravenous (IV) needle in your arm to help you stay relaxed and comfortable during the procedure. In some cases, the procedure can be done without a sedative. You may also be given a liquid medicine to gargle or a spray to numb your throat and help prevent you from gagging during the procedure. The health care staff will monitor your vital signs and keep you as comfortable as possible.
A mouthpiece will be placed in your mouth. You’ll be asked to lie on your left side on an exam table. The doctor will carefully pass the endoscope down your esophagus and into your stomach and duodenum. A small camera mounted on the endoscope will send a video image to a monitor, allowing close examination of the lining of your upper GI tract. The endoscope pumps air into your stomach and duodenum, making them easier to see. Most procedures take 15 to 30 minutes. The endoscope does not interfere with your breathing, and many people fall asleep during the procedure.
What Happens After the Upper Endoscopy?
- You will stay in a recovery room for at least 30 minutes for observation.
- You—or a friend or family member who is with you if you’re still groggy—will receive instructions on how to care for yourself when you are home. You should follow all instructions.
- Your gastroenterologist will discuss the results with you after the procedure, and they will send test results to your referring provider. If the results indicate that prompt medical attention is needed, the necessary arrangements will be made and your referring provider will be notified.
- Rest at home for the remainder of the day.
- You may have bloating or nausea for a short time after the procedure.
- You may feel a temporary soreness in your throat for 1-2 days. Lozenges may help.
- Go back to your normal diet once swallowing returns to normal.
What are the risks of an upper G.I. endoscopy?
Upper GI endoscopy is considered a safe procedure. The risks of complications from an upper GI endoscopy are low, but may include:
- Bleeding from the site where the doctor took the tissue samples or removed a polyp
- An abnormal reaction to the sedative, including breathing or heart problems
- Perforation in the lining of your upper GI tract (rare)
Bleeding caused by the procedure often is minor and stops without treatment. Serious complications such as perforation are uncommon. Your gastroenterologist may need to perform surgery to treat some complications. Your gastroenterologist can also treat an abnormal reaction to a sedative with medicines or IV fluids during or after the procedure.
Seek Care Right Away
If you have any of the following symptoms within 72 hours after an upper GI endoscopy, seek medical care right away:
- A continuous cough or fever
- Chest pain
- Problems breathing
- Problems swallowing or throat pain that gets worse
- Vomiting—particularly if your vomit is bloody or looks like coffee grounds
- Severe abdominal pain
- Bloody or black, tar-colored stool