Upper Endoscopy

Upper Endoscopy (also known as gastroscopy, EGD, or esophagogastroduodenoscopy) is a procedure that enables your doctor to examine the lining of the esophagus (swallowing tube), stomach and duodenum (first portion of the small intestine). A flexible, lighted tube about the thickness of your little finger is placed through your mouth and into the stomach and duodenum.

Why do an upper endoscopy?
What preparation is required?
What can I expect during the upper endoscopy?
What happens after upper endoscopy?
What complications can occur?

Why do an upper endoscopy?

Upper endoscopy is performed to evaluate symptoms of persistent upper abdominal pain, nausea, vomiting, difficulty swallowing or heartburn. It is an excellent method for finding the cause of bleeding from the upper gastrointestinal tract. It is more accurate than x-rays for detecting inflammation, ulcers or tumors of the esophagus, stomach and duodenum. Upper endoscopy can detect early cancer and can distinguish between cancerous and noncancerous conditions by performing biopsies of suspicious areas. These are then sent to the laboratory to be analyzed. A biopsy is taken for many reasons and does not mean that cancer is suspected.

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What preparation is required?

The stomach should be completely empty. You should have nothing to eat or drink for approximately eight hours before the examination. Your doctor will be more specific about the time to begin fasting depending on the time of day that your test is scheduled.

Medication may need to be adjusted or avoided. It is therefore best to inform your doctor of all your current medications as well as any allergies to medications a few days prior to the examination. Also, if you have any major diseases, such as heart or lung disease that may require special attention during the procedure, discuss this with your doctor.

You will most likely be sedated during the procedure and an arrangement to have someone accompany you home afterward is imperative. Sedatives will affect your judgment and reflexes for the rest of the day. You should not drive or operate machinery until the next day. See preparation instructions.

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What can I expect during the upper endoscopy?

You may have your throat sprayed with a local anesthetic before the test begins and be given medication through a vein to help you relax during the examination. You will lie on your side in a comfortable position as the endoscope is gently passed through your mouth and into your esophagus, stomach and duodenum. The procedure usually lasts 15-20 minutes. The endoscope does not interfere with your breathing. Most patients fall asleep during the procedure. A few find it only slightly uncomfortable.

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What happens after upper endoscopy?

You will be monitored in the recovery area for about an hour until the effects of the sedatives have worn off. Your throat may be a little sore for a day or two. You may feel bloated immediately after the procedure because of the air that is introduced into your stomach during the examination. You will be able to resume your diet and take your routine medication after you leave the endoscopy center, unless otherwise instructed. Your doctor will usually inform you of your test results on the day of the procedure, unless biopsy samples were taken. These results take about five days to return. The effects of sedation may make you forget what you were told and you should call your doctor’s office for follow-up or instructions, if you were not given any.

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What complications can occur?

Gastroscopy and biopsy are very safe when performed by doctors who have had special training and are experienced in these endoscopic procedures. Complications are rare. However, they can occur and include bleeding from the site of a biopsy or polypectomy and a tear (perforation) through the lining of the intestinal wall. Blood transfusions are rarely required. A reaction to the sedatives can occur. Irritation to the vein where medications were given is uncommon, but may cause a tender lump lasting a few weeks. Warm, moist towels will help relieve this discomfort. It is important for you to recognize the early signs of possible complications and to contact your doctor if you notice symptoms of difficulty swallowing, worsening throat pain, chest pains, severe abdominal pain, fever, chills or rectal bleeding of more than half a cup.

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