Upper Gastrointestinal (GI) Endoscopy

Upper GI endoscopy (also referred to as endoscopy, gastroscopy, upper endoscopy, EGD or esophagogastroduod endoscopy). is a procedure in which a doctor uses an endoscope—a flexible tube with a camera—to see the lining of your upper gastro-intestinal (GI) tract.

Why has your doctor requested this procedure?

Doctors use upper GI endoscopy to help diagnose and treat symptoms and conditions that affect the esophagus, stomach, and upper intestine or duodenum.

Upper GI endoscopy can help find the cause of unexplained symptoms, such as

• persistent heartburn
• bleeding
• nausea and vomiting
• pain
• problems swallowing
• unexplained weight loss

Upper GI endoscopy can be used to identify many different diseases:

• gastroesophageal reflux disease
• ulcers
• cancer
• inflammation, or swelling
• precancerous abnormalities such as Barrett’s esophagus
• celiac disease
• strictures or narrowing of the esophagus
• blockages

Upper GI endoscopy can check for damage after a person eats or drinks harmful chemicals.

During upper GI endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to obtain a small piece of tissue for testing. Biopsies are needed to diagnose conditions such as

• cancer
• celiac disease
• gastritis

Doctors also use upper GI endoscopy to

• treat conditions such as bleeding from ulcers, esophageal varices, or other conditions
• dilate or open up strictures with a small balloon passed through the endoscope
• remove objects, including food, that may be stuck in the upper GI tract
• remove polyps or other growths
• place feeding tubes or drainage tubes

Doctors are also starting to use upper GI endoscopy to perform weight loss procedures for some people with obesity.

What happens during the procedure?

A doctor performs an upper GI endoscopy in a hospital or an outpatient center. Before the procedure, you will likely get a sedative or a medicine to help you stay relaxed and comfortable during the procedure. The sedative will be given to you through an intravenous (IV) needle in your arm. In some cases, the procedure can be done without getting 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.

You’ll be asked to lie on your 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.

During the upper GI endoscopy, the doctor may

• take small samples of tissue, cells, or fluid in your upper GI tract for testing.
• stop any bleeding.
• perform other procedures, such as opening up strictures.

The procedure is quick and usually takes between 15 and 30 minutes. The endoscope does not interfere with your breathing, and many people fall asleep during the procedure.

What do you need to do?

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

• aspirin or medicines that contain aspirin
• arthritis medicines
• blood thinners
• blood pressure medicines
• diabetes medicines
• nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen

You can take most medicines as usual, but you may need to adjust or stop some medicines for a short time before your upper GI endoscopy. Your doctor will tell you about any necessary changes to your medicines before the procedure.

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.

Are there risks to the procedure?

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
• perforation in the lining of your upper GI tract
• an abnormal reaction to the sedative, including breathing or heart problems

Bleeding caused by the procedure often is minor and stops without treatment. Serious complications such as perforation are uncommon. Your doctor may need to perform surgery to treat some complications. Your doctor can also treat an abnormal reaction to a sedative with medicines or IV fluids during or after the procedure.

• chest pain
• problems breathing
• problems swallowing or throat pain that gets worse
• vomiting—particularly if your vomit is bloody or looks like coffee grounds
• pain in your abdomen that gets worse
• bloody or black, tar-colored stool
• fever