An upper endoscopy is a diagnostic test that allows a doctor to examine the upper portion of the gastrointestinal (GI) tract, including the esophagus (the muscular tube that connects the throat to the stomach), stomach, and duodenum (the top of the small intestine). It is also called upper GI endoscopy or esophagogastroduodenoscopy (EGD).
An endoscope (a thin, flexible tube with a light and a small video camera on the end) is inserted into the mouth, down the throat, and into the esophagus to look for tumors or other abnormalities. The doctor views the image on a video monitor. During this procedure, the doctor can remove polyps or other tissue for examination. When the examination is complete, the endoscope is slowly removed from the body.
The medical team
An endoscopy is performed in a doctor's office, GI clinic, or hospital. Many specialists can perform an endoscopy, but a gastroenterologist (a doctor who specializes in the GI tract) is the specialist who most often performs this procedure.
Questions to ask your doctor
Before having an endoscopy, consider asking your doctor the following questions:
- Who will perform the endoscopy, and who else will be in the room?
- What will happen during the endoscopy?
- How long will the procedure take?
- Will it be painful?
- Will I be given any type of anesthesia or sedation?
- What are the risks and benefits of having an endoscopy?
- When and how will I learn the results?
- Who will explain the results to me?
- What further tests will be necessary if the test results indicate cancer?
Preparing for the procedure
When you schedule the examination, you will get detailed instructions on how to prepare.
Tell your doctor about all medications you are taking, as well as vitamin supplements and over-the-counter antacids, and ask whether you should take your regular medications on the day of the examination. Review with your doctor any drug allergies or other medical conditions you have.
Because your stomach and duodenum must be completely empty, you should not eat or drink anything, including water, for up to eight hours before your endoscopy. Ask the doctor or nurse about these restrictions.
Your doctor might also tell you not to take aspirin or other over-the-counter pain medications for seven days before the exam; these products can increase the risk of bleeding during the procedure.
During the procedure
An endoscopy usually takes 20 to 30 minutes to complete. Before the procedure begins, you will take off your shirt and put on a hospital gown. If you wear dentures, you may be asked to remove them. You may be given pain medicine and a sedative through an intravenous (IV) needle in your arm. This will help you relax and reduce the discomfort you might otherwise feel during the endoscopy. You may feel a slight stinging where the IV needle is inserted.
At the beginning of the exam, your throat may be sprayed with a local anesthetic to numb the area, or you may be given an anesthetic medication to gargle. This will help prevent gagging. The doctor may also insert a mouthpiece to hold your mouth open during the exam.
You will lie on your side or on your back on an examining table. As the doctor inserts the endoscope, you will feel pressure through your esophagus. You will be able to breathe on your own throughout the exam. Taking slow, deep breaths through your nose will help you relax. Many patients sleep through the procedure.
The endoscope inflates your stomach by blowing air into it; this provides the doctor a better view of the stomach lining. If the doctor finds an abnormality, he or she may remove a tissue sample for examination (a biopsy ). This usually does not cause pain. If it causes bleeding, the doctor can stop the bleeding using tools passed through the endoscope.
When the examination is completed, the endoscope will be slowly removed from your body, and you will go to a recovery room.
Generally, the pain medicine and sedative you receive during the endoscopy should limit the amount of discomfort you feel during the procedure. Afterward, your throat may feel sore and you may have bloating or cramping because of the air blown into your stomach. You may also feel discomfort from lying still for an extended period of time.
Although rare, there is also the risk that the endoscope could puncture the stomach wall.
After the procedure
You will stay at the doctor's office or GI facility for up to two hours while the effects of the sedative wear off, and you will need a ride home. The doctor or nurse will tell you how soon you can eat or drink. You can expect to resume your normal activities the day after your endoscopy.
If you have a sore throat, you can gargle with salt water to relieve the discomfort. If you feel severe throat, chest, or abdominal pain or have a fever or trouble swallowing, call your doctor immediately.
Last Updated: February 23, 2011