Upper Endoscopy

Also called an EGD or gastroscopy, an upper endoscopy uses a thin scope, called an endoscope, to look inside the upper digestive system of the esophagus, stomach and the first part of the small intestine. The endoscope, which has a light and camera at its tip, is passed through the mouth and down the throat to the esophagus. It may also have a small biopsy instrument to remove tissue that is then checked under a microscope for abnormalities.

What to Expect: During the Screening

You will be given a sedative, and a local anesthetic may be sprayed into your mouth to suppress the gag reflex when the endoscope is inserted. A mouth guard will be inserted to protect your teeth as well as the endoscope. Dentures must be removed.

In most cases, an IV will be inserted into the arm to administer sedation and any medications that might be needed. You will lie on your left side and, after the sedative has taken effect, the endoscope will be gently guided through the esophagus to the stomach and the beginning of the small intestine. Air will be introduced through the endoscope to enhance viewing. The physician will examine the lining of the esophagus, stomach and upper small intestine, and perform any necessary biopsies at the same time. You will not feel the biopsies.

The actual test lasts about 10 to 15 minutes. After the procedure you may feel a sensation of gas. Because of the intravenous sedation, you most likely will not feel any discomfort and may have no memory of the test. After the test, food and liquids will be restricted to prevent choking until the anesthetic wears off and the gag reflex returns.

What can be found?

An upper endoscopy can help determine causes for heartburn, the presence of hiatus hernias, the cause of abdominal pain, unexplained anemia, the cause of swallowing difficulties, upper GI bleeding and the presence of tumors or ulcers.

How to Prepare

The stomach must be empty for the procedure to be thorough and safe, so you must refrain from eating about 6 to 12 hours before the test. You may also be told to stop aspirin and other blood-thinning medications for several days before the test. You should arrange for someone to take you home after the procedure because the sedation will make it unsafe for you to drive. Your physician may give other special instructions.

Reasons for Upper Endoscopy

  • Reflux
  • Chronic heartburn (for more than 5 years)
  • Motility issues
  • Barret’s screening
  • Trouble swallowing

Risks and Complications

An upper endoscopy is generally a low-risk procedure. However, complications include but are not limited to the following:

  • Perforation: Instruments may injure the GI tract wall, with possible leakage of GI contents into the body cavity. If this occurs, hospitalization or surgery may be required.
  • Bleeding: Biopsies, removal of polyps, or dilation can cause bleeding. Managing this complication may include careful observation, hospitalization, transfusions, and/or a surgical operation.
  • Infection: Entry of stomach contents into the lungs may cause pneumonia. Infection of the heart valve may occur on rare occasions.
  • Missing: Polyps or significant tumors may be overlooked.
  • Drug Reaction: Reactions to medications received before, during or after your procedure can cause nausea, vomiting, weakness, dizziness, lightheadedness and/or loss of consciousness, skin rash, itching, shallow breathing, decreased rate or absence of breathing, cardiac rhythm changes or cardiac arrest.
  • Other Risks: Additional risks include reactions and complications from diseases you may already have. Instrument failure and death are extremely rare but remain remote possibilities.