What is Upper Endoscopy? Purpose, Procedure & Results

Upper endoscopy is a medical procedure that lets your doctor see inside your upper digestive tract using a thin, flexible tube with a camera. This safe and commonly performed test helps diagnose problems in your esophagus, stomach, and the first part of your small intestine called the duodenum.

The procedure is also called EGD, which stands for esophagogastroduodenoscopy. While the name sounds complicated, the test itself is straightforward and typically takes just 15 to 30 minutes to complete.

What is upper endoscopy?

Upper endoscopy is a diagnostic procedure where a gastroenterologist uses a special instrument called an endoscope to examine your upper digestive system. The endoscope is a thin, flexible tube about the width of your pinky finger that contains a tiny camera and light at its tip.

During the procedure, your doctor gently guides this tube through your mouth, down your throat, and into your esophagus, stomach, and duodenum. The high-definition camera sends real-time images to a monitor, allowing your doctor to see the lining of these organs clearly and identify any abnormalities.

This direct visualization helps doctors diagnose conditions that might not show up clearly on X-rays or other imaging tests. The endoscope can also be equipped with small tools to take tissue samples or perform minor treatments if needed.

Why is upper endoscopy done?

Upper endoscopy is performed to investigate symptoms affecting your upper digestive tract and to diagnose various conditions. Your doctor might recommend this test if you're experiencing persistent or concerning digestive symptoms that need closer examination.

The procedure can help identify the cause of symptoms you might be experiencing. Here are some common reasons doctors recommend upper endoscopy:

• Persistent heartburn or acid reflux that doesn't improve with medication
• Difficulty swallowing or feeling like food gets stuck
• Ongoing stomach pain or abdominal discomfort
• Unexplained nausea and vomiting
• Evidence of bleeding in your digestive tract, such as vomiting blood or black stools
• Unexplained weight loss
• Chronic anemia that might be caused by internal bleeding

Upper endoscopy can also detect and diagnose various conditions, from common issues to more serious concerns. Your doctor can identify inflammation, ulcers, tumors, or structural abnormalities that might be causing your symptoms.

Sometimes doctors use upper endoscopy for screening purposes, especially if you have risk factors for certain conditions like Barrett's esophagus or if you have a family history of stomach cancer. The procedure can also monitor known conditions or check how well treatments are working.

What is the procedure for upper endoscopy?

The upper endoscopy procedure typically takes place in an outpatient setting, such as a hospital endoscopy suite or specialized clinic. You'll arrive about an hour before your scheduled procedure time to complete paperwork and prepare for the test.

Before the procedure begins, your medical team will review your medical history and current medications. You'll change into a hospital gown and have an IV line placed in your arm for medications. Your vital signs will be monitored throughout the entire procedure.

Most patients receive conscious sedation, which means you'll be relaxed and drowsy but still breathing on your own. The sedative medication helps you feel comfortable and reduces any anxiety or discomfort. Some patients may choose to have the procedure done with just a throat spray to numb the area, though this is less common.

During the actual procedure, you'll lie on your left side on an examination table. Your doctor will gently insert the endoscope through your mouth and guide it down your throat. The endoscope doesn't interfere with your breathing, as it goes down your esophagus, not your windpipe.

Your doctor will carefully examine each area, looking at the lining of your esophagus, stomach, and duodenum. They may take photographs or video recordings of anything unusual. If needed, they can take small tissue samples called biopsies using tiny instruments passed through the endoscope.

The entire procedure usually takes 15 to 30 minutes, depending on what your doctor finds and whether any additional procedures are needed. After the examination is complete, the endoscope is gently removed, and you'll be taken to a recovery area.

How to prepare for your upper endoscopy?

Proper preparation is essential for a successful upper endoscopy and your safety during the procedure. Your doctor's office will provide you with specific instructions, but here are the general preparation steps you'll need to follow.

The most important preparation requirement is fasting before your procedure. You'll need to stop eating and drinking for at least 8 to 12 hours before your scheduled appointment time. This ensures your stomach is empty, giving your doctor the best view and reducing the risk of complications.

You should also review your medications with your doctor beforehand. Some medications may need to be adjusted or temporarily stopped before the procedure:

• Blood thinners like warfarin or clopidogrel may need to be stopped several days before
• Diabetes medications might need adjustment due to fasting requirements
• Proton pump inhibitors for acid reflux may need to be stopped to allow better visualization
• Iron supplements can be discontinued temporarily as they may affect visibility

Make sure to arrange for someone to drive you home after the procedure, as the sedation medication will affect your ability to drive safely. You should also plan to take the rest of the day off from work or other activities to allow the sedation effects to wear off completely.

On the day of your procedure, wear comfortable, loose-fitting clothing and leave jewelry and valuables at home. Remove contact lenses, dentures, or any removable dental work before the procedure begins.

How to read your upper endoscopy results?

Your upper endoscopy results will typically be available immediately after the procedure, though biopsy results may take several days to a week. Your doctor will usually discuss the initial findings with you and your family member in the recovery area once you're alert enough to understand.

A normal upper endoscopy report will indicate that your esophagus, stomach, and duodenum appear healthy with no signs of inflammation, ulcers, tumors, or other abnormalities. The lining should appear smooth and pink, without any unusual growths or areas of concern.

If abnormalities are found, your doctor will explain what they saw and what it means for your health. Common findings might include:

• Gastroesophageal reflux disease (GERD) with evidence of acid damage to the esophagus
• Peptic ulcers in the stomach or duodenum
• Inflammation of the stomach lining called gastritis
• Hiatal hernia where part of the stomach pushes up through the diaphragm
• Barrett's esophagus, a condition where acid reflux changes the esophageal lining
• Polyps or small growths that may need monitoring or removal

If tissue samples were taken during your procedure, these will be sent to a pathologist for microscopic examination. Biopsy results help confirm diagnoses and rule out more serious conditions like cancer. Your doctor will contact you with these results and discuss any necessary follow-up care.

Your doctor will provide you with a written report that includes photographs from your procedure and detailed findings. This report is important to keep for your medical records and to share with other healthcare providers if needed.

What are the risk factors for needing upper endoscopy?

Certain factors can increase your likelihood of developing upper digestive tract problems that might require evaluation with upper endoscopy. Understanding these risk factors can help you recognize when symptoms might warrant medical attention.

Age is one of the most significant risk factors, as digestive problems become more common as we get older. People over 50 are more likely to develop conditions like peptic ulcers, gastritis, and Barrett's esophagus. However, upper digestive tract problems can occur at any age.

Several lifestyle factors can increase your risk of developing conditions that might require upper endoscopy:

• Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin
• Heavy alcohol consumption, which can irritate the stomach lining
• Smoking, which increases acid production and delays healing
• Chronic stress, which can worsen acid reflux and stomach problems
• Poor dietary habits, including excessive spicy, acidic, or fatty foods

Certain medical conditions also increase your risk of upper digestive tract problems. People with diabetes, autoimmune disorders, or chronic kidney disease may be more prone to gastritis and ulcers. A family history of stomach cancer or Barrett's esophagus may also warrant screening endoscopy.

Infection with Helicobacter pylori bacteria is another important risk factor for peptic ulcers and stomach inflammation. This common bacterial infection can be detected through blood tests, breath tests, or stool samples, and successful treatment usually resolves related symptoms.

What are the possible complications of upper endoscopy?

Upper endoscopy is generally a very safe procedure with a low risk of complications. Serious complications are rare, occurring in less than 1% of cases. However, like any medical procedure, there are some potential risks you should be aware of.

The most common side effects are mild and temporary. You might experience a sore throat for a day or two after the procedure, similar to what you might feel after a dental procedure. Some people also feel bloated or have mild stomach discomfort from the air that's used to inflate the stomach during the examination.

More serious complications are uncommon but can include:

• Bleeding, especially if biopsies are taken or polyps are removed
• Perforation or a small tear in the digestive tract wall
• Infection, though this is very rare with modern sterilization techniques
• Adverse reactions to sedation medications
• Aspiration if stomach contents enter the lungs

The risk of complications is slightly higher if you have certain medical conditions, such as severe heart or lung disease, or if you're taking blood-thinning medications. Your doctor will carefully evaluate your individual risk factors before recommending the procedure.

Most complications, if they occur, are minor and can be treated effectively. Your medical team is trained to recognize and manage any problems that might arise during or after the procedure. The benefits of getting an accurate diagnosis usually far outweigh the small risks involved.

When should I see a doctor for upper endoscopy?

You should consider discussing upper endoscopy with your doctor if you're experiencing persistent or concerning symptoms related to your upper digestive tract. The key is recognizing when symptoms are more than just occasional discomfort and might indicate a condition that needs medical evaluation.

Seek medical attention promptly if you experience any of these more serious symptoms, as they may indicate conditions that require immediate evaluation:

• Vomiting blood or material that looks like coffee grounds
• Black, tarry stools that might indicate internal bleeding
• Severe abdominal pain that doesn't improve with over-the-counter medications
• Difficulty swallowing that's getting worse or preventing you from eating normally
• Unexplained weight loss of more than 10 pounds
• Persistent vomiting that prevents you from keeping food or fluids down

You should also talk to your doctor about upper endoscopy if you have chronic symptoms that significantly impact your quality of life. Heartburn that occurs more than twice a week, persistent stomach pain, or ongoing nausea and vomiting warrant medical evaluation.

If you're over 50 and have risk factors like a family history of stomach cancer, your doctor might recommend screening endoscopy even if you don't have symptoms. Similarly, if you have Barrett's esophagus or other conditions that increase cancer risk, regular surveillance endoscopy may be recommended.

Don't hesitate to discuss your symptoms with your primary care doctor, who can help determine whether upper endoscopy is appropriate for your situation. Early evaluation and treatment of digestive problems often lead to better outcomes and can prevent more serious complications.