The Upper GI Endoscopy: Your esophagus, up close and personal
Many gastrointestinal issues, like gastroesophageal reflux disease (GERD), will wreck havoc on the upper GI tract – the mouth, throat, and esophagus, stomach and duodenum – the first part of the small intestine. An endoscopy allows a doctor a clear view of the upper GI tract and to take samples of suspect tissue for further diagnostic testing.
Why an endoscopy?
Endoscopies are ordered to determine the cause of a range of maladies including abdominal pain, nausea, vomiting, swallowing difficulties, gastric reflux, unexplained weight loss, anemia and bleeding in the upper GI tract. These symptoms often point to conditions like ulcers, abnormal growths, precancerous growths like Barrett’s esophagus, bowel obstructions, inflammation and hiatal hernia, all of which are diagnosed by an endoscopy.
How do you prepare for an endoscopy?
The GI tract must be completely empty before an endoscopy, so patients should not eat, drink, smoke or chew gum for four to eight hours before the procedure.
Patients will also be asked to stop taking certain medications that affect blood clotting or interact with sedatives such as blood thinners, blood pressure medications, diabetes medications, antidepressants and dietary supplements.
Finally, driving is not permitted for 12 to 24 hours following an upper GI endoscopy. This allows the effects of the sedative to completely subside. Patients should arrange for a ride home after the procedure.
How is an endoscopy performed?
An endoscopy is usually performed as an outpatient procedure in a hospital or outpatient clinic. The patient may be given a local anesthetic that is gargled or sprayed on the back of the throat to control the gag reflex and numb the throat. Some patients are given a sedative during the procedure through an IV.
During the procedure, the patient will lie on their back while the doctor guides a lighted, flexible tube – called an endoscope – with a small camera mounted on the end down the throat to view the esophagus, stomach and duodenum. The camera transmits a video image to a monitor, allowing a close examination of the intestinal lining. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier to examine.
If abnormalities are detected during the procedure, instruments that slide down the endoscope are used to take tissue samples, stop bleeding and remove abnormal growths.
How long is the recovery?
Immediately following an endoscopy, patients are moved to a recovery room for about an hour while the sedative wears off. Risk of complications during an endoscopy is very slim. Patients will likely feel bloated or nauseated after the procedure but can resume their normal diet, medications and activities the next day unless otherwise directed.
What will the results tell me?
Some results will be available immediately following the procedure and the doctor will share them with you after the sedative has worn off. Biopsies that require laboratory testing will take more time.
Are there other kinds of endoscopy?
Yes, there are. An endoscopic ultrasound uses the same type of procedure as an endoscopy but the endoscope used is fitted with a small ultrasound device on the end. This allows a clear view of the inside layers of the wall of the gastrointestinal tract and the surrounding organs including the pancreas, liver, gallbladder, spleen and adrenal glands.
And now to get really sci-fi: When a clear image of the midsection of the small intestine – duodenum, jejunum, ileum – is needed, a wireless capsule endoscopy is used. The wireless capsule endoscopy uses a pill-sized video camera with its own light source that is swallowed by the patient. As the capsule travels through the digestive tract, it takes pictures of the small intestines that are transmitted to a recording device the patient wears on his or her body. The doctor is able to view the pictures at a later time and the capsule itself passes through the large intestine and out of the body as waste.
National Institutes of Health, National Institute of Diabetes, and Digestive and Kidney Diseases. (May 2009). Upper GI Endoscopy. Retrieved from website: https://digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy/
American Society for Gastrointestinal Endoscopy, (November, 2010), Endoscopic Procedures. Retrieved from website: https://www.asge.org/press/press.aspx?id=548#endoscopy
Sara is a former editor for HealthCentral.