Upper Endoscopy

Upper endoscopy allows your doctor to examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). Your doctor will use a thin, flexible tube called an endoscope, which has its own lens and light source, and will view the images on a video monitor.

Upper endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It’s an excellent test for finding the cause of bleeding from the upper gastrointestinal tract. It’s also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.

Your doctor might use upper endoscopy to obtain a biopsy of small tissue samples. A biopsy helps your doctor distinguish between benign and malignant (cancerous) tumors. Remember, biopsies are taken for many reasons, and your doctor might order one even if he or she does not suspect cancer. For example, your doctor might use a biopsy test to check for Helicobacter pylori, a bacterium that causes ulcers.

Upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your doctor can pass instruments through the endoscope to directly treat many abnormalities with little or no discomfort. For example, your doctor might stretch a narrowed area, remove polyps (usually benign growths) or treat bleeding.

• You may have regular meals on the day before the test.
• Do not eat or drink anything after midnight. This also includes chewing gum, mints and hard candies. If your procedure is in the afternoon, you may have clear liquids until six hours before your scheduled procedure.
• You may take certain necessary medications with a small sip of water up to two hours before the test. Please check with your doctor regarding any medications you take.
• Notify the nurse or doctor if you are diabetic! Follow your doctor’s instructions regarding insulin dosage and when to take your pills for diabetes.
• You will be asked to sign an informed consent and provide information regarding allergies, medicines you are now taking, existing medical conditions and previous surgeries.
• If you received a sedative, you won’t be allowed to drive after the procedure even though you might not feel tired. You must arrange for someone to accompany you home because the sedatives could affect your judgment and reflexes for the rest of the day.
• Inform your doctor if you are taking any blood thinners such as aspirin, Coumadin and Plavix.

Your doctor might start by spraying your throat with a local anesthetic or by giving you a sedative to help you relax. You’ll then lie on your side, and your doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope doesn’t interfere with your breathing. Most patients consider the test only slightly uncomfortable, and many patients fall asleep during the procedure.

• You will be monitored until most of the side effects of the sedative have worn off.
• Your throat might be a little sore, and you may feel bloated because of the air introduced into your stomach during the test.
• You will be able to eat after you leave unless instructed otherwise by your doctor.
• You doctor generally can tell you your test results on the day of the procedure. However, the results of some tests might take several days.

Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. It is important to recognize early signs of possible complications:

• Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up.
• Other potential risks include a reaction to the sedative used, complications from heart or lung diseases, and perforation (a tear in the gastrointestinal tract lining).
• If you have a fever after the test, trouble swallowing or increasing throat, chest or abdominal pain, tell your doctor immediately.