Upper GI endoscopy lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the oesophagus, 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. You might hear your doctor or other medical staff refer to upper GI endoscopy as oesophago-gastro-duodenoscopy (OGD) or simply gastroscopy.
Upper GI endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It's the best test for finding the cause of bleeding from the upper gastrointestinal tract. It's also more accurate than X-rays or scans for detecting inflammation, ulcers and tumours of the oesophagus, stomach and duodenum.
Your doctor might use upper GI endoscopy to obtain a biopsy (small tissue samples). A biopsy enables examination of the tissues under a microscope, aiding diagnosis. Remember, biopsies are taken for many reasons, and do not necessarily mean that anything sinister is suspected. For example, a biopsy is used to test for Helicobacter pylori, the bacteria that causes ulcers.
Upper GI endoscopy is also used to treat conditions of the upper gastrointestinal tract. Instruments can be passed through the endoscope to directly treat many abnormalities, for example, to stretch (dilate) a narrowed area, remove polyps (benign growths) or treat bleeding.
An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink for approximately six hours before the examination. Your appointment information will tell you when to start fasting as the timing can vary.
Tell your doctor in advance about any medications you take; you might need to adjust your usual dose for the examination. Discuss any allergies to medications as well as medical conditions, such as heart or lung disease.
Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Inform your doctor about medications you're taking, particularly blood-thinning drugs such as aspirin, clopidogrel, warfarin or heparin, arthritis medications, insulin or iron tablets.
Your doctor may start by spraying your throat with a local anaesthetic and/or by giving you a sedative injection which will help you relax and may make you a little drowsy. You'll then lie on your side, and the doctor will pass the endoscope through your mouth and into the oesophagus, stomach and duodenum. The endoscope doesn't interfere with your breathing, Most patients consider the test only a little uncomfortable, it usually takes less than 10-15 minutes to perform. Patients who have had sedation often fall asleep during or after the procedure, and may remember little about it afterwards.
You will be monitored until most of the effects of the medication have worn off. Your throat might be a little sore, and you might feel bloated because of the air introduced into your stomach during the test. You will be able to eat before you leave unless instructed otherwise.
Your doctor will explain the results of the examination to you, although if biopsies are performed the results of these will not be available for a week or two.
If you have been given a sedative for the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgement and reflexes could be impaired for the rest of the day.
Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. Bleeding can occur at a biopsy site or where a polyp was removed, but it's usually minimal and rarely requires follow-up. Perforation (a tear in the gastrointestinal tract lining) may require surgery but this is a very uncommon complication. Some patients can have a reaction to the sedative drugs given, or complications from heart or lung disease.
Although complications after upper endoscopy are very uncommon, it's important to recognize early signs of possible complications. Make contact immediately if you have a fever after the test or if you notice trouble swallowing or increasing throat, chest or abdominal pain, or bleeding, including black stools. Note that bleeding can sometimes only be apparent several days after the procedure.