Upper Endoscopy Indications and Preparation

male stomach illustration
Science Picture Co./Getty Images

Why would your doctor order an endoscopy, what is it used to diagnose, and how can you prepare before you have this procedure? What happens after the procedure, how do you get your results, and what diagnoses can be made with an upper endoscopy?


An endoscopy is a procedure which allows doctors to look inside the body. Many people are familiar with "lower" endoscopy, the colonoscopies used to screen for colon cancer. An "upper" endoscopy, also known as esophagogastroduodenoscopy or EGD, allows the doctor to examine the inside of your esophagus, stomach, and duodenum – the first part of the small intestine – with an instrument called an endoscope. An endoscope is a thin, flexible tube with a lighted end which has a camera attached.

An upper endoscopy thus allows physicians to visualize (and take a biopsy sample or tissue needed for bacterial culture if needed) the walls and tissues of the upper digestive tract.

Symptoms and Indications

An endoscopy is usually ordered if there is concern that there may be a structural abnormality in the esophagus, stomach, or duodenum (the first part of the small intestine.) Some reasons include:

  • Anemia ("blood loss" appearing anemia or a vitamin deficiency related anemia) Some disorders of the gastrointestinal tract can lead to blood loss, which in turn can lead to anemia. Some digestive tract problems can also result in vitamin deficiencies, similarly causing anemia. In addition, anemia and cancer can be linked in several ways.
  • Heartburn
  • Abdominal pain
  • Dark blood (coffee ground appearance) in the stool
  • Nausea and vomiting
  • Difficulty swallowing or painful swallowing (dysphagia)
  • Persistent cough - Chronic acid reflux can sometimes result in a chronic cough
  • Unintentional or unexplained weight loss - Unintentional weight loss is defined as the loss of at least 5 percent of body weight (5 pounds for every hundred pounds of weight) over a period of 6 to 12 months

Results and Findings

Depending on the symptoms for which the endoscopy is ordered, it may help with the diagnosis of several different conditions. Some of these include"

How to Prepare

Most likely you will know what your doctor is looking for before you undergo your procedure. If not, you should discuss the reasons why she recommended an endoscopy and what diagnoses she may expect to find. The other thing that you should talk to your physician about is what medications, vitamins, and supplements you are taking. Basically, you want to disclose whatever you are taking by mouth daily or on a regular basis.

Next, arrange a ride home from the procedure. You are not allowed to drive for 24 hours afterward or until the effects of the sedative wear off. It is also helpful to have an extra set of ears available when your doctor explains any findings.

And as with most procedures in which the patient is sedated, you cannot eat, drink, smoke, or chew gum in the 8 hours leading up to the procedure.

What to Expect

You will either go to the hospital or to an outpatient facility for your test. Before the procedure, you will be given a local anesthetic that will be sprayed into your throat to suppress the gag reflex and an intravenous sedative that will help you relax.

You will lie on your side on an examining table. Then the doctor will slowly pass the endoscope through your mouth and down the esophagus. The gag reflex and the urge to vomit usually passes once the tube is in the esophagus. The tube will not interfere with breathing. Many people are surprised to discover that they can actually watch the procedure on a screen without feeling any discomfort caused by the tube.

Once the endoscope is in place, the doctor will be able to examine the esophagus and stomach through a tiny camera and detect any abnormalities. Other instruments can be inserted through the endoscope tube, which will allow the doctor to perform biopsies if conditions such as cancer or infections are evident.

After the Endoscopy

It is common that for a few days after the procedure, you may experience a sore throat. If you start vomiting a large amount of blood or experiencing severe stomach pains, the doctor should be notified immediately as these are signs of complications.

Getting Your Results

Your doctor will be able to tell you what she sees visually directly after the procedure. Since the sedative medications you receive may linger for a while, it's a good idea to have your friend who drove you listen to these findings and take notes. In some cases, the physician performing the endoscopy will instead send a report to your regular doctor, who will then discuss the results with you.

If tests for bacteria (H. pylori) or biopsies are taken during the procedure, you will be notified after the pathologist has reported the results. This may take several days depending on the tests. Before you leave on the day of the procedure, ask how you will be informed of any results. Will the endoscopy lab notify you or will your regular physician? Make sure to call if you have not received these results in a timely manner.

Other Diagnostic Tests That May Be Considered

In addition to an upper endoscopy, your doctor may recommend other tests. An endoscopy primarily gives structural information - what your upper digestive tract looks like. Further information about the function of your digestive tract may require tests such as a barium swallow or pH examination.

View Article Sources