About Upper Endoscopy

What is upper endoscopy?  Upper endoscopy lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (which is the first portion of the small intestine). An endoscope is a thin, flexible tube with a tiny vidoscopic camera located on the end.  The camera transmits an image to a TV monitor enabling the doctor to detect any abnormal changes in the lining of the esophagus, stomach and small intestine.  Novocaine gargle and intravenous (IV) sedation is used so there is no discomfort or gagging.

What are the indications for this procedure?  Abdominal pain, chronic heartburn, difficulty swallowing, nausea, vomiting, diarrhea, bleeding and anemia are evaluated with this procedure.  A cause for these symptoms is often found and specific treatment can then be prescribed.  For people who are discovered to have an ulcer associated with the bacteria Helicobacter pylori, we recommend an acid reduction medication or proton pump inhibitor (PPI) and two (2) antibiotics. See associated website. http://www.medicinenet.com/helicobacter_pylori/article.htm

What preparation is required for upper endoscopy?  A person undergoing this procedure should have an empty stomach, meaning nothing to eat or drink for 6 hours  before the test.  Because sedation is given, a designated driver is necessary to take the patient home after the procedure.  If a patient is taking Coumadin, Plavix, Aspirin, Ibuprofen or other anti-inflammatory medication, there may need to be dose adjustments.  IV antibiotics may be required if there are risk factors for infection of the heart valves. 

How long does the procedure last?  The procedure itself takes about 10-15 minutes and is followed by 1 hour in the recovery area.

Will the procedure be painful?  A topical anesthetic gargle together with a sedative is given to prevent gagging or any significant discomfort.  The sedatives are so effective that most people do not remember the procedure.

What will happen if biopsies are performed?  Biopsies or tissue samples can be safely obtained for examination under the microscope. Biopsies are taken with forceps that are passed through a channel in the endoscope.  Small, superficial pieces of the lining are obtained with pinch forceps.  Results are usually available in a few days.  Our office will send you a written letter detailing the results of the biopsy and if/when a repeat exam will be due.

How often is repeat upper endoscopy required?  Repeat upper endoscopy may be recommended to make certain an ulcer has healed.  If someone has Barrett's esophagus, endoscopy is usually performed every 1-2 years with biopsies obtained to look for pre-cancerous changes.  For those with significant gastroesophageal reflux disease (GERD) and/or Barrett's esophagus, we recommend a proton pump inhibitor (PPI) to suppress acid production.

What are the safety issues associated with upper endoscopy?  Upper endoscopy is a safe procedure.  Precautions are taken to avoid problems like infection, bleeding or perforation.  All patients have their oxygen level, cardiac status, blood pressure and pulse monitored carefully during the procedure.  Complications rarely occur.