Diagnostic procedure in which a thin flexible tube with a camera at the tip is used to directly inspect the esophagus, stomach, and duodenum and to take biopsies when needed.
Indication
- Long-standing heartburn, regurgitation (reflux), and burning behind the breastbone
- Difficulty swallowing (dysphagia), painful swallowing (odynophagia), or sensation of food sticking in the throat
- Unexplained weight loss, loss of appetite, and upper abdominal pain (dyspepsia)
- Signs of upper gastrointestinal bleeding (vomiting blood, black stools)
- Iron-deficiency anemia evaluation and suspected gastric ulcer or gastritis
- Biopsy for the diagnosis of Helicobacter pylori
- Suspicion and follow-up of gastric cancer, celiac disease, or Barrett esophagus
Preparation
- No food or drink for 6-8 hours before the procedure (an empty stomach is required)
- Approval from the physician is obtained for regular medications, especially blood thinners
- Diabetes medications/insulin doses are planned separately for the morning of the procedure
- Dentures, glasses, and jewelry are removed before the procedure
- If sedation is used, an accompanying person is required since the patient may not drive after the procedure
How it's performed
- An IV line is placed and blood pressure and oxygen levels are monitored
- The throat is anesthetized with a local spray, and intravenous sedation is given if needed
- The patient is placed on the left side and a mouthpiece is inserted to protect the teeth
- The endoscope is advanced through the mouth to sequentially examine the esophagus, stomach, and duodenum
- Painless biopsy samples are taken from suspicious areas using fine forceps
- The procedure usually takes 5-15 minutes; all images are recorded
Post-procedure
- After sedation, the patient is monitored for 30-60 minutes
- No food or drink is taken until throat numbness wears off (about 1 hour)
- Driving and important decisions are avoided on the day of the procedure
- Biopsy results are evaluated within 5-10 business days
- Mild sore throat and bloating subside within 1 day
Risks
- Transient sore throat, hoarseness, and bloating
- Mild bleeding after biopsy (usually stops on its own)
- Sedation-related respiratory depression and blood pressure changes (rare)
- Esophageal or gastric perforation — very rare (less than 1 in 1000)
- Aspiration (gastric contents entering the airway) — rare
FAQ
Is the procedure painful?
No pain is felt. The throat is numbed with a spray and intravenous sedation can be given on request. With sedation, most patients do not remember the procedure.
How long does the procedure take?
A diagnostic endoscopy takes an average of 5-15 minutes. Taking biopsies may add a few minutes.
Is taking a biopsy harmful?
No. The mucosa of the stomach and esophagus has no pain receptors; biopsy is not felt and healing occurs spontaneously.
When can I eat after the procedure?
After the throat numbness wears off (about 1 hour), water can be taken first, followed by soft foods.
Related Information
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Urea breath test — a non-invasive diagnostic test that detects Helicobacter pylori in a breath sample.
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Barium Radiography
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Barium radiography (upper GI series) — contrast X-ray examination of the pharynx, esophagus, stomach, and duodenum.
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