Upper GI Endoscopy

An upper GI endoscopy is a direct look at the lining of the food pipe, the stomach and the first part of the small intestine. A flexible tube about the width of a little finger, with a camera and a light at its tip, is passed through the mouth and down, and the images appear on a screen in high definition.

Seeing the lining directly is the point. Scans and blood tests describe the area from the outside; the camera shows the surface itself, and small samples can be taken painlessly through a channel in the tube for the laboratory to examine, which is how the surface is assessed at the level of its cells.

The same instrument treats as well as looks. A bleeding point can be clipped or injected, a narrowed segment can be stretched, a swallowed object can be retrieved, and a feeding tube can be placed through the stomach wall, all through the same tube and without any cut. Your doctor will tell you beforehand what is planned and what might be done if something is found.

You must not eat for six hours beforehand and may take clear fluids up to two hours before. Your doctor will give you specific instructions about blood thinners, diabetes medication and any acid-suppressing tablets, since the last of these can change what is seen.

On the day, a cannula is placed in your hand and sedation is given through it, so you are drowsy or asleep and most people remember very little. The back of your throat is usually sprayed with a numbing solution as well. A plastic mouthguard protects your teeth and the tube, and you lie on your left side with your head slightly bent forward.

The tube goes down the food pipe and does not go into the windpipe, so your breathing is not obstructed at any point, and oxygen is given through the nose throughout. Air or carbon dioxide is used to open the folds of the lining out so they can be inspected. Saliva is allowed to run out of the corner of your mouth and is suctioned away; swallowing it is what causes coughing.

The examination takes 5 to 15 minutes, longer where something is being treated. You rest in the recovery area for about an hour and go home the same day, accompanied by a responsible adult.

A mild sore throat and a bloated feeling for a day are the usual aftermath, and both settle without treatment. Warm fluids and a salt-water gargle help the throat.

Do not eat or drink until the numbness at the back of your throat has worn off, which takes about an hour, because a numb throat cannot protect your airway properly. Start with fluids, then soft food, and eat normally from the next meal onward unless you have been told otherwise.

Because of the sedation, do not drive, operate machinery, drink alcohol or sign anything legally binding for the rest of the day, and arrange for someone to be with you at home. Most people are back to work the following day.

Your doctor will usually tell you what was seen before you leave, though you may not remember it clearly, so take someone with you or ask for it in writing. Laboratory results on any samples taken take about a week, and the follow-up appointment is where the plan is set.