| Where It's Done | Who Does It | How Long It Takes | Discomfort/Pain |
| Hospital or outpatient endoscopy suite. | Doctor (gastroenterologist or gastrointestinal surgeon), helped by an endoscopy assistant. | About 10 minutes, plus preparation time; a little longer if a biopsy is done. | Anesthetic spray may have an unpleasant taste. Discomfort associated with swallowing the endoscope and with having air pumped into the stomach. |
| Results Ready When | Special Equipment | Risks/Complications | Average Cost |
| Immediately for visual findings; within 24-48 hours for biopsy results. | Fiber-optic endoscope and light source. | Perforation of esophagus or stomach, bleeding, aspiration of gastric juices into the lungs, infection, abdominal pain, and transient fever. | $$-$$$ (Cost varies depending upon extent of test.) |
Upper gastrointestinal (GI) endoscopy (or panedoscopy) or esophagoscopy (if esophagus alone is examined).
Purpose- To examine the inner lining of the esophagus, the stomach, and the duodenum when there are such unexplained symptoms as difficulty swallowing, diarrhea or heartburn that is not promptly relieved by drugs, persistent nausea or vomiting, vomiting blood or bloody stools, loss of appetite and weight loss, or chest pain in the absence of heart disease.
- To confirm or rule out suspected cancer of the esophagus or stomach.
- To perform a biopsy of the gastric antrum in order to identify H. pylori as a cause of peptic ulcer or gastritis.
- To perform a biopsy of the small bowel in cases of suspected malabsorption syndrome.
- As treatment, to control bleeding, remove polyps, dilate narrowed passages, or remove a foreign body.
- A fiber-optic viewing instrument called an endoscope is introduced into the digestive tract, allowing the doctor to view the organs of the digestive system directly.
- The endoscope has side channels that can be used to withdraw fluids, pump in air, or introduce brushes, snares, small forceps, or other devices required for obtaining tissue samples.
- Avoid taking aspirin and other nonsteroidal anti-inflammatory drugs for one week before the test because these can cause inflammation of the stomach lining as well as increasing the risk of bleeding.
- If the test is performed on an outpatient basis, you must arrange in advance to have someone drive you home afterward.
- Avoid ingesting food and drink for eight hours before the procedure.
- You may wear your own clothing or be asked to don a hospital gown. Dentures must be removed.
- Your throat is sprayed with a local anesthetic to suppress the gag reflex, and you receive a sedative intravenously. You may drift off to sleep during the procedure.
- A plastic mouthpiece called a bite block is placed between your teeth to prevent you from accidentally biting the endoscope.
- You are asked to swallow the endoscope, a thin, flexible tube. The device is then guided through the esophagus and, if necessary, the stomach and duodenum while the doctor watches its progress on a TV monitor.
- Air may be blown through the endoscope into the bowels in order to dilate them and make viewing easier.
- If a sample of tissue or digestive fluid is required, the doctor may perform an endoscopic biopsy using tiny tools within the scope (see Variations).
- When the examination is complete, the endoscope is gradually removed from your digestive tract.
While biopsies of the upper digestive tract are mostly performed during endoscopy, tissue samples from the small bowel may also be obtained using a tube that is similar to an endoscope but has no viewing lens (hence, the procedure is called a "blind" small bowel biopsy). The instrument is guided through the digestive tract with the help of a fluoroscope, a small X-ray machine held over the patient's abdomen. The blind biopsy allows the doctor to reach farther into the small bowel than is possible with EGD and to collect a larger piece of tissue.
After the test- You are taken to the recovery room, and your vital signs--heart and breathing rate, blood pressure, and temperature--are monitored.
- Once the sedation wears off, which usually takes about an hour, you are free to dress and have someone take you home.
- Avoid eating and drinking until the gag reflex returns, which may take two to four hours.
- Because of the amount of air instilled into your stomach, you may experience excessive belching and flatulence for the next 24 hours. You may also experience discomfort in the throat for a few days.
- Let your doctor know immediately if you have severe abdominal pain or blood in the stools after this test.
- Uncontrolled bleeding in the digestive tract and the presence of blood, food, or antacids in the stomach may interfere with the examination.
- As is true for all endoscopic procedures, lack of cooperation on your part will interfere with the test.
The doctor studies the lining of your digestive tract for abnormalities such as ulcers, erosions, polyps, tumors, or bleeding sites. Fluids and tissue samples obtained during the procedure are sent to a laboratory for analysis. They may be examined for the presence of infectious organisms (such as the bacterium Helicobacter pylori, believed to be responsible for at least some ulcers), inflammation, or cancerous cells.
Advantages- The test provides a direct view of the lining of the bowels.
- It also makes it possible to perform a biopsy without surgery.
- It's invasive and somewhat uncomfortable.
- It's also expensive.
- It makes it possible to see the inside of the digestive tract, but it does not allow viewing of solid organs such as the liver, abnormalities within the wall of the digestive tract, or the abdominal cavity outside the stomach and intestines.
Some people fear choking on the endoscope or being unable to breathe, but there is no such danger because the device does not enter the trachea (windpipe) or interfere with the passage of air.
