Upper GI Endoscopy

It can also be used to diagnose certain medical conditions or as a treatment.

Your doctor may recommend you have a gastroscopy to find out why you’re having certain symptoms. These include:

• Indigestion (acid reflux or discomfort in your upper tummy).
• Difficulty or pain when you swallow (dysphagia)
• Pain in your upper abdomen (tummy)
• Being sick (vomiting) repeatedly
• Vomiting blood or having very dark tar-like blood in your faeces (melaena)
• Cancer Screening

In some cases, your doctor may take small samples of tissue (a biopsy) during the endoscopy

A gastroscopy is usually done as a day-case procedure in hospital. This means that you’ll be an outpatient and won’t need to stay overnight. Before your gastroscopy, you’ll be given information about what is involved and how to prepare for it.

Before coming to hospital

It’s important to follow any advice you’re given.

If you’re taking certain medicines (PPI) that reduce your stomach acid, you may be asked to stop them two weeks beforehand. This is because they might stop your doctor getting a true picture of whether or not there are problems in your gullet or stomach.

It’s particularly important to let your doctor or the hospital team know if you’re taking anticoagulant or antiplatelet medicines (medicines that prevent your blood clotting). These include heparin, aspirin, clopidogrel, warfarin and new medicines such as dabigatran and rivaroxaban.  If you continue to take medicines that should be stopped, you may still be able to have a gastroscopy. But you probably won’t be able to have a biopsy or a treatment procedure
You should arrange for someone to take you home, and preferably stay with you for 24 hours afterwards.

On the day
Your stomach must be completely empty during the test, so you’ll probably be asked not to eat or drink anything for 6-8 hours before your gastroscopy.
Your doctor will discuss with you what will happen before, during and after your procedure, and any discomfort you might have. They’ll ask if you wish to have a local anaesthetic or sedation or both. The local anaesthetic is a spray that numbs your throat area. The sedative will make you drowsy, and is given as an injection at the start of the procedure.

Ask your doctor to explain the pros and cons of each type of anesthesia. If you choose to have the local anaesthetic spray, it may feel a little more uncomfortable at the time, but you won’t be drowsy afterwards.

A gastroscopy usually only takes five to 10 minutes, though occasionally it may be longer. The procedure will be carried out by a qualified doctor .

Your nurse will ask you to remove any dentures or dental plates and your glasses. If you wear contact lenses, you can leave them in.
If you’re having a sedative, this is given through a fine tube (cannula) into a vein in your arm. While you’re sedated, your nurse will monitor your heart rate and the amount of oxygen in your blood through a sensor attached to your finger.

You’ll be asked to lie on your left side. Your doctor will place a guard into your mouth to protect your teeth. They’ll then pass the gastroscope through the opening of the guard into your mouth, until it rests on your tongue at the back of your throat. You’ll then be asked to swallow to allow the gastroscope to pass into your esophagus and down towards your stomach. This part of the procedure may be uncomfortable for about 20 seconds, and it’s usual to gag once or twice. The discomfort usually soon passes.

Your doctor will look at images from the gastroscope on a monitor to examine the lining of your esophagus, stomach and duodenum. If necessary, your doctor can use the gastroscope to take a biopsy (a small sample of tissue). The samples will be sent to a laboratory for testing.

After your gastroscopy, you’ll need to rest in a recovery area until the effects of the sedative have passed. You’ll be able to go home when you feel ready, usually after 30 minutes to an hour. Someone else should drive you home.
If you had a local anaesthetic throat spray, you won’t be able to eat or drink until it wears off in about an hour. After that you can eat normally.
Before you leave the hospital, you’ll be given advice about your recovery, and what to do if you have any problems. It’s OK to ask questions if you have any concerns.
Your doctor or nurse may discuss the general findings of the gastroscopy with you before you leave. You may find it best to have a friend or family member there as well, because having a sedative can affect your memory.

Recovering from a gastroscopy
If you’ve had a sedative, you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. It’s best to have a friend or relative stay with you for the first 24 hours, while you rest.
Most people have no problems after a gastroscopy, but you should seek medical attention immediately if you:

• cough up or vomit blood (which may look like coffee grounds)
• have blood in your poo (faeces) or odd-coloured faeces
• have severe pain in your abdomen (tummy) or pain that gets worse
• have a raised temperature
• have problems breathing

If you have these symptoms, tell the doctor you see that you have recently had a gastroscopy.

The alternative to a gastroscopy is a test called a barium swallow and meal. This involves drinking a special liquid which coats the inside of your oesophagus and stomach and shows up on X-rays. You can find out more from our information on barium swallow and meal.
However, unlike a gastroscopy, a barium swallow and meal doesn’t allow your doctor to take a sample of any abnormal tissue they see. You can ask your doctor whether this may be an option for you.

As with every procedure, there are some risks associated with having a gastroscopy.

Side-effects

These are the unwanted but mostly temporary effects you may get after having the procedure.
After having a gastroscopy, you may have a sore throat or stomach discomfort for a few hours. You may feel bloated, but this usually passes quite quickly.

Complications

• This is when problems occur during or after the procedure.
• Complications of gastroscopy are very uncommon – the vast majority of patients have no problems at all.

When complications do happen, they may include the following:

• A reaction to the sedative, such as difficulty in breathing or heart problems.
• Bleeding, perhaps from where a biopsy is taken or a polyp removed.
• Damage or tears (perforation) to your throat, esophagus, stomach or duodenum.

Complications are more likely if gastroscopy includes a treatment procedure.