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Endoscopy intestinal: Upper endoscopy – Mayo Clinic

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Upper Endoscopy – Risks, Prep, & Procedure

Upper Endoscopy

Endoscopy is a medical procedure in which a doctor looks inside your body using an instrument called an endoscope—a long, thin, flexible tube with a tiny camera attached to it. Endoscopy is used for many examinations, but an upper endoscopy is used specifically to look at the esophagus, the stomach, and the first part of the small intestine (called the duodenum). An estimated 6.1 million upper endoscopies are performed in the U.S. each year1.

You may also hear the procedure called an upper GI endoscopy, esophagogastroduodenoscopy, or EGD. Whichever term is used, it’s important to understand the preparation, anesthesia, and post-procedure recovery involved, as well as the anesthesiologist’s role in keeping you safe and comfortable.

What diseases can an upper endoscopy detect?

An upper endoscopy can help identify gastroesophageal reflux disease (GERD), ulcers, cancer, precancerous abnormalities, and celiac disease, among other conditions.

When is an upper endoscopy needed?

Often, the impetus for the examination is to assess the cause of symptoms, such as persistent heartburn or acid reflux, bleeding (or dark stools that can indicate bleeding), nausea and vomiting, stomach pain, difficulty swallowing or pain while swallowing, and unexplained weight loss. People with cirrhosis may undergo upper endoscopies on a regular basis because of the disease’s potential to cause life-threatening enlargement or swelling of veins on the esophageal lining.

How should I prepare for an upper endoscopy?

You should not eat or drink anything for at least 8 hours before the procedure. Your doctor may advise you to begin your fast at midnight regardless of the time your endoscopy is scheduled to begin. Your doctor should also give you detailed instructions about what you can and cannot eat the day or two before your endoscopy. For example, you may be told to consume only clear liquids for 24 or 48 hours. You should follow all preparation instructions carefully to make sure the doctor will have a clear view of your upper gastrointestinal tract.

Be sure to provide your physician with a full list of all medications, vitamins, or other supplements you take. Your physician can then provide you with instructions about any you should temporarily stop taking to avoid complications such as bleeding.

What happens during an upper endoscopy?

Before the procedure begins, an IV will be inserted in your arm to administer anesthesia, and a bite block or plastic mouth guard will be placed in your mouth to protect your teeth, mouth, and the endoscope. You will most likely be positioned on your left side—before anesthesia is administered if undergoing sedation, but after if receiving general anesthesia. Once you have been anesthetized, your physician will insert the endoscope into your mouth and down your throat to conduct the exam. If you are under general anesthesia or moderate or deep sedation, you will not be aware of or remember what occurs during the procedure.

What are the considerations for anesthesia during the procedure?

Your endoscopy preparation should include an evaluation from an anesthesiologist, a medical doctor who specializes in anesthesia, pain management, and critical care medicine, who will asses your risk for anesthesia-related complications. They will ask about any medical conditions you have, because some conditions can impact the type and level of anesthesia that should be used.

Most types of anesthesia are administered through a vein in your arm. Options range from no anesthesia or sedation at all to general anesthesia, but for upper endoscopies, moderate or deep sedation is most common. The anesthetics that may be used to minimize pain and discomfort and reduce anxiety include propofol, benzodiazepines, and opioids.

  • No sedation. Although it does not occur frequently, endoscopies can be performed with no sedation. This is sometimes necessary for extremely high-risk patients and some pregnant patients. A topical anesthetic is typically applied to the back of the throat to make it easier for you to tolerate the endoscope.
  • Monitored sedation. The level of sedation can be minimal (you’ll feel drowsy but able to talk and follow directions), moderate (you may fall asleep), or deep (you will fall asleep). Under moderate or deep sedation, you’re likely to have no memory of the procedure, but you will not be unconscious.
  • General anesthesia. Although rare for an upper endoscopy, general anesthesia may be used in hospital settings with high-risk patients. Under general anesthesia, you will be unconscious, and many of your body’s functions will slow down or need help to work effectively. A tube may be placed in your throat to help you breathe.

How long does an upper endoscopy take?

The procedure itself is very brief—typically 5 to 10 minutes—although it can be a bit longer if tissue is taken for biopsy.

What should I expect in recovery?

Your throat might feel sore from the insertion of the endoscope, and you might temporarily feel bloated because of the carbon dioxide or air that’s used to give the physician a better view of the stomach. Nausea is possible, but the propofol often used for anesthesia helps prevent it.

You’ll feel groggy for about 30 minutes after the procedure, but that feeling should start to fade within the hour. Even so, you should not make any big decisions the rest of the day, and you will need to have someone take you home.

What are upper endoscopy risks?

The risk of complications is low, as noted by the National Institute of Diabetes and Digestive and Kidney Diseases. It identifies low but potential risks as an abnormal reaction to the sedative, perforation in the lining of your upper GI tract, and bleeding from the site where the physician took tissue samples or removed a polyp, if necessary.

As with any procedure requiring anesthesia, factors such as obesity, respiratory disease, and sleep apnea can increase risk. But these risks can be managed, which is why consultation with an anesthesiologist is so important.

1 Peery AF, Crockett SD, Murphy CC, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2018. Gastroenterology. 2019;156(1):254–272.e211. https://www.gastrojournal.org/article/S0016-5085(18)35147-3/fulltext?referrer=https%3A%2F%2Fjournals.lww.com%2F. Accessed November 16, 2021.

 

 

 

Anesthesiologists work with your surgical team to evaluate, monitor, and supervise your care before, during, and after surgery—delivering anesthesia, leading the Anesthesia Care Team, and ensuring your optimal safety.

Understanding upper endoscopy and colonoscopy – Dana-Farber Cancer Institute

Visiting Dana-Farber? See our prescreening and mask requirements.




  • What is endoscopy?

    Endoscopy is a procedure in which the gastro-intestinal tract (GI tract) is viewed through a lighted, flexible tube with a camera at the end (endoscope). Small samples of tissues cells (biopsy) can also be collected and sent for testing.

    There are two basic types of endoscopy:

    1. Upper endoscopy – The esophagus, stomach, and small intestines can be viewed by a thin flexible tube inserted through the mouth.
    2. Colonoscopy – The lining of the large intestine, colon and rectum can be viewed by a flexible tube inserted through the rectum.
    Preparation
    • Blood tests are sometimes required.
    • Medications can be given by vein if needed.
    • Please arrange for a ride home. You may feel drowsy after the procedure due to medications.
    • Upper endoscopy: No food or drink is allowed for six hours before the procedure. An empty stomach allows for the best view and safest exam.
    • Colonoscopy: Drink only clear liquids for at least 24 hours before the procedure. A laxative or special cleansing solution will be ordered by the physician to clear the bowel of stool so that the rectum/intestines can be seen. (See below for specific instructions)

    Day of procedure

    • The doctor will explain the procedure and get your consent.
    • Tell your doctor about medications you are taking.
    • Discuss allergies to medications and other medical conditions.
    • This is the time to ask questions about procedure.

    What can I expect during upper endoscopy?

    Your doctor will spray your throat with a local anesthetic or give you a sedative to help you relax. You’ll then lie on your side, and a doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope doesn’t interfere with your breathing. Most patients consider the test only slightly uncomfortable, and many patients fall asleep during the procedure.

    What happens after upper endoscopy?

    You will be observed closely until most of the effects of the medication have worn off. Your throat might be a little sore, and you might feel temporarily bloated due to the air introduced into your stomach during the test. You will be able to eat after you leave unless your doctor instructs you otherwise.

    Your doctor generally can tell you your test results on the day of the procedure; however, the results of some tests might take several days.

    If you received sedatives, you won’t be allowed to drive after the procedure even though you might not feel tired. You should arrange for someone to accompany you home because the sedatives may affect your judgment and reflexes for the rest of the day.

    What happens during colonoscopy?

    Colonoscopy is well-tolerated and rarely causes much pain. You might feel pressure, bloating or cramping during the procedure. You will likely receive a sedative to help you relax and better tolerate any discomfort.

    You will lie on your side or back while your doctor slowly advances a flexible tube (colonoscope) through your large intestine to examine the lining. The whole procedure itself usually takes 45 to 60 minutes, although you should plan on two to three hours for waiting, preparation and recovery.

    What happens after a colonoscopy?

    Your physician will explain the results of the examination to you, although you’ll have to wait for the results of any biopsies performed. If you were given sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgment and reflexes could be slow for the rest of the day. You may have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly when you pass gas.

    You should be able to eat after the examination, but your doctor may restrict your diet and activities, especially after the removal of any polyps.





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