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Upper GI Scope

About the author:

Dr. Minocha  is a practicing gastroenterologist and author of "Natural Stomach Care: Treating and Preventing Digestive Disorders with Best of Eastern and Western Therapies"

An upper gastrointestinal (GI) scope or endoscopy (esophago-gastroduodenoscopy a.k.a. EGD) directly visualizes the interior of the esophagus, stomach and duodenum. It is an

outpatient procedure usually performed in a hospital or outpatient surgery center.

A key advantage of the scope is the doctor can not only directly see whether there is any damage to the inner layer of the wall of the esophagus, stomach, or duodenum but he/she can also take immediate action, such as removing polyps or taking biopsy samples. An upper GI x ray on the other hand, looks at the organs indirectly and intervention cannot be undertaken at the time of the test.




EGD is recommended for the evaluation of persistent indigestion, longstanding or refractory heartburn, difficulty swallowing, upper abdominal pain, unexplained anemia and upper GI bleed. However, it is not 100% accurate and can miss lesions on rare occasions.


The scope is generally not performed in cases of perforation or tear in the bowel, or clinically unstable patients.

Before the procedure

You will be given written instructions on how to prepare for the test. This generally involves not taking anything by mouth after midnight prior to the day of test. In contrast to colonoscopy, laxatives are not needed. Other instructions involve your diet, and medications you may be taking such as insulin, iron pills or blood thinners. Be sure to tell your doctor if you require antibiotics prior to procedures such as dental work.

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On the day of the test

Arrive at the test site at least one hour before the procedure. Because sedatives are administered during the exam, you cannot and will not be allowed to drive yourself home. Bring someone with you or make arrangements to be picked up after the procedure.

After initial registration, a nurse will take your medical history and make an assessment. A needle/catheter will be inserted into a vein. This catheter allows for administration of fluids as well as medications for the procedure.



After a brief discussion with your doctor, sedatives will be administered intravenously. The goal is to keep you comfortable through conscious sedation and not general anesthesia. Most patients fall asleep and do not remember much about the test.

Sedatives are not mandatory, and some patients request that no sedation be administered. Rest of the procedure remains the same, and these patients can drive themselves back to home or work. Upper GI scope without sedation is the norm in most of the world, except U.S.A.

After administering sedatives, a bite-block is placed between the teeth. The scope is introduced into the throat, down into the esophagus and then advanced up to the first part of the small intestine.  If imagining this


process makes you feel like gagging, don’t worry: the gag reflex is significantly suppressed by the medications and most patients do not have any problem at all.

The flexible endoscope looks like a black hose. The video-camera inside the scope allows the doctor to see the inside of the digestive system on a TV monitor.

The stomach and intestine is filled with air so the doctor can see the entire circumference of the digestive wall. If you are awake, you may be able to watch your insides on the monitor. The doctor may give you additional sedatives during the procedure depending upon how you are feeling, and as long as your heart, respiration and blood pressure are fine.

The doctor may take biopsies or remove polyps during the procedure. You will not feel this because nerves in the gut respond to distention by air or the scope, but not to cutting. Similarly injections of medications and cauterization may be performed to control bleeding. Dilators may be passed through the scope or separately after removing the scope, to stretch your esophagus if it is narrowed.

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Just like accidents while driving, complications may occur during EGD. Bleeding, perforation of the bowel, cardiac, respiratory and blood pressure problems, and even death may occur. The rate of complications is low. Your doctor will recommend the test only if the benefits outweigh the risks.


An upper GI endoscopy only examines the structure, not the functioning of the upper digestive system. Thus, a normal exam does not exclude the possibility that your symptoms are related to the upper GI tract. For example, upper GI scope is normal in about half the patients with symptoms related to acid reflux disease.

After the test


You will be monitored in the recovery room for about 20-60 minutes depending upon your mental cardiac and respiratory status. You will be discharged to home with the family member or friend that came with you. You will be groggy for the next few hours and should remain at home resting for the remainder of the day. Full recovery by the next day is expected and you may drive and go to work.

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