Upper Endoscopy

In upper endoscopy, the gastroenterologist uses a type of endoscope called a gastroscope to examine the esophagus. The specialist can use this scope to visualize the entire length of the esophagus including, importantly, its juncture with the top of the stomach (an area of focus when GERD is suspected).

This test, also referred to as EGD or esophagogastroduodenoscopy, is commonly used to evaluate patients experiencing persistent esophageal reflux, dysphagia (difficulty swallowing), chronic indigestion or stomach pain, nausea, vomiting, and other symptoms. Upper endoscopy is a safe and widely used procedure requiring a stay of just a couple hours at an endoscopy facility. The procedure is also sometimes referred to as gastroscopy, if the primary area of evaluation is the stomach.

Patients fast prior to the test and then receive mild sedation. The specialist inserts a scope of about the thickness of a pencil into the mouth and advances it down the esophagus, to the stomach, and sometimes to the small intestine. (See illustration.) The physician can inspect for any visual signs of inflammation, infection, bleeding, cancer, or precancerous cell changes. The doctor can also identify anatomical changes such as constricted areas or hiatal hernia. For tissue areas of interest or concern, the specialist may take a biopsy (small sample of cells) with the endoscope for evaluation microscopically in the lab. These samples help confirm that tissue is healthy or that it has cancerous, precancerous, or infected characteristics.

Upper endoscopy has also found increasing use as treatment modality. Trained specialists can use it to expand narrowed areas, remove benign growths such as polyps, retrieve swallowed objects, and repair bleeding from ulcers or lining tears. These capabilities can spare patients surgical procedures.

The endoscopist will often inform patients of the preliminary findings of the upper endscopy while they are in the recovery area. A full report, including biopsy results, may take several more days.

For more on what this test entails, see: Preparing for your upper endoscopy.