Upper gastrointestinal endoscopy, also called upper GI endoscopy, gastroscopy or esophagogastroduodenoscopy, is a procedure used to examine the lining of the esophagus, stomach and first part of the small intestine, called the duodenum.
A thin, flexible tube with a light and camera is passed through the mouth, allowing the doctor to view these areas directly. Tissue samples can be collected during the same procedure to help diagnose cancer or other conditions.
Upper GI endoscopy may also be used for surveillance or to perform selected treatments. CT, PET-CT, endoscopic ultrasound or other tests may still be required to determine how deeply a tumour has grown or whether it has spread.
Role in Cancer Care
What to Expect Expect
Before the TestÂ
The stomach must be empty so the doctor can see clearly and reduce the risk of food or fluid entering the airway. You will usually be instructed not to eat or drink for a specified period before the procedure.
Inform the care team if you:
Take blood thinners, aspirin or medicines that affect clotting
Have diabetes and use insulin or other glucose-lowering medicines
Have heart, lung, kidney or liver disease
Have swallowing or breathing difficulties
Have allergies or have previously reacted to sedation or anesthesia
Are pregnant or may be pregnant
Have a pacemaker or another implanted device
Have loose teeth, dentures, crowns or other dental concerns
Take prescription medicines, non-prescription medicines or supplements
Do not stop or adjust any medicine unless specifically instructed. Blood tests or other assessment may be required if a biopsy or treatment is planned.
If sedation will be used, arrange for a responsible adult to accompany you home. You should not drive after receiving sedation.
During the Test
You will usually lie on your left side. A local anesthetic spray may be applied to the throat, and sedation may be given through a vein to help you relax. The type of sedation or anesthesia depends on the planned procedure and your health.
A mouth guard is placed to protect the teeth and endoscope. The doctor then guides the endoscope through the mouth and into the upper digestive tract. The scope passes through the esophagus and does not obstruct the airway.
Air or carbon dioxide may be introduced to expand the area being examined. You may feel pressure, bloating or the urge to burp. Tissue sampling is not usually felt because the lining of the digestive tract does not sense cutting in the same way as skin.
A routine diagnostic endoscopy commonly takes approximately 10 to 30 minutes. A procedure involving lesion removal, bleeding control, dilation or stent placement may take longer.
After the TestÂ
You will be monitored until the effects of sedation have reduced. Temporary bloating, mild nausea or a sore throat may occur.
Wait until swallowing has returned to normal before eating or drinking if throat-numbing medicine was used. Follow the instructions provided about diet, medicines and activity.
If you received sedation, do not drive, operate machinery, drink alcohol, sign important documents or make major decisions for the period specified by the care team. Arrange for someone to stay with you if advised.
The doctor may discuss the visual findings after the procedure. Biopsy results take longer because the tissue must be processed and examined by a pathologist.
Contact the care team or seek urgent medical attention if you develop:
Difficulty breathing or swallowing
Severe or worsening chest or abdominal pain
Fever
Persistent vomiting
Vomiting blood or material resembling coffee grounds
Black, tarry stools or significant rectal bleeding
Marked dizziness, weakness or fainting
Potential Benefits
- Direct visualisation: The lining of the esophagus, stomach and duodenum can be examined in real time.
- Magnified assessment: Small, flat or subtle abnormalities may be seen more clearly than with some other tests.
- Tissue diagnosis: Biopsies can be taken directly from suspicious areas.
- Accurate localisation: The position and visible extent of an abnormality can be documented.
- Diagnostic and therapeutic use: Selected abnormalities can be assessed and treated during the same procedure.
- Early-lesion removal: Some superficial precancerous or cancerous lesions may be removed endoscopically.
- Symptom relief: Bleeding, narrowing or obstruction may be treated in selected patients.
- Surveillance: Endoscopy can monitor selected high-risk or precancerous conditions over time.
