Having an upper gastrointestinal (GI) endoscopy

What is an upper GI endoscopy? 

An upper GI endoscopy allows an endoscopist to look inside the upper part of your digestive system. This is done using a small flexible tube that passes through your oesophagus (the tube which takes the food from the mouth to the stomach), and into the first bend of your duodenum (small intestine). 

This procedure will not affect your breathing at any time as the tube does not go through your windpipe. During the procedure a piece of tissue may be taken for further testing, this is known as a biopsy.  

You may feel a slight tugging sensation when this is taken but it should not be painful. It is very normal to experience a slight gagging sensation during the procedure. 

Why am I having this procedure? 

Your doctor or nurse has recommended that you have this procedure to find out more about the cause of your symptoms. An upper GI endoscopy can help to diagnose: 

• ulcers 

• inflammation 

• infection 

• the presence of some bacterias 

• coeliac disease (the inability to digest gluten) 

• cancer 

Will I have an anaesthetic? 

Most people will have a local anaesthetic which can be sprayed onto the back of your throat to numb the area. The advantages of local anaesthetic are: 

• you can go home immediately after the procedure 

• you do not need a friend or relative to take you home 

• you will be able to drive immediately after the procedure 

• you can return to work immediately after the test 

You may also be able to have a sedative known as conscious sedation. This is different from a general anaesthetic as it will not put you to sleep, but it will make you feel relaxed, and you will be able to respond during the procedure. You may experience a slight amnesic effect (loss of memory) with this type of anaesthetic. 

For conscious sedation to be administered, you will need to have a small needle and canula (a thin tube) inserted into the back of your hand. You will not be able to go home on your own so you will need a friend or relative to accompany you for at least 24 hours after the procedure.  

If you have not arranged for this in advance, we will not be able to offer you this type of anaesthetic. 

How do I prepare for the procedure? 

It is important that you follow all the instructions outlined below. If you do not, you risk your procedure being cancelled.  

To ensure there is a clear view during the procedure, your stomach must be completely empty. This means that you must not eat or drink for at least six hours prior to the procedure but you are allowed small sips of water for up to two hours before.  

If you have tea or coffee in the 6 hours before, there should be no milk in it.  

If you are diabetic, please see the separate leaflet enclosed for further instructions on how to prepare. 

Please bring a list of all your medications with you to your endoscopy appointment. Certain medications may need to be stopped prior to your procedure, please see the advice below: 

What will happen on the day of the procedure? 

When you arrive for your appointment, please report to reception to check in. We aim to see you as close to your appointment time as possible and we will keep you informed if there are any delays. 

You will be seen by a nurse prior to your procedure to discuss your medical history, perform some simple checks and explain what will happen. You will then be seen by an endoscopist who will discuss the risks and benefits of having an endoscopy and take your consent (permission) to carry out the procedure. 

Please ensure you ask the team any questions you may have at this point, no matter how small. You will then have the type of anaesthetic you have chosen. A nurse will be with you throughout the procedure which only takes about five to 10 minutes to complete.  

To help keep your mouth slightly open during the procedure, a mouthpiece will be placed between your teeth. The endoscopist may pass some air down the tube to get a clearer view if required, this may make you feel slightly bloated or cause you to burp but it won’t be painful.  

What happens after the procedure? 

If you have had an anaesthetic throat spray, you will have your blood pressure recorded before you are ready to leave the department. You will also have to wait approximately one hour before having anything to eat or drink. 

If you chose to have sedation, you will be transferred to the recovery area where nursing staff will monitor your condition for one to two hours before your friend or relative takes you home.  

You must not drink alcohol, operate machinery, drive or make important decisions for 24 hours after the procedure as the sedative can impair your judgement. 

You will receive the results of the procedure before you leave the department.  

If you had a biopsy taken it can take a few weeks for you to receive the results and you will be told your final diagnosis by the team who requested the procedure. This may be done by letter or during a clinic appointment. Copies of your results will also be sent to your GP. 

How will I feel after my procedure? 

It is normal to experience a sore throat or a bloated sensation for a few days after your endoscopy. If you have severe pain, black tarry stools (poo), shortness of breath, are vomiting blood, passing blood or have persistent bleeding, you should go to your nearest hospital emergency department for further advice. 

Please check the discharge sheet you were given when leaving your endoscopy appointment for any other specific advice that may help. 

What are the benefits, risks and alternatives to this procedure? 

Having an upper GI endoscopy is a very safe and effective procedure for diagnosing upper GI conditions and can help to provide a more accurate diagnosis. 

Serious complications from this procedure are rare but can include: 

• a very small risk (one in about 10,000) of bleeding or making a hole in the intestine during the procedure which may require surgery or a blood transfusion 

• aspiration pneumonia  

• damage to loose teeth or to dental bridgework 

Using sedation can cause breathing complications during one in 200 procedures, these are not usually serious. 

An upper GI endoscopy is recommended as the most effective procedure for diagnosing your condition however alternatives include a barium meal or a CT scan. However, for both procedures, biopsies cannot be taken you so may still need an upper GI endoscopy. 

A barium meal involves having an X-ray after drinking some barium liquid. As X-rays can’t go through the barium, the outline of your stomach shows up on your X-ray. 

Giving your consent (permission) 

Before your endoscopy you will be asked to sign a consent form. This means you agree to have the procedure and that you understand what it involves. In this leaflet there may be an example of the consent form you will be asked to sign on the day of your procedure.  

You do not need to sign this before your endoscopy, it is only so you can familiarise yourself with it beforehand. 

Training 

Training doctors and other health professionals is essential to the continuation of the NHS and improving the quality of care. Your treatment can provide an important opportunity for such training under the careful supervision of an experienced doctor.  

You can, however, decline to be involved in the formal training of medical and other students. This won’t affect your care and treatment.