Upper endoscopy preparation

Overview

An upper endoscopy is a test where a doctor uses a thin, flexible tube with a tiny camera to look inside your oesophagus (food pipe), stomach, and the first part of your small intestine. It helps find problems like ulcers, inflammation, or bleeding.

Yes, upper endoscopy is a common procedure done in hospitals and clinics around the world.

It is used for people of all ages who have symptoms like persistent heartburn, stomach pain, nausea, vomiting, or difficulty swallowing.

Symptoms

Common symptoms

• Persistent heartburn or acid reflux that does not improve with lifestyle changes or over-the-counter medicines.
• Unexplained upper abdominal pain or discomfort.
• Trouble swallowing or pain when swallowing.
• Nausea or vomiting that lasts for weeks.
• Feeling full quickly after eating small amounts.
• Vomiting blood or having black, tarry stools (signs of bleeding in the digestive tract).

Symptoms in children

• Ongoing vomiting or spitting up that is forceful or contains blood.
• Poor weight gain or growth.
• Unexplained stomach pain that keeps coming back.
• Difficulty swallowing or choking on food.

Symptoms in older adults

• Anaemia (low red blood cells) with no obvious cause.
• Unintentional weight loss along with digestive symptoms.
• New or worsening trouble swallowing.
• Bleeding from the digestive tract, which may show as black stools or vomiting blood.

Causes

Main causes

• The procedure is done to find the cause of symptoms like ongoing heartburn, stomach pain, or bleeding.
• Common conditions found include gastroesophageal reflux disease (GERD), stomach ulcers, inflammation of the stomach lining (gastritis), or celiac disease.
• It may also be used to check for abnormal growths, such as polyps or tumours.

Risk factors

• Having chronic acid reflux (GERD).
• Taking certain pain medicines called non-steroidal anti-inflammatory drugs (NSAIDs) for a long time.
• Being infected with H. pylori bacteria.
• Having a family history of stomach cancer or other digestive cancers.
• Being over the age of 50, as the risk of stomach conditions increases.

When to see a doctor

See a doctor urgently if:

• If you are vomiting blood or have black, tarry stools, contact your doctor or go to the emergency room immediately.
• If you have severe abdominal pain that comes on suddenly and does not get better.

Book a routine appointment if:

• If you have had heartburn, indigestion, or stomach discomfort for several weeks that does not improve with over-the-counter remedies.
• If you have trouble swallowing or feel like food is getting stuck in your chest.

Diagnosis

The diagnosis of conditions affecting the upper digestive tract often starts with a discussion of your symptoms and a physical exam. If your doctor suspects a problem, they may recommend an upper endoscopy as the best way to see inside your digestive system directly.

Tests that may be done

• Upper endoscopy (oesophagogastroduodenoscopy – EGD) – the main test.
• Sometimes a small sample of tissue (biopsy) is taken during the endoscopy to check for inflammation, infection, or abnormal cells.
• If needed, other tests like a barium swallow X-ray or a pH test for acid reflux may be done before or after the endoscopy.

What to expect at your appointment

Before the endoscopy, you will be asked to stop eating and drinking for several hours. You may receive a sedative to help you relax. The doctor will gently insert the endoscope through your mouth and guide it down your throat while you are lying on your side. You might feel some pressure but it should not be painful. The test takes about 15 to 30 minutes. Afterward, you will rest in a recovery area until the sedative wears off. You will need someone to drive you home because the sedative can make you drowsy.

Treatment

Treatment depends on what the endoscopy finds. If the test reveals a condition such as a stomach ulcer, inflammation, or a precancerous growth, your doctor will talk to you about the best treatment plan. This plan may include lifestyle changes, medicine, or, in rare cases, surgery.

Self-care at home

• Before the endoscopy, follow all preparation instructions exactly, especially about not eating or drinking.
• After the test, rest for the remainder of the day. Do not drive or operate machinery until the next day.
• You may have a mild sore throat – drinking cool liquids or sucking on ice chips can help.

Medical treatments

If ulcers or inflammation are found, doctors often prescribe medicines that reduce stomach acid. These might include proton pump inhibitors (PPIs) or H2 blockers. If an infection like H. pylori is found, a course of antibiotics will be given. If abnormal growths or early cancer are discovered, they may be removed during the endoscopy or require further treatment like surgery or chemotherapy. Your healthcare team will discuss the specific options with you.

When is surgery considered?

Surgery is rarely needed for conditions found during an upper endoscopy. It may be considered for large bleeding ulcers that do not stop bleeding, for removing large polyps that cannot be removed during endoscopy, or for early-stage stomach cancer.

Living with this condition

After an upper endoscopy, most people go back to their normal routine the next day. If you had a biopsy or if a condition was found, your doctor will give you guidance on what to do next. Follow any treatment plan and attend follow-up appointments as recommended.

Lifestyle tips

• If you have acid reflux or heartburn, avoid eating large meals late at night, and try not to lie down right after eating.
• Limit foods that trigger your symptoms, such as spicy, fatty, or acidic foods.
• Quit smoking if you smoke, as it can worsen many digestive conditions.
• Manage stress with relaxation techniques like deep breathing or gentle exercise.

Diet and exercise

After the endoscopy, you may be advised to eat light, soft foods for the first few hours until your throat feels normal. In the long term, a balanced diet rich in fruits, vegetables, and whole grains can support digestive health. Regular, moderate exercise can also help with digestion and overall well-being.

Mental health and emotional wellbeing

Waiting for a test result or dealing with a digestive condition can cause anxiety or worry. It is normal to feel concerned. Talk to your doctor about your fears, and consider speaking with a counsellor if you need extra support. Remember that most conditions found during an upper endoscopy are treatable.

Prevention

While you cannot always prevent conditions that need an endoscopy, you can lower your risk by maintaining a healthy weight, not smoking, limiting alcohol, and avoiding long-term use of certain pain medicines without medical supervision.

Screening programmes

Routine screening upper endoscopy is not recommended for everyone. However, if you have a strong family history of stomach cancer or certain genetic conditions, your doctor may suggest periodic endoscopies to check for early signs. Talk to your healthcare provider about whether screening is right for you.

Complications

If left untreated

• If the underlying problem (like a bleeding ulcer or early cancer) is not treated, it can worsen over time.
• Untreated infections such as H. pylori can lead to chronic inflammation and increase the risk of stomach ulcers or stomach cancer.
• Severe narrowing of the oesophagus (stricture) can make swallowing increasingly difficult.

Long-term outlook

Upper endoscopy is a safe and very common procedure. Most conditions found can be successfully treated, especially when caught early. With proper care, the outlook for most digestive problems is very good. Your healthcare team will guide you through every step.

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