Understanding upper gi endoscopy
Upper gastrointestinal endoscopy, also called gastroscopy, lets the clinician look at the lining of the oesophagus, stomach and first part of the small intestine. Tissue samples can be taken when needed.
It may help investigate persistent upper digestive symptoms or treat certain problems. Your referral should explain the clinical question the test is intended to answer.
The camera is passed through the mouth and into the oesophagus, stomach and duodenum. It provides a direct view of the lining rather than the outside of these organs. This makes it useful for ulcers, inflammation and other mucosal changes, but a normal test does not rule out every cause of abdominal symptoms.
Biopsies can investigate inflammation, infection or other microscopic changes and are not taken only for suspected cancer. An immediate visual report and a laboratory result are different parts of the assessment. The plan should identify who will review both and decide whether further investigation is needed.
Types & classification
Inspection of the upper digestive tract, with biopsies if indicated.
Selected problems such as bleeding or narrowing may be treated during an appropriate procedure.
Symptoms & causes
Symptoms to look for
- Persistent upper abdominal discomfort or reflux
- Difficulty swallowing
- Unexplained vomiting or anaemia
Common causes & risk factors
- Suspected inflammation or ulcer disease
- Assessment of swallowing problems
- Investigation of bleeding or another abnormal finding
When to see a surgeon
- Discuss persistent symptoms and unexplained weight loss with a clinician.
- Vomiting blood, black stools with dizziness, severe pain or collapse requires emergency assessment.
How it is diagnosed
Symptoms, age, medicines, previous tests and alarm features guide the decision. Persistent swallowing difficulty, unexplained anaemia, bleeding or weight loss require clinical assessment rather than treatment based on symptoms alone.
The endoscopist examines the upper digestive lining and records relevant findings. A normal appearance is useful information but must be interpreted alongside the original symptoms.
Small tissue samples may be taken to investigate specific conditions. Ask what is being tested, how long results may take and how to obtain them.
If the examination does not explain symptoms, blood tests, imaging or other specialist investigations may be advised. An endoscopy is not a substitute for all abdominal tests.
Treatment options
The appropriate option depends on your diagnosis, examination and general health. Your clinician will explain the benefits and risks of the available approaches.
Some symptoms can initially be managed after a clinical review. A trial of treatment should include a plan for reassessment if symptoms persist or change.
This is chosen when examining the lining or obtaining tissue is likely to guide care. Throat spray, sedation and other comfort options are discussed beforehand.
Selected bleeding lesions or narrowings may be treated with suitable endoscopic techniques. These procedures have their own consent, risks and aftercare and should not be assumed to be included in every diagnostic appointment.
Medication, surveillance, another investigation or surgery may be recommended depending on the diagnosis. The report should lead to a clear next step.
Preparing for treatment
- Follow the unit’s exact fasting instructions.
- Ask for individual instructions about blood thinners and diabetes medicines; do not stop them yourself.
- If sedation is planned, arrange an escort and follow restrictions afterwards.
- Follow the written fasting instructions exactly; the stop times for solid food and clear drinks can differ. Contact the unit if you ate or drank outside the instructions.
- Tell the team about blood thinners, diabetes medicines, weight-loss medicines, allergies, loose teeth, dentures and previous anaesthetic reactions.
- Ask whether any acid-suppressing medicine needs adjustment for the intended test; do not stop it without advice.
- If sedation is planned, arrange a responsible adult to take you home and provide the supervision requested.
The procedure, step by step
- Assessment and consentThe team checks the reason for the test, fasting, medicines and consent for any planned sampling or treatment.
- Comfort and monitoringA throat spray may numb the throat. If IV sedation is used, it helps you relax and feel sleepy but is not necessarily a general anaesthetic. Monitoring is provided as appropriate.
- Passage of the cameraWith you usually lying on your side and a mouth guard in place, the flexible scope is passed through the mouth. The team guides you through swallowing and manages saliva.
- Inspection and samplingAir or gas helps open the view. The lining is examined and samples or consented treatment are undertaken when needed.
- Recovery and dischargeAfter the scope is removed, you rest as required. The team explains when eating and drinking can resume and gives the report, precautions and follow-up plan.
Recovery timeline
- First hourWait for throat sensation and safe swallowing to return before eating or drinking, following the unit’s instructions. You may have mild throat soreness or bloating.
- First 24 hours after sedationAn escort and appropriate supervision are needed. Feeling awake does not mean judgement and coordination have fully recovered. Follow the restrictions on work, driving and important decisions.
- Following dayAfter an uncomplicated diagnostic examination, ordinary activities are often possible once sedation restrictions have ended and you feel well. Additional treatment may require longer precautions.
- Results and follow-upBiopsy results are not usually immediate. Confirm who will review them and what to do if symptoms continue despite a reassuring visual report.
Benefits of this approach
- Direct inspection of the digestive lining
- Biopsy or selected treatment during the same examination
Risks & possible complications
Every operation carries risk, and you should hear about it before you consent rather than afterwards. These are discussed individually at consultation in the context of your own health.
- Sore throat or bloating
- Sedation-related problems
- Bleeding or a tear in the digestive tract, which are uncommon but important
- Aspiration of stomach contents, especially if fasting instructions are not followed.
- Dental or mouth injury, particularly with loose teeth or existing dental work.
- A normal or incomplete examination may not explain symptoms; further assessment can still be needed.
What affects the cost
- Diagnostic inspection alone versus biopsies or an endoscopic treatment
- Throat spray, sedation or anaesthetist involvement
- Laboratory testing and any additional instruments required
- Observation or admission if treatment or illness requires it