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If your doctor has recommended an endoscopy, you may have questions such as “Why do I need an endoscopy?”, “Is an endoscopy painful?”, “What will the doctor look for?” and “How should I prepare?”
An upper gastrointestinal endoscopy, commonly called an upper GI endoscopy or EGD, is a procedure used to examine the inside of the esophagus, stomach and duodenum using a thin, flexible tube with a camera. It can help identify the cause of persistent digestive symptoms, detect abnormalities, take tissue samples and, in some situations, treat problems during the same procedure.
For someone experiencing ongoing acidity, heartburn, stomach pain, vomiting or difficulty swallowing, an endoscopy may help a gastroenterologist understand what is happening inside the upper digestive tract.
An endoscopy is a procedure that allows a doctor to see the inside of the upper digestive tract using a flexible tube called an endoscope.
The endoscope has a small camera and light at its tip. During an upper GI endoscopy, it is carefully passed through the mouth into the:
The images are displayed on a monitor, allowing the doctor to examine the lining of the digestive tract.
During the procedure, the doctor may also:
A biopsy generally does not cause discomfort because the tissue is collected through the endoscope. Biopsies may be taken for several reasons, including testing for H. pylori, and are not necessarily an indication that cancer is suspected.
An endoscopy is usually recommended when a doctor needs more information about persistent or unexplained upper digestive symptoms or suspects a condition that needs direct examination.
Common reasons include:
Clinical guidance from the American Society for Gastrointestinal Endoscopy includes persistent upper abdominal symptoms despite appropriate treatment, difficulty swallowing, persistent vomiting and reflux symptoms that continue or recur despite treatment among indications for considering upper GI endoscopy.
Having acidity or stomach pain does not automatically mean that you need an endoscopy. The decision depends on your symptoms, medical history, examination and individual risk factors.
Digestive symptoms such as heartburn and acid reflux are common across populations.
A systematic review of 102 studies from 37 countries estimated the global prevalence of gastroesophageal reflux disease (GERD/GORD) at 13.98%, with an estimated 1.03 billion people worldwide affected based on the population estimates used in the study. The prevalence varied considerably between regions and countries.
However, this does not mean that everyone with acidity or heartburn requires an endoscopy.
The need for an endoscopy depends on factors such as the persistence of symptoms, response to treatment and the presence of symptoms that require further investigation.
An endoscopy may be recommended when your doctor needs to directly examine your upper digestive tract to identify a possible cause of symptoms or to guide treatment.
If your pain continues despite appropriate treatment, an endoscopy may help investigate possible causes.
If heartburn or reflux symptoms continue or return despite appropriate treatment, your doctor may consider an endoscopy.
Difficulty swallowing, known medically as dysphagia, can have several causes and should be evaluated.
Repeated vomiting without a clear explanation may require further investigation.
Blood in vomit or black, tar-like stools can indicate bleeding in the upper digestive tract and require prompt medical assessment.
Unintentional weight loss together with digestive symptoms may be a reason for further investigation. The decision is individualized and should be made by a qualified healthcare professional.
Stomach pain can have many causes, so an endoscopy is not automatically required.
Your doctor may ask:
If upper abdominal symptoms persist despite appropriate treatment, an upper GI endoscopy may be considered to investigate the cause.
An upper GI endoscopy can help doctors investigate several conditions affecting the upper digestive tract.
GERD and reflux-related changes
Endoscopy can identify certain complications of acid reflux, including inflammation and other structural changes.
Gastritis
Inflammation of the stomach lining may be visible during an endoscopy. A biopsy may also be taken when appropriate.
Stomach and duodenal ulcers
An endoscopy can identify ulcers and, in some cases, treat bleeding from an ulcer.
Esophagitis
Inflammation of the esophagus may be associated with acid reflux or other conditions.
Barrett’s esophagus
Endoscopy may be used to identify and monitor Barrett’s esophagus in appropriate patients.
Gastrointestinal bleeding
Endoscopy can help identify the source of upper GI bleeding and may allow treatment during the same procedure.
Abnormal growths
If the doctor sees an unusual area, a biopsy can be collected and sent to a laboratory for examination.
NIDDK notes that upper GI endoscopy can be used to investigate ongoing pain, heartburn, vomiting and swallowing problems and can help identify conditions including GERD, Barrett’s esophagus, celiac disease and cancer.
An endoscopy can identify suspicious areas and allow a biopsy to be taken, but seeing an abnormal area during endoscopy does not by itself confirm cancer.
If the doctor identifies an area that needs further evaluation, a small tissue sample can be collected. The biopsy is then examined by a pathologist.
Biopsies may also be taken to investigate conditions such as inflammation or H. pylori infection and are not only performed when cancer is suspected.
Yes.
An upper GI endoscopy can identify ulcers in the esophagus, stomach or duodenum. If bleeding is found, certain endoscopic techniques can be used to control it.
Your doctor may also take tissue samples when necessary to investigate the underlying cause.
Endoscopy can identify certain complications associated with GERD, including esophageal inflammation or Barrett’s esophagus.
However, not every person with GERD symptoms has visible changes during endoscopy.
Therefore, a normal endoscopy does not necessarily mean that a patient’s reflux symptoms are not genuine.
Your gastroenterologist will decide whether endoscopy or another diagnostic approach is appropriate based on your symptoms and clinical history.
If this is your first endoscopy, knowing what to expect can make the procedure less stressful.
Before the procedure
You will receive instructions about fasting and your medicines.
Tell your doctor about:
Some medicines may need to be adjusted before the procedure. Do not stop prescribed medicines on your own.
You will generally lie on your side.
Depending on your procedure and medical condition, you may receive a sedative to help you relax. Your throat may also be numbed with a local anesthetic. The doctor carefully passes the endoscope through your mouth and into your esophagus, stomach and duodenum.
The camera sends images to a monitor, allowing the doctor to examine the digestive tract. An upper GI endoscopy typically takes around 10 to 20 minutes. The endoscope does not interfere with breathing, and many patients sleep during the procedure.
If necessary, the doctor can take biopsies or perform certain treatments during the procedure.
Most patients do not experience significant pain during an upper GI endoscopy, although temporary discomfort or gagging can occur.
Sedation may be used to make the procedure more comfortable, and many patients sleep through much of it.
Afterward, you may experience:
These effects are generally temporary. If you are anxious about an endoscopy, tell your doctor before the procedure so your concerns can be discussed.
An empty stomach helps the doctor see the upper digestive tract clearly and safely.
You may be asked to:
NIDDK states that patients may be instructed not to eat or drink for up to 8 hours before an upper GI endoscopy, although the exact timing can vary.
ASGE similarly advises patients to follow the fasting instructions provided by their doctor.
Always follow the specific instructions given by your healthcare team.
Some medicines can be continued, while others may need to be adjusted.
Tell your doctor if you take:
Your doctor will tell you whether any medication needs to be changed before the procedure.
After the procedure, you will usually remain under observation until the effects of sedation begin to wear off.
You may temporarily experience:
NIDDK states that patients may remain at the hospital or outpatient centre for about one hour after the procedure while the sedative wears off, although recovery times can vary.
If sedation was used, arrange for someone to take you home. You should follow your doctor’s instructions about driving, work and other activities.
Your doctor may discuss the findings immediately after the procedure. If a biopsy was taken, the laboratory results will take longer.
Upper GI endoscopy is generally considered a low-risk procedure, but complications can occur.
Possible complications include:
Serious complications are uncommon. ASGE reports that large studies have reported adverse-event rates ranging from approximately 1 in 200 to 1 in 10,000, depending on the study population and how complications were defined. Data from approximately 140,000 upper GI endoscopy procedures reported a cardiopulmonary event rate of about 1 in 170 and mortality of approximately 1 in 10,000.
These figures are population-level data and do not represent an individual’s personal risk. Your doctor will consider your age, medical conditions, medications, sedation and the type of endoscopy being performed.
Mild throat discomfort or bloating can occur after the procedure.
However, seek medical attention promptly if you experience:
These symptoms can indicate a complication and should be assessed promptly.
Although both procedures use an endoscope, they examine different parts of the digestive system.
| Feature | Upper GI Endoscopy | Colonoscopy |
| Examines | Esophagus, stomach and duodenum | Colon and rectum |
| Entry point | Mouth | Rectum |
| Common symptoms investigated | Heartburn, upper abdominal pain, vomiting, swallowing difficulty | Changes in bowel habits, rectal bleeding and other lower GI symptoms |
| Biopsy | Yes | Yes |
| Certain treatments | Yes | Yes |
Your doctor will recommend the appropriate procedure based on your symptoms and the part of the digestive tract that needs evaluation.
Not every digestive problem requires an endoscopy. Depending on your symptoms, your doctor may consider:
The purpose of a consultation is to determine which test can provide the information needed to diagnose or manage your condition.
This is why persistent digestive symptoms should be assessed by a qualified doctor rather than assuming that an endoscopy is necessary.
Consider consulting a Gastroenterology specialist in Mumbai if your digestive symptoms are persistent, recurrent or affecting your daily life.
You should seek medical evaluation if you experience:
A gastroenterologist can review your symptoms and medical history and determine whether you need an endoscopy, another investigation or medical treatment.
At Smt S R Mehta & Sir K P Cardiac Institute, patients can receive evaluation and treatment for gastrointestinal and digestive conditions as part of the hospital’s multidisciplinary healthcare services.
An endoscopy can provide important information when digestive symptoms persist or when your doctor needs to examine the upper digestive tract more closely.
It can help investigate heartburn, GERD, stomach pain, vomiting, swallowing difficulties, ulcers, inflammation and gastrointestinal bleeding. It can also allow doctors to take biopsies and perform certain treatments during the same procedure.
However, not every person with acidity, heartburn or stomach pain needs an endoscopy. The decision should be based on your symptoms, medical history, examination and your doctor’s clinical judgment.
If you have persistent or recurring digestive symptoms, speaking with a qualified Gastroenterology specialist in Mumbai can help you understand the possible cause and whether an endoscopy or another diagnostic test is appropriate.
Smt S R Mehta & Sir K P Cardiac Institute provides multidisciplinary healthcare services, including evaluation and management of gastrointestinal conditions.
An endoscopy is a procedure in which a doctor uses a thin, flexible camera to examine the inside of the upper digestive tract, including the esophagus, stomach and duodenum.
An endoscopy is done to investigate symptoms such as persistent stomach or upper abdominal pain, heartburn, vomiting, difficulty swallowing or gastrointestinal bleeding. It can also help identify ulcers, inflammation and other abnormalities and allow biopsies or certain treatments.
Not everyone with acidity needs an endoscopy. It may be considered when reflux symptoms persist or return despite appropriate treatment or when warning symptoms such as difficulty swallowing, bleeding, unexplained weight loss or persistent vomiting are present.
An endoscopy can cause temporary discomfort or gagging, but sedation and throat-numbing medication may be used to improve comfort. Many patients sleep during the procedure.
The upper GI endoscopy itself generally takes around 10–20 minutes, although preparation and recovery mean that you will spend longer at the healthcare facility.
Yes. An upper GI endoscopy can identify ulcers in the esophagus, stomach or duodenum and may allow the doctor to treat bleeding when necessary.
An endoscopy can identify suspicious areas and allow the doctor to take a biopsy. The tissue is then examined by a pathologist to determine the diagnosis.
Endoscopy can identify certain complications of GERD, including inflammation or Barrett’s esophagus. However, some patients with reflux symptoms may have a normal endoscopy.
You will generally need an empty stomach before an upper GI endoscopy. Your healthcare team will provide specific instructions about when to stop eating and drinking.
S.R. Mehta & Sir K.P. Cardiac Institute, Mumbai’s premier facility noted for excellence in heart health services, provides the greatest cardiac hospital experience.