Upper gastrointestinal endoscopy at Cardiff and Vale Hospitals

An upper GI endoscopy lets a doctor look directly inside your oesophagus (gullet), stomach and duodenum using a thin, flexible tube called a gastroscope. It's sometimes called a gastroscopy or an OGD (oesophago-gastro-duodenoscopy), and it can find problems and treat some of them in the same visit.

Why might I need an upper GI endoscopy?

This procedure may be recommended to find the cause of symptoms, which may include:

• ongoing heartburn, indigestion or acid reflux
• difficulty or pain when swallowing
• unexplained abdominal pain, nausea or vomiting
• unexplained weight loss or anaemia
• chest pain that isn't related to your heart
• vomiting blood, or dark, tarry stools.

It is also used to diagnose conditions such as gastroesophageal reflux disease (GORD), gastritis, coeliac disease, stomach ulcers, Barrett's oesophagus, hiatus hernia, and both cancerous and non-cancerous growths.

What are the benefits of an upper GI endoscopy?

This test gives a direct view of the lining of your gullet, stomach and duodenum, and is generally more accurate than an X-ray-based test such as a barium meal for spotting abnormal growths.

If your endoscopist finds a problem, they can often treat it in the same session, for example by taking a biopsy, stopping bleeding, or widening a narrowed area, without you needing a separate procedure or surgery.

Are there different types of upper GI endoscopy?

Endoscopy is a general term for any examination using a flexible camera, and this test is more specifically called a gastroscopy, OGD or upper endoscopy, since it looks only at the upper part of your digestive system. Doctors sometimes use these terms interchangeably.

You may also be offered a choice in how it's carried out:

• With a local anaesthetic throat spray only: That means you stay fully alert throughout
• With sedation given through a vein: Which helps you feel relaxed and comfortable, and means you may not remember much of the procedure afterwards.

How do I prepare for an upper GI endoscopy?

Your stomach needs to be empty so your endoscopist gets a clear view. You'll usually be asked not to eat for 6 hours beforehand, and to stop drinking clear fluids a couple of hours before your appointment time. Your team will give you exact timings to follow.

Tell your doctor about all the medications you take, especially:

• blood-thinning medication, which may need to be paused beforehand
• diabetes medication, which may need adjusting on the day
• aspirin or anti-inflammatory painkillers.

You can usually continue most other medication as normal, with a small sip of water. If you're being sedated, you'll need to arrange for a responsible adult to take you home and stay with you afterwards, as you won't be able to drive.

On the day, wear loose, comfortable clothing and avoid bringing valuables. You will be asked to remove any dentures or glasses just before the procedure.

What happens during an upper GI endoscopy?

1. Your throat will be numbed with a local anaesthetic spray. If you're having sedation, this is given through a small needle into a vein in your hand or arm
2. A small mouth guard is placed between your teeth to protect them, and you'll lie on your left side on a couch
3. The gastroscope is passed through your mouth, down your throat, and into your oesophagus, stomach and duodenum. Air is pumped in through the tube to give a clearer view, which can feel like bloating or wind
4. The camera on the end sends live pictures to a screen, allowing your endoscopist to examine the lining closely, take biopsies, or carry out any treatment needed
5. The tube is removed once the examination is complete.

The test itself usually takes about 10 to 20 minutes, though it can take longer if treatment is needed. It shouldn't be painful, but you may feel some discomfort – you can ask for it to stop at any point.

What happens after an upper GI endoscopy?

If you only had a throat spray, you'll wait until the numbness wears off, usually after about 30 minutes, before being offered a drink and going home.

If you were sedated, you'll rest until the immediate effects wear off, usually within about an hour, before the person you've arranged to take you home can collect you. The effects of sedation can last up to 24 hours, so during this time you shouldn't drive, operate machinery, drink alcohol, or sign anything legally binding.

It's normal to feel bloated, pass wind, or have a sore throat for 24 to 48 hours afterwards; cold drinks can help soothe your throat.

Your endoscopist may tell you the outcome before you leave, and a report is normally sent to your GP. If you had a biopsy, results can take anywhere from a couple of weeks up to 6 weeks, depending on the service.

Contact your doctor or seek urgent medical care if you develop worsening throat, chest or abdominal pain; difficulty breathing or swallowing; vomit that's bloody or looks like coffee grounds; black or tarry stools; or a fever.

What are the risks or side effects?

This is a safe procedure with a low overall risk, though as with any medical test, complications can occasionally happen.

• Discomfort, bloating and a sore throat for a day or two, which is common and usually mild
• Rarely, damage to teeth or bridgework, which the mouth guard helps prevent
• Complications such as bleeding or a perforation of the lining of your gut are rare
• If you're sedated, a reaction affecting your breathing, heart rate or blood pressure – you'll be closely monitored throughout
• A small chance the test is incomplete, or that a problem is missed – endoscopy is very accurate but not perfect.