What Do Doctors Look for During an Upper Endoscopy?

Similar to colonoscopies, upper endoscopies are valuable procedures used by healthcare professionals and gastroenterologists to examine the upper digestive tract, including the esophagus, stomach, and duodenum. In the United States, over 20 million gastrointestinal (GI) endoscopies are performed each year, making them an extremely common screening procedure. 

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During an endoscopy, a gastroenterologist inserts a thin, flexible tube with a lighted camera into your upper GI tract through your mouth or nose. As they gently advance the tube down toward your digestive organs, doctors take images and review live video footage of your esophagus, stomach, and duodenum linings. Because of the diverse functionality of your upper GI system, doctors may be on the lookout for various issues or indicators of GI dysfunction. Here, we will explore a few things your gastroenterologist might be looking for when performing your endoscopy and why screening is so important.

The Upper Endoscopy Procedure 

Upper Endoscopy also known as esophagogastroduodenoscopy (EGD), typically conducted in a hospital or outpatient endoscopy center, are valuable for examining the upper gastrointestinal system for abnormalities. To ensure patient comfort and minimize discomfort during the procedure, sedation is administered while doctors carefully insert the endoscope through the nose or throat. Sedation is typically accomplished through either moderate sedation with fentanyl (a pain medication), and Versed (a sedative), or by using a stronger sedative called propofol.  Fentanyl and Versed can be administered by your gastroenterologist. Propofol requires the participation of an anesthesiologist. A live video feed of the upper gastrointestinal tract is viewed and analyzed to provide a diagnosis.

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Patients are monitored in a recovery room until fully awake after the procedure. While some temporary discomfort, such as a sore throat or bloating, may be experienced, most patients recover quickly. As a safety measure, a friend or relative must accompany you home after the procedure, even if you feel capable of driving.

When Should You Consider an Endoscopy?

If you are experiencing persistent issues with your upper GI tract or have a family history of Gi issues such as cancer, Crohn’s disease, or gastrointestinal reflux disease (GERD), your primary care physician might recommend that you visit a gastroenterologist for further evaluation and to schedule an endoscopy appointment. Common symptoms that might require screening include:

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• Frequent heartburn
• Nausea
• Indigestion
• Persistent vomiting
• Difficulty swallowing
• Unexplained weight loss
• Blood in stool

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Suppose these symptoms remain persistent and do not resolve with over-the-counter medications. In that case, your doctor may recommend that you get regularly scheduled endoscopies to evaluate your health over time and assess for the development of diseases or cancer.

Preparing for an Endoscopy

Preparing for your endoscopy typically involves fasting for several hours before your procedure and avoiding certain medications or supplements. Up to four hours before your procedure, you may consume a clear liquid diet of broth, Jell-O, black coffee, tea, or pulp-free juice without red, orange, or purple colorings and flavorings.  

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Following a specific diet beforehand is crucial to obtain a clear view of your upper gastrointestinal system during the procedure. Avoid consuming heavy meals or foods with red, orange, or purple hues, as these can interfere with the screening process and may be misinterpreted as blood or inflammation. When doctors cannot gather an accurate interpretation of your GI health, you may need to reschedule and redo the procedure. 

What Doctors Might Find During Your Endoscopy

The upper gastrointestinal tract is responsible for vital bodily functions, including eating, swallowing, talking, breathing, and digestion. Therefore, doctors screen for various potential causes of your symptoms or discomfort. Some common findings that might indicate a medical condition include the following:

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Ulcers: Ulcers are sores that can develop in the esophagus, stomach, or duodenum lining. While various factors, such as poor diet, prolonged medication use, or genetic conditions, can contribute to ulcers, doctors often investigate the presence of Helicobacter pylori (H. pylori) bacteria as a potential cause.

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Gastritis: Usually characterized by inflammation of the stomach lining, gastritis can be caused by various factors, including H. Pylori infections, excessive acid production, and certain medications. 

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Esophagitis: Acid reflux, infection, or other underlying conditions can cause inflammation in the esophagus. If you are experiencing a persistent sore throat or pain when swallowing, doctors will look closely at the esophageal tract to evaluate for any possible diagnoses. 

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Barrett’s Esophagus: Barrett's Esophagus is a condition where the normal tissue lining the esophagus is replaced with tissue resembling the intestine. This change, often resulting from chronic inflammation, can elevate the risk of esophageal cancer if not addressed.

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Polyps: Polyps are small growths that can develop in the esophagus, stomach, or duodenum lining. While many polyps are benign, some can be precancerous.

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Cancer: During an endoscopy, doctors can obtain valuable information about your upper gastrointestinal system and collect tissue samples for cancer testing. Endoscopies are often used to detect early-stage esophageal cancer and assess a patient's risk of developing the disease.

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Hiatal Hernia: A hiatal hernia occurs when part of the stomach bulges through an opening in the diaphragm. Endoscopies can help diagnose these hernias and evaluate their severity, determining if surgical repair is required.

Post-Procedure Evaluation

Once your gastroenterologist and medical team have reviewed the findings from your endoscopy, they will discuss the next steps in your treatment plan. By analyzing your symptoms and discomfort, they can diagnose you and recommend appropriate treatments, such as medication, dietary changes, or surgery.

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Visiting a qualified endoscopist can be a valuable experience in identifying gastrointestinal and digestive tract conditions. Through gentle practices and quality care, endoscopists ensure that your GI health is being thoroughly evaluated and that you receive the best care possible for a long and healthy life.

Visit Dr. Ernest Castro, M.D for Specialized Gastrointestinal Care

As Denver’s premier destination for colonoscopy, endoscopy, and hemorrhoid treatment, Dr. Ernest Castro, M.D., and his team of professionals provide high-quality care and accurate and timely diagnoses to those experiencing GI issues. With an emphasis on putting patients’ needs first, Dr. Castro utilizes a personal and honest approach to addressing GI care. Get answers to your GI questions with Dr. Castro today! To request an appointment, visit our website or call (720) 868-3111 for more information.