What Is an Endoscopy?
An upper GI endoscopy is used to find out what’s wrong with the upper digestive system and treat it. People think of the area from the mouth to the beginning of the small intestine (the duodenum) as the upper GI tract.
There are signs that might tell you to call your doctor. Endoscopy can find a lot of different diseases, so the signs can be very different. A lot of GI problems have the same kinds of signs, so a much closer look is the only way to really tell what’s wrong. Some signs that you might need to call your doctor are:
- Pain in my stomach
- Having diarrhea, constipation, or both sometimes
- Vomiting and feeling sick
- Having your throat or stomach burn
- Going back up into the throat or mouth, this is called regurgitation.
- Disgrace (having trouble eating)
- Changes in bowel habits that can be seen
You should let your doctor know about these symptoms if they don’t go away with regular treatments like taking antacids or proton pump inhibitors (PPIs). This way, you can plan the procedure.
The process of getting ready for the endoscopy and actually doing it are both very simple. Most likely, your doctor will tell you not to eat or drink anything after midnight, except for small amounts of water to take your medicine.
A doctor can do an upper GI in a hospital or in their office. The whole process, from getting there to leaving, takes less than two hours for an outpatient treatment. It doesn’t take long for the endoscope to happen.
You will talk to the anesthesiologist, the doctor, and the lead nurse when you get there. You will be put under light anesthesia. It will be checked, and an IV will be given to you so that the anesthesia can work.
After that, you’ll be taken to the operation room and told to lie on your side. The process is done by the doctor after anesthesia is given. An endoscope is a long, thin, bendable tube that has a small camera on the end of it. The endoscope will be put into your mouth by your doctor so that pictures can be taken of the whole GI tract, from the mouth to the duodenum (a part of the small intestine).
Photos can only show so much, so it’s possible that your doctor will take biopsies and tissue samples to send to the lab. Your gastroenterologist will be able to give you a more accurate report once the samples and biopsies come back.
After the surgery, you are taken to a room for healing. The team will keep an eye on you for about 30 minutes to see if you have any side effects. As long as you have someone drive you home, you should be able to eat normally again after the process. If you are a doctor, you should stop doing more things for up to 24 hours.
Diseases and Conditions That Can Be Detected
To help your gastroenterologist make the right diagnosis, they use endoscopy to look for signs of many upper (and lower) GI problems that look alike. Endoscopy can find a lot of different diseases, but these are the most common ones.
Gastroesophageal Reflux Disease (GERD)
A lot of people have gastroesophageal reflux disease (GERD). Heartburn, also known as acid reflux, is the main sign of this condition, but vomiting may happen along with it. Gastric acid gets into the esophagus, which is not where it should be.
This is called reflux. The lower esophageal sphincter (LES) is the name of the muscle at the bottom of the stomach. After food or liquid goes through the LES, it should close all the way.
But in some people, the LES doesn’t work right and can stay open all the way or just a little. GERD is usually handled with medicines (like proton pump inhibitors) and changes to how you live your life.
Helicobacter pylori (H. pylori)
Another common GI problem is an infection with Helicobacter pylori (H. pylori). About half of the people in the world are thought to have H. pylori in their stomach, but for some people, it makes the walls of their stomach swell up.
Some people don’t have any symptoms, while others have problems like stomach pain and indigestion. Stomach ulcers are often caused by H. pylori, and it can also make you more likely to get stomach cancer, though stomach cancer is not common.
Antibiotics are often used to treat an H. pylori infection and other medicines, like PPIs, are used to help with the symptoms.
Esophageal Stricture and Dilatation
For people who have esophageal stricture, which is when the esophagus gets tight, it can be hard to swallow. Acid reflux can cause this in a number of ways, but damage is the most common. It can also be caused by eosinophilic esophagitis (an “allergic” esophagus) or esophageal cancer much less often.
You can also have esophageal dysmotility, which means your stomach doesn’t move normally, which can lead to esophageal stricture. Endoscopy is often able to find a stricture, but esophageal dilatation is often used during the process to be sure of the diagnosis. In esophageal dilatation, a tube is put in the narrow spot to make the esophagus wider. After that, the balloon is taken away before the endoscope is over.
Stomach and Duodenal Ulcers
Peptic ulcers, which are tears or breaks in the stomach lining, can happen in both the stomach and the duodenum. Most of the time, H. pylori is to blame for peptic ulcers. Antibiotics and acid-lowering drugs are used to treat them and ease the symptoms if they happen.
People used to think that worry, diet, or smoking could cause ulcers, but now we know that H. pylori infections or taking too many nonsteroidal anti-inflammatory drugs (NSAIDs) are the main culprits.
Stomach Cancer & Esophageal Cancer
Endoscopy can find both stomach cancer and esophagus cancer, even though they are not common. Cancer treatments, like radiation and chemotherapy, are used to find and treat cancer.
Gastric cancer is not common, but it can cause stomach pain, heartburn, trouble eating, weight loss, nausea, and vomiting, among other things. Because these symptoms sound like other kinds of stomach problems, you should see a doctor if they don’t go away.
Barrett’s esophagus is a digestive disease that changes the lining of the esophagus. It is caused by acid reflux. Barrett’s esophagus is found with an endoscopy and will probably need more severe treatment than GERD or acid reflux. This is because being given this diagnosis makes you a lot more likely to get esophageal cancer.
It is common for dysplasia (precancerous cells) to happen at the same time as changes in the lower lining of the stomach. If there is no dysplasia, low-grade dysplasia, or high-grade dysplasia, the treatment for Barrett’s will be different. If you don’t have dysplasia, your gastroenterologist will probably give you GERD medicines (like PPIs) and do regular endoscopies to check on the cells in your stomach.
During your endoscopy, if you have low-grade dysplasia, your doctor may remove the damaged cells. This is called endoscopic removal. There are also treatments like radio-frequency ablation, which cuts away the damaged tissue, and cryotherapy, an endoscopic process that treats damaged cells with cold and then heat, killing them (autophagy).
Liver Disease, Cirrhosis, Portal Hypertension
It can also find many types of liver diseases, like cirrhosis, gastric varices, and portal hypertension. Some liver diseases are:
- Cirrhosis and Hepatitis
- Cancer of the liver
- Having fatty liver
- NAFLD stands for nonalcoholic fatty liver disease.
- Treatment can be very different depending on the type of finding. Radiation, chemotherapy, orsurgery are often used to treat liver cancer.
Cirrhosis is when the liver gets scars that don’t go away, and alcohol use disorder (AUD) is one of the main causes of it. A swollen liver is a sign of cirrhosis, and the liver is normally a very flexible organ. If someone has fatty liver or high liver enzymes, they can get better by not drinking alcohol.
But cirrhosis is hard to treat because it leaves scars that can’t be removed. Patients have a much better chance of getting better if they get it caught early. Stopping drinking is always the first thing that should be done. NAFLD can also leave scars on the liver, and people with it may need a liver transplant.
Endoscopies are often used by gastroenterologists to identify liver disease because they can find portal hypertension. Portal hypertension is when the pressure in the portal veins is too high. It is mostly caused by cirrhosis, which scars the liver.
You can also find esophageal varices with endoscopy, and they are a sign of liver disease. Varices are esophageal veins that can tear and bleed, which can be very dangerous. If your doctor thinks you might have esophageal varices, he or she may order an endoscopy right away because it can treat both current bleeding and esophageal varices.