If you have symptoms such as abdominal pain, nausea or vomiting, heartburn or difficulty swallowing and your doctor doesn’t know why, you might need some tests that are commonly called endoscopies.
Emil Graf, MD, a surgeon at Banner Health in Arizona, explained that your doctor might recommend an upper GI (gastrointestinal) series, an esophagogastroduodenoscopy (EGD) or both. “Both are performed safely and provide a lot of information to patients and the physicians caring for them,” he said. Dr. Graf shared more about how these procedures work and what they can uncover.
What is an upper GI series?
This test examines the upper digestive tract, which includes the esophagus, stomach and duodenum or the first portion of the small intestine. For this procedure, you’ll fast for eight hours beforehand, so you have an empty stomach. You’ll also need to be prepared to change into a hospital gown.
During an upper GI series, you’ll swallow barium, a contrast agent that’s visible on X-rays. Then you’ll have a series of X-rays as the barium passes through your upper GI tract. Your doctor can see the barium on the X-rays as it moves through your esophagus, stomach and duodenum. You may need to change position from your back to your side to your stomach so your doctor can see your upper digestive system from various angles. The procedure is not invasive, and you don’t need to be sedated.
“It’s painless and easy, with minimal impact on your day—you can get back to your normal activities right away,” Dr. Graf said. The main complaint is that some people don’t like the taste of the barium.
What is an upper endoscopy?
This test is also referred to as an esophagogastroduodenoscopy (EGD). With this type of endoscopy, doctors use a flexible endoscopy tube with a light and tiny camera on the end of it, called an endoscope, to view the upper portion of the digestive tract. The camera sends the images to a video screen.
This procedure is more invasive than an upper GI series, and there is some risk of infection or bleeding. You’ll need to fast for eight hours and stop taking blood thinners before the procedure, and your doctor may also ask you to take a laxative ahead of time.
During the procedure, you’ll need an IV. You’ll be sedated but awake, and you may have numbing medication sprayed in your throat, so you don’t gag. Your doctor may also place a bite block in your mouth to keep it open. You may feel some pressure as the tube moves through your upper digestive system. Most of the time, upper endoscopies take just five to 10 minutes.
Doctors can use small tools attached to the endoscope to take tissue samples if needed and, sometimes, to treat problems. For example, if you have trouble swallowing because your esophagus is narrow, your doctor might be able to widen it. And some stomach ulcers can be treated endoscopically rather than with surgery.
You’ll need to be monitored by nursing staff as your sedative wears off. Be prepared as you can’t drive for the rest of the day, and you’ll need to have a family member or friend stay with you for 24 hours after the test. You may have a slight sore throat afterward, and you might feel the effects of the sedative for some time after an upper endoscopy. It can also take a little while for your gag reflex to return, and you shouldn’t eat until it does.
Why you might need these tests
“These procedures are both performed very commonly for a long list of gastrointestinal symptoms,” Dr. Graf said. You could need either or both to identify what’s causing:
- Abdominal pain
- Chronic nausea
- Difficulty swallowing
- Unexplained weight loss
- Bleeding in the upper GI tract
“Your doctor will hopefully be able to make an accurate diagnosis with the information gleaned from the upper endoscopy or upper GI series,” Dr. Graf said.
These tests can diagnose:
- Gastroesophageal reflux disease (GERD)
- Blockages or narrow areas
- Hiatal hernias
- Celiac disease
- Crohn’s disease
Other types of endoscopies
For other health problems, your doctor might recommend different types of endoscopies:
- Bronchoscopy, which examines your airways and lungs
- Colonoscopy, which screens your lower digestive tract
- Sigmoidoscopy, which looks inside your rectum and lower colon
The bottom line
If you have problems with your upper digestive tract, your doctor may recommend an upper GI series, an upper endoscopy or both. These tests can identify what’s causing your symptoms so your doctor can develop a treatment plan.