Imaging of the upper GI tract may involve special X-rays. Or they may do the imaging endoscopically, a minimally invasive procedure. During an endoscopy, doctors guide a thin, lighted tube with a camera through the mouth and down the throat.

These tests provide much more detail than X-rays. They can see the lining of your esophagus, stomach, and the upper part of the small intestine.

Upper GI endoscopy lets your care team look directly inside your digestive system. Your doctor may suggest one of these tests if you have:

• Heartburn
• Nausea and vomiting
• Bleeding from the upper GI tract
• Belly pain
• Unexplained weight loss
• Trouble swallowing

Doctors can use upper GI imaging to help diagnose:

• Bacterial infections
• Celiac disease
• Ulcers
• Tumors
• Crohn’s disease
• GERD
• Blockage or narrowing of the esophagus

In some cases, endoscopy may also be used as a treatment option, including for certain weight loss procedures.

To diagnose the cause of your symptoms, your doctors may suggest one of these endoscopic procedures:

• Upper endoscopy: Your doctor may call it an esophagogastroduodenoscopy (EGD). Doctors take photos of your digestive tract using an endoscope, looking for ulcers, growths, or irritated areas. They can also use an EGD to help perform some treatments on your upper GI tract.
• Capsule endoscopy: Instead of a tube, this noninvasive procedure uses a capsule with a tiny camera and light to image your GI tract. You swallow the capsule, which works its way through your digestive tract. It takes thousands of photos and sends them to a recorder outside your body. While capsule endoscopy is a good option for many people, it isn't right for everyone because the capsule can become stuck in certain parts of the digestive tract. Your doctor will determine whether it's a safe option for you.
• Endoscopic retrograde cholangiopancreatography (ERCP): Combines upper GI endoscopy with X-rays to locate and treat problems of the bile and pancreatic ducts. During an ERCP procedure, doctors inject a special dye into the bile and pancreatic ducts to make the X-rays easier to read. They may also take tissue samples for testing.
• Endoscopic ultrasound (EUS): This endoscopy uses a probe equipped with ultrasound abilities to produce images of your organs and blood vessels. Doctors use EUS to find tumors, identify the cause of digestive problems, and screen for pancreatic cancer in people at high risk.

Endoscopic treatments for weight loss

In some cases, endoscopy can be used not just to diagnose conditions, but to treat them. These minimally invasive procedures are performed through the mouth, without external incisions.

Examples include:

• Endoscopic sleeve gastroplasty (ESG): A procedure that reduces the size of the stomach using sutures to support weight loss.
• Transoral outlet reduction (TORe): A procedure for patients who have had prior weight loss surgery and are experiencing weight regain. It tightens the connection between the stomach and small intestine.

These options may make sense if you’re not a candidate for surgery or prefer a less invasive approach. Learn more about your options for weight loss care.

The different types of endoscopic procedures vary somewhat. But in general, here’s what you should expect from any upper GI imaging using an endoscope.

Before

For upper endoscopy prep, you must stop eating and drinking 6 – 8 hours before the procedure. Your doctor will tell you if you should stop taking medications as well.

You’ll need a friend or family member to drive you to and from the endoscopy. That’s because you’ll receive medicine that will make you drowsy or put you to sleep.

At the clinic, a care team member will ask about your medical history and any medicines you take. You’ll have an IV for fluids in your arm or hand, and you’ll receive anesthesia. The sedative may put you to sleep, or you may receive one that makes you sleepy but awake.

During

A care team member will spray your throat with a numbing medicine, so you don’t feel the endoscope pass through. They’ll also give you a mouthguard to protect your teeth.

Once the care team sedates you, they gently pump air to inflate the digestive tract, allowing the endoscope to move easily. The doctor will move the tube down your throat and through the digestive system. 

The doctors see enlarged live images on a video screen. Your doctor can remove a tissue sample to test in the lab if needed.

After

You’ll stay in a recovery room until your sedative wears off. Depending on your recovery, you may be able to go home that day (although someone will need to drive you). A care team member will walk you through your follow-up care and visits.

Most people return to normal activities about 24 hours after an endoscopy.