What to Expect During an Endoscopy

An upper GI endoscopy —also called a panendoscopy or esophagogastroduodenoscopy (EGD)— allows the gastroenterologist to directly examine the esophagus, the stomach, and the first portion of the small intestine. Although the name may sound intimidating, the procedure is routine, well tolerated, and essential for diagnosing many of the most common causes of digestive discomfort.

What is it?

An upper GI endoscopy is a procedure in which the gastroenterologist inserts a thin, flexible tube —the endoscope— through the mouth to view the inside of the upper digestive tract in real time: the esophagus, stomach, and duodenum (the first portion of the small intestine).

The endoscope has a small built-in camera that transmits images to a monitor. This allows the doctor to detect abnormalities such as inflammation, ulcers, polyps, bleeding, Helicobacter pylori infection, or other lesions. When necessary, biopsies (tiny tissue samples) can be taken during the same procedure, with no need for another intervention.

When is it ordered?

An upper GI endoscopy is always performed on a doctor's orders. The most common scenarios in which it is requested include:

• Persistent symptoms of the upper digestive tract: heartburn, reflux, pain in the pit of the stomach, nausea, or feeling full early that does not improve with initial treatment.
• Investigation of upper GI bleeding (vomiting blood or black, tarry stools).
• Suspected peptic ulcer or Helicobacter pylori infection that requires confirmation with a biopsy.
• Surveillance of conditions such as Barrett's esophagus or chronic gastritis.
• Difficulty swallowing (dysphagia) without an apparent cause.
• Follow-up after surgical or medical treatment of the upper digestive tract.

How to prepare

Preparing for an upper GI endoscopy is relatively simple compared with other tests, but it must be followed carefully to get clear results and ensure your safety.

Follow your doctor's instructions exactly — they may vary depending on your health and the medical center's protocol. General guidelines include:

• Fasting: the doctor will tell you how many hours you must go without eating or drinking before the procedure. This time can vary; do not take any food, drink, or oral medication without checking first.
• Medications: tell your doctor about all the drugs you take, especially blood thinners, antiplatelet agents (such as aspirin), and diabetes medications. The doctor will decide which to continue and which to pause temporarily.
• Wear comfortable clothing and bring someone you trust who can take you home after the procedure, since the temporary sedation will keep you from driving.
• Remove removable dental prostheses before the test if you use them.

Step by step: what happens on the day of the procedure

When you arrive: The nursing staff will verify your information, confirm that you followed the fasting instructions, and take your vital signs. You will sign an informed consent form. You will have the opportunity to ask questions before starting.

Sedation: An upper GI endoscopy is usually performed with IV sedation, which will leave you relaxed and calm. Some centers also apply a local anesthetic to the throat to reduce the gag reflex. Most patients do not remember the procedure or remember it only minimally.

The procedure: You will be asked to lie on your side. A small mouthguard will be placed to keep your mouth open and protect the endoscope. The gastroenterologist will insert the endoscope gently through your mouth. To better visualize the walls, a small amount of air is insufflated; you may feel some pressure or mild nausea at first, but the sedation will keep it under control.

The doctor will advance the endoscope through the esophagus, the stomach, and the duodenum, examining each area and taking biopsies if necessary. This process does not hurt; if tissue samples are taken, you will not feel that either.

When it's over: You will move to a recovery area. Once the healthcare team confirms that the sedative is wearing off and your vital signs are stable, you will be able to leave. The doctor will discuss the immediate findings with you; biopsy results take several days.

Risks and recovery

An upper GI endoscopy is a safe procedure performed by specialists. The risks are low, but it is worth knowing them:

• Throat discomfort or a feeling of abdominal bloating for the following hours: these are normal and go away on their own.
• Minor bleeding at the biopsy site: rare and usually self-limited.
• Perforation: very uncommon; it may require additional management.
• Reaction to the sedative: infrequent; the team is prepared to manage it.

Rest and a liquid or soft diet, as directed by your doctor, are recommended for the rest of the day. The vast majority of people resume their normal activity the next day.

Cost

At private clinics and hospitals in Mexico, the cost of an upper GI endoscopy generally ranges between $5,000 and $8,250 MXN, depending on the city, the type of institution, and whether biopsies or additional procedures are included. When scheduling, ask what that price covers (interpretation, biopsies, sedation).

Through IMSS or ISSSTE (Mexico's public health systems for private-sector and government workers, respectively), the test can be ordered by the gastroenterologist or the family doctor at no direct cost, subject to availability and wait times. Many private insurers also cover endoscopy when there is a documented medical indication; check your policy in advance.