Why You Need Endoscopy

Reviewed by Grace Juniaty, MD

A View From Both Ends


Upper endoscopy is a medical gastroenterology procedure that inserts a flexible tube down your esophagus with a camera on the end. The gastro­entero­logist looks for polyps, gastro­­intestinal bleeding, or signs of erosion within the esopha­gus, stomach, or duodenum. Patients with Barrett’s esopha­gus should be enrolled in a surveil­lance program to look for signs of abnormal tissue (dysplasia) or cancer.

Warranted Over Time

The American College of Physicians (ACP) recommends doctors not regularly perform upper endoscopy screening in women of any age. ACP also discourages endoscopy in men under the age of 50 with heart­burn because the preva­lence of cancer is extremely low in this age range. Multiple risk factors for Barrett’s esophagus include obesity, tobacco use, or noctur­nal acid reflux. In men over 50 years of age, this warrants upper endos­copy screening.

Based on patient history, age and symptoms, doctors may first prescribe antacid or proton pump inhibitor medications. After a few weeks without resolution, diagnostic endos­copy can help determine the cause of persistent abdominal pain, vomiting, or bleeding.

Generally Painless Procedure

During the gastroenterology procedure, the endoscopist or gastroenterologist can do a biopsy on suspicious areas or remove polyps. An endoscope can be retro­fitted with an ultra­sound probe to create unique images of the wall of your esopha­gus or stomach. An endo­scopic ultra­sound may also help your doctor develop images of hard-to-reach organs, such as your pancreas.

Pain could be a result of heartburn or gastroesophageal reflux disease (GERD). Gastrointestinal ulcers can develop from taking too many NSAIDs over a long period of time. Treatment can include dietary modifica­tion such as elimination of caffeine and spicy foods. Alternative prescrip­tions can neutralize stomach acids.

Your doctor will give you specific instruc­tions to prepare for your endoscopy. Despite mild sedation or local anesthetic, there is no thrill in taking time away from other activities to have some­one snake a tube down your throat. Depending on your insurance plan, it might even cost money you do not want to spend. Appreciate that the incon­venience will help doctors to prescribe the best course of treat­ment and possibly make you feel better.

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Updated: Apr 30, 2022

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