Upper Endoscopy for Diagnosing Heartburn and Reflux

Medically Reviewed by Minesh Khatri, MD on January 27, 2022
4 min read

An upper endoscopy can be used to determine the cause of heartburn and is often performed as an outpatient procedure. Upper endoscopy uses a thin scope with a light and camera at its tip to look inside of the upper digestive system -- the esophagus, stomach, and the first part of the small intestine, called the duodenum. During endoscopy, certain procedures such as taking a small tissue sample (biopsy) for testing may be performed.

Sometimes, the procedure is done in emergencies in the hospital or emergency room to both identify and treat upper digestive system bleeding such as from an ulcer.

In addition to heartburn, the procedure may also be used to help evaluate:

Endoscopy can also help identify inflammation, ulcers, and tumors.

Upper endoscopy can be more accurate than X-rays or other imaging for detecting abnormal growths and for examining the inside of the upper digestive system.

Before the upper endoscopy, tell your doctor about any medications (including over-the-counter) or supplements you are taking and about any medical problems or special conditions you have. You may be asked to hold off on certain medications or supplements prior to the procedure or afterward.

An upper endoscopy requires that you have an empty stomach before the procedure. Do not eat or drink anything for at least six hours before the procedure, or as directed by your doctor or nurse.

Talk to your doctor about any changes that may be needed to your regular medication regimen. Ask if necessary medications may be taken with a small sip of water.

If you have diabetes and use insulin, you must adjust the dosage of insulin the day of your upper endoscopy. Ask your doctor for details. Bring your diabetes medication if your doctor recommends that you take it after the procedure.

No. You will need to bring a responsible adult with you to take you home after the endoscopy. You should not drive or operate machinery for the rest of the day of the procedure to ensure that the sedative effects have worn off.

On the day of your procedure:

  • A doctor will explain the upper endoscopy in detail, including possible complications and side effects. The doctor will also answer any questions you may have.
  • An experienced doctor will perform the procedure.
  • You will be asked to wear a hospital gown and to remove your eyeglasses and dentures.
  • A local anesthetic (pain-relieving medication) may be applied at the back of your throat.
  • You will be given a pain reliever and a sedative intravenously (in your vein). You will feel relaxed and drowsy.
  • A mouthpiece will be placed in your mouth. It does not interfere with your breathing.
  • You will lie on your left side during the procedure.
  • The doctor will insert the endoscope into your mouth, through your esophagus (the "food pipe" leading from your mouth into your stomach) and into your stomach. The endoscope does not interfere with your breathing.
  • Most procedures take 15 to 30 minutes.

When your procedure is through:

  • You will stay in a recovery room for about an hour for observation.
  • You may feel a temporary soreness in your throat. Lozenges may help. Some people may feel nauseated or bloated.
  • The doctor who performed the endoscopy may discuss initial findings with you after the procedure but will send the test results to your primary or referring doctor.
  • The specialist or your primary doctor will discuss any biopsy results with you once they become available several days after the procedure. If the results indicate that prompt medical attention is needed, the necessary arrangements will be made and your referring doctor will be notified.

Risks of an upper endoscopy include bleeding, perforation of the upper digestive system, and abnormal reaction to the drugs used for sedation.

If you have severe or worsening abdominal or throat pain , or have any chest pain, continuous cough, fever, chills, or vomiting after an upper endoscopy, get emergency medical help right away..