Upper Endoscopy (Gastroscopy)

Upper endoscopy is a procedure that’s also called gastroscopy. It’s a way to look inside your esophagus  (food pipe), stomach, and the upper part of your small intestine. It can be done to look for and treat many conditions. For people with cirrhosis, it’s usually done for swollen veins called varices. Your healthcare team might recommend an upper endoscopy if you’re at risk for varices or if you’re bleeding.

Varices form when pressure in the portal vein (the one that takes blood to the liver) gets too high. They can be dangerous because if they get too big, they can break open and bleed.

The Procedure

Before the upper endoscopy, you’ll be asked not to eat or drink for at least 6 to 8 hours.

When you come into the procedure room, the doctor might numb the back of your throat with a spray. You’ll lie on your left side, and an endoscopy team member will put a mouthguard in place to protect your teeth. You’ll get medicine through an intravenous, or IV, which is a small tube or needle put in a vein. This will help you relax and prevent pain. You probably won’t remember the procedure.

The doctor will put a long, thin tube with a light and camera—called a scope—through your mouth. They use the scope to look in your esophagus and stomach for varices. Varices can be big or small.

If you have large ones in your esophagus or if they’re bleeding, the team might do a band ligation, called banding for short. This is when the doctor gently suctions up the enlarged vein and puts a tiny rubber band around it. In time, the band falls off and will pass through your bowels.

If you have varices in your stomach that need treatment, the doctor will inject them with a glue-like substance that causes the blood inside to harden. This is called sclerotherapy.

After the Procedure

After the upper endoscopy, the team will check on you often. You’ll probably stay in the recovery area for 1 or 2 hours. When it’s safe for you to leave, have a responsible adult drive you home. You may feel sleepy for a while. Don’t do things that need close attention—like driving or signing documents—for at least 8 hours.

As with any procedure, upper endoscopy can have side effects. These side effects are rare. They include bleeding or damage to the lining of your esophagus, stomach, or small intestine. Pay attention to how you feel in the days after your upper endoscopy. If you had banding, you might have some pain or discomfort when you swallow. Drinking fluids and eating soft foods can help. If you have bad pain or you can’t swallow, tell your healthcare team right away.

Go to the emergency department if you throw up blood, have black bowel movements, get a fever, or have trouble breathing.

Depending on what your upper endoscopy showed, you may need more procedures in the coming weeks or months. Your healthcare team will let you know.

References:

The information on this page was adapted (with permission) from the references below, by the Cirrhosis Care Alberta project team (physicians, nurse practitioners, registered nurses, registered dietitians, physiotherapists, pharmacists, and patient advisors).

This information is not intended to replace advice from your healthcare team. They know your medical situation best. Always follow your healthcare team’s advice.

References: 

  1. US Department of Veterans Affairs, Veterans Health Administration 
  2. Canadian Liver Foundation
Last reviewed March 15, 2021
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