Samuel N. Marcus M.D., Ph.D.



Upper Endoscopy

When you’re experiencing issues in your gastrointestinal (GI) tract, there is only so much information we can learn from the signs and symptoms. There is a point where we need to take a closer look. For this, we require special medical equipment that can access, illuminate and take pictures and/or videos of the tissues and parts that make up the GI tract.

One of these pieces of equipment is called an endoscope and it can be used for a procedure called an upper endoscopy, which provides images of your esophagus (the tube that leads from your mouth to your stomach), the stomach and the upper-portion of the small intestine (called the duodenum).

Why Have an Upper Endoscopy?

If you are scheduled for an upper endoscopy, odds are you’re experiencing one or more of the following symptoms:

  • Difficulty swallowing
  • Persistent nausea
  • Vomiting
  • Persistent abdominal pain
  • Bleeding that seems to be coming from the upper GI

Because your GI organs are soft tissues, rather than bone, they don’t show up well on X-rays. Plus, X-rays use radiation. With an upper endoscopy, we can get a much clearer image of the tissues and organs in question – without any radiation required. We can see even the barest hint of inflammation, a small ulcer, punctures or tears that may be causing discomfort, abnormal cells or tumors.

In addition to providing an image, the endoscope is also equipped to remove cell and tissue samples for biopsy. Don’t be alarmed if you find out something needs to be biopsied. Most of the time, these tests come back normal – or with a diagnosis of a condition that is easily treated. Serious or life threatening results are more rare.

Wielding the endoscope, Dr. Marcus also has the ability to treat certain conditions, such as the quick and efficient removal of a polyp or the immediate treatment of visible bleeding. These procedures are only mildly discomforting at most, and some patients don’t feel anything at all.

Preparation for an Upper Endoscopic Procedure

In order for the procedure to be 100% effective, your stomach needs to be as empty as possible. Therefore, we ask that patients abstain from eating and drinking anything for at least six hours prior to the appointment time – and that includes water. Avoiding salty food prior to the recommended fasting period, and hydrating well beforehand will help to prevent uncomfortable thirst levels. Failure to respect this rule can result in faulty results, or may require us to reschedule your appointment for a later date.

Your doctor will need to know about any medications you’re currently taking – including over-the-counter medications and supplements. This list includes:

  • Aspirin products, antiplatelet agents or any anti-coagulants/blood thinners (heparin or warfarin)
  • Clopidogrel
  • Insulin
  • Iron

Dr. Marcus also needs to know about any allergic reactions you’ve had to medications in the past. The doctor will let you know which of your  medications are fine to continue with up until your upper endoscopy and which ones will should be avoided before the procedure.

For example, we typically ask patients on blood thinners or asprin to stop taking them as long as 14-days before the procedure, and to remain off them for a few days or more afterwards.

What Happens During an Upper Endoscopy?

The procedure for an upper endoscopy is fairly straightforward. We will spray your throat a few times with a numbing agent. This helps to stop your gag reflex, so you can relax as the doctor inserts the endoscope. In most cases, we administer a mild sedative to further relax the patient.

Patients are often relieved to learn that because the esophagus and trachea (the tube that connects from your throat to your lungs) are separate, breathing is completely unaffected by your endoscopy. You will be able to breathe in a relaxed fashion the entire time.

Once the tube is successfully inserted in the mouth and down the throat, and we’ve verified that you’re doing okay, the doctor will continue feeding the scope down into and past the stomach, and into the duodenum. At certain points, the endoscope will express air into the cavity to inflate the area a bit for better viewing. All the while, he will be viewing the images transmitted on the screen, looking to make sure that all is well – and expertly identifying any areas of concern for diagnosis, treatment and/or further examination.

The entire procedure will only take about 10 or 15 minutes.

At worst, our patients find the procedure to be mildly uncomfortable. At best, our patients fall sound asleep during the scope and are surprised when we wake them up to let them know it’s over!

After the Procedure

Once the upper endoscopy is complete, we will remove the tube and relocate you to an area where you can relax while the majority of the sedative effects wear off. You may notice that your throat feels a little sore –this is completely normal. You may also feel a bit bloated from the air that was used to inflate different parts of the upper GI during the procedure.

In almost all cases, you will be allowed to get a drink of water, and you can get something to eat once you leave the office unless the doctor informs you otherwise.

Dr. Marcus will take a moment to tell you what he saw, and discuss anything that was unusual or required removal or samples for biopsy. When the biopsy results are in, our office will give you a call to discuss the results.

If you were given a sedative, someone must be available to take you home. Even though you may feel perfectly fine, the effects of the sedatives can last for the rest of the day so you are not safe to drive or operate a car, truck or heavy machinery. We recommend you give yourself a break and take the rest of the day off!

Complications from an upper endoscopy are incredibly rare. However, you should contact our office immediately if you experience bleeding, a worsening sore throat, trouble swallowing, abdominal pain, fever or blood in the stool in the days following your procedure.

Contact the office of Dr. Marcus to learn more about upper endoscopy or to schedule your appointment.