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Bachelor of Medicine and Surgery MBChB (UCT).
Fellow of South African College of Surgeons
Diploma in Obstetrics & Gynaecology
Upper and Lower Endoscopy: A Patient's Guide
What are Upper and Lower Endoscopy?
Endoscopy is a procedure that allows your doctor to view the lining of your digestive tract using a thin, flexible tube with a camera and a light on the end (an endoscope).
Upper Endoscopy (EGD): This procedure examines the upper part of your digestive tract, including the oesophagus (food pipe), stomach, and the first part of your small intestine (duodenum).- Lower Endoscopy (Colonoscopy): This procedure examines the lower part of your digestive tract, specifically the large intestine (colon) and the rectum.
In some cases, your doctor may recommend that both an upper and lower endoscopy be performed during the same sedation, especially if you have symptoms that involve both parts of the digestive system.
Indications: When are these procedures recommended?
These procedures are essential diagnostic tools for a wide range of gastrointestinal symptoms and conditions.
Upper Endoscopy is typically recommended for:
- Investigating the cause of persistent heartburn, chest pain, nausea, vomiting, or difficulty swallowing.
- Diagnosing conditions like ulcers, acid reflux (GERD), and hiatal hernias.
- Finding the source of unexplained bleeding or anaemia.
- Checking for abnormal growths or tumours and taking tissue samples (biopsies).
- Performing minor treatments, such as widening a narrowed eosophagus or removing polyps.
Lower Endoscopy (Colonoscopy) is typically recommended for:
- Screening for colorectal cancer, especially for individuals over the age of 45 or with a family history of the disease.
- Investigating the cause of chronic diarrhoea, constipation, or rectal bleeding.
- Diagnosing inflammatory bowel diseases like Crohn's disease and ulcerative colitis.
- Finding the source of unexplained abdominal pain or weight loss.
- Removing colon polyps, which can be precancerous.
The Procedures: What to expect
- Preparation: Proper preparation is crucial for these procedures.
- Upper Endoscopy: You will be instructed to fast (not eat or drink) for 6 to 8 hours before the procedure to ensure your stomach is empty.
- Lower Endoscopy: You will be given detailed instructions for a "bowel prep," which involves consuming a special liquid to completely clean out your colon. This is essential for a clear view of the colon lining.
- Anaesthesia/Sedation: Both procedures are typically performed under "conscious sedation" to help you relax and feel comfortable. You will be awake but drowsy, and most patients have no memory of the procedures. Your throat may be numbed with a spray for an upper endoscopy.
- The Endoscopies:
- Upper Endoscopy: You will lie on your side, and the doctor will gently guide the endoscope through your mouth, down your oesophagus, and into your stomach and duodenum.
- Lower Endoscopy: You will lie on your side, and the doctor will gently guide the colonoscope through your rectum and into the large intestine.
- Both procedures usually take between 20 to 60 minutes, depending on what the doctor finds. Air may be used to inflate the organs for a better view.
- After the Procedures: You will be taken to a recovery area to allow the sedation to wear off. You will not be able to drive for the rest of the day and must have someone to take you home.
Recovery
After your procedures, you may experience some minor and temporary side effects:
- Sore Throat: A mild sore throat is common after an upper endoscopy.
- Bloating or Gas: It is normal to feel bloated or gassy from the air that was introduced during both procedures.
- Drowsiness: You will feel sleepy from the sedation.
Your doctor will discuss the initial findings with you before you leave. If biopsies were taken or polyps were removed, the results will be available in a few days. You will be able to resume a normal diet and activities after the sedation wears off, unless instructed otherwise.
Risks and Complications
Upper and lower endoscopies are very safe procedures, and complications are rare. However, like any medical procedure, there are potential risks, which will be discussed in detail with your doctor. These can include:
- Bleeding: This can occur at a biopsy or polyp removal site.
- Perforation: In very rare cases, the endoscope can cause a small tear or hole in the lining of the digestive tract.
- Reaction to Sedation: Some patients may have a reaction to the sedatives used.
Please note: The information provided above and on this website is for education and interest purposes only. It is not intended to replace a personal one-on-one consultation, nor is it meant to substitute professional medical advice, diagnose or treat any condition. A consultation with a specialist and qualified health care provider such as Dr. Mitchell or Dr. Munda is essential for correct diagnosis and management, as well as to answer any queries that you may have. Never disregard or delay in seeking professional medical advice due to something you have read on this website. Dr. Mitchell and Dr. Munda take no responsibility for any errors or omissions present on this website and they are not liable for any consequences that may occur from misinterpretation of the information on this website. In the event of uncertainty or an emergency, please visit your nearest casualty.