Upper Gastrointestinal Endoscopy

Upper gastrointestinal endoscopy, also called upper GI endoscopy, uses a thin, flexible tube with a camera that is passed through the mouth to examine the lining of the esophagus, stomach, and duodenum.

In cancer care, upper GI endoscopy is mainly used to detect and evaluate cancers of the esophagus and stomach. Unlike imaging tests such as CT, endoscopy allows doctors to directly examine the lining of the upper digestive tract and obtain tissue samples from suspicious areas for pathology, making it an important tool for diagnosing upper gastrointestinal cancers.

Upper GI endoscopy may be recommended for patients with persistent difficulty swallowing, upper abdominal symptoms, unexplained gastrointestinal bleeding, black stools, anemia, significant weight loss, or other findings that raise concern for cancer or another upper gastrointestinal condition.

When imaging identifies a suspicious lesion in the esophagus or stomach, endoscopy can provide a closer assessment of its location, size, and appearance and allow a biopsy to establish a pathological diagnosis.

For selected early esophageal or gastric cancers and precancerous lesions, endoscopy may also be used for treatment. Procedures such as endoscopic submucosal dissection (ESD) can remove certain superficial lesions without conventional surgery.

Patients are generally asked to avoid food and drinks for a period before the procedure so the stomach is empty. Before endoscopy, the healthcare team reviews medical conditions, allergies, and the use of anticoagulant or antiplatelet medications.

During the procedure, the endoscope is passed through the mouth into the esophagus, stomach, and duodenum. If a suspicious area is identified, small tissue samples can be collected for biopsy. The examination may be performed with or without sedation or anesthesia, depending on the patient's needs and local practice.

Some patients may also undergo endoscopic ultrasound (EUS) to help evaluate how deeply a tumor has grown and assess nearby lymph nodes.

Diagnostic upper GI endoscopy is generally safe. Temporary throat discomfort, bloating, or nausea may occur after the procedure. Bleeding can occur after a biopsy, while serious complications such as perforation are uncommon. Sedation or anesthesia also carries its own potential risks.

Although endoscopy allows direct examination and tissue sampling, it cannot provide complete cancer staging on its own. After esophageal or gastric cancer is diagnosed, pathology, CT, PET-CT, endoscopic ultrasound, or other tests may be needed to determine the extent of disease and guide treatment.