Diagnostic Tests to Examine the Upper GI Tract
Your doctor usually can't assess the health of your upper digestive tract from an external exam. He or she needs an internal view of your digestive tract through an upper endoscopy, an upper gastrointestinal (GI) series, esophageal manometry, or pH monitoring.
An upper endoscopy examines the inside lining of the esophagus, stomach, and duodenum. A long, thin, flexible tube with a tiny light and video camera at its tip (an endoscope) is used to look for abnormalities such as inflammation, ulcers, and tumors. If you're experiencing difficulty swallowing, nausea, vomiting with or without blood or coffee grounds-like material, heartburn, indigestion, upper abdominal pain, or chest pain, your doctor may perform an upper endoscopy.
This test is performed in a hospital or doctor's office and takes about 30 minutes. A numbing agent is often sprayed into your throat to prevent gagging when the endoscope is inserted. A pain medication and a sedative also are given to keep you relaxed and sleepy.
While you lie on your left side, the doctor slowly and gently passes the endoscope through your mouth and into your esophagus, stomach, and duodenum. Air is blown through the endoscope to make it easier for the doctor to see the lining of the digestive tract.
The doctor views the images from the endoscope on a television monitor. If he or she notices anything abnormal in the lining of the upper digestive tract, a sample of the tissue may be removed (biopsied) and examined under a microscope. Instruments can be inserted through the endoscope to stop bleeding from an ulcer, to remove a noncancerous (benign) growth, or to stretch a narrowed area of the esophagus, stomach, or duodenum.
Upper endoscopy is safe when performed by a doctor who is trained and experienced in the procedure. Serious complications, such as excessive bleeding, allergic reactions to the sedative, aspiration of stomach contents or saliva into the lungs, and puncture of the intestinal wall, are rare. Some people have mild complications, such as a sore throat or bloating. These problems usually disappear within 24 hours. If you experience signs of a serious complication after the procedure (for example, fever, swallowing difficulties, or increasing throat, chest, or abdominal pain), you should contact your doctor immediately.
Upper Gastrointestinal (GI) Series
An upper GI series (also called a barium x-ray) is usually used to evaluate areas of the small intestine that an endoscope cannot reach. In addition, if you cannot undergo an upper endoscopyperhaps because you tend to bleed excessively or the number of platelets in your blood is lowan upper GI series may be performed to examine the esophagus, stomach, and duodenum.
An upper GI series is performed by a radiologist. First, you drink a solution containing barium (a heavy metal). The radiologist follows the passage of the barium through the upper digestive tract using a machine called a fluoroscope. X-rays also are taken. The barium coats the inner layer of the digestive tract, making it visible on the x-rays.
The x-rays can reveal ulcers, tumors, strictures (abnormal narrowings due to scar tissue), areas of swelling and inflammation, and fistulas (abnormal connections between two organs).