A Complete Patient Guide to Upper Endoscopy

If your doctor has recommended an upper endoscopy, or if you have been experiencing persistent symptoms such as heartburn, difficulty swallowing, abdominal pain, nausea, or unexplained weight loss, this guide will walk you through everything you need to know.

Upper endoscopy is one of the most commonly performed procedures in gastroenterology and is a cornerstone of how we diagnose and treat conditions affecting the oesophagus, stomach, and upper small intestine.

At Redus Center for Digestive Health in Lagos, our specialists perform upper endoscopy using high-definition equipment to deliver accurate diagnoses and, where needed, effective treatment in a single session.

What is Upper Endoscopy (Gastroscopy / EGD)?

Upper endoscopy — also called gastroscopy or oesophagogastroduodenoscopy (EGD) — is a minimally invasive procedure that allows a gastroenterologist to directly visualise the lining of the upper digestive tract. A thin, flexible tube called a gastroscope or endoscope is passed through the mouth and gently guided down the oesophagus (food pipe), into the stomach, and through to the duodenum (the first part of the small intestine).

At the tip of the gastroscope is a high-definition camera that transmits real-time video images to a monitor. This allows the physician to examine the mucosal lining of these structures in fine detail. This helps to identify inflammation, ulcers, growths, bleeding sources, and structural abnormalities that cannot be seen from the outside.

Upper endoscopy is unique in that it is both diagnostic and therapeutic. In many cases, the doctor can treat a condition (such as stopping a bleed, removing a polyp, dilating a narrowed segment, or taking a biopsy) during the same procedure, without the need for separate surgery.

The procedure is performed under sedation, meaning patients are deeply relaxed and comfortable throughout, and most have little to no memory of it afterwards. It typically takes between 15 and 30 minutes, though longer procedures may be required when therapeutic interventions are performed.

Understanding the Upper Digestive Tract

Upper endoscopy examines three main structures, each of which can be affected by a range of conditions:

The Oesophagus
The oesophagus is a muscular tube approximately 25 cm long that connects the throat to the stomach. It is lined with a smooth, pale mucosa. Common oesophageal conditions that upper endoscopy can identify include gastro-oesophageal reflux disease (GORD), oesophagitis, Barrett’s oesophagus, oesophageal strictures, varices (enlarged veins), and oesophageal cancer.

The Stomach
The stomach is a muscular organ that stores and begins to digest food. Its inner lining (the gastric mucosa) can be affected by inflammation (gastritis), ulcers (peptic ulcer disease), infection with Helicobacter pylori (H. pylori), polyps, and stomach cancer (gastric carcinoma). Upper endoscopy provides a direct view of the entire stomach lining and allows targeted biopsies of any suspicious areas.

The Duodenum
The duodenum is the first section of the small intestine, beginning just beyond the stomach. It receives digestive enzymes from the pancreas and bile from the liver. Upper endoscopy can detect duodenal ulcers, coeliac disease changes (villous atrophy), duodenitis, and tumours in this region, and allows biopsy samples to be taken for laboratory analysis.

Why is Upper Endoscopy Performed?

Upper endoscopy is recommended when symptoms or clinical findings suggest disease in the upper gastrointestinal tract. At Redus Center for Digestive Health, our specialists may recommend the procedure for the following reasons:

Persistent Heartburn and Gastro-Oesophageal Reflux Disease (GORD)
Heartburn — a burning sensation in the chest caused by stomach acid flowing back into the oesophagus — is extremely common. When symptoms are frequent, severe, or fail to respond to medication, upper endoscopy is recommended to assess the degree of oesophageal damage, check for Barrett’s oesophagus (a pre-cancerous change in the oesophageal lining), and exclude other causes of chest discomfort.
Difficulty Swallowing (Dysphagia)
Dysphagia — difficulty or pain when swallowing — can result from a range of conditions including oesophageal strictures (narrowings), eosinophilic oesophagitis, oesophageal rings, achalasia (a motility disorder), or oesophageal cancer. Upper endoscopy allows direct visualisation of the oesophagus and, where appropriate, biopsy or dilation during the same procedure.
Upper Abdominal Pain
Persistent pain or discomfort in the upper abdomen (epigastric pain) is one of the most common reasons for referral for upper endoscopy. It may be caused by gastritis, peptic ulcer disease, H. pylori infection, or less commonly, gastric cancer. Endoscopy allows the physician to examine the stomach lining directly and take biopsies to confirm the diagnosis and guide treatment.
Nausea, Vomiting, and Indigestion
Chronic or recurrent nausea and vomiting, particularly when associated with bloating, early satiety, or weight loss, can indicate underlying gastric pathology. Upper endoscopy helps identify causes such as gastroparesis (delayed gastric emptying), gastric outlet obstruction, peptic ulcers, or gastric tumours.
Gastrointestinal Bleeding
Upper gastrointestinal bleeding, which may present as vomiting blood (haematemesis), passing black tarry stools (melaena), or unexplained iron deficiency anaemia, requires urgent upper endoscopy. Common sources of upper GI bleeding include peptic ulcers, oesophageal varices, Mallory-Weiss tears (at the gastro-oesophageal junction), and vascular malformations (angiodysplasias). Endoscopy identifies the bleeding source and allows immediate treatment in most cases.
Suspected Peptic Ulcer Disease
Peptic ulcers are sores in the lining of the stomach or duodenum that cause recurring upper abdominal pain. These pains may be worse at night or relieved by eating. Upper endoscopy confirms the diagnosis, assesses the size and depth of the ulcer, and allows biopsy to check for H. pylori infection and exclude malignancy.
Helicobacter pylori (H. pylori) Investigation
H. pylori is a bacterium that infects the stomach lining and is strongly associated with peptic ulcer disease and gastric cancer. During upper endoscopy, biopsy specimens can be taken for rapid urease testing (RUT) and histological examination to confirm or exclude H. pylori infection, guiding targeted antibiotic treatment.
Suspected Coeliac Disease
Coeliac disease is an autoimmune condition triggered by gluten that causes damage to the lining of the small intestine. The diagnosis is confirmed by taking biopsies from the duodenum during upper endoscopy and demonstrating characteristic changes (villous atrophy and crypt hyperplasia) under the microscope.
Barrett’s Oesophagus Surveillance
Barrett’s oesophagus is a condition in which the normal lining of the lower oesophagus is replaced by intestinal-type tissue in response to chronic acid reflux. It carries an increased risk of oesophageal adenocarcinoma. Once diagnosed, regular upper endoscopy surveillance is recommended at defined intervals to detect any progression to dysplasia (pre-cancerous change) or early cancer, when treatment is most effective.
Screening and Surveillance for Gastric Cancer
Gastric (stomach) cancer is a significant health concern in many parts of Africa and globally. Patients with risk factors (a family history of gastric cancer, atrophic gastritis, H. pylori infection, or previous gastric surgery) may be advised to undergo upper endoscopy for screening or surveillance. Early detection of gastric cancer dramatically improves survival outcomes.
Investigation of Unexplained Weight Loss
Unintentional weight loss can be a sign of underlying malignancy or significant gastrointestinal pathology. Upper endoscopy is often part of the investigation, particularly when accompanied by symptoms such as poor appetite, abdominal pain, or early satiety.
Foreign Body Removal
Upper endoscopy is the standard method for retrieving foreign bodies (accidentally swallowed objects, food bolus impactions, or coins in children) that have become lodged in the oesophagus or stomach.

Therapeutic Uses of Upper Endoscopy

Beyond diagnosis, upper endoscopy can be used to treat a wide range of conditions during the same procedure. This is one of its greatest advantages as it helps avoid the need for separate surgical intervention in many cases.

Treatment of Upper GI Bleeding
When a bleeding source is identified — such as a bleeding peptic ulcer or a ruptured varix — the endoscopist can apply targeted treatment through the scope. Techniques include injection of adrenaline around a bleeding vessel, application of haemostatic clips, bipolar electrocoagulation (heat therapy), and banding of oesophageal or gastric varices. These interventions stop the bleeding in the majority of cases without the need for surgery.

Oesophageal and Pyloric Dilation
When the oesophagus or the outlet of the stomach (pylorus) is narrowed due to scarring, stricture, or prior surgery, endoscopic dilation using a balloon or bougie (a tapered dilating instrument) can widen the narrowing and restore normal swallowing or gastric emptying. This is usually performed as a day procedure with sedation and provides significant and often long-lasting symptom relief.

Polypectomy and Mucosal Resection
Polyps found in the stomach or duodenum can be removed during upper endoscopy using a wire snare or biopsy forceps. For larger or flatter lesions, endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) techniques allow complete removal of early-stage cancers or pre-cancerous lesions without surgery, with curative intent in carefully selected patients.

Placement of Feeding Tubes
Percutaneous endoscopic gastrostomy (PEG) is a procedure performed under upper endoscopy guidance to place a feeding tube directly into the stomach through the abdominal wall. This is used in patients who cannot eat or swallow adequately due to neurological conditions, head and neck cancers, or other causes of severe dysphagia.

Stenting of Oesophageal or Gastric Outlet Obstruction
In patients with inoperable oesophageal or gastric cancer causing obstruction, self-expanding metal stents can be placed endoscopically to restore the ability to eat and drink, significantly improving quality of life.

Treatment of Achalasia
Achalasia is a motility disorder in which the lower oesophageal sphincter fails to relax properly, causing progressive difficulty swallowing. Endoscopic treatment options include pneumatic balloon dilation and peroral endoscopic myotomy (POEM), a minimally invasive endoscopic procedure that cuts the muscle to relieve the obstruction.

Preparing for Your Upper Endoscopy at Redus Health

Good preparation ensures the procedure can be performed safely and that the stomach lining is clearly visible. Your care team at Redus will provide personalised instructions, but the following general guidelines apply:

What is an Upper Endoscopy?

Fasting

You must not eat or drink anything — including water — for at least 6 to 8 hours before the procedure. This ensures the stomach is empty, gives the endoscopist a clear and unobstructed view, and importantly reduces the risk of aspiration (inhaling stomach contents into the lungs) while under sedation.

Medication

Inform your gastroenterologist and the care team about all medications, supplements, and herbal remedies you take. In particular:

Blood-thinning medications (anticoagulants and antiplatelets such as warfarin, aspirin, clopidogrel, and rivaroxaban): These may need to be paused before the procedure, particularly if biopsy, polypectomy, or other therapeutic interventions are planned, to reduce the risk of bleeding. Your doctor will advise on timing.

Diabetes medications: Fasting requirements mean your insulin dose or oral hypoglycaemic agents may need to be adjusted on the day of the procedure. Your care team will advise specifically.

Proton pump inhibitors (PPIs) and antacids: Your doctor will advise whether to continue or pause these before the procedure.

NSAIDs: Non-steroidal anti-inflammatory drugs increase bleeding risk and should be discussed with your doctor ahead of any ther

Allergies

Inform your care team of any known allergies, particularly to sedative medications, latex, or any prior adverse reactions to anaesthesia or endoscopy.

Medical History

Disclose any significant medical history, particularly cardiovascular or respiratory conditions, swallowing disorders, previous upper gastrointestinal surgery, or prior endoscopies. Any history of oesophageal varices, liver disease, or bleeding disorders should also be communicated, as these affect procedural planning.

Arranging Transport

Because sedation is used, you will not be able to drive, operate machinery, take public transport alone, or make important decisions for the remainder of the day following the procedure. Please arrange for a responsible adult to accompany you and take you home safely.

What to Expect During an Upper Endoscopy

Arrival and Pre-Procedure Assessment

On arrival at Redus Center for Digestive Health, our nursing team will welcome you, confirm your preparation, review your medical history, take your vital signs, and obtain your informed consent. An intravenous (IV) cannula will be placed in your arm for the administration of sedation and any other medications required during the procedure.

Throat Spray and Positioning

A local anaesthetic throat spray is applied to the back of your throat to numb the area, minimise the gag reflex, and make scope passage more comfortable. You will be positioned lying on your left side, which is the standard position for upper endoscopy as it allows optimal passage of the scope and reduces the risk of aspiration.

Sedation

You will receive intravenous sedation that makes you deeply relaxed and drowsy within moments. Most patients are conscious during the procedure in a technical sense but are so comfortable and relaxed that they have little or no memory of it afterwards. Your oxygen levels, heart rate, and blood pressure are monitored continuously throughout.

Scope Insertion and Examination

A mouthguard (bite block) is placed between your teeth to protect both your teeth and the endoscope. The gastroscope is then gently passed through your mouth and into your throat. You may be asked to swallow once to help it pass. From this point, the scope is guided entirely by the physician — you simply need to relax and breathe normally.

The endoscopist advances the scope through the oesophagus, into the stomach, and through the pylorus (the outlet of the stomach) into the duodenum. The camera at the tip transmits high-definition video images to a monitor, allowing a thorough, systematic examination of all three structures.

Small amounts of air or carbon dioxide may be gently introduced through the scope to expand the walls slightly and improve visibility. This can cause mild bloating, which resolves quickly after the procedure.

Biopsies and Therapeutic Interventions

If any abnormalities are identified — such as an ulcer, inflamed mucosa, polyp, or suspicious lesion — the endoscopist can immediately take biopsies using small forceps passed through the working channel of the scope. Biopsies are painless. Therapeutic interventions such as bleeding control, dilation, polypectomy, or stenting may also be performed if clinically indicated.

Procedure Duration

A straightforward diagnostic upper endoscopy typically takes 15 to 30 minutes. Procedures involving biopsy, therapeutic interventions, or detailed examination of complex pathology may take up to 45 to 60 minutes. You should plan to spend approximately 2 to 3 hours at Redus in total, including preparation and recovery.

Recovery and Post Procedure Care

Immediate Recovery
After the procedure, you will be moved to a comfortable recovery area where nursing staff will monitor your vital signs, oxygen levels, and comfort until the effects of sedation have fully worn off — typically 30 to 60 minutes. You may feel drowsy, slightly disoriented, or a little bloated during this period, all of which are normal and settle quickly.

Going Home
Most patients are discharged on the same day. You must be accompanied home by a responsible adult, as sedation affects your coordination, judgement, and reaction times for several hours. You should not drive, use heavy machinery, drink alcohol, sign legal documents, or make important decisions on the day of the procedure.

Diet and Activity
Your throat may feel slightly numb from the spray for an hour or two after the procedure — avoid eating or drinking until this feeling has completely resolved to reduce the risk of choking. Once the numbness has cleared, you can start with cool, soft foods and fluids and return to your normal diet as tolerated. Most patients are able to eat a normal meal within a few hours and resume usual activities the following day.

Normal Side Effects
Some mild, short-lived side effects are entirely normal after upper endoscopy:

Mild sore throat: Very common due to scope passage through the oropharynx. Usually resolves within 24 to 48 hours. Cool fluids and throat lozenges can help.
Bloating and gas: From air introduced during the procedure. Typically settles within a few hours.
Mild abdominal discomfort: Can occur, particularly if biopsies were taken or therapeutic interventions were performed.
Drowsiness: From the sedation. Usually resolves within a few hours of the procedure.

Warning Signs: When to Seek Urgent Medical Attention
While complications after upper endoscopy are rare, you should seek immediate medical attention or return to Redus if you experience any of the following:

Severe or worsening chest, throat, or abdominal pain
Difficulty swallowing that is new or significantly worse than before the procedure
High fever or chills
Vomiting that does not settle, particularly vomiting of blood
Black or tarry stools, or blood in the stool
Shortness of breath or difficulty breathing
Swelling of the neck (which could indicate perforation)

Risk and Complications of Upper Endoscopy

Upper endoscopy is one of the safest procedures in medicine, with a very low overall complication rate. However, as with any invasive procedure, risks exist and patients should be fully informed before consenting.

Peforation

A perforation — a tear or hole in the wall of the oesophagus, stomach, or duodenum — is a rare but serious complication. It is more likely when therapeutic interventions such as dilation, polypectomy, or endoscopic mucosal resection are performed, but can very rarely occur during diagnostic endoscopy as well. Perforation typically requires hospitalisation and may need surgical repair.

Bleeding

Minor bleeding at a biopsy site is common and almost always stops spontaneously. Clinically significant bleeding requiring treatment is uncommon, occurring most often after polypectomy or dilation. Patients on anticoagulant or antiplatelet therapy are at higher risk, which is why these medications are typically reviewed and paused before therapeutic procedures.

Adverse Reaction to Sedation

Reactions to the sedative medications used during upper endoscopy are uncommon. Our team monitors your vital signs, oxygen saturation, and consciousness level continuously throughout the procedure and is fully equipped and trained to manage any adverse event.

Aspiration

There is a small risk of inhaling stomach contents into the lungs (aspiration), particularly in patients who have not fasted adequately, have delayed gastric emptying, or are at high risk due to other medical conditions. Strict fasting and careful procedural technique minimise this risk.

Infection

Infection following diagnostic upper endoscopy is extremely rare. All endoscopes at Redus are reprocessed according to strict decontamination protocols between procedures to ensure patient safety.

Missed Lesions

While upper endoscopy performed by an experienced endoscopist is highly accurate, very small lesions, flat lesions, or lesions in difficult anatomical positions may occasionally be missed. Advanced imaging techniques such as chromoendoscopy or narrow-band imaging (NBI), available at Redus, enhance the detection of subtle mucosal abnormalities.

Your gastroenterologist will explain the specific risks relevant to your individual situation before the procedure.

Upper Endoscopy vs. Barium Swallow

Patients are sometimes asked whether a barium swallow X-ray can substitute for upper endoscopy. While both investigations evaluate the upper gastrointestinal tract, they differ significantly in what they can provide:

Barium swallow / barium meal: An X-ray study in which the patient swallows a contrast agent (barium) that coats the oesophagus and stomach, making them visible on X-ray. It provides a functional view of swallowing and structural anatomy, and is useful for detecting large strictures, hiatus hernias, and motility disorders. However, it cannot detect subtle mucosal changes, cannot take biopsies, and cannot treat any condition found.
Upper endoscopy: Provides direct visualisation of the mucosal lining in high definition. Can detect inflammation, erosions, early cancer, Barrett’s oesophagus, and subtle lesions that barium studies would miss. Allows biopsy and therapeutic intervention in the same session.

For most clinical situations where there is diagnostic uncertainty or suspicion of significant pathology, upper endoscopy is the investigation of choice, as it provides both diagnosis and the ability to treat or sample in a single procedure.

Upper Endoscopy at Redus Center for Digestive Health, Lagos

At Redus Center for Digestive Health, located in Lekki Phase 1, Lagos, we perform upper endoscopy using high-definition gastroscopes and advanced imaging technologies. Our consultant gastroenterologists are highly trained and experienced in both diagnostic and therapeutic upper endoscopy, and our endoscopy unit adheres to the highest international standards of equipment reprocessing, patient safety, and infection control.

We understand that the prospect of any medical procedure can be anxiety-provoking. Our patient-centred approach means we take the time to explain your procedure clearly, answer all your questions before you proceed, and ensure you feel supported and comfortable from arrival to discharge.

We welcome both GP and specialist referrals and are happy to see patients seeking an independent opinion or wishing to self-refer for evaluation of digestive symptoms.

Frequently Asked Questions About Endoscopy

Is upper endoscopy painful?

Upper endoscopy is performed under sedation, so the vast majority of patients experience no pain during the procedure. The sedation makes you deeply relaxed and most patients have little or no memory of it. You may experience mild bloating or throat discomfort afterwards, but these are short-lived and settle within a day.

How Long Does Upper Endoscopy Take?

A standard diagnostic upper endoscopy takes approximately 15 to 30 minutes. If therapeutic interventions are required, the procedure may take longer. Including preparation and recovery, plan to spend 2 to 3 hours at Redus in total.

Will I be Awake During the Procedure

Sedation is used rather than general anaesthesia, so you are not fully unconscious in the technical sense. However, the sedation makes you deeply relaxed and most patients are completely unaware of the procedure while it is taking place and have very little or no memory of it afterwards.

Can I Eat Before An Upper Endoscopy?

No. You must fast for at least 6 to 8 hours before the procedure. This means no food, drink, or chewing gum. An empty stomach is essential for a safe and effective examination. You will be advised when you can resume eating and drinking after the procedure.

How Soon Will I Get My Results?

Your gastroenterologist will share their direct endoscopic findings with you shortly after the procedure, once you are awake and alert. If biopsies were taken, pathology results typically take 3 to 7 working days. A follow-up appointment will be arranged to discuss these findings and any recommended next steps.

How Often Do I Need an Upper Endoscopy?

This depends entirely on your clinical situation. A single diagnostic endoscopy may be all that is required to identify and address a problem. Patients with Barrett’s oesophagus, atrophic gastritis, or other conditions carrying cancer risk may require regular surveillance endoscopy at intervals defined by guidelines and their individual risk profile.

Is An Upper Endoscopy The Same as a Gastroscopy?

Yes — upper endoscopy, gastroscopy, and EGD (oesophagogastroduodenoscopy) all refer to the same procedure. The different names reflect the different parts of the digestive tract examined: the oesophagus, stomach (gastro-), and duodenum. The terms are used interchangeably.

Can Upper Endoscopy Detect Stomach Cancer?

Yes. Upper endoscopy is one of the most important tools for detecting gastric (stomach) cancer. It allows direct visualisation of the stomach lining and targeted biopsy of any suspicious areas. Early-stage gastric cancer can often be identified before it causes significant symptoms — which is why screening is recommended in high-risk patients — and outcomes are considerably better when the disease is detected early.

Book Your Upper Endoscopy Consultation at Redus Health

If you have been referred for an upper endoscopy, or if you are experiencing persistent symptoms such as heartburn, difficulty swallowing, upper abdominal pain, nausea, unexplained weight loss, or any concern about the health of your upper digestive tract, we encourage you to contact our team at Redus.

Our specialists will review your symptoms and clinical history, discuss whether upper endoscopy is the most appropriate investigation, and guide you through every aspect of the procedure and your care with transparency, expertise, and compassion.

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