What is an upper GI endoscopy and dilatation?

An upper gastrointestinal (GI) endoscopy is a procedure to look at the inside of your oesophagus (gullet), stomach and duodenum using a flexible endoscope.

Your symptoms or previous tests suggest you may have a narrowing (stricture). A dilatation involves stretching the narrowed area.

What are the benefits of an upper GI endoscopy and dilatation?

An upper GI endoscopy and dilation is performed so that your healthcare team can find out why you have certain symptoms.

If there is a narrowing, the endoscopist (the person doing the endoscopy) can stretch (dilate) the area with surgical instruments.

Are there any alternatives to an upper GI endoscopy and dilatation?

Your healthcare team has suggested an upper GI endoscopy and dilatation as it is the best way of finding and treating the problem. You can leave it alone, but this is not recommended, especially if you are having difficulty swallowing food.

What will happen if I decide not to have the procedure or the procedure is delayed?

Your healthcare team may not be able to confirm or manage what is causing your symptoms, and they may get worse. If they do, speak to your healthcare team. If you decide not to have an upper GI endoscopy and dilatation, you should discuss this carefully with your healthcare team.

What does the procedure involve?

An upper GI endoscopy and dilatation usually takes about 15 to 20 minutes.

The endoscopist may offer you a sedative or painkiller to help you to relax and feel more comfortable.

The endoscopist will place a flexible telescope (endoscope) into the back of your throat. From here the endoscope will pass into your duodenum.

The endoscopist will be able to look for problems in these organs. They will be able to perform biopsies and take photographs to help make the diagnosis.

The endoscopist can perform a dilatation using one of the following techniques.

• Balloon dilator — This involves passing a balloon dilator down the endoscope and inflating it while inside the narrowing.
• Guidewire and dilators — This involves inserting a guidewire (thin flexible wire) down the endoscope and across the narrowing.

What complications can happen?

The healthcare team are trained to reduce the risk of complications.

Any risk rates given are taken from studies of people who have had this procedure. Your healthcare team may be able to tell you if the risk of a complication is higher or lower for you.

Some complications can be serious.

Complications of an upper GI endoscopy

• Sore throat. This gets better quickly.
• Damage to teeth or bridgework. A member of your healthcare team will place a plastic mouthpiece in your mouth to help protect your teeth. Let your healthcare team know if you have any loose teeth.
• Incomplete procedure caused by a technical difficulty, food or blockage in your upper digestive system, complications during the procedure, or discomfort.
• Missed diagnosis. There is a small chance that significant findings may be missed during the procedure. The risk is higher if your stomach is not completely empty, or it cannot keep hold of the air that was blown into it.
• Breathing difficulties or heart irregularities. To help stop this, your oxygen levels will be monitored, and a suction device will be used to clear any secretions from your mouth.
• Blurred vision, if you are given a Buscopan injection. This usually gets better after about an hour. Sometimes the injection can affect the pressure inside your eye. This is more likely if you have a rare type of glaucoma. If your vision becomes blurred and your eye becomes red and painful, let the endoscopist or your healthcare team know straight away.
• Allergic reaction to the equipment or medication. The healthcare team are trained to detect and treat any reactions that may happen. Let the endoscopist know if you have any allergies or if you have reacted to any medication or tests in the past.
• Infection. It is possible to get an infection from the equipment used, or if bacteria enter your blood. The equipment is disinfected before the procedure, so the risk is low. Let your healthcare team know if you get a high temperature or feel unwell.
• Making a hole in your gullet (oesophagus), stomach or part of your small intestine. If this complication happens at the clinic you may need to be admitted to hospital for more treatment, which may include surgery. This complication can lead to severe chest pain or pain in your tummy. If you get these symptoms at home, let your healthcare team know straight away.
• Heavy bleeding from minor damage caused by the endoscope. This usually stops on its own. If you have had to continue to take blood-thinning medication during this procedure, the endoscopist will usually not perform a dilatation.
• Rarely, a heart attack (where part of the heart muscle dies) or stroke (loss of brain function resulting from an interruption of the blood supply to your brain) can happen if you have serious medical problems.
• Death. This is rare.

Complications of dilatation

• Making a hole in your gullet (oesophagus). The risk is higher if the narrowing is caused by cancer. If this complication happens at the clinic you may need to be admitted to hospital for more treatment, which may include surgery. This complication can lead to severe chest pain or pain in your tummy. If you get these symptoms at home, let your healthcare team know straight away.
• Heavy bleeding caused by the dilatation. This usually stops on its own.

What happens after the procedure?

After the procedure, you will be moved to the recovery area where you can rest.

The healthcare team will tell you the results of the procedure and talk to you about any treatment or follow up care you may need. Results from the biopsies will not be available until a later date, so the healthcare team will write to you, call you or ask you to come back to the clinic to give you the results.

Your healthcare team can advise you when you should be able to return to work after the procedure.

Summary

An upper GI endoscopy and dilatation is usually a safe and effective way of finding out if there is a problem with the upper part of your digestive system and managing your symptoms.

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