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Benefits, Risks, and Alternatives

Benefits
Upper GI endoscopy is extremely effective for diagnosing and evaluating a number of gastrointestinal disorders because the inner lining of the upper GI tract can be viewed clearly. Often during the same procedure, the provider can use the endoscope to diagnose disease by direct visualization and taking tissue samples, treat disease by removing growths or other objects, control bleeding, and intervene on symptomatic disease, for example, with dilation or luminal stent placement.

Risks
Upper GI endoscopy is considered a safe procedure. The risks of complications are low, but may include bleeding from the site where tissue samples were taken or a growth removed; perforation, or partial tearing, in the lining of the upper GI tract; and an abnormal reaction to the sedative, including breathing or heart problems. Although rare, serious complications such as perforation may require surgery. There is also a slight risk of missed lesions or diagnosis. Even with careful inspection and sampling, disease can be missed.

Alternatives
There are alternative methods to examine the upper GI tract, which do not have the same capabilities as upper GI endoscopy, including:

  • Barium swallow, or upper GI series, which uses a series of x-rays and swallowed barium to act as a contrast agent in order to visualize the contours of the inside of the upper digestive tract.
  • Abdominal ultrasound, which uses high-frequency sound waves to create images of abdominal organs and soft tissues, but cannot clearly evaluate the esophagus, stomach, or duodenum. Abdominal ultrasound is primarily used for visualizing the liver and gallbladder.
  • Computed tomography, or CT, scan, which uses a combination of x-rays and computer technology to create images of organs and tissues.
  • Magnetic resonance imaging, or MRI, which uses a combination of radio waves and magnets to create images of organs and tissues.
  • Endoscopic ultrasound, or EUS, which uses an endoscope with an ultrasound probe at the end, but requires examination with upper GI endoscopy just prior to ensure insertion of the slightly larger EUS scope is safe. EUS is particularly useful for evaluating submucosal nodules, depth of invasion of a tumor or mass, and neighboring lymph nodes.