Back to Learn

Endoscopy 101: What You Should Know if You Have Acid Reflux

Image of Endoscopy 101: What You Should Know if You Have Acid Reflux
Image of Endoscopy 101: What You Should Know if You Have Acid Reflux

So, you’re one of the not-so-lucky people who deals with acid reflux, and you’re always on the lookout for ways that you can improve your symptoms.

As you’re doing your routine googling for “acid reflux treatment,” you see this word coming up again and again: endoscopy.

Huh? What is that? And more importantly, how can you tell if you actually need one? Here’s what you need to know.

Endoscopy 101

As the Mayo Clinic explains, an endoscopy is a procedure that allows your doctor to get a better look at your upper digestive system. This is done by inserting a camera at the end of a long, flexible tube (called an endoscope) through your mouth and into your esophagus.

During an upper endoscopy, your doctor can examine your upper GI tract, which includes your esophagus, stomach, and the first part of your small intestine. Your doctor will check for (and possibly even treat) a variety of conditions that might affect those areas.

Endoscopies are typically performed by gastroenterologists, which is the fancy word for doctors who specialize in the digestive system.

How do you know if you need an endoscopy?

Not everybody needs an endoscopy. If you’re someone who occasionally struggles with heartburn and needs to reach for antacids after a large or spicy meal, this procedure likely isn’t indicated.

However, there are a number of more consistent or severe signs and symptoms that indicate an endoscopy would be helpful to get a better sense of what’s going on. These include:

  • Bleeding of the GI tract
  • Difficulty or pain when swallowing food or liquids
  • Persistent or recurrent acid reflux or GERD despite therapy
  • Persistent vomiting
  • Significant and unexplained weight loss
  • Unexplained chest or stomach pain

Endoscopies might also be required in more emergent situations, such as assessing injury caused by swallowing caustic chemical agents.

What conditions does an endoscopy diagnose?

Because an endoscopy gives your doctor a clear look at what’s happening in your upper digestive system, Johns Hopkins Medicine explains that this procedure is used to diagnose a variety of problems and conditions, including (but certainly not limited to):

  • Celiac disease
  • Crohn’s disease
  • GERD
  • Hiatal hernias
  • Infections of the upper GI tract
  • Inflammation and ulcers
  • Larger than normal veins in your esophagus
  • Narrowing or blockages
  • Tumors

The endoscope can also be used to take tissue samples so that a biopsy can be performed.

Is there another way to diagnose GERD?

Yes, since GERD is a clinical diagnosis, it can be diagnosed with history alone. For instance, a doctor asking about about a patient’s history of heartburn and regurgitation can make the diagnosis of GERD.

GERD can also be diagnosed with Ambulatory esophageal pH monitoring. This is a procedure where the doctor places a catheter transnasally. Over the next 24 hours the catheter can take pH measurements to make to diagnosis of acid reflux.

Where do you get an endoscopy done?

Typically, an endoscopy will be performed by a gastroenterologist in a hospital or an outpatient facility. However, in emergency situations, the endoscopy could be performed in the emergency room (ER).

How long does an endoscopy take?

The exam itself is over pretty quickly—generally within 15 to 30 minutes. However, you’ll want to allow somewhere between two to four hours for your entire visit.

That’s because you’ll need to register, complete your pre-procedure checks, spend some brief time recovering following the procedure (it’s not tough, we promise!), and then be discharged to go home.

How do you prepare for an endoscopy?

Preparing for an endoscopy is pretty straightforward and painless. Your doctor will provide you with some specific directions to follow, and those are important to refer to for your specific case.

But generally, Stanford Health Care explains that you’ll be asked to stop taking things like iron, aspirin products, or Pepto Bismol® about a week before your scheduled procedure. Five days before, you’ll also need to stop taking non-steroidal anti-inflammatories (think things like Motrin® or Advil®).

The least fun part is that you shouldn’t have any solid food after midnight the night before your procedure (so long, midnight snacks!), and you shouldn’t have anything to eat or drink at least eight hours before. Most doctors will allow you to take any necessary medications that won’t interfere with the procedure, but you’ll have to do so with very small sips of water.

Be aware that the no eating rule is pretty strict—and it includes breath mints or chewing gum. Fortunately, you can brush your teeth before the procedure. If you’re a smoker, it’s wise to stop smoking at least eight hours before the procedure as well.

Dress comfortably in loose-fitting clothing for your endoscopy (yep,this an excuse to wear sweats). It’s also recommended that you don’t wear makeup or nail polish, as your natural skin and fingernail color will help your doctor monitor how you’re doing during the procedure.

Do they put you to sleep for an upper endoscopy?

Typically speaking, yes. General anesthesia (that’s the combination of intravenous drugs and inhaled gasses) isn’t used during endoscopies. However, monitored anesthesia is and it has the same effect.

But don’t worry, you’ll still be super relaxed. You will get a sedative injected into the IV that’s in your arm or hand. You’ll technically be awake, but you’ll be very groggy and might not even remember much of the procedure.

You’ll be asked to lay on your left side on the table with your head bent forward. The doctor will likely also spray some numbing medicine down the back of your throat so you don’t gag as the endoscope is passed down your esophagus.

It sounds worse than it is. Endoscopies typically aren’t painful, and most people only report mild discomfort — similar to what you’d get with indigestion or a sore throat.

What happens after the endoscopy is over?

When the procedure is over, you’ll rest for about an hour while some of the effects of the sedative wear off. Either way, you’ll definitely want to get a ride home from a willing friend or family member — even if you feel fine, you shouldn’t be driving right after the procedure.

You might experience a little discomfort, such as bloating and excess gas or a sore throat where the endoscope was inserted. That’s expected and shouldn’t last more than a day. Make sure to let your doctor know if you’re dealing with anything severe or unexpected. It’s always better to ask!

If your doctor used numbing spray, you should wait to eat for at least two hours and then start with soft foods. It’s also smart to eat small meals for the first 24 hours or so to reduce your chances of a lot of bloating or cramping.

When it comes to showering? We can’t blame you for wanting to get squeaky clean, but wait until you’ve rested, eaten something, and feel steady on your own two feet.

How long until you get your endoscopy results?

As the National Institute of Diabetes and Digestive and Kidney Diseases mentions, some results — such as the things your doctor simply observed during the procedure — will be available right away, and your doctor will probably discuss those with you following your endoscopy.

If you needed a biopsy or some other test performed, those results can take a little bit longer. The exact timeframe can vary anywhere from a few days to a couple of weeks.

We know it’s tough to wait, but rest assured that your doctor will get in touch with you soon after your results are available.

Is an endoscopy safe? Does it hurt?

As we mentioned earlier, endoscopies shouldn’t be painful. While we won’t promise that you’ll ever look forward to the procedure, very mild discomfort is really about as unpleasant as things should get.

Endoscopies are also incredibly safe, common, and routine. In fact, there were an estimated 75 million endoscopies performed in the United States in 2017, so this definitely isn’t a rare or particularly risky procedure.

However, no procedure is guaranteed to be safe (that’d be a medical miracle!), so the Mayo Clinic outlines a few very rare risks and dangers related to endoscopies:

  • Bleeding
  • Infection
  • Tearing of the gastrointestinal tract
  • Reaction to sedation

But again, these aren’t common. The vast majority of patients make it through their endoscopies without any adverse reactions or side effects.

How much does an endoscopy cost?

Medical care can get pricey, so we certainly can’t blame you for wanting to know what kind of financial burden you’re in for when getting an endoscopy.

Much like any other medical procedure, the cost will depend on a variety of factors — such as your insurance plan or where you have the endoscopy performed.

Medicare’s Procedure Price Lookup tool estimates that the total cost of an endoscopy in a hospital outpatient department is around $760. However, it’s noted that this price doesn’t include physician fees.

Other research indicates that the average cost of an endoscopy in the United States is $2,750, but prices can range anywhere from $1,250 to $4,800.

If you want more certainty in terms of what you’ll be expected to pull out of your own wallet, call your insurance company ahead of time to understand what they’ll cover and what your responsibility will be. If you don’t have insurance, you can speak directly to your doctor’s office about pricing.

Are there other options?

If you’re unable to get an endoscopy (or simply don’t want one), your doctor may suggest starting you on a proton pump inhibitor, like esomeprazole (generic Nexium®) or omeprazole (generic Prilosec®).

Endoscopies aren’t the right choice for everyone. But, for people who are dealing with an array of unexplained and persistent digestive symptoms, the procedure can help your doctor get a better idea of what’s going on in your upper GI tract.

The good news is that the thought of the procedure is typically far more unpleasant than the reality. Endoscopies don’t require a ton of complicated prep, and they’re safe and largely painless. Trust us—it’ll be over before you know it.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Esomeprazole and omeprazole are oral medications used to treat gastroesophageal reflux disease (GERD; acid reflux). Tell your doctor if you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. Tell your doctor if you are taking any of these drugs: atazanavir, clopidogrel, nelfinavir, rifampin, rilpivirine, or St. John's wort. Do not start, stop, or change the dose of any drug without checking with your doctor. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: headache, falling asleep, abdominal pain, diarrhea, constipation, gas, dry mouth, upset stomach. Full prescribing information for esomeprazole is available here. Full prescribing information for omeprazole is available here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: or call 1-800-FDA-1088.

Photo by Arseny Togulev on Unsplash