If your gastroenterologist thinks you may have EoE, or if they need to see how you’re improving on treatment, they’ll likely perform an upper endoscopy. Before your procedure, you’ll get specific instructions to follow from your endoscopy center or doctor’s office. These help the process go smoothly and help your gastroenterologist get the best images of your throat (esophagus) for a diagnosis.
Gastroenterologists can use an upper gastrointestinal (GI) endoscopy to look for signs of EoE. Also known as an esophagogastroduodenoscopy (EGD), the procedure involves a long, thin, flexible tube known as an endoscope with a camera and light attached to the end. The endoscope is placed down your throat to look for inflammation, narrowing or strictures, and other signs of EoE.
During the procedure, the gastroenterologist may also take a small piece of tissue, known as a biopsy. This tissue can then be stained with different chemicals and looked at under a microscope for eosinophils and other immune cells. The staining lets your gastroenterologist know how severe your EoE is.
Your gastroenterologist’s office will give you instructions on how to prepare for your appointment. Preparation typically begins five to seven days before the procedure. Some offices may have different recommendations than others, so be sure to follow the information you’re given specifically. These instructions will help prevent complications and make the procedure as successful as possible.
One to five days before your upper endoscopy, your doctor might advise you to stop taking blood thinners, such as warfarin (Coumadin), enoxaparin (Lovenox), and clopidogrel (Plavix). These can increase your risk of bleeding during the procedure. Your doctor will guide you on how to safely stop taking these medications, including how far before the procedure you should pause them.
Some doctors may recommend stopping certain anti-inflammatory drugs for pain relief, as they also have blood-thinning effects. These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). However, other doctors may let you continue to take them before your endoscopy procedure. Your doctor will tell you what they recommend. If you need to take a pain reliever in the meantime, acetaminophen (Tylenol) is generally safe to use.
If you are taking other medications, be sure to ask your doctor which you can still take and which you should stop. Do not stop taking your medications without talking to your doctor first, because this may lead to unexpected health issues.
During an endoscopy, it’s important that there is no food in your stomach to interfere with the test. Do not eat any solid foods after midnight the night before your procedure. On the day of your procedure, you may take routine medications allowed by your doctor with a sip of water. You’re also allowed to brush your teeth and rinse your mouth, but try to avoid swallowing anything.
If your doctor allows you to drink clear liquids up to four hours before your procedure, you may have:
Nonclear liquids are any liquids that you can’t see through. Examples typically not allowed the morning of your endoscopy include:
Wear comfortable clothing on the day of your endoscopy. Some offices may let you wear a short-sleeved shirt underneath the gown you’ll wear. The procedure room may be cold as well, so you’ll want to wear socks.
If you use a continuous positive airway pressure (CPAP) machine, bring it to the appointment. You’ll also need a current list of all your medications and any other paperwork the doctor’s office requested. Expect to be at the office for a few hours.
Once you arrive at your doctor’s office, you’ll be taken back to the procedure room to prepare for your endoscopy. You’ll put on a gown and have different monitors attached to your body to check your heart rate, blood pressure, and breathing. You may also be given a numbing spray to help numb your throat before the procedure.
You’ll then be given sedative medication through an intravenous needle to help you relax during the procedure. This is not the same as being put under general anesthesia where you are completely asleep. Instead, you’ll be under moderate sedation — you won’t remember the procedure or events shortly after it, but you’ll be awake enough to answer questions.
During the endoscopy, the doctor inserts the endoscope down your throat to look for any abnormalities associated with EoE. The procedure takes from 15 to 30 minutes.
After your endoscopy is completed, you’ll be taken to a recovery area to relax and allow the sedative to wear off. You’ll be monitored by health care staff to make sure your breathing and blood pressure are stable. Depending on your gastroenterologist’s office, you may stay in the recovery area for around an hour.
Once you’re ready to leave, you’ll be given an instruction packet and sent home with a responsible adult who can drive you. You’re not allowed to drive yourself home after an endoscopy. The sedatives may cause you to feel lightheaded or sleepy, so you shouldn’t perform any activities that may put you in danger, such as operating machinery or using a stove without supervision. You should also avoid drinking alcohol until the sedative’s effects wear off.
After your endoscopy, you can continue eating your normal diet. Because you won’t have had anything to eat or drink for several hours, your stomach may be upset. If needed, you can eat soft foods that are easy for your stomach to digest. These include applesauce, soups, eggs, and puddings. Be sure to drink plenty of fluids to help your body recover as well. These include water, broth, and electrolyte beverages.
Your throat may be sore for a few days after the procedure, but that should go away on its own. If needed, you can take pain relievers as suggested by your gastroenterologist. You may also feel bloated, but this should pass within a day or two after the endoscopy. It’s best to avoid foods that may irritate your stomach or throat, such as fried or fatty foods and caffeine. These can make your discomfort worse.
Endoscopies are generally safe procedures, but you may have some complications. If you experience any of these symptoms after your endoscopy, call your gastroenterologist’s office right away:
If you have any questions or concerns before your endoscopy, talk to your gastroenterologist or doctor. They’ll be able to address your needs and answer any questions about your medications and preparing for the procedure.
At myEoEcenter, the site for people with eosinophilic esophagitis and their loved ones, people come together to gain a new understanding of EoE and share their stories with others who understand life with EoE.
Have you had an upper endoscopy for your EoE? Share your experiences in the comments below.