About Your Upper Endoscopy

This information will help you get ready for your upper endoscopy. An upper endoscopy is a test to look at your esophagus (food pipe), stomach, and the first part of your small intestine.

During your upper endoscopy, your healthcare provider will use a flexible tube called an endoscope. It lets them see the inside of your esophagus, stomach, and small intestine on a video screen. They can also take a small tissue sample or remove a polyp (growth of tissue). This procedure is called a biopsy.

1 week before your procedure

Ask about your medications

You may need to stop taking some of your medications before your procedure. Talk with your healthcare provider about which medications are safe for you to stop taking. We’ve listed some common examples below.

Anticoagulants (blood thinners)

If you take a blood thinner (medication that affects the way your blood clots), ask the healthcare provider doing your procedure what to do. They may recommend you stop taking the medication. This depends on the type of procedure you’re having and the reason you’re taking a blood thinner.

Examples of common blood thinners are listed below. There are others, so be sure your care team knows all the medicine you take. Do not stop taking your blood thinner without talking with a member of your care team.

Medications for diabetes

You may be taking insulin or other medications for diabetes. Ask the healthcare provider who prescribes your medication what you should do the morning of your procedure. You may need to change the dose before your procedure.

Do not take metformin (such as Glucophage^® or Glumetza^®) or a medication that contains metformin (such as Janumet^®) the day before or the day of your procedure.

Tell your healthcare provider if you have an AICD

Tell your MSK healthcare provider at if you have an automatic implantable cardioverter-defibrillator (AICD). If you have an AICD, you’ll need to have your procedure done at Memorial Hospital, MSK’s main hospital.

Get a letter from your doctor, if needed

• If you have an automatic implantable cardioverter-defibrillator (AICD), you’ll need to get a clearance letter from your cardiologist (heart doctor) before your procedure. A clearance letter is a letter that says you can safely have the procedure.
• If you’ve had chest pain, dizziness, trouble breathing, or have fainted in the last 6 weeks, you need to be checked by your doctor, and get a clearance letter from your doctor before your procedure.

Your MSK doctor’s office must have your clearance letter at least 1 day before your procedure.

Arrange for someone to take you home

You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.

If you don’t have a responsible care partner to take you home, call one of the agencies below. They’ll send someone to go home with you. There’s a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you.

3 days before your procedure

An endoscopy nurse will call you between 8 a.m. and 6 p.m. 3 days before your procedure. They’ll review the instructions in this guide with you and ask you questions about your medical history. The nurse will also review your medications. They will tell you which medications to take the morning of your procedure.

The day before your procedure

Note the time of your procedure

A staff member will call you after 12 p.m. (noon) the day before your procedure. The staff member will tell you what time you should arrive for your procedure. If you’re scheduled for your procedure on a Monday, they’ll call you the Friday before. If you don’t get a call, call your healthcare provider’s office.

If you need to cancel your procedure, call the healthcare provider who scheduled it for you.

Instructions for eating

‌ 
Stop eating at midnight (12 a.m.) the night before your surgery. This includes hard candy and gum.

If your healthcare provider told you to stop eating earlier than midnight, follow their instructions. Some people need to fast (not eat) for longer before their surgery.

The day of your procedure

Instructions for drinking

Between midnight (12 a.m.) and 2 hours before your arrival time, only drink the liquids on the list below. Do not eat or drink anything else. Stop drinking 2 hours before your arrival time.

• Water.
• Clear apple juice, clear grape juice, or clear cranberry juice.
• Gatorade or Powerade.
• Black coffee or plain tea. It’s OK to add sugar. Do not add anything else.
  • Do not add any amount of any type of milk or creamer. This includes plant-based milks and creamers.
  • Do not add honey.
  • Do not add flavored syrup.

If you have diabetes, pay attention to the amount of sugar in these drinks. It will be easier to control your blood sugar levels if you include sugar-free, low-sugar, or no added sugar versions of these drinks.

It’s helpful to stay hydrated before surgery, so drink if you are thirsty. Do not drink more than you need. You will get intravenous (IV) fluids during your surgery.

‌ 
Stop drinking 2 hours before your arrival time. This includes water.

Things to remember

• Take only the medications your healthcare provider told you to take the morning of your procedure. Take them with a few sips of water.
• Don’t put on any lotion, cream, powder, makeup, perfume, or cologne.
• Remove any jewelry, including body piercings.
• Leave valuable objects (such as credit cards and jewelry) at home.
• If you wear contact lenses, wear your glasses instead.

What to bring

• A list of the medications you take at home, including patches and creams.
• Your rescue inhaler (such as albuterol for asthma), if you have one.
• A case for your glasses.
• Your Health Care Proxy form, if you have completed one.

Where to go

Your upper endoscopy will take place at one of these locations:

• David H. Koch Center
  530 East 74th Street
  New York, NY 10021
  Take the elevator to the 8th floor.
• Endoscopy Suite at Memorial Hospital (MSK’s main hospital)
  1275 York Avenue (between East 67th and East 68th Streets)
  New York, NY 10065
  Take the B elevator to the 2nd floor. Turn right and enter the Endoscopy/Surgical Day Hospital Suite through the glass doors.
• MSK Monmouth
  480 Red Hill Road
  Middletown, NJ 07748

Visit www.msk.org/parking for parking information and directions to all MSK locations.

What to expect

Once you arrive

Once you arrive, you’ll be asked to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.

After changing into a hospital gown, you’ll meet your nurse. They’ll place an intravenous (IV) catheter into one of your veins, usually in your hand or arm. The IV will be used to give you anesthesia (medication to make you sleep) during your procedure. You may also get fluids through the IV before your procedure.

You’ll talk with your doctor before your procedure. They’ll explain the procedure and answer your questions.

During your procedure

When it’s time for your procedure, you’ll go into the procedure room and be helped onto an exam table. Your healthcare provider will set up equipment to monitor your heart, breathing, and blood pressure. You’ll get oxygen through a thin tube that rests below your nose. You’ll also get a mouth guard placed over your teeth to protect them.

You’ll get anesthesia through your IV, which will make you fall asleep. Once you’re asleep, your doctor will pass the endoscope through your mouth. It will go down your esophagus, into your stomach, and into your small intestine. Your doctor will do biopsies to get tissue samples, if needed. Then they will remove the endoscope.

After your procedure

Your nurse will keep monitoring your heart, breathing, and blood pressure. You may feel soreness in your throat. If you do, it should go away in 1 to 2 days.

Once you’re fully awake, your nurse will remove your IV. Your nurse will explain your discharge instructions to you before you go home.

At home

Do not drink alcoholic drinks for 24 hours (1 day) after your procedure.

When to call your healthcare provider

Call you healthcare provider if you have any of the following:

• A fever of 101 °F (38.3 °C) or higher
• Chest pain or shortness of breath (hard to breathe)
• Severe pain, hardness, or swelling in your abdomen (belly)
• Blood in your vomit (throw up)
• Weakness, faintness, or both
• Any other questions or concerns