What It Does Upper endoscopy is similar to colonoscopy, except that the scope is inserted down your esophagus while you're sedated to examine your esophagus, stomach, and beginning of your small intestine. Endoscopy is used to investigate the cause of specific symptoms, such as chronic reflux, swallowing difficulty, and upper abdominal pain. Just as with colonoscopy, your doctor can also remove any polyps on the spot. "It's important to look at patients over age sixty who have reflux or sudden pain swallowing, because the older esophagus is less sensitive--so by the time you feel pain, any disease that is present may be more severe," says Lawrence Brandt, MD, emeritus chief of gastroenterology at Montefiore Medical Center, in Bronx, NY. A diagnostic endoscopy should take about 5 to 7 minutes; if you have any polyps, it might take a few minutes longer.
The Fear Factor There's little preparation; you just have to fast for 6 to 8 hours before the test. "Many patients are concerned that they'll gag or throw up when the scope is inserted," even though they'll be sedated, says Dr. Brandt. Those reactions rarely happen, but because the doctor inserts air while the scope is down, you might feel pressure. This usually goes away within a few hours; afterward, you might also have a slight sore throat.
Schedule it for First Thing in the AM You naturally fast while you're sleeping, so Dr. Brandt suggests eating dinner as usual the night before and scheduling an early morning procedure.
Ask for an Anesthetic Spray If you can't shake the fear of gagging, request an anesthetic spray before the procedure for peace of mind.
Treat Your Throat Gently Afterward If your throat feels sore from the scope, Dr. Brandt recommends eating soft foods for the rest of the day. Ease back in with yogurt, Jell- O, and ice pops, and skip anything irritating, like spicy or hard foods.
Are There Any Alternatives?
An old-fashioned upper GI series--in which you ingest a chalky barium drink and your esophagus, stomach, and first part of your small intestine are x-rayed-- is still an option, but there's also a newer development: With a capsule endoscopy, you swallow a large pill-size capsule that has a miniature camera inside. As the camera moves painlessly through your entire GI tract, it transmits images to a receiver you wear in a vest--no sedatives required. You can go home or to work while the camera travels through your system; it is eventually eliminated in your stool, and you can flush it away. The drawback? Because it allows only for diagnosis (not treatment) and has potential complications, capsule endoscopy is used and covered by insurance only when traditional colonoscopy and endoscopy have failed to locate the source of pain or bleeding.
What It Does MRI (magnetic resonance imaging) uses a strong magnetic field and radio waves to create cross-sectional images of your body. Because it shows organs, soft tissue, and bones, doctors use MRI to help diagnose everything from torn ligaments to brain tumors and cancer. You'll be sent headfirst into an enclosed tube and must lie still while listening to the taps and thumps of the scanner (you'll be offered earplugs). It can take from 10 minutes to over an hour.
The Fear Factor An MRI doesn't cause any physical pain, but the psychological challenge of lying still in a narrow tube may make a person feel claustrophobic.