Upper GI Endoscopy: How to Prepare, What to Expect, What the Report Tells You

10 September 2026 · 3 min read

Upper GI endoscopy (OGD) is the standard test for persistent upper abdominal pain, difficulty swallowing, unexplained anaemia in the older adult, or suspected GERD not responding to medication. In India it costs ₹2,500-6,000 and takes 15-20 minutes. Understanding what happens and what the report typically shows makes the whole experience less anxious.

The prep

  • Nothing to eat for 8 hours before, nothing to drink for 4 hours.
  • Diabetics: hold morning insulin if the test is morning; discuss with doctor.
  • Blood thinners: usually held for 5-7 days before, resumed after — discuss.
  • Bring a companion — sedation prevents driving.
  • Wear loose clothing.

The procedure

  • Local anaesthetic spray to numb throat.
  • Sedation (usually midazolam) via IV.
  • Endoscope passed through mouth into stomach and first part of duodenum.
  • Biopsies taken if any abnormal area.
  • Duration 10-20 minutes.
  • Recovery 30-45 minutes.
  • Report available same day; biopsy result in 5-10 days.

What the report might show

  • Finding: Normal · What it means: No lesion in oesophagus, stomach, duodenum
  • Finding: Erosive esophagitis · What it means: Acid damage to lower oesophagus (GERD)
  • Finding: Hiatal hernia · What it means: Part of stomach slid up; often asymptomatic
  • Finding: Gastritis (mild/moderate) · What it means: Stomach inflammation
  • Finding: Ulcer (gastric or duodenal) · What it means: Open lesion; needs biopsy + H. pylori test
  • Finding: Barrett's oesophagus · What it means: Precancerous change from chronic acid exposure
  • Finding: H. pylori evidence · What it means: Common bacterial infection; treatable
  • Finding: Polyp · What it means: Usually benign; biopsy confirms
  • Finding: Mass / malignancy · What it means: Requires biopsy and staging

H. pylori — the specific thing worth knowing

H. pylori infection is very common in India (~60-80% adult prevalence) and often asymptomatic. It is a major cause of peptic ulcer and increases stomach cancer risk long-term. Endoscopy usually includes a rapid urease test (CLO) or biopsy for H. pylori. If positive, a 7-14 day course of antibiotics + PPI clears it in 80-90% of cases. A follow-up urea breath test confirms eradication.

When to have endoscopy — reasonable indications

  • Reflux symptoms persisting after 8 weeks of PPI treatment.
  • Difficulty swallowing or food sticking.
  • Unexplained weight loss with GI symptoms.
  • Anaemia in men or postmenopausal women without obvious cause.
  • Vomiting blood or coffee-ground material.
  • Black tarry stools.
  • Alarm symptoms with new-onset dyspepsia over 50.

What NOT to endoscope

  • Simple dyspepsia in an under-50 without alarm symptoms — trial of PPI first.
  • Occasional heartburn responsive to over-the-counter treatment.
  • As screening in asymptomatic adults (unless family history of gastric cancer).

Every endoscopy report plus its biopsy should be saved. If a Barrett's diagnosis exists, surveillance endoscopy every 3-5 years matters — the specific interval depends on the biopsy grade. Without the historical report in hand, the interval becomes guesswork.

References

Free for 90 days, no card needed. After that, keeping the record costs ₹349 for the year.

General information, not medical advice. Always talk to a qualified doctor about your own care. Where this and your doctor disagree, your doctor is right.

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