How do I prepare for an upper endoscopy?

An empty stomach allows for the best and safest upper endoscopy examination, so you should have nothing to eat or drink, including water, for approximately six hours before the examination. Your doctor will tell you when you should start fasting as the timing can vary. Tell your doctor in advance about any medications you take; you might need to adjust your usual dose for the examination. Discuss any allergies to medications as well as medical conditions, such as heart or lung disease.

Here's a synopsis of the key things that you should do to prepare for an upper endoscopy, a medical procedure to visually examine the esophagus, the stomach, and part of the duodenum:

1. Call your insurance company and ask if the endoscopy test is covered for the reason given by your doctor.
2. Ask your insurance company if you need a referral for the upper endoscopy. If they say "yes," then you MUST get a referral from your primary care physician.
3. Update your hospital registration.
4. Make plans for someone to come with you to the hospital.
5. If you take Coumadin, Plavix, or other blood thinners, please talk to the doctor who prescribed it.
6. If you are diabetic, please talk to your doctor about how to take your medication in order to prevent low blood sugar.

Before having an upper gastrointestinal endoscopy, tell your doctor if you:

• Are allergic to any medicines, including anesthetics.
• Are taking any medicines.
• Have bleeding problems or take blood-thinning medicine, such as warfarin (Coumadin). 
• Have heart problems.
• Are or might be pregnant.
• Have diabetes and take insulin.
• Have had surgery or radiation treatments to your esophagus, stomach or the upper part of your small intestine.

Do not eat or drink anything for 6 to 8 hours before that says you understand the risks of the test and agree to have it done. An empty stomach helps your doctor see your stomach clearly during the test. It also reduces your chances of vomiting. If you vomit, there is a small risk that your stomach contents could enter your lungs (aspiration). If the test is done in an emergency, a tube may be inserted through your nose or mouth to empty your stomach.

You may be asked to sign a consent form before the test. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done or what the results will mean.

You may be asked to stop taking aspirin products or iron supplements 7 to 14 days before the test. If you take blood-thinning medicines regularly, discuss with your doctor how to manage your medicine.

Do not take sucralfate (Carafate) or antacids on the day of the test. These medicines can interfere with your doctor's ability to view the gastrointestinal tract.

If biopsy samples are taken or polyps are removed during the test, bleeding may also occur. This bleeding usually stops on its own without treatment. To reduce this risk, avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for several days before the endoscopy. If you take blood-thinning medicine, you may be instructed to stop the medicine temporarily before the test.

Before the test, you will put on a hospital gown. If you are wearing dentures, jewelry, contact lenses or glasses, remove them. For your own comfort, empty your bladder before the test begins.

Arrange to have someone take you home after the test because you will be given a sedative before the test.