At a glance
Upper endoscopy, also called gastroscopy, is a procedure in which a doctor passes a thin, flexible tube with a small camera at its tip through your mouth to look directly at the lining of your oesophagus (food pipe), stomach, and the first part of your small intestine (duodenum).
The tube, called an endoscope, transmits live video to a screen so the doctor can spot inflammation, ulcers, abnormal growths, or bleeding in real time. If something suspicious is found, the doctor can pass tiny instruments through the same tube to take a small tissue sample (biopsy) without making any cut in the skin.
Medical Condition
Gastroscopy is ordered when a doctor needs a direct view of the upper digestive tract to find the cause of symptoms or to confirm a diagnosis already suspected from other tests.
- Persistent heartburn or acid reflux (stomach acid rising into the food pipe) that does not respond to medication
- Difficulty swallowing or pain when swallowing
- Unexplained nausea, vomiting, or vomiting blood
- Upper abdominal pain or discomfort that does not go away
- Black or tarry stools, which may signal bleeding in the upper digestive tract
- Suspected peptic ulcer (a sore on the lining of the stomach or duodenum)
- Monitoring of Barrett's oesophagus (a pre-cancerous change in the food-pipe lining)
- Investigating unexplained weight loss or iron-deficiency anaemia (low red blood cells caused by low iron)
- Confirming or following up on coeliac disease (an immune reaction to gluten that damages the small intestine)
- Removing a small polyp (a tiny tissue overgrowth) or foreign object swallowed accidentally
There are situations where gastroscopy is delayed or avoided until the patient is more stable.
- Suspected perforation (a hole) in the stomach or intestine wall
- Severe, uncontrolled heart or lung conditions that make sedation unsafe
- Very recent heart attack, unless the procedure is urgently needed to stop bleeding
- Inability to cooperate with the procedure and no option for sedation
Risks & Complications
Gastroscopy is one of the safer procedures in medicine, and serious complications are uncommon, but they do exist and a doctor will discuss them with you beforehand.
- Sore throat or discomfort in the mouth and throat for a day or two after the procedure
- Bloating or a gassy feeling caused by air pumped into the stomach during the examination
- Temporary drowsiness or dizziness if a sedative is used
- Mild bleeding at the biopsy site, which nearly always stops on its own
- Reaction to the sedative medication, such as low blood pressure or breathing changes, monitored by nursing staff throughout
- Aspiration (accidentally breathing in saliva or stomach contents into the lungs), more likely if the patient has a full stomach
- Perforation (a small tear in the wall of the oesophagus, stomach, or duodenum), a rare but serious complication that may require surgery
- Infection, very rare when standard hygiene protocols are followed
Preparation & Procedure
The stomach must be completely empty so the doctor has a clear view and the risk of aspiration is reduced. In most hospitals this means stopping all food and solid drinks at least six hours before the procedure, and stopping plain water two hours before.
Before the day of the procedure, your doctor will review your current medications. Blood thinners and certain diabetes medications may be paused or adjusted. Tell your doctor about any allergies, especially to sedatives or latex.
Smoking and alcohol are usually asked to be stopped for at least 24 hours before the procedure, as both can irritate the stomach lining and make the images harder to read.
Routine tests before gastroscopy may include a blood test to check clotting (how well blood stops bleeding) and an ECG (a heart tracing) if sedation is planned and you are older or have heart conditions.
On the day, the procedure itself typically follows these steps:
- You change into a hospital gown and a nurse checks your blood pressure, pulse, and oxygen levels.
- A small plastic mouthguard is placed between your teeth to protect them and guide the scope.
- A local anaesthetic spray (numbing spray) is applied to the back of your throat to reduce gagging.
- If sedation is used, a cannula (a tiny plastic tube) is placed in a vein in your arm and the sedative is given. You remain conscious but deeply relaxed, or you may drift into a light sleep.
- You lie on your left side and the endoscope is gently guided over your tongue and down through your oesophagus into your stomach and duodenum.
- The doctor examines the lining carefully, takes photographs, and collects a biopsy if needed.
- The scope is slowly withdrawn and the procedure ends. The whole examination usually takes between five and twenty minutes, though this varies with findings.
Aftercare
After the procedure you are moved to a recovery area where nurses monitor your oxygen levels, blood pressure, and alertness until the sedative, if one was used, has worn off enough for you to be safe.
- You stay in the recovery area for usually 30 to 60 minutes before being discharged, though this varies if complications arose.
- If you received sedation, you must not drive, operate machinery, or sign legal documents for the rest of that day. Arrange for someone to take you home.
- A mild sore throat and some bloating are normal for the first day or two and can be managed with warm fluids and soft foods.
- You can usually eat and drink normally once the throat numbness from the spray has fully worn off, typically within an hour.
- If a biopsy was taken, avoid blood-thinning medications, aspirin, or anti-inflammatory painkillers for a period your doctor will specify, to reduce bleeding risk.
- Watch for warning signs that need urgent medical attention: vomiting blood, black or tarry stools, severe abdominal pain, fever, or difficulty swallowing that gets worse rather than better.
- Biopsy results usually take several days to a week to come back from the laboratory. Your doctor will contact you or schedule a follow-up appointment to discuss them.
- If the gastroscopy was done to monitor a long-term condition such as Barrett's oesophagus or coeliac disease, your doctor will recommend a schedule for repeat procedures.
Cost & What Determines It
The price of a gastroscopy varies widely depending on where it is done, how it is done, and what is found during the examination. A straightforward diagnostic gastroscopy with no added interventions costs significantly less than one where polyps are removed or multiple biopsies are taken and sent to a specialist laboratory.
- Complexity of the procedure: a simple visual examination costs less than one that includes biopsy, polyp removal, or treatment of a bleeding vessel
- Hospital class and country: a private hospital in a major city, or a hospital abroad, prices the procedure differently from a public or regional facility
- Type of sedation chosen: no sedation, light sedation, or full general anaesthesia each carry different fees, including anaesthetist charges where applicable
- Biopsy laboratory fees: tissue samples sent for pathology (laboratory analysis) are usually billed separately from the procedure itself
- Additional diagnostic tests: blood tests, ECG, or imaging ordered at the same visit add to the total
- Length of stay and recovery monitoring: most gastroscopies are day procedures, but if a complication requires observation or admission, the cost increases accordingly
- Consultation fees: the gastroenterologist's fee before and after the procedure may or may not be included in the package price
Hospital packages for gastroscopy typically include the endoscopist's fee, use of the endoscopy suite, nursing care during and after the procedure, and standard sedation. Items that are commonly billed separately include pathology fees for biopsies, specialist anaesthetist fees, any medication prescribed to take home, and follow-up consultation charges.
For Indonesian patients, BPJS Kesehatan and most Indonesian private insurance plans do not cover procedures performed abroad, so the full cost usually comes out of pocket or through an international private health insurance policy that explicitly covers overseas treatment. Before travelling, ask the hospital for a written cost estimate that lists what is and is not included. This written quote is the most reliable way to understand the total expected spend and to avoid unexpected bills on arrival or after discharge.
Frequently Asked Questions
Does an upper endoscopy hurt?
Most people feel little to no pain during an upper endoscopy. The doctor passes a thin, flexible tube called a gastroscope through your mouth and down into your stomach, and you are usually given a sedative (a medicine that makes you drowsy and relaxed) so you are comfortable throughout. Some patients notice mild throat discomfort or bloating afterwards, but this tends to pass within a few hours.
How do I prepare for an upper endoscopy, and do I need to fast?
Yes, you will need to fast, meaning no food or drink, for usually six to eight hours before the procedure so your stomach is empty and the doctor can see clearly. Your care team will also ask about any medicines you take, especially blood thinners, since some may need to be paused beforehand. Follow the exact instructions given by your hospital, as the details can vary slightly depending on your situation.
How long does an upper endoscopy take?
The procedure itself usually takes between fifteen and thirty minutes, though you should plan to be at the facility for longer to allow time for preparation and recovery from the sedative. Most people are ready to go home within one to two hours after the scope is finished. You will need someone to accompany you home, as the sedative can leave you feeling drowsy.
How much does an upper endoscopy cost?
The cost varies depending on several factors specific to this procedure, including the class of hospital you choose, whether sedation is used, the experience level of the specialist performing it, and whether any tissue samples called biopsies are taken during the same session. The most reliable way to know what you will pay is to request a written cost estimate directly from the hospital before your appointment.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
