stroesophageal reflux disease, or GORD (GORD in the US), is a condition where acid moves out of the stomach and into the oesophagus. It’s estimated that GORD effects approximately 10-30% of the adult population in the UK.

The condition causes heartburn, a burning sensation in the oesophagus due to the acid. Other symptoms include chest pain, coughing, hoarseness, and regurgitation (where the stomach contents flow up into the throat or mouth).

The initial diagnosis is usually made based on a patient’s medical history. However, if a doctor suspects an underlying problem, you can have an endoscopy for acid reflux disease. Below, we cover the purpose of an endoscopy for GORD, including when it’s recommended, what the procedure involves, and what the risks are.

In this guide:

What is an Endoscopy?

An endoscopy is a medical procedure involving the insertion of an instrument into the upper gastrointestinal (GI) tract via the mouth. The instrument contains a camera and light, allowing your doctor to visualise your throat, oesophagus, and stomach. Perfect for diagnosing the problems associated with reflux disease, including silent acid reflux. 

When is Endoscopy Recommended for GORD?

Endoscopy doesn’t directly diagnose GORD. For that, you will need to undergo acid reflux testing, monitoring the acidity levels in your oesophagus for 24 hours. An endoscopy is advised for prolonged reflux disease. It can identify the characteristic changes into the oesophagus linked to reflux disease, such as inflammation, ulcer, or signs of any other disease. 

Barrett’s oesophagus is a major concern. It is a change in the lining of the oesophagus associated with an increased risk of cancer. Other potential diagnoses include a hiatus hernia or other anatomic abnormalities. 

An endoscopy is recommended if: 

• You have experience GORD symptoms for four or more weeks.

• You have severe GORD symptoms like weight loss, vomiting, or coughing up blood.

• Your GORD symptoms will not respond to treatment.

• Swallowing is difficult or your regurgitating food

• You have blood in your stool

• You have a persistent cough

• You have a pre-existing Barrett’s oesophagus

People with Barrett’s oesophagus undergo routine endoscopic monitoring. This surveillance program looks for signs of cancer. If the initial endoscopy shows no signs of oesophagitis (inflammation of the oesophagus) or Barrett’s oesophagus and the GORD symptoms are well-controlled, then repeated endoscopies are not necessary (unless there is a change in symptoms).  

What to Expect for an Endoscopic Procedure for GORD? 

Preparing for an Endoscopy 

After listening to your medical history and performing a physical examination, your doctor may decide you need an endoscopy to assess for acid reflux disease. Before the procedure you will need to: 

• Adjust or stop certain medications, such as blood thinners, aspirin, diabetes medications, and nonsteroidal anti-inflammatory drugs (NSAIDs). These medications increase the risk of bleeding. This is only a temporary adjustment until after the procedure.

• Not eat or drink anything for at least 6 to 8 hours before the endoscopy. This allows the doctor to get the best view of the upper GI tract.

• Speak to your doctor about your medications and other supplements you’re taking. It’s important to be open and honest so they can accurately assess any risks.

• Ask someone to drive you home after the procedure. You should not drive yourself or use public transport as this can be unsafe if you have sedation.

• These instructions are general steps to follow. Your doctor will provide specific instructions detailing how to prepare for the procedure. It’s important to follow the instructions carefully.  

How an Endoscopy for GORD Works

When you arrive for your endoscopy for acid reflux disease, you will change into a hospital gown. The medical team will check your vital signs, include heart rate, blood pressure, and blood oxygen levels.  

The procedure itself is quick, lasting only 15 to 30 minutes. You can expect the following steps: 

1. A sedative or numbing throat spray is administered to help patients stay relaxed and minimise discomfort during the procedure.

2. A thin, flexible tube with a small camera (endoscope) is gently inserted through the mouth and guided into the oesophagus, stomach, and upper intestine.

3. The doctor examines the lining of the oesophagus and stomach to check for inflammation, ulcers, or other signs of damage caused by GORD.

4. Small tissue samples (biopsies) may be taken if abnormalities are found, which will be sent for further analysis.

5. After the procedure, patients are monitored until the sedative wears off and are usually advised to rest for the remainder of the day. What Happens After an Endoscopy

Following the endoscopy, you will be monitored for 1-2 hours – especially if a sedative was given. You can then return home. Always follow any instructions provided by the medical team.

The numbing throat spray impairs your gag reflux. Therefore, it’s crucial not to eat anything to avoid choking. You may notice some bloating or cramping for a short-time, and a sore throat. This only lasts a few days.

You will receive your results within a few days detailing the findings. Your GP can help explain the next steps if there is a positive diagnosis.

Potential Risks of an Endoscopy?

Aside from a sore throat, difficulty swallowing, and a little bloating, endoscopy is a safe and routine procedure. In rare cases, potential risks include: 

• Infection

• Bleeding from biopsy site

• Tear in upper GI tract lining

• Reaction to the sedative

An endoscopy isn’t the only diagnostic procedure for GORD. A gastric reflux test monitors the presence of acid in the oesophagus for 24 hours. It’s a highly reliable test for acid reflux disease. Less invasive than an endoscopy, it’s often preferred by patients who find an endoscopy too uncomfortable. We support patients throughout their diagnosis, performing the test for reflux and explaining the results.