An upper endoscopy (EGD) is a procedure used to visually examine the lining of the upper digestive tract, including the esophagus, stomach, and the first part of the small intestine. This involves inserting a thin, flexible tube equipped with a camera through the mouth and down the throat. Many patients report experiencing a mild burning sensation in the chest or throat afterward. This temporary discomfort mimics heartburn and is considered normal following an EGD. This post-procedure irritation is typically short-lived, resolving within 24 to 48 hours, and results from the mechanical process of the examination.
Understanding Post-Procedure Irritation
The discomfort experienced after an endoscopy often results from the physical manipulation of the delicate tissues lining the upper digestive system. As the endoscope passes through the throat and esophagus, it can cause transient inflammation and irritation to the mucosal lining. This temporary irritation can feel like a sore throat or a generalized burning sensation in the chest, closely resembling the feeling of acid reflux.
Another factor contributing to post-procedure symptoms is the necessary use of air or carbon dioxide (CO2) insufflation. To allow the physician a clear view of the tract’s interior, the digestive tube must be gently inflated, separating the walls of the esophagus and stomach. Residual air that remains in the stomach and intestines after the procedure causes bloating, pressure, and burping, which can push stomach contents upward.
This internal pressure may temporarily compromise the function of the lower esophageal sphincter (LES), the muscle ring that acts as a barrier between the stomach and the esophagus. The physical passage of the scope through the LES can temporarily affect its muscle tone, making it easier for stomach acid to reflux. This transient disruption, combined with the lining irritation, translates into the perception of heartburn. The resulting discomfort is typically mild and subsides as the introduced air is absorbed or passed.
Recognizing Signs That Require Medical Attention
While mild, temporary irritation is common, it is important to distinguish it from symptoms that may signal a serious complication. Persistent, severe chest pain that is much worse than typical heartburn requires immediate medical attention. This is especially true if the pain radiates into the neck or back, as it could indicate a perforation, which is a tear in the digestive tract wall.
Difficulty swallowing (dysphagia) or new difficulty breathing should be treated as serious signs requiring prompt evaluation. Signs of internal bleeding, such as vomiting material that looks like coffee grounds or passing black, tarry stools (melena), are also red flags.
Systemic signs of infection, like a fever above 100.4°F (38°C) or chills, must be reported to the healthcare provider immediately. Most normal post-procedure symptoms resolve completely within 24 to 48 hours. If any discomfort, including heartburn, persists or intensifies beyond this timeframe, contact the physician who performed the procedure.
Strategies for Managing Temporary Discomfort
For the expected mild post-endoscopy discomfort, several simple steps can help manage the symptoms. It is advisable to begin reintroducing food with a light, bland diet, such as clear liquids, broth, or gelatin. For the first day, strictly avoid foods known to trigger reflux, including spicy, acidic items like citrus and tomatoes, and high-fat or greasy meals.
Maintaining an upright posture for at least a few hours after eating helps reduce the chances of stomach acid flowing back into the esophagus. If the burning sensation occurs during the night, elevating the head of the bed by six to eight inches uses gravity to aid in symptom relief. This positioning helps keep stomach contents in place while the digestive tract recovers.
To soothe a sore throat, which often accompanies the procedure, gargling with lightly salted warm water or sucking on throat lozenges can provide relief. If mild heartburn persists, over-the-counter antacids may offer temporary relief. Patients should consult their physician before resuming or starting any prescription acid-reducing medications.