Endoscopy for GERD: Why and When It’s Recommended by Gastroenterologist Dr. Sandeep Pal
Persistent heartburn isn’t just uncomfortable — it could be silently damaging your esophagus. While most people rely on antacids for relief, over 30% of chronic GERD patients develop complications that only an endoscopy can detect early.
In this essential guide, Dr. Sandeep Pal, a leading gastroenterologist in Chandigarh, explains:
✔ 5 hidden dangers of untreated GERD (from Barrett’s esophagus to strictures)
✔ When to say “yes” to endoscopy (beyond just persistent symptoms)
✔ The 10-minute procedure demystified (what really happens during the exam?)
✔ 10 critical FAQs (from “Is anesthesia safe?” to “Can endoscopy worsen reflux?”)
Why Endoscopy? The Silent Threats of Chronic GERD
1. Barrett’s Esophagus (Pre-Cancerous Changes)
- What happens: Stomach acid transforms esophageal cells → 30x higher cancer risk
- Who’s at risk? White males >50 with 10+ years of weekly heartburn
2. Esophageal Strictures
- Scarring narrows the food pipe → swallowing feels like “food stuck in chest”
3. Erosive Esophagitis
- Ulcers form where acid burns the lining → risk of bleeding
4. Hiatal Hernia
- Stomach pushes into chest → worsens reflux → needs surgical repair
5. Unexpected Findings
- Stomach cancer mimicking GERD symptoms
Dr. Pal’s Case:
*”A 45-year-old with ‘normal’ GERD for years… endoscopy revealed early esophageal cancer — caught just in time for cure.”*
When Should You Get Scoped? 5 Clear Indicators
Alarm Symptoms:
- Difficulty swallowing
- Unexplained weight loss
- Vomiting blood
Long-Standing GERD:
- 5 years of weekly symptoms despite meds
Failed Medication Trial:
- PPIs (like Pantoprazole) don’t fully control symptoms
Pre-Op Evaluation:
- Before anti-reflux surgery (LINX, fundoplication)
Screening for Barrett’s:
- If multiple risk factors (male, white, obese, smoker)
The Endoscopy Experience: Step-by-Step
Before the Procedure
- 6-hour fasting (even water)
- Throat spray (lidocaine) or light sedation (propofol)
During (10–15 mins)
- A thin, flexible tube with camera passes through mouth
- Checks:
- Esophagus for damage
- Stomach for ulcers
- Duodenum for bile reflux
After Effects
- Mild throat scratchiness (1–2 hours)
- No memory if sedated
Cost in Chandigarh:
- Diagnostic: ₹2,500–4,000
- With biopsy: ₹4,500–6,000
10 Must-Know FAQs
1. “Is endoscopy painful?”
No — just mild discomfort. Sedation makes you sleep through it.
2. “Can endoscopy worsen GERD?”
❌ Myth. It diagnoses but doesn’t aggravate reflux.
3. “How often repeat endoscopy?”
- Barrett’s esophagus: Every 3–5 years
- Normal exam: Only if new symptoms
4. “Why biopsy if everything looks normal?”
Microscopic eosinophilic esophagitis or H. pylori can hide visually.
5. “Anesthesia risks?”
Propofol is safer than driving when administered by specialists.
6. “Can I eat after endoscopy?”
Wait 1 hour (until throat numbness wears off).
7. “Difference between endoscopy & colonoscopy?”
- Endoscopy: Upper GI (esophagus/stomach)
- Colonoscopy: Lower GI (colon)
8. “Will it detect gallbladder issues?”
No — gallbladder needs ultrasound/HIDA scan.
9. “Alternative tests?”
- Barium swallow (less detailed)
- Capsule endoscopy (for small intestine)
10. “Can kids get scoped for GERD?”
Yes — pediatric endoscopes exist for severe cases.
What Endoscopy Can’t Do
❌ Treat GERD (just diagnoses)
❌ Check acid levels (needs pH monitoring)
❌ Replace lifestyle changes (diet/elevation still key)
Myths vs Facts
❌ “Endoscopy is only for cancer.”
✅ Fact: It finds pre-cancerous Barrett’s before malignancy develops.
❌ “Home remedies make scopes unnecessary.”
✅ Fact: Baking soda can’t detect esophageal damage.
❌ “Normal endoscopy = No need for meds.”
✅ Fact: Functional heartburn may still need treatment.
Key Takeaways
- GERD beyond 5 years? Get scoped — even if symptoms are “controlled.”
- Barrett’s esophagus requires surveillance every 3 years.
- Sedation makes the procedure painless.
- Early detection prevents esophageal cancer.
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