Before an upper endoscopy, tell your care team about all medicines and supplements, drug allergies, long-term health conditions, bleeding problems, implanted devices, and any past problems with sedation or anesthesia. Mention pregnancy or a chance you could be pregnant, too. These details help the team plan the procedure and medicines safely. Bring an up-to-date medication list, and do not stop prescribed medicines unless your clinician tells you to.
Why does your medical history matter before an upper endoscopy?
An upper endoscopy, also called an esophagogastroduodenoscopy (EGD) or gastroscopy, uses a thin, flexible tube with a camera to examine the lining of the esophagus, stomach, and first part of the small intestine. The procedure may involve a numbing spray for the throat, sedative medicines to help you relax, or anesthesia, depending on your circumstances and the planned examination.
Your medical history helps the gastroenterology team understand your current health, review possible medication concerns, and plan appropriate monitoring. The American Society for Gastrointestinal Endoscopy (ASGE) advises patients to report their medicines, medication allergies, and conditions such as heart or lung disease before the procedure.
Which medicines should you disclose?
Provide a complete list of prescription medicines, over-the-counter products, vitamins, herbal remedies, and other supplements you use. Include each medicine's name, dose, and how often you take it. Mention medicines you take only occasionally, as well as any recent changes to your usual treatment.
Some medicines may require specific instructions before an endoscopy. The Guy's and St Thomas' NHS Foundation Trust identifies several important groups to discuss with the endoscopy team:
- Blood thinners and medicines that affect clotting: Examples include warfarin, apixaban, rivaroxaban, dabigatran, aspirin, clopidogrel, and ticagrelor. These medicines may affect decisions about preparation and the procedure.
- Diabetes medicines: Tell the team if you take insulin, tablets for diabetes, or other glucose-lowering medicines. Fasting may affect your usual medication plan.
- Weight-loss medicines: Include medicines such as semaglutide or tirzepatide, including products prescribed for weight management or diabetes.
- Stomach and acid-reducing medicines: Report proton pump inhibitors, such as omeprazole and pantoprazole, H2 blockers, such as famotidine, and antacids.
- Iron supplements and pain medicines: Include iron products, prescribed painkillers, and medicines used for long-term pain.
- Sleep aids, sedatives, and other substances: Report prescribed sedatives, sleeping tablets, and other medicines that may affect alertness or interact with procedural medicines.
Do not stop blood thinners, insulin, diabetes tablets, or other prescribed medicines on your own. The appropriate plan depends on the medicine, your health, and what the endoscopist expects to do. Ask the endoscopy team for clear instructions about which medicines to take, adjust, or temporarily withhold and when to take them.
Which medical conditions should you mention?
Tell your clinician about ongoing health conditions, even if they are stable or seem unrelated to your digestive symptoms. Some conditions influence the choice of sedative, the monitoring required, or how medicines should be managed before and after the procedure.
- Heart conditions: Report significant heart disease, heart failure, irregular heart rhythms, or other relevant cardiovascular problems.
- Lung or breathing conditions: Mention asthma, chronic lung disease, sleep apnea, or a history of breathing difficulties during sleep. Also tell the team if you use a breathing device at night.
- Diabetes or hormone-related conditions: Include diabetes and conditions such as adrenal insufficiency or Addison's disease.
- Bleeding or clotting disorders: Report conditions such as hemophilia, unusual bleeding or bruising, or a previous bleeding complication.
- Kidney or liver disease: Mention known problems with kidney or liver function, particularly if you take several medicines.
- Other significant conditions: Include any serious chronic illness or health problem that has required recent hospital care or a change in treatment.
The ASGE guidance on sedation and anesthesia in gastrointestinal endoscopy emphasizes reviewing pre-existing conditions, sleep apnea or snoring, current medicines, drug allergies, and previous adverse reactions to sedation or anesthesia. Share these details even if you have undergone endoscopy successfully in the past.
What should you tell the team about allergies and previous procedures?
Describe any known allergy to a medicine, local anesthetic, sedative, or other substance used during medical care. Whenever possible, explain what happened when you were exposed. For example, tell the team whether you developed a rash, swelling, breathing difficulty, or another reaction. If a previous reaction was severe or its cause is uncertain, say so clearly.
Also mention any previous problems with sedation or anesthesia, including unexpected breathing difficulties, a significant reaction to a medicine, or a difficult recovery. Tell the team if you have had an upper endoscopy or another procedure before and experienced a complication. Previous uneventful procedures are useful information, but they do not replace a review of your current health and medicines.
The Mayo Clinic's information on upper endoscopy explains that sedation or anesthesia may be used and that a reaction to these medicines is a possible complication. Sharing your previous experiences helps the team assess your history when planning the procedure.
Should you disclose pregnancy or an implanted medical device?
Tell your endoscopy team if you are pregnant or think you might be pregnant. Pregnancy may affect planning for the procedure and the medicines used. Let the team know before the appointment, rather than waiting until the procedure is about to begin.
Also report implanted medical devices, particularly a pacemaker or implantable cardioverter-defibrillator (ICD). The clinic may need information about the device, such as its type, manufacturer, implant date, or device card. Depending on the device and planned procedure, the team may need to coordinate with another specialist before proceeding.
The UK National Health Service (NHS) guidance on gastroscopy specifically advises patients to notify the hospital if they are pregnant and to bring information about their medicines. It is sensible to contact the endoscopy unit before the appointment if you are unsure what information it needs.
What symptoms and previous digestive problems should you report?
Explain why the upper endoscopy was recommended and describe the symptoms you have experienced. The team may ask when they started, how often they occur, whether they are changing, and whether they relate to eating or swallowing. Mention symptoms even if they seem minor or have improved since the procedure was scheduled.
Relevant details may include:
- Ongoing heartburn, acid reflux, or indigestion.
- Upper abdominal discomfort or pain.
- Difficulty or pain when swallowing.
- Repeated nausea or vomiting.
- Vomiting blood or passing black, tar-like stools.
- Previous abnormalities found during an endoscopy, including biopsy results, if known.
Also mention previous operations involving your esophagus, stomach, or upper digestive tract, if applicable. Bring previous endoscopy or biopsy reports if they are available and the treating team has requested them. These details can help the clinician understand your history and interpret the findings in context.
Does your alcohol, tobacco, or substance use matter?
Tell the care team about current alcohol use, tobacco use, and recreational substances, including cannabis, as well as medicines taken for sleep, anxiety, or pain. If asked, explain how much you use and when you last used it. This information helps the team review potential interactions and sedation-related concerns. Answer honestly; the aim is to plan your care safely, not to judge you.
How can you prepare your medical history before the appointment?
Writing down the main details in advance can make check-in easier and help prevent important information from being overlooked. You do not need to memorize every medicine or date. Bring your notes, current medication packaging or an accurate medication list, and any relevant device information or previous reports.
- Prepare an up-to-date list of all medicines, supplements, and their doses.
- Write down known allergies and the reactions you experienced.
- List your major medical conditions, previous operations, and any history of problems with sedation or anesthesia.
- Bring details of a pacemaker, ICD, or other relevant implanted device, if applicable.
- Summarize your current symptoms and any important changes since the endoscopy was arranged.
- Note any questions about fasting, medication timing, or your usual treatment routine.
Follow the fasting instructions provided by your endoscopy unit. Eating or drinking at the wrong time may mean that the team needs to delay or reschedule the procedure. If you have accidentally eaten or drunk something outside the permitted period, tell the staff rather than withholding that information.
What if you remember something important at the last minute?
Contact the endoscopy unit as soon as possible if you remember an important medical detail, discover a medication change, or develop a new health problem before the appointment. If you cannot reach the unit beforehand, tell the clinical team when you arrive and before any sedative or procedural medicine is given.
Do not assume that a detail is unimportant because you have already completed a pre-procedure questionnaire. New symptoms, a recent hospital admission, a medication started by another clinician, or a previously unreported reaction may change the information the team needs. If you are uncertain, share the detail and let the healthcare professional decide whether it affects the plan.