When Should You Get an Endoscopy?
Clear and complete guide on situations when you need an upper digestive endoscopy, explained simply so you can understand everything
Gastroscopy is a fundamental tool for diagnosis and treatment of digestive diseases
Quick Summary - The Essentials
🚨 Alarm Symptoms (urgent):
- • Difficulty swallowing or pain when swallowing
- • Unexplained weight loss
- • Vomiting blood or black stools
- • Anemia with no clear cause
📋 Other Common Indications:
- • Persistent digestive discomfort >45 years
- • Follow-up of ulcers or atrophic gastritis
- • Barrett's esophagus surveillance
- • Celiac disease diagnosis
What is a gastroscopy and what is it for?
A gastroscopy (also called upper endoscopy or EGD) is like a "miniature video camera" that we introduce through your mouth to see inside your esophagus, stomach, and the first part of your small intestine (duodenum). Think of it as having a flashlight with a camera that allows us to see exactly what's happening in there.
It's not just for "looking": we can also take small samples (biopsies) to analyze them in the laboratory, treat bleeding ulcers, remove polyps or suspicious lesions, and dilate narrowed areas. It's like having a miniature repair workshop inside your body.
Why is it so important?
Gastroscopy allows us to detect digestive problems in very early stages, when they're easier to treat. It's like doing a complete technical inspection of your upper digestive system: we can find everything from simple inflammations to more serious lesions, and often we can fix them right at that moment.
Alarm Symptoms: When gastroscopy is urgent
According to the latest ESGE European guidelines 2025, there are certain symptoms that are like "red lights" on your car's dashboard: they indicate we should look inside as soon as possible, without waiting.
Warning Signs - Immediate Consultation
Dysphagia (difficulty swallowing)
If you feel that food "gets stuck" when going down, or you have to make an effort to swallow, you need a gastroscopy soon. This may indicate narrowing or lesions in the esophagus.
Unexplained weight loss
Losing more than 5 kilograms (11 pounds) in a few weeks without dieting or exercising is an important alarm signal requiring urgent investigation.
Gastrointestinal bleeding
Vomiting blood (red or "coffee grounds") or black, sticky stools (melena) indicate bleeding in the upper digestive tract. This is an emergency!
Iron deficiency anemia without cause
If your blood tests show anemia (iron deficiency) and there's no clear explanation (like heavy periods in women), you may be losing blood through your digestive tract without realizing it.
Persistent vomiting
Vomiting that lasts for days and doesn't improve, especially if it prevents you from eating or drinking normally, requires a gastroscopy to find the cause.
Reassuring message
If you have any of these symptoms, it doesn't automatically mean there's something serious, but we DO need to check it as soon as possible. Often we find completely treatable problems like ulcers, severe gastritis, or complicated reflux. The key is early diagnosis.
Persistent digestive discomfort: When to investigate?
Many people have discomfort in the pit of their stomach, heartburn, heavy digestion, or bloating. Most of the time, these symptoms can be treated without needing tests. But there are situations when we DO recommend a gastroscopy.
When to do gastroscopy for digestive discomfort?
Over 45-50 years with new symptoms
If you've never had digestive discomfort and it's starting now, it's important to do a gastroscopy to rule out more serious problems. From this age, the risk of ulcers and other lesions increases.
Symptoms that don't improve with treatment
If you've tried stomach medications (like omeprazole) for 4-8 weeks and symptoms stay the same or get worse, we need to see what's happening inside.
Family history of gastric cancer
If a direct family member (parents, siblings) has had stomach cancer, it's more prudent to do a gastroscopy even if you're young, especially if you have symptoms.
Confirmed Helicobacter pylori infection
If this bacteria has been detected in your tests, gastroscopy allows us to see what damage it has caused in your stomach and take biopsies to plan the best treatment.
Surveillance and follow-up of known diseases
If you've already been diagnosed with certain digestive conditions, periodic gastroscopies are essential to monitor their evolution and detect changes early. It's like taking your car for scheduled maintenance: it prevents bigger problems.
Barrett's Esophagus
A condition where the esophagus "transforms" due to chronic reflux. It requires periodic endoscopic surveillance every 3-5 years depending on the grade, to detect early precancerous changes.
Atrophic gastritis and metaplasia
When the stomach has chronic inflammation with changes in its cells, it needs personalized endoscopic controls every 3 years in high-risk cases.
Gastric ulcers
When we find an ulcer in the stomach, it's essential to repeat the gastroscopy at 8-12 weeks to verify it has completely healed with treatment.
Esophageal varices
In patients with liver cirrhosis, periodic gastroscopies are essential to detect and treat varices that could bleed.
Other frequent indications for gastroscopy
Celiac disease diagnosis
If your blood tests suggest celiac disease (positive antibodies), we need to do duodenal biopsies through gastroscopy to confirm the diagnosis. It's the only definitive method to diagnose this condition.
Learn more about celiac disease in our complete guide.
Eosinophilic esophagitis
If you have difficulty swallowing, frequent choking with solid foods, or food impactions in the esophagus, it could be this inflammatory disease of the esophagus. Gastroscopy with biopsies is essential for diagnosis.
Discover more about eosinophilic esophagitis and its treatment.
Foreign bodies or caustic ingestion
If you've swallowed something you shouldn't have (coins, batteries, fish bones...) or drunk a toxic product, urgent gastroscopy allows us to extract the object or assess the damage caused and treat it immediately.
Achalasia and motility problems
When the esophagus doesn't work well and has problems moving food to the stomach, gastroscopy helps with diagnosis and, in selected cases, allows advanced treatments like endoscopic myotomy (POEM).
Need a gastroscopy or want more information?
As an advanced endoscopy specialist, I can help you determine if you need a gastroscopy and perform it with the most modern and safe techniques available.
Book an AppointmentHow do you prepare for a gastroscopy?
Preparation is very simple, but it's important to follow it well so the test is effective and safe:
Preparation steps
Complete fasting for 6-8 hours
Don't eat or drink anything (not even water) for the 6-8 hours prior. If your appointment is in the morning, it means don't eat dinner too late and don't have breakfast.
Inform about your medications
Especially anticoagulants (Warfarin, Pradaxa, Xarelto) or antiplatelet drugs (Aspirin, Plavix). In most cases you can take them normally, but it's important that we know.
Come accompanied
Since we use mild sedation so you're comfortable and don't remember anything, you'll need someone to accompany you home afterward. You won't be able to drive that day.
Comfortable clothing
Wear comfortable, loose clothing. We'll give you a special gown for the test.
About sedation
Gastroscopy is performed with mild sedation administered by an anesthesiologist. You'll be asleep and won't feel or remember anything. The test lasts only 5-15 minutes and you'll wake up shortly after feeling well. It's a very safe procedure we do daily.
Practical information: Price and access
Gastroscopy is available in both public and private healthcare systems. If you decide to do it privately to avoid waiting lists or because you prefer to choose your specialist, prices are accessible.
Private gastroscopy in Madrid
In my private practice in Madrid, we perform gastroscopies with the most advanced technology and with all the time needed for each patient. The price includes:
- • Prior assessment consultation
- • Sedation by anesthesiologist
- • Complete gastroscopy with high-definition equipment
- • Biopsies if necessary
- • Immediate detailed report
- • Follow-up afterward
Check the updated prices for private gastroscopy and colonoscopy in Madrid on our specific page.
Advanced endoscopy with international experience
Specialized training in Japan and Europe
I completed my advanced endoscopy training at the National Cancer Center in Tokyo, Japan in 2013, a world-leading country in endoscopic techniques. I'm currently European advisor for Olympus and have been recognized with the TopDoctors 2024 Award.
This experience allows me to perform not only diagnostic gastroscopies but also complex therapeutic procedures such as:
- • Endoscopic submucosal dissection (ESD) for precancerous lesions and early cancer
- • Endoscopic mucosal resection for polyps and flat lesions
- • Peroral endoscopic myotomy (POEM) for achalasia
- • Dilations and treatment of strictures
- • Endoscopic hemostasis of bleeding ulcers
You can learn more about my background, training, and work philosophy on my main page.
Conclusion: Gastroscopy as a health tool
The most important thing to remember
Gastroscopy is a safe, quick, and very useful test that allows us to see exactly what's happening in your upper digestive system.
Don't be afraid to get a gastroscopy if your doctor recommends it. With proper sedation you won't feel anything, and the information we obtain is invaluable for taking care of your digestive health.
Whether you have alarm symptoms, persistent digestive discomfort, or need follow-up of a known condition, gastroscopy gives us clear and precise answers. And in many cases, it allows us to solve problems at the same time as the examination.
Have doubts about whether you need a gastroscopy?
In consultation, we'll evaluate your specific case and I'll explain exactly what we can find and how endoscopy can help you.
Book an AppointmentScientific References
- 1. Areia M, Esposito G, Leclercq P, et al. Performance Measures for Upper Gastrointestinal Endoscopy: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative - Update 2025. Endoscopy. 2025. doi:10.1055/a-2674-4912
- 2. Săftoiu A, Hassan C, Areia M, et al. Role of Gastrointestinal Endoscopy in the Screening of Digestive Tract Cancers in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy. 2020;52(4):293-304. doi:10.1055/a-1104-5245
- 3. Rodríguez-de-Santiago E, Frazzoni L, Fuccio L, et al. Digestive Findings That Do Not Require Endoscopic Surveillance - Reducing the Burden of Care: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy. 2020;52(6):491-497. doi:10.1055/a-1137-4721
- 4. Dinis-Ribeiro M, Libânio D, et al. Management of epithelial precancerous conditions and early neoplasia of the stomach (MAPS III): European Society of Gastrointestinal Endoscopy (ESGE) Guideline update 2025. Endoscopy. 2025.
