An endoscopy is a very safe procedure. Rare complications include:

  • Bleeding. Your risk of bleeding complications after an endoscopy is increased if the procedure involves removing a piece of tissue for testing (biopsy) or treating a digestive system problem. In rare cases, such bleeding may require a blood transfusion.
  • Infection. Most endoscopies consist of an examination and biopsy, and risk of infection is low. The risk of infection increases when additional procedures are performed as part of your endoscopy. Most infections are minor and can be treated with antibiotics. Your provider may give you preventive antibiotics before your procedure if you are at higher risk of infection.
  • Tearing of the gastrointestinal tract. A tear in your esophagus or another part of your upper digestive tract may require hospitalization, and sometimes surgery to repair it. The risk of this complication is very low — it occurs in an estimated 1 of every 2,500 to 11,000 diagnostic upper endoscopies. The risk increases if additional procedures, such as dilation to widen your esophagus, are performed.
  • A reaction to sedation or anesthesia. Upper endoscopy is usually performed with sedation or anesthesia. The type of anesthesia or sedation depends on the person and the reason for the procedure. There is a risk of a reaction to sedation or anesthesia, but the risk is low.

You can reduce your risk of complications by carefully following your health care provider's instructions for preparing for an endoscopy, such as fasting and stopping certain medications.

Symptoms that could mean a complication

Symptoms to watch for after your endoscopy include:

  • Fever
  • Chest pain
  • Shortness of breath
  • Bloody, black or very dark colored stool
  • Difficulty swallowing
  • Severe or persistent abdominal pain
  • Vomiting, especially if your vomit is bloody or looks like coffee grounds

Call your provider immediately or go to an emergency room if you experience any of these symptoms.

Aug. 26, 2022
  1. Feldman M, et al., eds. Preparation for and complications of gastrointestinal endoscopy. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Aug. 4, 2022.
  2. Cohen J, et al. Overview of upper gastrointestinal endoscopy (esophagogastroduodenoscopy). https://www.uptodate.com/contents/search. Accessed Aug. 4, 2022.
  3. Upper GI endoscopy. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diagnostic-tests/upper-gi-endoscopy. Accessed Aug. 4, 2022.
  4. Understanding upper endoscopy. American Society for Gastrointestinal Endoscopy. https://www.asge.org/home/for-patients/patient-information/understanding-upper-endoscopy. Accessed Aug. 4, 2022.
  5. Picco MF (expert opinion). Mayo Clinic. Aug. 16, 2022.

Upper endoscopy