When you are ready medication will be given through your IV to make you feel sleepy and relaxed. To make the examination more comfortable your healthcare provider will also spray a numbing medication into the back of your throat or you may gargle with it. This will make your mouth and throat numb for approximately 30 minutes. Then you will positioned on your left side or on your stomach. A small plastic mouthpiece, or guard, will be put in your mouth to prevent you from accidentally biting the tube or your doctor's finger when the tube is slowly placed into your esophagus, or food pipe.
In order to help relax the muscles in the back of your throat and help open the passageway you will need to take slow, deep breaths. As the doctor begins to push the tube in you will be asked to swallow. Swallowing makes the tube go down more easily.
Once the endoscope is inside your digestive tract your doctor will examine your stomach and pass the tube into the duodenum. While your doctor is examining structures a photograph, biopsy, or cytology may be taken. A biopsy is a small sample of tissue, while cytology is a brushing of cells.
To better see the area, your duodenum is gently filled with a small quantity of air through the endoscope. This will help your doctor find the main opening where the pancreatic and bile ducts empty into the duodenum. Once found your doctor will carefully insert a plastic tube into the duct and inject a small amount of dye. This special dye shows up on the x-ray screen and allows your doctor to see any blockages that may be present. Your doctor will repeat the injection several times, looking at the ducts from different angles. You may be asked to switch positions during this part of the exam so that your doctor can clearly view all of the necessary areas.
If gallstones or other blockages are found in your bile duct, your doctor may perform a sphincterotomy to enlarge the opening of the bile duct. To do this, a device will be inserted into the duct. Using this device your doctor will cut the opening of the duct using electrical current. This will enlarge the duct opening wide enough so that if any stones are blocking the duct they can now travel through. These stones will be removed in a tiny basket or left to pass in the intestine. You will not be able to feel your doctor cutting the duct.
When the examination is finished the doctor will slowly pull the tube out through your mouth. Your healthcare provider will continue to watch you for 15 to 30 minutes after the procedure to be sure you are recovering normally. Then the IV will be removed. The procedure usually takes from 1 to 3 hours.