Biopsy - Esophagus

This procedure involves the removal of a suspicious sample of tissue from the esophagus to check for the presence of abnormal, or cancerous, cells.

This procedure involves the removal of a suspicious sample of tissue from the esophagus to check for the presence of abnormal, or cancerous, cells.

The esophagus carries food or liquid from the mouth to the stomach. A biopsy of the esophagus involves the removal of a suspicious sample of tissue from the esophagus to check for the presence of abnormal, or cancerous, cells.

  • An upper endoscopy and biopsy of your esophagus may be done to check for cancer or precancerous conditions, like Barrett's esophagus.
  • Barrett's esophagus is a change in the cells that line the esophagus. It can happen when the stomach contents frequently back up into the esophagus and cause chronic irritation.
  • An upper endoscopy is an exam of the esophagus, stomach and upper part of the small intestine using a thin, lighted tube with a camera on the end.

Esophageal cancer accounts for about 1% of cancers occurring in the U.S. The occurrence is greatest in men, especially those over the age of fifty. The risk factors for esophageal cancer depend on the specific type of cancer.

  • Squamous cell carcinoma of the esophagus has been associated with smoking and excessive alcohol intake.
  • Adenocarcinoma of the esophagus has been associated with Barrett's esophagus (a complication of GERD, or gastroesophageal reflux disease), male sex, obesity and smoking. This type of esophageal cancer is more common than squamous cell carcinoma of the esophagus.

To decrease your risk of developing cancer of the esophagus, you should quit or avoid smoking and limit the amount of alcohol you drink - or not drink at all. If you have chronic reflux or have a diagnosis of Barrett's esophagus, you may need to undergo periodic screenings for esophageal cancer. Screenings are often done with an upper endoscopy and biopsy and can lead to an early diagnosis and improved survival. The symptoms of esophageal cancer can include:

  • Reflux, or backwards movement of stomach contents into the esophagus, also known by some as “sour brash”
  • Trouble swallowing food or liquids, including pain on swallowing
  • Heartburn
  • Blood in vomit
  • Unexplained loss of weight

Contact your healthcare provider if you have any of the above symptoms. He or she will review your symptoms and perform a physical examination. They may also recommend one of the following tests:

  • A barium swallow to see the lining of the esophagus
  • A CT scan of the chest and/or abdomen area, typically to identify the stage of the cancer
  • An ultrasound of the esophagus, typically to identify the stage of the cancer
  • An upper endoscopy or EGD (esophagogastroduodenoscopy) with the removal of tissue for examination under a microscope (biopsy)

If your healthcare provider recommends an esophageal biopsy, prior to the procedure tell them about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before and after the procedure. These include:

  • Medications you should not take before the procedure, such as blood thinners
  • Regular medications you should continue to take on the day of your procedure
  • How many hours you should stop eating and drinking before the procedure (usually at least 8 hours to make sure your upper digestive tract is empty)

Your throat will be numbed before the test and you will be given a medicine to make you sleepy and relaxed or to put you to sleep (sedative).

  • You will not be allowed to drive for twelve to twenty four hours after the test, so you must have someone drive you home.
  • If you are diagnosed with Barrett's esophagus or esophageal cancer, additional testing will most likely be needed.

Contact your healthcare provider if you have symptoms of cancer of the esophagus. Be prepared to discuss your symptoms and how long you've had them.

  • Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
  • Make a list of your medications (including over-the-counter).
  • Write down any questions, symptoms or concerns you want to talk about.
  • If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having a biopsy of my esophagus?

  • What is the reason for the procedure? Are there any alternatives? What are the benefits and risks of each?
  • What are the possible complications for this procedure?
  • What happens if I don't go through with the procedure?
  • Is there any special preparation for the procedure? (If so, get clear instructions on what you need to do.) What kind of sedation will I have? What are the possible side effects?
  • How will I feel after the procedure and will I have to modify my activity?

After your procedure, you should know what you had done, what medication was given and what symptoms you should report to your healthcare provider after discharge. You should also understand all home care instructions (including medications and side effects) and follow-up plans.

  • Your surgeon should also communicate with your primary care physician.
  • Don't forget to make arrangements for transportation to and from the facility and help at home.


Also known as:

Esophagus Biopsy
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