Endoscopic ultrasound can show abnormalities that may be missed by magnetic resonance imaging (MRI) or computerized tomography (CT) scans.

An endoscopic ultrasound (EUS) merges two unique medical technologies to form a minimally invasive, but highly effective, procedure that scans the GI tract and surrounding organs for abnormalities.

EUS uses a special type of thin, lighted tube (endoscope) called an echoendoscope. This small device emits ultrasound waves from inside the body, giving clinicians a better view than traditional abdominal ultrasound.

The sound waves send data back to a GI specialist who can see any barriers the waves encounter, including small lumps or lesions.

There are two types of EUS examination procedures: upper EUS and lower EUS.

During an upper gastrointestinal (GI) tract examination, your clinician will insert the echoendoscope through your throat. The tube will not impair your ability to breathe.

An upper EUS allows your clinician to look at your esophagus, stomach, small intestine, pancreas, and other surrounding structures.

During a lower GI examination, your clinician will insert the echoendoscope through your anus. Your clinician can view your rectum, sigmoid colon, and colon.

Your clinician may recommend a EUS to identify the root cause of a range of gastrointestinal conditions. This includes:

They may also recommend a EUS if they suspect a tumor or lesion, particularly if other scans have proved unsuccessful at locating any abnormalities.

Your clinician can attach a small needle to the endoscope and use it to grab a tissue sample (biopsy) during the examination.

Insurance providers, including Medicare and Medicaid, may cover some or all of the cost of EUS. Most insurance providers require prior authorization, so be sure to consult with your insurance company in advance.

Some research suggests that EUS is slightly more cost-effective than other diagnostic tests. Your overall cost depends on the following:

  • your geographical location
  • whether EUS is done as an inpatient or outpatient procedure
  • whether EUS is used alongside other diagnostics
  • whether a biopsy is taken

If you don’t have insurance, or your insurance won’t cover it, talk with your clinician. They may be able to offer care on a sliding financial scale or offer a payment plan.

Upper and lower EUS require a clear digestive tract. Your procedure may be rescheduled if your GI tract isn’t clear at the time of your appointment.

If your appointment is in the morning, you typically can’t have anything to eat or drink, including gum or mints, after midnight. You can still take medication as directed with small sips of water.

If your appointment is in the afternoon, you can usually consume clear liquids up to 8 hours before the procedure. You can’t have any liquids — including water — within 8 hours of the procedure.

Be sure to tell your doctor about any over-the-counter or prescription medications you take on a routine basis. Some medications may need to be temporarily discontinued or adjusted before the examination.

As always, consult with your clinician if you have questions and follow their specific recommendations.

A doctor or other healthcare professional will administer an IV to deliver the medications needed to begin sedation.

If you’re getting an upper EUS, your clinician may apply a topical anesthetic to your throat to make the procedure more comfortable. They’ll place a bite block in your mouth to help protect your teeth and prevent you from biting the scope.

If you’re getting a lower EUS, your clinician will apply a local anesthetic to the anus before inserting the scope.

Your clinician will study the images on a nearby monitor. If EUS reveals a suspicious lump, your clinician may use the fine needle on the scope to take a tissue sample.

If EUS reveals an irregular fluid collection, such as a pseudocyst, your clinician may use the echoendoscope to take a sample, place a stent, or drain it.

After your EUS, you’ll be taken to a recovery room to be monitored until your anesthesia has worn off. This usually takes 1 to 2 hours.

If a biopsy was taken, it might be a few days before the results are available. Otherwise, your clinician will discuss your results with you before you’re discharged.

You’ll need someone to drive you home afterward. You shouldn’t operate a vehicle or mechanical equipment until the following day.

Is an endoscopic ultrasound painful?

EUS is a minimally invasive procedure. When you wake up, you may experience the following:

What risks are possible with an endoscopic ultrasound?

If your clinician takes a biopsy, you may experience bleeding after the examination. Bleeding is usually minimal and does not require a follow-up.

In rare cases, you may experience a tear in the lining of the intestine during the procedure. Surgery may be necessary to repair severe tearing.

How long does an endoscopic ultrasound take?

An exploratory EUS typically takes less than 60 minutes, but you’ll need to allow a few hours for your full preparation, procedure, and recovery journey.

When will you know the results of your endoscopic ultrasound?

Your clinician will share any initial results before you’re discharged. Biopsy results may require more time.

What’s the difference between an endoscopic ultrasound and an endoscopy?

The difference between an endoscopy and a EUS is the use of high-frequency ultrasound to examine the GI tract. An endoscopy is used to examine the inside lining of the gut. EUS can be used to examine adjacent tissue.

EUS may be recommended to diagnose stomach pains, locate tumors, or assess cancerous areas. It’s a noninvasive way to investigate the GI tract without the need for surgery. A EUS can include the upper or lower GI tract and can be completed in an outpatient procedure.

Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.