How to Prepare for an Eosinophilic Esophagitis (EoE) Endoscopy When Switching Treatments
Published on December 5, 2025
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An endoscopy can diagnose eosinophilic esophagitis (EoE), but it’s also an important tool for monitoring how well medical therapy is working — especially when you switch treatment types. “Typically an endoscopy is done 6 to 12 weeks after a treatment is started or changed,” says Alex Koral, MD, a gastroenterologist and an associate professor of pediatric gastroenterology at Yale School of Medicine in New Haven, Connecticut.
Before scheduling an endoscopy, your doctor will review your overall health, medications, and any risk factors to make sure the procedure and sedation are safe for you, says Hector Gonzalez, MD, a gastroenterologist with Gastro Health in Plantation, Florida. “The goal is to make sure you feel comfortable, informed, and confident going into your endoscopy.”
As your procedure day approaches, it can help to know how to plan for an EoE endoscopy. Your healthcare provider will give you specific instructions before your appointment, but you can also prepare with the expert-backed tips below.
Don’t Eat or Drink Before the Test
Most providers will tell you not to eat anything for at least eight hours before your endoscopy. “It is important to avoid eating on the day of your endoscopy to reduce the risk of aspiration (when the contents of your gastrointestinal tract get into your lungs) while you are under sedation,” says Dana Sloane, MD, a gastroenterologist and the site director at MedStar Franklin Square Medical Center in Baltimore.
Forgoing food also means your stomach will be empty for the endoscopy, which is necessary for your doctor to be able to clearly see the inside of your gastrointestinal tract. The exact timing of your limitations will depend on the time of your endoscopy. “Generally, you should not eat anything starting at midnight on the day of the procedure,” says Dr. Koral.
For much of the time you’re fasting, you’ll usually be able to have clear liquids, which can include water, broth, and plain gelatin. But you can’t have anything at all within two to four hours of the endoscopy. Different providers have different guidelines, so it’s important to follow your doctor’s specific instructions.
Take Approved Medications With a Sip of Water
You can take essential medications the morning of your endoscopy with a small amount of water, says Dr. Gonzalez. Before scheduling your endoscopy, you will need to discuss all of your medications with your provider. They may tell you to temporarily stop taking some of them in the days before the procedure.
“I recommend holding medications that may increase the risk of bleeding or anesthesia-related complications,” says Dr. Sloane. Some drugs can keep your doctor from seeing your GI tract clearly. Medications you may need to pause before the procedure include:
- Iron supplements (Feosol, Slow FE)
- Bismuth subsalicylate (Pepto-Bismol)
- Nonsteroidal anti-inflammatory medications (NSAIDs) like aspirin, ibuprofen (Advil), and naproxen (Aleve)
- Blood thinners like warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), and dabigatran (Pradaxa)
- Fish, mineral, or flaxseed oil
- Vitamin E
- Antacids
If it’s necessary, your provider will tell you how many days prior to the endoscopy you should stop each medication and when it’s safe to start taking them again.
They may also recommend stopping weight loss medications like GLP-1s for a week or two before the procedure, says Sloane. These drugs keep food in your stomach longer, which can increase the risk of anesthesia complications during the endoscopy, such as food moving from your gastrointestinal tract to your lungs, and they can also prevent your doctor from getting a good look inside your stomach.
Even with approved medications, you’ll probably be told to take them before the cutoff time for clear liquids ahead of your procedure.
Arrange for Someone to Come With You
If you receive anesthesia for your endoscopy, you’ll feel groggy for a time afterward, and your thinking and reaction times may be affected for the rest of the day. That means you’ll have to have someone with you to drive you home. Most providers don’t allow you to return home alone on public transportation or even in a taxi or ride share.
“Most patients feel very well after their endoscopy, but having a driver is imperative to ensure a safe trip home,” says Sloane. It can also be helpful to have an extra set of ears in the room with you when you get your aftercare instructions. If you need to find support to get home and for afterward, your provider may be able to help you make arrangements.
Dress for Comfort
On the day of the procedure, wear loose, comfortable clothing. Depending on the facility where you have your endoscopy, you may be able to wear a short-sleeved shirt underneath your hospital gown. It can get cold in the procedure and recovery rooms, so be sure to ask for blankets if you need them.
Some facilities offer lockers to store valuables, but it’s best to leave whatever you can at home or with your companion. Your nurse will need to measure your oxygen levels during the procedure by placing a pulse oximeter on a finger, so if you wear nail polish, you’ll need to remove it from at least one fingernail.
The Takeaway
- An EoE endoscopy can help your provider monitor how well medical therapy is working, especially after you switch treatments.
- To prepare for your EoE endoscopy, don’t eat or drink for eight hours before your test. Take approved medication with a small sip of water on the day.
- Plan to have a trusted friend or family member drive you home afterward.
Resources We Trust
- Mayo Clinic: Upper Endoscopy
- Cleveland Clinic: Eosinophilic Esophagitis
- North American Society for Pediatric Gastroenterology: Endoscopy Photo Gallery
- American Gastroenterological Association: Eosinophilic Esophagitis (EoE) Resource Center
- Asthma and Allergy Foundation of America: Life With Eosinophilic Esophagitis (EoE)
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Pasta A et al. Endoscopic Management of Eosinophilic Esophagitis: A Narrative Review on Diagnosis and Treatment. Journal of Clinical Medicine. May 27, 2025.
- Preparing for an Upper Endoscopy (EGD). Stanford Health Care.
- Upper Endoscopy. Mayo Clinic. July 2, 2024.
- Saeed F et al. NPO at Midnight: Reassessing Unnecessary Pre-Endoscopy Fasting. Rhode Island Medical Journal. October 2021.
- Clear Liquid Diet. Mayo Clinic. September 4, 2025.
- Joshi GP et al. 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-Containing Clear Liquids With or Without Protein, Chewing Gum, and Pediatric Fasting Duration — a Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting. Anesthesiology. February 2023.
- Preparing for Your Upper Endoscopy. U.S. Department of Veterans Affairs. October 23, 2025.
- Vetrugno L et al. A Narrative Review of Glucagon-Like Peptide-1 Receptor Agonists Prior to Deep Sedation or General Anesthesia. Journal of Anesthesia, Analgesia and Critical Care. March 28, 2025.
- Primm AN. Upper Endoscopy. American Society of Anesthesiologists. March 11, 2024.
- EGD Discharge. Mount Sinai.
- During the Endoscopic Procedure. Stanford Health Care.
Meet Our Experts
Rabia de Latour, MD
Medical Reviewer
Rabia de Latour, MD, is a therapeutic endoscopist and gastroenterologist at NYU Grossman School of Medicine, where she serves as the director of endoscopy and chief sustainability officer at Bellevue Hospital. She is the host of Sirius XM Doctor Radio Internal Medicine Show.
Abby McCoy, RN
Author
Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.
McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.