Hi Friends,
Dr. Storage here. 👋
Last week, I posted a TikTok that went viral... and I think I know why.
I performed an upper endoscopy on my colleague, Dr. Tabibian...
With NO sedation.
The comments section lost its mind. And honestly?
Good :)
Because the fear around this procedure is keeping people from a test that can find cancer, catch ulcers, and diagnose conditions that have caused misery for years.
If you haven't seen the video yet, here it is.
Now please read on, because what Dr. Tabibian experienced, and what he said afterward…
Might completely change how you think about endoscopy.
WHY YOU SHOULD READ THIS NOW
Upper endoscopy is one of the most commonly performed procedures in gastroenterology, and one of the most feared. The fear is almost always worse than the reality.
You might not know you have sedation options. Including the option to skip it entirely and be done in under 10 minutes with no recovery time.
TODAY’S OPPONENT:
Endoscopy Anxiety
Upper endoscopy, also called an EGD (esophagogastroduodenoscopy, try saying that three times fast), is a procedure that lets your doctor look directly at your esophagus, stomach, and the beginning of your small intestine using a thin, flexible camera.
It diagnoses and treats a long list of conditions: acid reflux, H.pylori, GERD, ulcers, Barrett's esophagus, EoE, celiac disease, unexplained nausea, difficulty swallowing, and more. In some cases, it finds things that are life changing and life saving.
But people avoid it because they fear the gag reflex, or being uncomfortable, or not knowing what to expect.
So let's fix that right now.
What Actually Happens (Step by Step)
Step 1: The Throat Spray
Before anything else, we numb your throat with a topical anesthetic spray.
This is the step most people don't know about - and it changes everything.
By the time the scope reaches your throat, you've already lost most of the sensation there.
That gag reflex everyone dreads? Largely blunted before we even begin.
Step 2: Choose Your Sedation (Including NONE)
Most people assume sedation is mandatory. It isn't. You have 3 paths:
→ No sedation: The throat spray can be sufficient. You're awake and done in 5 to 10 minutes with zero recovery time. This is what Dr. Tabibian chose. But we acknowledge it might not be for everyone.
→ Moderate Sedation (Fentanyl + Versed): You're relaxed and drifting in and out. Most patients have little to no memory of the procedure.
→ Monitored Anesthesia Care / MAC (Propofol): An anesthesiologist administers this fast-acting medication and you drift into a deep, comfortable sleep. You're breathing on your own the whole time. This is NOT general anesthesia.
Most patients wake up feeling genuinely refreshed. You will not feel any discomfort.
Step 3: The Procedure Itself
Five to ten minutes. That's the whole thing. Your team monitors you throughout, and the moment it ends, we're already reviewing what we found.
If you went without sedation, you can drive yourself home. If you had sedation, someone picks you up, and by that evening most people feel completely normal.
The Part Where the Doctor Became the Patient
Here's what I want you to really sit with.
Dr. Tabibian knows exactly what an upper endoscopy feels like from the physician's side. He knows the anatomy, the technique, every step of the process.
Yet he still chose to do it. He laid on that table, awake, throat numbed with the spray, and let me scope him…
In front of a camera, no less!
Because he wanted YOU to see what this actually looks like.
Not the dramatized version. The real one.
Afterward, he told me he felt minimal discomfort. That it was over before he expected.
That the throat spray did exactly what it's supposed to do (albeit it tasted bad).
So… if the doctor who performs these procedures would do his own with NO sedation, what does that tell you about the procedure?
"I chose to have my endoscopy without sedation for one reason: I wanted patients to see that this procedure, when performed well, is genuinely tolerable. The throat spray made a real difference.
I felt minimal discomfort, it was over quickly, and I walked out completely fine. I've told patients for years not to fear this test. Now I can say I've been on the other side of it - awake - and I meant every word.”
"An upper endoscopy finds things that matter: ulcers, Barrett's esophagus, early cancers. Do not avoid this procedure if you need it.”
Know Someone Who Keeps Putting Off Their Endoscopy?
Forward this to them. Or share the TikTok (:
A lot of people found it reassuring, and your person might too. You could be the reason they finally make the call.
Talk soon,
Dr. Storage
~(and Dr. Tabibian, my new star patient)
**IMPORTANT NOTE: The no sedation option isn’t for everyone. In fact, it’s generally appropriate for a relative minority of patients. It’s not something we as physicians would ever push you to do, but it is an option.
WHAT’S ON YOUR MIND?
Respond to this email and let us know!
As gastroenterologists, we definitely have a lot to talk about when it comes to your gut health and well-being. But we can’t always get to everything (you know… like coffee enemas)! So reply directly to this email or DM us on TikTok below and maybe YOUR topic will be featured soon!
