Diagnostics

Fibrogastroduodenoscopy (FGDS)

When the doctor prescribes fibrogastroduodenoscopy (FGDS) during the examination, patients often develop fear, and the news itself is very unpleasant.

Many people are afraid to carry out FGDs, but, despite some features of the study and its minus, this method is one of the most effective and informative, to detect diseases of the gastrointestinal tract. Therefore, it is important to know what the FGDs can show how the results are conducted and decoded.

What does the doctor see?

FGDS is often confused with a similar study called FGS, but the latter can analyze only the stomach and its organs, and FGDS allows to conduct a study not only in the stomach, but also in the duodenum. Such a diagnosis is carried out using an endoscopic device. In other words, it is a tube with a small chamber at the end, which is inserted into the patient’s oral cavity and lowered inwards for a detailed examination of the organs and walls of the mucous membrane. EGD is used to visualize the internal organs, the image is displayed on the computer monitor due to the installed camera.

As a result of such a diagnosis, EGD may be the last study that is assigned to confirm the diagnosis. Decoding results can only be done by a competent doctor. Often this method of research is used in order to identify diseases in the early stages and prevent them from developing into more serious pathologies. In addition, if neoplasms were noticed, they can be quickly cured or removed with FGDS.

When FGDS is performed, the doctor will be able to see on the computer screen the entire surface of the esophagus and stomach. The specialist examines the mucosa, as well as its deformation and other changes. According to the data obtained, the doctor may conclude that the organs may pass. If a patient begins to bleed inside or has started bleeding earlier, then due to FGDS it will be possible to determine its exact place, in addition, the doctor can immediately eliminate the bleeding. Using the equipment, the doctor will see the following:

  • All possible neoplasms in the esophagus or stomach that are dangerous.
  • The site of localization of polyps, scars and other pathologies, whether the walls of the mucous membrane are normal.
  • Bacteria, for example, Helicobacter pylori, which can cause gastritis or ulcers, and with already developed pathologies, such a bacterium can only aggravate the situation.
  • Already developed ulcer, as well as the threat of perforation.

After the FGD examination, a special certificate will be issued to the patient, where it will be written in detail about the condition of the digestive tract organs.

Preparation for the study

So that the doctor can carry out FGDs normally, it will be necessary to prepare for the diagnosis. Preparation allows not only to facilitate the work of the doctor himself, but also less discomfort will be delivered to the patient, and the procedure itself will pass faster. The general preparatory rules are as follows:

    How to prepare for FGDs of the stomach

FGDs is performed only on an empty stomach. The patient should have dinner on the eve of the procedure no later than 8 pm, while the study should be conducted in the morning. If the procedure is scheduled for the second half of the day, then it will be possible to have breakfast with light products, but it should be 8 hours before FGDS.

  • Do not even drink water on the day of the FGDS. The interval between the last drink and the reception should be 5 hours.
  • 7 days before the start you will need to remove from the diet all the dishes and foods that can irritate the stomach and esophagus. It is necessary to abandon alcohol, cigarettes and try to lead a correct lifestyle. All this allows to achieve normal acidity of the stomach.
  • There are certain drugs that adversely affect the gastrointestinal tract and can distort the data obtained on FGDS. In order to avoid trouble, and the doctor could establish the correct diagnosis, it is recommended to stop using the pills or replace them with other medicines, as advised by the attending physician.
  • Adhering to such simple rules, it will be possible to prepare for stomach EGDs on your own, and make the study quick and with minimal discomfort.

    What is FGDs?

    Fibrogastroduodenoscopy is an endoscopic method of research that allows you to visually inspect the esophagus, stomach and duodenum from the inside. Currently, this method is one of the most effective ways to study the gastrointestinal tract, which allows in a relatively short period of time to diagnose and, if necessary, remove tumor formations.

    It should be noted that this study can also be found under the name of fibroesophagogastroduodenoscopy.

    The term fibroesophagogastroduodenoscopy means the following:

    • «fibro"Is a flexible fiberglass
    • «esophago"Translated from Latin means esophagus,
    • «gastro"Translated from Latin means stomach,
    • «duodeno"Translated from Latin means duodenum,
    • «scopy"Means visual inspection.
    Currently, gastroscopes are made by various manufacturers, such as Olimp, Pentax, Fujinon and others. A standard gastroscope consists of a control device, a thin fiber-optic tube with a diameter of eight to eleven millimeters and a length of about one hundred centimeters, as well as a movable tip (rotates 180 degrees around its axis) located at the end of the tube. At the end of this tube there is a built-in illuminating light bulb, as well as a camera that during the procedure captures and transmits the image of the test organ to the monitor.

    Fibrogastroduodenoscopy is performed with the following objectives:

    • diagnostics,
    • treatment.
    Using this method, you can perform the following procedures:
    • remove foreign body from the stomach,
    • remove benign lesions (for example polyps),
    • take a piece of tissue for biopsy for histological and cytological examination,
    • enter drugs (for example, with gastric bleeding, burns to the esophagus),
    • electrocoagulation of a bleeding vessel
    • apply clips and ligatures for gastric or intestinal bleeding,
    • monitor the effectiveness of treatment of certain diseases, such as peptic ulcer.
    By urgency of FGDs divided into:
    • planned,
    • urgent

    Fibrogastroduodenoscopy is performed in a specially equipped room. During the examination, the patient lies comfortably on the couch, on the left side, while the hands are placed on the stomach. In order to avoid injuries, as well as to facilitate the passage of the device, a special plastic cap is inserted into the patient's mouth. The patient, depending on the purpose of the study, may be offered local anesthesia (lidocaine solution is injected into the mouth) or the introduction of intravenous sleeping pills, so that the patient will sleep the whole procedure. After anesthesia, the gastroenterologist injects a fibrogastroscope into the mouth (or in the bow) and with the help of a built-in video camera it performs a thorough examination of the gastrointestinal tract.

    The duration of the study with a diagnostic purpose is from five to fifteen minutes. The procedure, which may require therapeutic manipulations, can take anywhere from twenty to thirty minutes.

    If the study produced local anesthesia, then most often after the end of the procedure, the patient is given the results of the study and released home. When using general anesthesia, a short-acting patient is transferred to the ward, where he needs to stay until the action of the drug is completed.

    As a rule, complications are not observed after fibrogastroduodenoscopy, however, if the asepsis rules are not followed, an infection may be introduced during the examination. Also during the study, there may be such a complication as bleeding in case of perforation of the esophagus, stomach or duodenum.

    Note: If, after fibrogastroduodenoscopy, symptoms such as fever, vomiting, black stools and pain in the abdomen are observed, it is urgent to seek medical help.

    What does FGDs reveal normally?

    The esophagus is a long tube about 25 cm long. Its main function is to carry a food lump from the oropharynx into the stomach.

    In the esophagus there are three parts:

    • neck part
    • chest part
    • abdominal part (passing through the esophageal opening the diaphragm flows into the stomach).
    When examining the esophagus using fibrogastroduodenoscopy normally, there are three physiological contractions:
    • the first narrowing is at the beginning of the esophagus,
    • the second narrowing is at the level of a split trachea,
    • the third narrowing is at the point where the esophagus passes through the diaphragm.
    The wall of the esophagus consists of:
    • mucous membrane (forms longitudinal folds),
    • submucosa,
    • muscle shell,
    • adventitious shell (covers outside).

    Normally, when performing fibrogastroduodenoscopy, the mucous membrane of the esophagus has a light pink color. The wall of the esophagus in the study looks smooth without protrusion and pathological changes (erosions, ulcers).

    The esophagus has two sphincters:

    • upper esophageal sphincter,
    • lower esophageal sphincter.
    The sphincter is a circular muscle, which, thanks to its own contraction, controls the transition, in this case, the food bolus from the pharynx to the esophagus (upper esophageal sphincter) or from the esophagus into the stomach (lower esophageal sphincter). Normally, these sphincters, after advancing the food contents, should completely close, preventing the food from being thrown back (reflux).

    Hydrochloric acid is formed in the stomach, but it is protected from this acid by a special mucous membrane. In the esophagus, such a shell is absent, therefore, in violation of the lower esophageal sphincter, when gastric acid is thrown into the esophagus, a person has heartburn, bitter taste in the mouth, belching, and other symptoms. Acid at this time, acting negatively on the esophagus, corrodes it, as a result of which inflammation, redness, erosion and ulceration are formed on the esophagus wall.

    The stomach is an expanded part of the alimentary canal. Above it communicates with the esophagus, and below with the duodenum.

    The place of entry of the esophagus into the stomach is called the cardiac part, the cardiac sphincter is located here, and at the place of transition of the stomach into the duodenum, the circular layer of muscles thickens, forming the pyloric sphincter.

    When a pyloric sphincter malfunctions, the contents of the duodenum are released back into the stomach. This phenomenon is called duodenogastric reflux, and is accompanied by a lesion of the mucous layer of the stomach, causing irritation and inflammation. A person may experience symptoms such as nausea, vomiting with an admixture of bile, pain in the abdomen, belching, and others.

    The wall of the stomach consists of the following layers:

    • The mucous membrane has a large number of folds and dimples, which open the stomach glands, secreting gastric juice.
    • A submucosal layer in which a large number of blood and lymphatic vessels and nerves pass.
    • The muscle layer consists of muscle cells arranged in three layers.
    Normally, the mucous layer of the stomach and esophagus is pale pink in color, smooth, without pathological changes (for example, ulcers, inflammation of the layer). In the study of the cavity of the body it is found "mucous pond", which secretes the stomach. Normally, this lake should be transparent and slightly cover the gastric folds. If the secret of the stomach has a yellow or green color, this may indicate the presence of bile due to duodenogastric reflux. The reddish tint of the lake may indicate the presence of blood and possible bleeding.
    The thinnest part of the endoscope with an optical system clearly and clearly displays on the screen of the monitor the relief of the mucous membrane, which ensures early diagnosis of various diseases, including cancer of the gastrointestinal tract.

    Duodenum

    The duodenum is the initial section of the small intestine, which has a horseshoe shape. It starts immediately after leaving the stomach. The length of the duodenum is 25 - 30 cm.

    In the duodenum opens the pancreatic duct, and here also opens the excretory duct, which goes from the liver and removes bile.

    When conducting fibrogastroduodenoscopy in the normal mucous layer of the duodenum velvety, pale pink color, without redness, inflammation or ulceration.

    Indications for FGDs

    Today, fibrogastroduodenoscopy is an indispensable method for studying the gastrointestinal tract. During the procedure, using a fibroscope, you can enter the drug into the body, take a sample of the pathological material in the lesion focus for detailed diagnosis, and also perform some surgical procedures.

    There are the following indications for fibrogastroduodenoscopy:

    • Stomach pains after eating. This symptom may be a sign of diseases such as gastritis or peptic ulcer.
    • Hungry pains of a pulling character about six hours after eating. Hunger pains are usually a symptom of duodenitis (duodenal ulcer disease).
    • Long-term heartburn.
    • Bloating.
    • Frequent belching.
    • Decreased appetite.
    • Sharp decrease in weight.
    • Recurrent (repeatingvomiting
    • Dysphagia (swallowing disorder).
    • In preparation for surgery, for example, surgery on the joints, on the heart and others.
    • If you suspect gastric bleeding.

    An ulcer is a pathological formation characterized by a profound lesion of the mucous membrane. With this defect, the patient is worried about severe sharp pains in the stomach that occur after a meal. This symptom is a characteristic symptom of diseases such as gastritis or peptic ulcer.

    Also, the patient observed:

    • nausea and vomiting after eating,
    • heaviness and overflow in the stomach,
    • sour belching
    • heartburn.

    Contraindications for FGDs

    Fibrogastroduodenoscopy is a fairly safe procedure, however, if a patient has certain diseases, this study may be contraindicated.

    Contraindications to fibrogastroduodenoscopy are divided into two groups:

    • relative contraindications
    • absolute contraindications.
    There are the following relative contraindications:
    • angina,
    • hypertension of the third stage,
    • acute inflammatory-infectious diseases of the pharynx and larynx,
    • cervical lymphadenitis (enlarged cervical lymph nodes),
    • mental illness
    • acute infectious diseases of tonsils.
    The following absolute contraindications exist:
    • rachiocampsis,
    • acute myocardial infarction,
    • recently suffered a stroke
    • in the presence of pathological processes of the mediastinum (eg tumor, aortic aneurysm), shifting the esophagus,
    • bleeding disorder (cirrhosis of the liver, hemophilia),
    • goiter (enlarged thyroid gland),
    • atherosclerosis,
    • stenosis (constrictiona) esophagus,
    • exacerbation of bronchial asthma.
    It should be noted that when prescribing this research method, the physician individually takes into account many factors, including the risks that the patient has. In this regard, the patient before the FGDS can be assigned additional research methods (ultrasound (ultrasound), electrocardiography, blood tests for biochemistry and clotting, as well as some others at the discretion of the attending physician). It should also be noted that if necessary (for example, for removal of a foreign body or coagulation of a bleeding vessel) urgent gastroduodenoscopy can be carried out even if the patient has contraindications in a hospital where the patient can be given first aid.

    Contraindications to FGDs

    The gastroscopy technique of the stomach is fairly safe, however, like any other medical procedure, it has a number of contraindications.

    You should not resort to this method of detection of diseases, if the patient has the following physical manifestations:

    • Acute conditions of cardiovascular activity: severe hypertension, myocardial infarction, stroke, etc.,
    • Genetic or physiological bleeding disorders,
    • Mental disorders,
    • Bronchial asthma.

    Side effects occur in just 1% of patients, which characterizes this method of research as relatively safe. Such reactions may be associated with perforation of the walls of the stomach or intestines by the endoscope tube.

    In order to avoid the occurrence of these consequences, it is necessary to trust the procedure to be performed only by experienced graduates in a reputable clinic, where it is possible to perform the procedure on modern equipment. All these conditions you will find in clinic neomed at the endoscopy unit.

    Our medical center is the best choice for FGDS in St. Petersburg, because you can save not only money, but also your personal time, which will take you to wait in long lines of public medical institutions. In addition, the specialists of the clinic NEOMED will provide a video protocol of the procedure recorded on a digital medium, which will allow the patient to avoid the need to undergo a re-examination.

    FGDS principles

    The question of the study should be decided by the attending physician together with the endoscopist, who are responsible for the health of the patient. According to modern standards FGDs are performed with medical accompaniment, reducing unpleasant sensations and the likelihood of complications.

    Any kind of instrumental diagnostic manipulation carries certain risks, including death, disability, or surgery. In this regard, he must be acquitted.

    Estimated diagnostic benefits of fibrogastroduodenoscopy should prevail over risks.

    In some cases, the performance of EGD may require the normalization of the function of the nervous, respiratory, cardiovascular, and other organ systems, which will be an indication for postponing a planned endoscopy. In fact, any dubious point should be interpreted in favor of canceling the procedure, putting the patient's safety higher.

    In the case of severely ill patients, endoscopic examination may be performed in the operating room mode, where doctors of other areas will be present, which may be required for emergency care, as well as the head of the department.

    Features of the study

    Fibrogastroduodenoscopy refers to the most common variant of endoscopic examination of the initial sections of the gastrointestinal tract. The immersion level of the instrument depends on the readings, and the following parts are inspected:

    • Pharyngeal ring and esophagus (esophagoscopy),
    • All sections of the stomach (gastroscopy),
    • The bulb of the duodenum (duodenoscopy).

    Sometimes an endoscopist can hold the instrument a little further, if there are appropriate indications.

    After preparing the patient for FGDs, consisting of pre-cleaning of the gastrointestinal tract, psycho-emotional attitude to the need for a procedure to select a more correct treatment strategy, pain relief and / or other premedication with a view to better tolerability.

    The procedure is based on the swelling of the hollow organs of the gastrointestinal tract by means of air or physiological fluid, which provides a viewing field and the path of the endoscope itself. A visual assessment of the state of the walls, the size of the lumen, defects or neoplasms is performed.

    Many modern installations allow, directly during the procedure, to take material for further histological examination (biopsy), to remove small structures, to stop bleeding and other manipulations.

    After removing the air / fluid, the endoscopist should assess the patient’s general condition and calm him down. Sometimes it is necessary to observe him for some time in order to be in time in case of an emergency. The doctor has the right to release the patient only in the absence of any doubts about the normal endoscopy.

    With esophagogastroscopy

    The study of the stomach is carried out using flexible endoscopes with several instrumental channels having different diameters. The upper sections are considered the most accessible, therefore contraindications to FGDs occur quite rarely.

    However, the following groups of contraindications to FGDS of the stomach and esophagus are distinguished:

    1. Absolute (for which the benefits do not cover possible health risks):
      • Presence of phlegmonous esophagitis (purulent inflammation),
      • Mucosal burn
      • Exacerbations of diseases (COPD, bronchial asthma),
      • Acute vascular disease (heart muscle or brain infarction),
      • Blood clotting disorders (hemophilia, thrombocytopenia),
      • Esophageal stricture with high risk of obstruction
      • Aortic aneurysm with a high risk of perforation,
      • Unauthorized patient’s refusal of the procedure,
      • Critical (severe) condition of the patient.
    2. Relative (carrying out the procedure in which it is possible strictly according to the indication of the doctor if it plays a decisive role in the choice of further treatment tactics):
      • Esophagus Diverticula,
      • Infectious diseases of the oral cavity, upper respiratory tract and gastrointestinal tract,
      • Various deformities of the spinal column in the cervical and thoracic, • Unspecified bleeding with an estimated source from the stomach,
      • Goiter with compression syndrome
      • Coronary heart disease,
      • Varicose veins of the esophagus last degree (3-4)
      • Decompensated diseases of the cardiovascular and / or respiratory systems,
      • Violations of the neuropsychiatric sphere.

    There is also the concept of emergency endoscopy, in which many of the contraindications on the contrary become the reason for its implementation, especially when deciding on emergency surgical intervention.

    In the case of gastric bleeding FGDs, it is desirable to carry out no earlier than 12-14 hours after the episode. Crucial for the purpose of the study are the data of anamnesis and the initial examination of the patient.

    With duodenoscopy

    A distinctive feature of duodenoscopy is the use of instruments with greater length and the presence of lateral optical devices. Because of this, there are certain difficulties in their rotation in the hollow organs. In fact, this increases the risk of traumatic damage to the walls, in parallel narrowing the field of view of the doctor (forms "blind zones").

    To avoid serious complications before examining the duodenum, prior to this, ehophagoduodenoscopy is performed (thinner and more flexible instruments are used). With this type of EGD contraindications are the same as with gastroscopy. However, the risks are much higher. It is important to consider the degree of narrowing of the hollow organs in order to select the required tool diameter.

    Possible complications

    The main failure is considered to be the complete absence of the possibility of adequate FGDs. The following 3 main reasons are distinguished:

    1. Improper preparation of the patient to stay in the gastrointestinal tract of the endoscope (foreign body), leading to the following consequences:
      • Psychomotor agitation provocation
      • Strong gag reflex,
      • Puffing (breathing disorder until it stops completely - apnea),
      • Regurgitation (return throw) of mucus / saliva in the respiratory tract,
    2. Improper preparation of the digestive tract itself (in not present food, blood, fluid, which not only worsens the review, but also contributes to the throwing of the contents into the respiratory tract),
    3. Lack of qualifications or experience endoscopist, lack of technical capabilities (for example, there are no tools of the required diameter, which forces the use of inappropriate).

    The most common complications of EGD include the following:

    • Damage to the hypopharynx of varying depth. It leads to a change in phonation, the accession of a secondary infection (usually of a purulent character),
    • Trauma to the wall of the esophagus, stomach or duodenum. May be accompanied by the development of massive bleeding, perforation of hollow organs,
    • Education esophageal-tracheal fistula,
    • Mediastinitis
    • Peritonitis,
    • Formation of abscesses in the retroperitoneal space,
    • Mediastinal emphysema,
    • Neck emphysema, subcutaneous.

    Now anyone has the right to voluntarily undergo endoscopic examination in private. However, a person cannot at the same time adequately relate the benefits and risks in order to avoid the development of complications, including in the long-term period. Therefore, FGDs should be prescribed exclusively by the attending physician.

    When prescribed FGDs

    Fibrogastroduodenoscopy or fibrogastroscopy (FGS) is appointed in the presence of:

    • unreasonable abdominal pain,
    • discomfort in the esophagus,
    • foreign object in the esophagus,
    • persistent heartburn
    • regular vomiting,
    • problems with appetite, strong weight loss,
    • anemia caused by no apparent reason
    • pancreatic, liver or gallbladder pathologies,
    • cancer of the stomach or ulcers,
    • chronic gastritis.

    The study also needs to be done before certain types of surgery, to monitor the effectiveness of ulcer treatment, and before removing polyps.

    In some cases, medications that act as anesthesia can be used. For a short time they immerse the patient in a dream, he will not feel anything - no discomfort. These tools are used if you need to carry out the procedure for a child or an adult who cannot transfer it. Although the study does not cause much pain. Unpleasant sensations occur only when the probe passes through the mouth and when it is pulled back.

    EGD is a rather unpleasant procedure. Therefore, to alleviate the suffering of the patient can use special drugs. They have the property to reduce the gag reflex and eliminate painful sensations inside the throat.

    In which cases it is prohibited to conduct FGDs

    All contraindications to FGDS of the stomach are divided into 2 groups:

    1. Diseases in which it is impossible to conduct a study.
    2. Pathologies requiring a postponement procedure until recovery.

    The first group includes myocardial infarction in the acute stage, spinal curvature, stroke of hemorrhagic or ischemic type, the presence of a neoplasm in the esophagus, impaired function of the coagulation system, bronchial asthma during an exacerbation, aortic aneurysm. To conduct a gastroscopy will not work also, if the patient categorically refuses it.

    The second group of contraindications includes inflammatory processes in the area of ​​the larynx or pharynx, an increase in the cervical lymph nodes, hypertension, angina pectoris, mental disorders in which a person does not control himself.

    In some cases, gastroscopy can hold, even if there are contraindications to it. This can be done when an urgent need to remove a foreign object from the esophagus or for first aid in case of bleeding of the vessel. This can be done only in medical institutions that have all the necessary equipment for conducting research and providing first aid if complications arise.

    Before FGDs, individual characteristics of the body and the presence of factors that may cause complications in the process of gastroscopy are taken into account.

    To protect the patient, before the procedure may appoint:

    • ultrasound procedure,
    • blood test for biochemical research,
    • electrocardiography and other procedures.

    In addition to the above, there are other conditions in which FGDS cannot be performed.

    This procedure is prohibited if:

    1. Not three days have passed since the radiography of the gastrointestinal tract, which used a contrast agent.
    2. The patient suffers from acute infectious pathologies of the respiratory system organs.
    3. There are all signs of respiratory failure.
    4. A person is diagnosed with arrhythmia.
    5. There was a hypertensive crisis.
    6. The patient suffers from heart failure.
    7. Recently suffered a heart attack or stroke.
    8. There are disorders of the nervous system.

    What is FGDs

    EGD (fibrogastroduodenoscopy) is a method of examination with the help of an endoscope of the surfaces of the esophagus, stomach and the beginning of the 12 duodenal ulcer. In gastroenterology is considered the most informative method for making and clarifying the diagnosis.

    The examination is carried out with a thin flexible probe 8-11 mm thick, which is inserted through the mouth and esophagus into the stomach. The image is projected on the screen. There is a type of examination where a probe is inserted through the nose.

    Advantages of FGDs method:

    • informative,
    • security,
    • no pain
    • easy to carry.

    The design of the device allows for diagnostics, taking tissue samples for analysis, and performing surgical procedures at the time of the procedure.

    Preparation for FGDs of the stomach - some important recommendations

    The FGDs procedure requires some preparation and it is desirable for the patient to get acquainted in advance with the requirements that must be fulfilled in order for the procedure to be successful and with the greatest information.

    So how to properly prepare for FGDs, is it possible to drink water, what to eat?

    Requirements for preparation:

    • food that is digested for a long time (nuts, seeds, fatty and fried meat), as well as products containing coloring matter (coffee, chocolate), soda, alcohol, smoked foods should be excluded from the diet 2 days before the examination,
    • food intake should be 12 hours before the procedure, i.e. you need to have dinner on the eve at 18.00, excluding raw vegetables and heavy food,
    • Do not smoke for 3 hours before the study (smoking increases the amount of mucus in the stomach),
    • not to take medications in capsules and tablets on the day of the examination, if this is not possible - to warn the doctor conducting the study,
    • if there is an allergy, some diseases or something bothering at the moment - tell your doctor about it,
    • Do not drink before the procedure (or it should take at least three hours and only clean water in a small amount),
    • don't chew gum
    • if the examination is not carried out in the morning, then you need to consult a doctor about the possibility of eating breakfast,
    • clothes should be free so as not to interfere with extra sensations
    • do not use perfume - it prevents the doctor,
    • to bring a sheet (on the couch), a towel,
    • immediately before the procedure, remove, if present, dentures,
    • Before the procedure, you need to calm down, adjust yourself in a positive way (excessive excitement can interfere with the examination) and be ready to do everything that the doctor advises.

    Proper preparation of the patient, the right attitude will help to pass the study without any difficulties.

    What to take for a stomach exam

    • passport,
    • medical policy
    • insurance certificate is often required
    • referral from a gastroenterologist / therapist,
    • results of previous surveys, biopsies,
    • in some cases, other test results, outpatient card,
    • towel sheet
    • removable shoes or shoe covers,
    • regularly taken medication.

    Indications for gastroscopy (FGDS)

    Not always tests, X-ray examination makes it possible to make a diagnosis, and carrying out FGDS allows you to see the picture of the disease from the inside, to clarify or make the final diagnosis. Basically, the examination is conducted to diagnose diseases of the gastrointestinal tract, especially its upper part.

    When FGDs are held:

    • in the presence of nausea, heartburn, belching,
    • cough for no apparent reason
    • pain when swallowing,
    • dysfunction of swallowing,
    • bloating, gas formation,
    • noticeable weight loss
    • abdominal pain, especially in the area of ​​epigastria,
    • blood in feces
    • vomiting, blood in vomit,
    • B12 deficiency anemia,
    • with gastric bleeding,
    • to deliver the drug
    • remove polyps
    • to take tissues, gastric juice for analysis, tests on gastrobacteria, for example, often together carry out a urease test for the presence of Helicobacter pylori (Helicobacter pylori),
    • monitoring the effectiveness of the treatment.

    EGD reveals the following diseases: gastritis, gastric and duodenal ulcer, stomach and esophagus cancer, inflammation of the esophagus, reflux disease, polyps, duodenitis and other diseases.

    Timely FGDS of the stomach will help diagnose the disease at an early stage, which makes it possible to start treatment on time.

    In chronic diseases FGDS is carried out once a year, in other cases - according to indications and the direction of the attending physician.

    Contraindications FGDs

    Although the FGDs procedure is informative and sometimes it is difficult to make a diagnosis without it, it is not always possible to perform it. There are states when conducting research is contraindicated:

    • narrowing of the esophagus due to neoplasms and for physiological reasons
    • narrowing of the stomach,
    • signs of intestinal obstruction,
    • severe gastric bleeding,
    • mental illness in the acute stage,
    • bulging of the esophagus walls,
    • aortic aneurysm,
    • myocardial infarction,
    • stroke,
    • disorders of the heart,
    • immediately after a hypertensive crisis,
    • bronchial asthma,
    • strong gag reflex,
    • enlarged thyroid gland
    • severe upper respiratory tract diseases,
    • severe anemia, obesity,
    • bleeding disorder,
    • colds when the procedure is impossible (nasal congestion, cough, laryngeal edema, high fever).

    FGDs procedure

    A nurse or doctor irrigates the throat with lidocaine spray if it is not allergic (this question must be clarified in advance).

    The patient is placed on the couch on the left side. The pose should be comfortable and comfortable for the patient, otherwise he will be tense, and this prevents the introduction of the probe.

    A mouthpiece is inserted into the mouth for ease of insertion of the endoscope (sometimes the device for FGS is called a gastroscope) and in order not to injure the mucous of the lips and mouth.

    The doctor begins to introduce the endoscope, the patient performs a swallowing movement at the doctor’s command. At the time of the introduction, an emetic reflex may appear, but if you breathe deeply and calmly, this condition disappears. After insertion of the endoscope it is impossible to swallow, saliva is collected by suction.

    When the probe is inserted, air is pumped into the stomach (to clear the folds) so that the mucosa can be better seen.

    The duration of the procedure is 5-10 minutes and, if the requirements of the doctor are met, it does not cause much discomfort to the patient.

    If any therapeutic measures are taken, the time of its holding comes to 30 minutes.

    In some cases, the study is conducted under general anesthesia (children, the patient's agitated state, and complete pain intolerance).

    When FGDs can be seen:

    • What is the condition of the mucosa and the walls of the stomach and esophagus,
    • scarring,
    • narrowing of the lumen of the esophagus,
    • the degree of reflux (reflux - the contents of the stomach enters the esophagus),
    • various neoplasms.

    After the procedure, the endoscopist is issued FGDS conclusion - the result of the survey, a description of a consistently seen pattern of mucous membranes of the esophagus, stomach, pylorus, duodenal bulb (duodenum). It indicates the presence of free flow, peristalsis, the amount of gastric secretion / reflux of bile, varicose veins, plaque, cardiac outlet / insufficiency, inflammation (hyperemia, swelling), folds, damage.

    Quite often, a biopsy is taken - a microscopic piece of mucous membrane for the presence of malignant cells.

    Complications after FGDs

    Properly performed FGDs procedure and the patient’s implementation of the doctor’s recommendations practically do not give any complications. The most serious complication is a violation of the mucous membrane of the esophagus or stomach, the drift of infection.

    To avoid unwanted reactions of the body, any complications, the doctor always asks about the presence of diseases, and the patient must be told about his individual characteristics, about his condition before the examination (if he does not like something in his feelings).

    Complications after FGDs:

    • body temperature rises to 38 degrees
    • black color of feces,
    • gag reflex and blood in the vomit,
    • pain in the abdomen.

    If there is any unwanted symptom, you should definitely consult a doctor.

    After FGDs - when you can eat, feeling

    After FGDs, mild nausea is sometimes observed, there may be dryness and sore throat, but these symptoms usually pass quickly.

    After 30 minutes, if everything is good, you can drink water in small quantities, weak tea (drinks with gas, alcoholic drinks can not be drunk), and after an hour - eat. Food should be light, not spicy, so as not to injure the mucous membrane of the stomach.

    If a biopsy was taken, then a light diet is recommended to be followed for a couple of days, there is no hot and irritating food.

    How to prepare for the study to avoid discomfort

    FGS requires some preparation.
    Compliance with all the recommendations of a specialist will significantly reduce discomfort during the study and prevent the development of complications:

    • it is very important to prepare yourself morally. It is advisable not to be nervous and relax. This will help get rid of muscle tension and ease discomfort,
    • you can not eat any food. Cleansing the stomach from food occurs within a few hours. And some foods can stay there longer. Therefore, for several days before the procedure, it is desirable not to eat any flour products, nuts and seeds. To avoid an unpleasant outcome, it is better not to use anything after dinner, if the next day is gastroscopy. This recommendation should be followed, since vomiting may occur during the procedure, which is not only unpleasant, but also dangerous. The doctor may not be able to safely remove the probe, resulting in damage to the stomach walls,
    • smokers need to give up this habit for a while. Cigarettes cause increased gag reflex and accumulation of gastric mucus. This will significantly complicate gastroscopy,
    • in the presence of dentures they need to be removed, as they can damage the equipment,
    • Specialists may prescribe additional funds to speed up the digestion process.

    Damage to the stomach can be obtained only if the person made sudden movements during the study or if there were food debris in the stomach that caused vomiting. The most serious complication is bleeding. This can occur if a person suffers from esophageal varices. The vessels are easily damaged by the endoscope.

    Watch the video: Gastroduodenoscopia en Teckel. Teckel gastro-duodenoscopy. (April 2020).