Under gastroscopy means the procedure by which examine the membranes and the cavity of the esophagus, stomach. The area of the duodenum is also affected. In some cases, gastroscopy allows you to visualize the image and display it on the screen. For the study using a gastroscope, which is introduced through the oral cavity into the esophagus, then into the stomach. The gastroscope can be thought of as a flexible tube of small diameter that the patient swallows. At the end or inside is a special optical system, which makes it possible to inspect the internal cavity.
In accordance with the order of the Ministry of Health, since 2010, all gastroenterological offices should be equipped with two gastroscopes with the possibility of taking a biopsy. This requirement is explained by the importance and diagnostic significance of the procedure, which makes it possible to identify pathologies in the early stages and take the necessary measures in a timely manner, to prescribe treatment. Many experts recommend regularly undergo such examinations with a preventive purpose. At the very least, it is not necessary to ignore the study in the event that it is prescribed by a doctor. So there are reasons for this.
Does it hurt to do a gastroscopy?
The study is not without discomfort and pain. However, today there are many methods that make it less unpleasant and painless. For example, the use of anesthesia, the latest probe-free research methods.
The procedure is applied for the purpose of a detailed study of the stomach walls. Most often used for suspected tumor process or possible bleeding, ulcers. The method allows you to visually convince the nature of the pathological process, to confirm or refute the diagnosis. Based on an accurate diagnosis, further research is carried out. Often used to establish the clinical picture of other diseases of the stomach and esophagus. It can be used as an additional research method for diseases that are not directly related to the digestive system.
Also carried out in the event of pain of a different nature in the stomach, esophagus. Allow us to determine the nature of pain, timely detect the pathological process. With such symptoms as nausea, vomiting, heartburn, gastroscopy is mandatory. If there is bleeding, vomiting of blood, abnormal stools - gastroscopy is a must-have procedure. Often carried out with a diagnostic purpose for suspected cancer process, for example, anemia, drastic weight loss, lack of appetite. It is carried out in case of other diseases, when it is necessary to evaluate the condition of the mucous membrane of the stomach, esophagus, and when food does not pass. It can be carried out with the medical purpose.
Gastroscopy without pain and torment, tips
Still, I decided to write about gastroscopy. This procedure is not as scary as it seems. Relax, it's quick and not painful. I give you four tipswhich compliance will allow
get unforgettable pleasure mitigate discomfort. Everything is verified by personal experience. I dedicate my opinion about gastroscopy to those people who shovel the entire Internet in fear and are looking for something like a Japanese eye in a dream, without pain and how to stay alive :))
I have to say that the scary Japanese eye is the nightmare of my childhood. My parents and I were smart enough to abandon him at a tender age. But I already knew that he would come after me. Now I grew up and was not scared :)) And medicine is already more modern. But I understand your fear.
- Forget about gastroscopy, do not get enough sleep, take your time, be late for 5 minutes. Do not think about it, it is not scary and not painful.
- Be sure to use local anesthesia (I sprinkled my tongue with 10% lidocaine spray).
- Listen carefully to the instructions of the doctor, he will tell you when and how to breathe properly. Breathe in your mouth. Get ready, the first 30 seconds I could not breathe.
- Make sure that the gastroscope is Japanese, not Russian. If there is no imported equipment in your hospital, look for another hospital or pay for it, especially if you decide to examine the child (although in my case it has managed).
Today did a gastroscopy. Very afraid. did the first time. Before that, I read a lot of reviews, tuned in to visit a doctor)))
Now I decided to write myself, tell others, suddenly to whom it would be useful.
So: I came to 8-20 in the clinic. On the eve of anything after 19 hours you can neither eat nor drink! Nothing at all!
The doctor sprinkled lidocaine in my throat (local anesthesia) and told me to lie down on the couch on my left side. Under the head they put a towel that I brought, so that I couldn’t give the entire couch to them with saliva))) The nurse put a plastic figure into her mouth so that I wouldn’t gnaw them with their hose.
Then my saddle started to beat like mad, it was scary. I have problems with my throat (glands), and I know that I have a very strong gag reflex, and I was afraid of it.
The doctor took the hose (or how it is called correctly :)) I do not know). Thick about the finger and he began to push through me.
Feelings certainly unpleasant. There is nothing painful, no pain, it is simply unpleasant that something climbs into my throat and this is what made me constantly gagging. Even the tears flowed a little. The doctor spoke to breathe, but I could hardly breathe, every 5-10 seconds I had a creative reflex.
The doctor before the procedure said that all this disgrace will last 1 minute. Indeed, they did it in about a minute, maybe even a little less. I thought they would torment me longer))
So, of course, it’s unpleasant, but 1 minute can be experienced.
Greetings to my sister in misfortune! Thank you for sharing your experience and leaving your gastroscopy tips. Good health to you!
It feels like you are being stifled and a worm is crawling in your guts. This was the first time on this barbaric analysis. Now I go to it ONLY by the modern method, under anesthesia.
And I did gastroscopy in Onclinic under narakozy. It is good that there is already an alterantiva to the old draconian methods of examination.
The procedure for gastroscopy was prescribed for me on Monday. The day before I read a few reviews on the Internet and went to bed with peace of mind. The most important thing for a person is the absence of even the most minimal sensations of pain, and from articles and comments of people who have done gastroscopy I have repeatedly I realized that it wouldn’t be there at all. After 19:00 I didn’t eat or drink water. Of course, before I fell asleep, I inspired myself that it wasn’t scary, because besides pain there is also fear. I also didn’t ate and did not drink any water The procedure was set for 8: 05. I went into the office first, which is also good. the hose between patient receptions must lie in the solution for at least half an hour. There are two cabinets, in the first one I was given local anesthesia (double leap of ice cream), and after ten seconds we passed to the second room. The main thing is to listen to the instructions of the doctor and the nurse's advice. I lay down on my left side, they put a holder in my mouth so that it would not close during the procedure and the doctor began to slowly insert the hose. It was over. 2-3-4 minutes, I can’t say for sure and the procedure was over. The involuntary gag reflex when the hose was inserted (this is normal as I understood.) And the tears from the eyes, not from the pain of course. Further, the doctor wrote a conclusion, and thanking him, I said the next one already in the corridor.
Even without anesthesia, my gastroscopy was done absolutely painlessly in a clinical hospital on Yauza. a little bit unpleasant is the moment when the doctor inserted this tube, and then everything is tolerated.
When can I register for gastroscopy of the stomach?
The examination is performed at the slightest manifestation of the following symptoms:
- Nausea, heartburn, vomiting.
- Pain in the upper abdomen.
- Internal bleeding. It appears together with vomit, melena, sudden loss of consciousness.
- The presence of pain when swallowing food.
- Lack of appetite, resulting in weight loss.
Make a gastroscopy in Moscow is necessary for various diseases of the digestive system. For example, the condition of the gastric mucosa is examined in acute pancreatitis. This is a prerequisite, by adhering to which it is possible to promptly identify and eliminate the complications of the disease.
Contraindications for gastroscopy
The procedure can be planned and emergency. Contraindications to its implementation will depend on these factors. In the second variant, the examination is carried out in case of acute diseases, including acute myocardial infarction, as it excludes contraindications. Here the efficiency and focus on avoiding heavy consequences are important.
When planned gastroscopy need to pay attention to:
- Mental disorders.
- Severe diseases of the cardiovascular system.
- Violation of the respiratory process.
- Insufficiency of cerebral circulation.
- The rehabilitation period after a stroke, myocardial infarction.
- Hypertensive crisis.
- Aneurysms of the heart, aorta, carotid sinuses.
Only a qualified specialist determines the feasibility of gastroscopy and provides an assessment of possible contraindications. Therefore, before its holding consultation with a doctor is imperative. All necessary medical information is provided to the specialist.
Preparation for the procedure
In order to undergo gastroscopy in Moscow, it is necessary to adhere to certain rules that will help the patient to prepare for the examination. For preparation it takes 3 days. To achieve the most correct results, it is necessary to empty the stomach prematurely. Dieting will cleanse the digestive system. Should refuse:
- greasy food
- products that can cause gas,
- legumes, any dairy products, natural juices, black bread, fruit, carbonated drinks and vegetables.
Festal or Mezim, which should be taken immediately before the procedure, will help prevent bloating. One of the most important rules to adhere to is not to eat 12 hours before the procedure and not to use liquid 4 hours before it. This will help get rid of the gag reflex.
It is imperative to do certain tests, which the doctor will prescribe before the procedure. The patient can provide the doctor with ready-made tests, if they were done at another medical facility. However, it is worth paying attention to the type of analysis, because some readings can change pretty quickly and need to be repeated.
The list of analyzes in the ABC Clinic is extensive:
- biochemical blood test,
- clinical analysis of urine, blood,
- HIV test
- determination of blood group and rhesus factor
- analysis for hepatitis B, C,
Where can I do gastroscopy of the stomach in Moscow?
"ABC Clinic" provides all the conditions for the procedure. Gastroscopy can be recorded via the website or by calling the phone number listed in the “Contacts” section, you can also contact the clinic directly. For conducting FGDS, a separate room has been allocated and equipped with modern equipment.
FGDs is carried out as follows: the patient is located on a couch in a specially designated room. The correct placement of the patient is important: you need to sit on your left side. For the convenience of the patient and the physician, the legs of the first should be bent to the chest. Experienced staff supports the patient. With sudden movements, the latter can harm the equipment, so the medical staff keeps his hands. The instrument is removed very carefully, one wrong movement can damage the patient's internal organs.
Before the gastroscope is inserted into the patient's mouth, a mouthpiece is inserted, which helps prevent damage to the device. A thin, bendable device is inserted through the nose or mouth. At the end is a miniature camera, with which the doctor examines the organs of the gastrointestinal tract. A deep breath is taken, along with which the hose easily passes inwards and does not damage soft tissue. You need to breathe calmly, evenly and deeply. Do not attempt to remove the gastroscope by yourself. The whole procedure will not take more than 20 minutes, the results can be collected on the same day. Except when the biopsy tissue item was sent, the response time will be delayed for a period of 5-10 days.
Interpretation of results
After passing gastroscopy of the stomach fee in Moscow, it is important to correctly understand and interpret the results of the examination. Pink coloring of the gastric mucosa is the norm for him. In this case, on the smooth shiny surface of the front wall is a small amount of mucus. In the normal state, the mucosa of the posterior wall has a folded structure. The cone-shaped pylorus has a good cross.
Signs of gastritis are: hyperemic mucosa, the formation of edema, the presence of hemorrhages under the mucosa, the amount of mucus exceeds the norm. Atrophic gastritis can be identified by pale staining of the mucous, thin folds. A stomach ulcer is easy to determine, an ulcer crater is formed, the surface is covered with purulent or mucous plaque. An ulcer after scarring is characterized by a spot of whitish hue. The malignant ulcer has rough and knotted edges. Smoothing of folds, grayish-white color of the mucous membrane - the primary signals about gastric cancer.
What is gastroscopy of the stomach?
Gastroscopy is a very generalized name for endoscopic examination, which is used to inspect the gastric mucosa.
Gastroscopy refers to methods of examining the organs of the gastrointestinal tract, and is often combined with studies of other organs, for example:
- Esophagoscopy - examination of the esophagus, without going into the stomach,
- Esophagogastroscopy - examination of the stomach and esophagus,
- Esophagogastroduodenoscopy - examination of the stomach, esophagus and duodenum.
The method of gastroscopy is non-traumatic, painless, but very unpleasant. This intervention in some patients causes activation of the sympathoadrenal system, so there are ways to reduce the patient's discomfort and stress factor. According to this principle, the following methods of gastroscopy can be distinguished:
- gastroscopy without the introduction of drugs
- gastroscopy under general anesthesia
- gastroscopy under sedatives.
Now gastroscopy is most often carried out using a fibrogastroscope, an instrument consisting of a flexible tube with an optical fiber system inside and a video camera that captures a true picture of the stomach and sends its images to a computer monitor. Additionally, through the flexible tube of the endoscope, you can enter the tools for taking biopsies (pinching off a piece of tissue for laboratory testing), coagulating damaged vessels (cauterization) or administering drugs.
In addition to the so-called classical gastroscopy in recent years it has become possible to conduct an examination of the gastric mucosa without swallowing the probe. This study has its advantages and disadvantages, but if the patient has contraindications for conventional gastroscopy, the method of a tubeless examination can be an ideal and practically the only way out.
Fibrogastroscopy is the most common way to study the gastric mucosa by introducing a fibrogastroscope into the organ cavity. This procedure is indicated for patients who are suspected of gastritis, gastric ulcer, tumors, polyps. Sometimes FGS is prescribed to identify possible causes of allergies or neurosis, the range of diseases is quite wide. Now the study is conducted in two versions of the probe: through the mouth and through the nose.
FGS with the transoral route of administration
The procedure lasts only a few minutes, and the doctor may announce the preliminary results immediately after the manipulation.
The patient is in a reclining position on his stomach, clamping a special plastic mouthpiece in his mouth. An endoscopist-gastroenterologist passes a probe through it and asks the patient to swallow the tube. Since the light anesthesia was carried out in advance, his gag reflex was weakened, and the patient does not feel emetic urges, only discomfort and foreign body sensation.
The advantages of this method include:
- short duration of the study (only 2-5 minutes),
- fast receipt of visual observation,
- the ability to manipulate a video camera under eye control in order to study areas of particular interest,
- the possibility of therapeutic measures (biopsy, coagulation of bleeding vessels, removal of polyps),
- minimal risk of complications.
The disadvantages of fibrogastroscopy include:
- a long period of preparation for the study, nutritional restrictions,
- discomfort during gastroscopy,
- a large number of contraindications.
FGS with transnasal route of administration
This study has not yet become widespread, transnasal research means holding a flexible probe through the nose, along the back of the pharynx down the esophagus. Since the fiberscope does not affect the root of the tongue and the tongue of the soft palate, the patient does not bother the gag reflex. The patient no longer needs local anesthesia or sedation. If there are allergic reactions to the anesthetic, this will become a separate item in favor of the transnasal method.
Obviously, the tube in this case will be much thinner than with mouth fibrogastroscopy. The diameter of the tube should not exceed half a centimeter, which means that additional gastroscopic possibilities will be significantly limited (it is impossible to take a biopsy through a thin canal, it is impossible to coagulate with bleeding). It is easier to enter such a tube, and the quality of the research itself does not deteriorate at all.
In addition, with the transnasal method of administration, the patient's verbal functions are preserved, he can immediately inform the specialist about any unpleasant sensations, which significantly reduces fear and anxiety before the procedure.
But, as with any procedure, transnasal FGS has its drawbacks. Some patients note the appearance of nasal bleeding after gastroscopy through the nose.
For fibrogastroscopy, regardless of the method of administration, there are a number of contraindications that reduce the versatility of the method. Relative contraindications are temporary, with the restoration of reduced body functions, they are removed, and the FGS is possible. In addition, with the development of life-threatening conditions and the need for urgent gastroscopy, some of these indications can be closed eyes. These restrictions include:
- inflammatory diseases of upper respiratory tract,
- last trimester of pregnancy
- burns of the esophagus and oral cavity,
- angina pectoris and advanced hypertension.
Absolute contraindications limit perpetual gastroscopy indefinitely. In the presence of varicose veins, severe narrowing, scarring of the esophagus, aortic aneurysm and curvature of the spine FGS is strictly contraindicated.
Gastroscopy without swallowing the probe
Transnasal fibrogastroscopy is partly related to this type of examination, so the probe is carried out through the nasal passages and descends into the stomach along the back of the pharynx. This is a gentle method designed for particularly sensitive patients exposed to stress. For example, in hypertension, the introduction of a fibroscope through the mouth can trigger a pressure surge or even a hypertensive crisis. With transnasal FGS, these undesirable consequences can be avoided, since negative emotions from manipulation are minimized.
Gastroscopy of the stomach without swallowing the probe becomes possible in its pure form due to capsule endoscopy. The patient is invited to swallow a small capsule, inside which is a built-in video camera and a video signal transmitter for it. There are different companies that produce capsules, they may have features, for example, there are capsules designed for the small or large intestine for the stomach. Together with the capsule, the patient receives a receiver for the signal. Then, from this receiver, the doctor will take the data obtained during capsule endoscopy, but at this stage the patient can leave the hospital and return home. Later, the capsule will naturally leave the gastrointestinal tract, having previously captured the entire picture throughout the entire gastrointestinal tract. It is disposable and it is not necessary to control its output.
If you feel uncomfortable, change the nature of the chair or pain, you should immediately contact your doctor. The relative disadvantage of this study is that it is only of a diagnostic nature, there is no possibility to carry out therapy or take material for analysis.
The price of the study of the gastric mucosa correlates with the complexity of the study. On average, prices for classic fibrogastroscopy vary from 2 to 4 thousand. With additional manipulations (biopsy, pH-metry), conducted during the study, the price may increase to 10 thousand.
Transnasal gastroscopy is limited to an average of 4 thousand rubles, so no additional actions can be performed.
Video capsular gastroscopy is the most expensive research, since the most expensive materials and modern technological developments are used to create a disposable capsule (20-50 thousand).
* Prices are in rubles.
Daria, 21 years old.
I did fibrogastroscopy three (!) Times. And the first time I had to do it when I was in 9th grade. Frankly, it was awful. Bitter anesthetic, a foreign object in the mouth, I did not know how to breathe (I really did not explain anything). Tears hail. One calms, the whole procedure did not last long. But treatment is treatment. Diagnosed my gastritis, prescribed treatment. After two years of re-painting the pain in my stomach, I had to go to the gastroenterologist again for execution. At that time, everything went much better, although pleasant is also not enough. In fact, a lot depends on the doctor, on the mood before FGS. By the way, the last time I had a parallel gastric pH-metry. I can not say that it added some new sensations. No, I did not feel anything. Just time and price have increased, probably doubled.
Anna, 29 years old.
I heard about capsule gastroscopy quite recently and ran to the CDC for joy. It was necessary to check, and after the last usual gastroscopy I was sick for two more days, and I shuddered at these terrible memories. And the video capsules are, after all, painlessly introduced / output ... Listen, I understand everything: innovation ... But still it is very expensive! Looks like you'll have to put up the tube again.
Vladimir, 34 years old.
I myself did not do a gastroscopy, I follow the diet and healthy, like a bull. And my mother is a hypertensive patient with an experience of 20 years. Her stomach has been bothering her for a long time, but what can you do if you are hypertensive? Ultrasound, X-ray, and that's it. Complained to a colleague at work, and she surprised me, they say, there is a way. Recorded with my mother on transnasal gastroscopy. The doctor immediately reassured us that hypertension was not the end of the world. And everything really passed quickly and calmly. We were warned that there might be nose bleeding, there is still high blood pressure, but nothing happened. Now we will treat my mother's ulcer with peace of mind. It is a pity, of course, that it was impossible to send a piece of tissue to the laboratory, to see what was happening with oncology ... But, what can you do, let's go to donate blood for tumor markers.
Fedor, 45 years old.
Here everyone asks about capsule endoscopy ... So, I did. Of the advantages, I can note the painlessness (which is natural), convenience (you are not lying on the couch, choking on saliva and belching, and in a civilized way swallowing the “smart tablet”, you take the receiver). Among the shortcomings: still, you need to prepare for the study, the very diets, restrictions and espumizan. By the way, you will have to go to the hospital not once, but twice, to take readings from the device. Gastroscopy is faster in this regard. And, of course, expensive.
Gastroscopy during gastritis
Gastroscopy can be a very informative procedure used for gastritis and suspicion of it. Allows you to visualize the internal space, get a complete clinical picture of the pathology. Conducted with sharp pains in the epigastrium, nausea, vomiting. It can be carried out both with the medical, and with the preventive purpose. To study the gastroscope is introduced through the mouth into the esophagus, looking through the wall, then moving into the stomach, assess the condition of the walls, mucous membranes. If necessary, take a biopsy. According to the results, you can confirm or deny the diagnosis, as well as identify other possible pathologies.
The doctor makes preliminary conclusions directly during the procedure. Assessing the condition of the mucous membrane, he can diagnose gastritis, peptic ulcer, colitis with absolute precision. By changing the color of the mucous membrane, the presence of puffiness and hyperemia, we can assume the presence of neoplastic diseases. According to this data, a preliminary conclusion is made. If a biopsy was taken or a bacteriological examination was taken for scraping, the results will be ready after 5-7 days. Based on the preliminary conclusion and the results of the analysis, a conclusion is drawn up for the gastroenterologist.
What does gastroscopy show?
Gastroscopy makes it possible to detect inflammatory and infectious processes, ulcers, burns of the mucous membrane, polyps, hernias, scars. Of particular importance is the ability to detect malignant neoplasms in the early stages of their development. With the help of gastroscopy it is possible to detect zones of formation of ruptures, which will later become a source of hemorrhage. In addition, intestinal parasites and foreign bodies can be detected.
During the diagnostic procedure, there may be a need to remove polyps. They are excessive growths of the mucous membrane, which can later develop into a cancerous tumor. Polyps are removed during the procedure, the total duration of diagnosis and removal does not exceed 15-20 minutes. There is no pain. Blood may be released in small quantities, but it stops very quickly without the need to take any measures.
The stomach is one of the organs in which cancer tumors are most often found. Usually, it is rather difficult to identify a tumor in the gastrointestinal tract. With the help of gastroscopy can detect the shape, size, localization of the tumor. You can also determine the shape of the tumor: icteric, cachectic or painful. Approximately 65% of patients with cancer appear in the antrum of the stomach. In the stomach of the tumor occurs in 1.2-2.6% of cases. According to the histological type, adenocaricinoma is most often diagnosed. Usually, tumors are diagnosed in the later stages, when they reach large sizes. But with the help of gastroscopy, they can be detected in the early stages, and take appropriate measures.
Apparatus for the procedure
For inspection of the stomach cavity, special devices are used, which are called gastroscopes, or endoscopes. The difference between them lies in the structure of the optical system at the end, which allows you to visualize the image. Also, the device can be located on either side: at the side, at the end of the tube.
Technique of gastroscopy
Gastroscopy is carried out in a special room. The patient must lie on its side. The throat is pre-treated with local anesthetics. Often used lidocaine solution in the form of a spray. The throat is irrigated, while the gag reflex is reduced, and pain is eliminated. It also makes it possible to relax the muscles, so that the probe will be freely swallowed without damaging the walls of the organs. Sedation is often used. This is a procedure in which various sedatives and painkillers are administered to the patient, which greatly facilitate the procedure. In some cases, general anesthesia is performed. In this case, the injection is done, most often intravenously.
After the preliminary preparation is carried out, the patient is laid, the patient is given a mouthpiece, which must be clamped in the teeth. It prevents damage to the teeth and lips, prevents the eating of a gastroscope. The gastroscope is slowly inserted into the throat, then propelled into the esophagus. At this time, an emetic reflex inevitably occurs, the patient should breathe deeply and calmly. Then air is supplied through the device, which makes it possible to straighten the walls. Inspection of mucous membranes, walls, cavities. The esophagus, stomach, and upper part of the duodenum are examined. If necessary, a biopsy, therapeutic effects. Many modern gastroscopes provide an opportunity to visualize the image on the screen, take photos and video. After the inspection and the necessary manipulations, the gastroscope is removed outside.
When gastroscopy, the patient has discomfort. There is discomfort during the ingestion of the tube. This is accompanied by a gag reflex. If the patient is too nervous and fearful, the procedure may be delayed for an even longer time. so you need to behave calmly, try not to be nervous, then the procedure will be quick, and will bring at least inconvenience. Many patients have unpleasant pain in the throat, which lasts from 1 to 3 days.
When is gastroscopy prescribed?
Gastroscopy, or FGDs, is an examination of the surface of the stomach and esophagus with a special fiber-optic device.
The tool has a content complex structure. Its main part is the head in which you can see several holes. Two of them have small lamps that illuminate the organs. Other openings are used to supply air and water. During the study, the gas expands the intestinal walls, and the fluid washes them, improving visibility. Medical instruments or drugs can be inserted into the remaining holes during the procedure in order to perform manipulations for therapeutic purposes.
On the head there is also a video lens, which transfers the image to the screen or to the eyepiece.
The middle part is made of high-quality fiber, protected by a special film, resistant to gastric juice.
The handle is equipped with a remote control that regulates the movement of the endoscope, the flow of water and air.
Gastroscopy is prescribed for suspected pathology of the stomach or pancreas. Symptoms for which FGDs are performed:
- stomach pain or in pancreas,
- frequent heartburn and nausea
- systematic vomiting
- unusual stool color,
- disturbed stool.
Endoscopy is used to diagnose pancreatitis. An increase in the pancreas can be seen on the device as a slight bulge on the wall of the stomach.
Gag reflex during gastroscopy
During the procedure, an emetic reflex may occur. It occurs in almost everyone, since it is a natural defensive reaction. Urges can be quite intense, but, as a rule, the contents can be contained. Thanks to modern pharmacological agents, the gag reflex can be successfully overcome and suppress. Anesthesia and muscle relaxants provide an opportunity to relax the muscles of the esophagus, to calm the nervous system. Apply mainly local anesthesia.
What is gastroscopy?
There are various types of gastroscopy. The first can be identified:
The latter can be differentiated into planned and emergency (to remove a foreign object).
Diagnostic gastroscopy also has its own subspecies. The separation is based on the type of manipulations that the specialist performs:
- Planned. During her only visual examination of the mucous membranes is carried out.
- EGD with tissue sampling. It is used in cases of suspected malignant tumors and the bacterium Helicobacter pylori. During the study, a small piece of mucous membrane is separated and studied in the laboratory.
- Gastroscopy with a contrast agent. A solution is sprayed onto the surface of the organs, which helps to determine the deviations: ulcers or neoplasms.
- A study to determine the level of acidity in the stomach.
Gastroscopy is carried out only in the hospital with the appropriate equipment.
How to breathe with gastroscopy?
During the procedure you should breathe slowly and calmly, in a normal rhythm. The tube does not affect the airway and does not block the flow of air. Moreover, the diameter of the tube is very small, so that the air circulates freely through the respiratory tract. The more the patient relaxes and will be less nervous, the easier it will be to breathe, since in many ways the lack of air is a contrived mechanism.
Anesthesia for gastroscopy
Many patients dream of gastroscopy without pain. Today, this is made possible through the use of anesthetic solutions and painkillers. This makes it possible not only to eliminate pain, but also suppresses the gag reflex. At the request of the patient, even gastroscopy is performed under complete anesthesia. Features of local anesthesia are that it acts in the region of the pharyngeal ring. There is local anesthesia and simultaneous relaxation of the muscles of the larynx. But at the same time, a person is in full consciousness, can control everything that happens, sees and realizes it.
Types of gastroscopy
There are three main types of research.
Esophagogastroduodenoscopy, or EGD, makes it possible to examine the internal organs with an endoscope. At the same time inspect the mucous membranes of internal organs. It makes it possible to assess the condition of the internal organs, at the early stages to evaluate possible pathologies and select the optimal treatment.
The fibroesophagogastroduodenoscopy, or FEGDS, allows the examination of the mucous membrane of the stomach and duodenum using a conventional gastroscope. This is a traditional gastroscopy.
Also used video endoscopes, which make it possible to obtain a detailed and clear image from the cavity of the internal organs. The image is displayed on the monitor screen, then it can be printed using a printer. Gives you the opportunity to make the correct diagnosis, choose a treatment. The main advantage of this method is the ability to save the result.
Gastroscopy with sedation under general anesthesia
Some people are too sensitive, with a weak nervous system. They are too afraid, nervous, which makes it impossible to carry out the procedure. Therefore, there is a gastroscopy under general anesthesia, during which a person is injected into general anesthesia, he is in a state of sleep, and in the meantime the doctor can calmly carry out the procedure. This method is also used for children, since it is often difficult for them to carry out a similar procedure due to their restlessness, fear, and excessive activity.
Gastroscopy of the stomach without swallowing the probe
The study can be conducted without the traditional ingestion of the probe. The capsular method is used for this. The essence of the method consists in swallowing a special capsule that contains the optical system. The capsule is washed down with water, then it begins to move along the digestive tract and transfer the image to the screen. It is displayed after a certain time in a natural way and does not cause harm to the body.
Transnasal Nasal Gastroscopy
A very unusual, nonetheless, effective method that allows you to explore the stomach and esophagus. It is used for fear of suffocation or the inability to enter the endoscope through the oral cavity. In this study, the tube is inserted first into the nose, then through the throat into the esophagus and stomach. The difference lies in the method of reference and the size of the endoscope. It has extremely thin sizes - no more than 6 mm. Gives the opportunity to explore the gastrointestinal cavity as effectively as with the introduction of the endoscope in the traditional way. In this case, the urge to vomit does not occur, but a cough may occur when the endoscope passes through the throat.
In most cases, a cough occurs only if the throat is tight and something goes wrong. With a relaxed throat and in a calm state, a cough does not occur. At this stage, you just need to relax and trust a specialist who will carry out all the necessary manipulations as accurately and harmlessly as possible.
The rest of the procedure is similar to traditional gastroscopy. If necessary, the doctor can take a piece of tissue for biopsy. With the help of this technique, it is possible to diagnose various pathologies, including gastritis, ulcers, and cancerous tumors.
In addition to biopsy, carried out hromoskopiya, medical procedures. The duration of the procedure is no more than 15 minutes. Many patients who performed this study were satisfied, because they do not have to swallow the probe, there is no gag reflex. The patient also lies on the side, while the device is inserted into one nostril. The second remains free. The mouth is also closed and not busy. In this regard, there is no panic and feeling of lack of air. Many patients note that with such a procedure, anesthesia is not needed, since it is completely painless. To facilitate the introduction of the tube, a special lubricating gel is used. If necessary, can be applied and anesthesia. The discomfort can be felt for a short time when the doctor turns the gastroscope, but they quickly disappear.
Of interest is the fact that even a runny nose is not a contraindication for the procedure. But this procedure can cause nosebleeds if the person has a tendency to bleed, or there is damage to the mucous membrane.
The procedure itself is much simpler. Complications practically do not arise, there is no need for anesthesia. Painful sensations also do not arise. A person can go about his business immediately after the procedure. The patient does not have sore throat, which often accompany traditional gastroscopy, and much less nervous. The risk of injury to the mucous membrane is significantly reduced, respectively, there is practically no risk of developing an infectious and inflammatory process.
Under the capsular gastroscopy means a new method of research, which is carried out using a disposable capsule. The patient swallows the capsule, drinks it with water. The size of the capsule does not exceed 1.5 cm. In the middle of the capsule there is a color miniature video camera, light sources, as well as a mini-radio transmitter. The device is designed for 6-8 hours of operation. At this time, he moves along the digestive tract and transmits the image to the screen of the doctor. Also in the direction of travel you can take photos and video, save images. After the study is completed, the capsule will pass the remaining path and is excreted from the body with feces.
During data transfer, their registration is performed using a special reader. It can be in different forms: sometimes the patient is put on a device with wires, similar to an armored vest. Sometimes in a patient’s pocket there is simply a device that looks like a telephone. He perceives the signal from the capsule. Materials are downloaded to the computer with the installed program for decoding them. There is a processing of the received data. The preliminary diagnosis is set by the program automatically. The impulses and all the data on the basis of which this diagnosis was determined are also saved. The doctor views the result. He can either confirm the diagnosis, or assign additional studies.
Using this research method, the doctor determines which problems exist in the stomach and intestines. The peculiarity of this method is that it makes it possible to diagnose the small intestine. No other method has such capabilities, since they do not get to this site. The capsule makes it possible to identify numerous diseases of the gastrointestinal tract, which practically can not be investigated by any other methods. It is the most effective method for diagnosing colon cancer, Crohn's disease, gastrointestinal pathologies and hidden bleeding. Also, using this method, you can diagnose iron deficiency anemia, damage caused by hormonal drugs.
The disadvantages of this method include the fact that if any pathology is detected, the capsule will simply transmit a signal about it to the computer. No therapeutic manipulations can be carried out. You also can not take a piece of tissue for histological examination, you can not take smears on the microflora and Helicobacter. It is also necessary to take into account that the capsule moves evenly along the digestive tract, with a certain speed, and the doctor remains just an observer. He can neither deploy, nor slow, nor accelerate its passage. However, researchers are constantly working on improving the technology, and in the near future it will be possible to control the camera from a computer, deploy it if necessary, adjust the angle and speed of transmission.
The study of the esophagus is carried out in the presence of evidence. Most often, the need for such a study arises if a person is suspected of any damage to the surface of the esophagus, mucous membranes. The study can give a lot of information if you suspect an oncological process, when diagnosing esophageal cancer. Obstruction of the esophagus is the main indication for gastroscopy. The procedure is painless. Its duration ranges from 2 to 15 minutes. It can be delayed if there is a need to conduct any additional research. Often in the study of the esophagus there is a need for taking a biopsy for further histological examination. Sometimes found polyps, or other structures on the wall of the esophagus. They need to be removed immediately.
Gastroscopy of the esophagus is the main method of early detection of esophageal cancer. Preliminary training includes the preliminary observance of dietary nutrition, refusal of alcohol. The last meal should be 8 hours before the test. Drinking water on the day of the study is also impossible. For the study used a capsule or endoscope. Each method has its advantages and disadvantages. Therefore, the doctor independently decides on the need for a particular research method.
Most often, they still resort to traditional gastroscopy with the help of an endoscope, since this method makes it possible to immediately carry out therapeutic manipulations when such a need arises. Also, with the help of an endoscope, you can take a biopsy, scraping or smear for research. In the process of gastroscopy, all the walls of the esophagus are examined. Additionally, with the help of an endoscope, air and water are supplied, which make it possible to examine the walls more carefully, which will spread out. Using the camera built into the endoscope.
Fully intestine can be investigated only with the help of capsule gastroscopy. A colonoscopy is used to examine the lower intestine. But it gives the opportunity to explore only the rectum and partly the large intestine. In the study of the upper sections with the help of gastroscopy can be achieved only the upper sections. The study will end at the duodenum. With the help of a capsule, absolutely all departments can be investigated, since it moves along the entire digestive tract and is subsequently brought out through the rectum with stool masses.
The essence of the procedure is that the patient swallows the capsule, which contains a built-in sensor. The capsule moves along the digestive tract and transmits a signal to the doctor’s computer. Then with the help of a special program is processing data. The procedure is absolutely harmless, the patient does not feel any pain or discomfort.
Gastroscopy with biopsy
During the procedure, it may be necessary to take a biopsy for further investigation. The material is taken for further histological examination in cases of suspected oncological process. After taking the material is studied under a microscope, characteristic cells are found that may indicate the development of a malignant neoplasm. When such cells are found, they are sown on special nutrient media. Within a few weeks, cells are incubated, then the nature and rate of growth confirm or refute the oncological process. This study is the main method for diagnosing colon cancer, esophageal cancer. When cancer cells are detected at an early stage, it is possible to remove the tumor without any consequences, and to prevent the development of a malignant tumor with further metastasis.
Also, a fragment of the mucous membrane can be taken for histological examination in order to detect the depth and extent of damage to the internal organs by bacteria. Such a need often occurs with peptic ulcer disease. Using this method, you can determine the pathogen, its quantitative and qualitative characteristics. Also, the great advantages of this method are the ability to choose the optimal drug in the right dosage and to conduct antibiotic therapy as accurately as possible.
Gastroscopy in a dream
Conducted in the event that a person is too afraid of the procedure. Sometimes because of fear, or the previous unsuccessful experience, the procedure is impossible. There is a way out: gastroscopy can be carried out in a dream. The patient is given special medications that act like anesthesia. A person is in a state of medication sleep. The doctor is conducting research at this time.
The advantage is that it does not apply anesthesia, and not anesthesia, which have a negative effect on the heart, blood. Special short-acting hypnotics are used, during which a person calms down and falls asleep. Sleep lasts about 20-30 minutes. During this time, the doctor manages to conduct a study.After that, the patient wakes up, does not remember anything. Such a dream is absolutely harmless to the body, does not exert any load on vital organs. Can be used repeatedly. Often used when you need to track changes in the dynamics in the treatment of ulcers. With this diagnosis, procedures are performed 2-3 times a week.
The disadvantage of this method is that the doctor performs almost all blind manipulations. In the usual state, the doctor controls the patient's condition, the depth and strength of the movement, focusing on the reactions and reflexes. During sleep, these indicators are absent. In this regard, the likelihood of damage increases. Also, after the procedure it is impossible to sit behind the wheel for a long time, because the concentration of attention, the reaction rate decreases. Heavy physical exertion is also contraindicated during the day.
Gastroscopy is used primarily for diagnostic purposes. Gives you the opportunity to diagnose various diseases of the esophagus, stomach. Used to confirm inflammatory and infectious processes, such as gastritis, colitis, ulcers. It is the main method that can detect cancer in the early stages. Using this method, you can perform a biopsy and take a scraping from the mucous membrane. Determine the degree of contamination by bacteria of the genus Helicobacter, which are the causative agents of gastritis and peptic ulcer diseases.
Gastroscopy can also be used for therapeutic purposes, for example, to remove polyps, which are formations on the mucous membrane of the esophagus, or in the submucosal layer. They can also manipulate the need to stop bleeding from ulcers. Gastroscopy is used to apply ligatures to the damaged vessels of the esophagus or veins undergoing varicose dilatation. It can be used to extract foreign bodies from the esophagus and stomach.
Also, the gastroscope allows you to make injections directly into the tissue of the stomach and esophagus, inject drugs and irrigate the mucous membranes. Treatment of the vascular and lymphatic systems is also carried out with the help of a gastroscope. The procedure makes it possible to solve the problem of the constricted lumen in the esophagus. If necessary, a special probe is introduced, through which a nutrient mixture is fed into the stomach. The therapeutic effect is achieved by introducing various auxiliary tools into the cavity of the endoscope.
Such a procedure is known as virtual gastroscopy. The essence of the procedure is that special X-rays are used for the study. The image of the esophagus and intestines is displayed on the monitor screen. Usually the image is two-dimensional or three-dimensional. A virtual study is no less informative, gives a clearer image than a regular X-ray study, takes less time. The patient after the procedure does not need help and can immediately go home.
Esophagogastroduodenoscopy and gastroscopy
EGDS - a method of visual examination of the walls of the esophagus, stomach, duodenum. Gives the opportunity to diagnose most of the diseases in the early stages, allows you to visualize the clinical picture of diseases. There is also the possibility of conducting histological and cytological studies, the results of which become known after about 5-7 minutes. During the procedure, the material is sampled for this study.
The duration of the procedure is 10-20 minutes, you need standard training, which is in compliance with the diet and drink. Do not eat food and water for 8 hours before the study. It must be remembered that the procedure has its own contraindications, so the doctor needs to talk about the presence of concomitant diseases and medication.
The essence of the procedure is the introduction into the esophagus of a tiny device containing a sensor. The signals from it are converted into an image on the monitor screen.
A big plus is the ability to diagnose cancer in the early stages, which allows for timely treatment. According to statistics, approximately 80% of patients with cancer learn about their disease only in the later stages. With the help of EGD and gastroscopy, in 99% of cases cancer can be diagnosed at an early stage, or at the stage of nucleation of a cancerous tumor. Also, with the help of this study, it is possible to analyze for lactase deficiency, to determine Helicobacter pylori.
Gastroscopy during menstruation
It is better to postpone the procedure for several days, because during the menstruation the woman's sensitivity increases. This can increase pain and gag reflex. Also during this period, blood coagulability decreases, and the risk of bleeding increases accordingly, even with minimal tissue damage. If there is a need to take a biopsy or remove polyps, there is a risk of bleeding.
First, the patient's age, history of the disease. Subjective complaints and results of an objective examination of the patient are noted. The protocol of gastroscopy shows the state of the mucous membrane of the gastrointestinal tract of the upper sections. The presence or absence of erosion, ulcers, foci of cellular transformation is noted. It is noted whether there is leukoplakia, Barrett's esophagus, or tumor formation. A biopsy is taken, information about this should also be specified in the protocol. If there is a need for therapeutic measures, their essence is also displayed in the protocols.
Separately, the state of the esophagus, stomach, mucous membrane, pylorus, duodenal ulcer, and post-bulbar section is described.
Ultrasound after gastroscopy
Sometimes after gastroscopy may be required and ultrasound. These studies open up completely different patterns of pathology for the physician and provide an opportunity to comprehensively assess the situation. Each of the procedures has its drawbacks as well as its advantages. The doctor makes a choice in favor of a particular technique based on the expected results and what needs to be investigated.
Ultrasound allows you to study the structure of the stomach from different angles, allows you to study the characteristics of blood circulation through the vessels of the stomach. It gives the opportunity to study the state of the neighboring organs, which are located nearby, in the zone of action of ultrasound. There is the possibility of studying the basic processes in dynamics. In addition, this method eliminates the possibility of damage to the walls and mucous membranes. It allows you not to involve the patient in a state of stress, because the method is quite comfortable and natural for a person. There are no contraindications. You can even hold people with a weak heart and psyche.
The disadvantages of ultrasound should include the impossibility of taking a biopsy and physiological fluids for research. With this method, you can evaluate only the external picture of the body. The method is ineffective in the diagnosis of tumors, as it does not make it possible to detect a tumor in the early stages. It is not always possible to diagnose and gastritis.
Thus, each method has its pros and cons. For a more accurate picture, it is better to go through 2 studies. Therefore, they are often appointed together. Ultrasound provides an opportunity to assess the external side, structure and functional activity of organs. With the help of gastroscopy, you can detail the image and examine the organs from the inside. Traditionally, ultrasound is prescribed first, then gastroscopy, which is justified by logic: from the general to the particular. At first the picture as a whole is studied, then it is possible to pass to special cases.
Gastroscopy for children
The principle of the method does not differ from that for adults. The difference is in the size of the probe for ingestion: for children, the probe is shorter and thinner. Diameter - 5-6 mm. Preparation is the same as for adults. It is much more difficult for children to perform gastroscopy, since they are mobile and restless. Many refuse to swallow the tube, arrange tantrums. Psychological preparation and support of a loved one, especially mothers, is important for a child. The study should be carried out with extreme caution, since the mucous and muscular layers are not sufficiently developed, they are easy to damage. Children under the age of 6 years gastroscopy carried out under general anesthesia.
Gastroscopy during pregnancy
In various diseases of the gastrointestinal tract it is often necessary to conduct a study for a woman, despite pregnancy. The procedure begins with the application of a special anesthetic to the larynx and the back of the throat. After the onset of numbness give sedatives. The woman falls asleep, is half asleep, but at the same time with full consciousness, which makes it possible to maintain constant contact. To improve the efficiency of the procedure, air is introduced into the cavity of the stomach. It smoothes the walls and improves visibility. The duration of the procedure varies from 10 to 25 minutes.
In pregnancy, it is used if other diagnostic methods are ineffective. It makes it possible to clearly determine the location of the inflammatory and infectious process, to detect possible pathologies, in particular, cancerous tumors. The procedure is considered safe in the first and the beginning of the second trimester. The main prerequisite for safety is the correct choice of anesthetic. Most commonly used lidocaine. Pregnant food should not be consumed 10-12 hours before the start of the study. Within half an hour after the end of the procedure, one should neither eat nor drink. If a biopsy was performed, the food for the next day should be only warm and soft to avoid complications.
Also, many tend to the feasibility of the procedure in a dream. By themselves, drugs that provide drug sleep, do not harm the body of a woman. But the benefits of them are palpable - the pregnant woman is not nervous, is in a completely calm state, respectively, anxiety is not transmitted to the fetus.
Gastroscopic examination technique
Any instrumental examination of the internal organs requires patient preparation. In the case of gastroscopy, it is the refusal of junk food, harmful habits and medications for a few days. The procedure is performed on an empty stomach in the first morning hours.
Swallowing the probe causes fear and a gag reflex in most people, so local anesthesia is always required before the procedure. This is not enough for some, then other types of gastroscopy, absolutely painless for humans, are used.
Indications and Contraindications
Endoscopic examination is prescribed for any type of stomach pain, as well as heartburn or vomiting. Also, endoscopy can be prescribed for acne, because it is often caused by violations of the gastrointestinal tract. Gastroscopic examination can help in emergency situations, for example, to identify the extent of damage to the stomach lining during a burn or poisoning by pesticides, when other tests are impossible due to the patient’s complex condition.
In order to prevent gastroscopy, it is prescribed to people with a stomach ulcer and polyps in history or atrophic gastritis. Once a year, screening for prophylaxis is also recommended for people with aggravated heredity, such as stomach cancers among blood relatives in previous generations.
It is strictly contraindicated to conduct gastroscopy with:
• infarction or acute heart failure,
• hemophilia, hemorrhagic diathesis,
Also, gastroscopy is undesirable for people with:
• severe obesity,
• scars, oncological formations and varicose disease of the esophageal system,
• a strong increase in thyroid,
• acute inflammatory processes in the oropharynx, rhinitis and enlarged lymph nodes,
Diagnosis without gastroscopy
Some elite clinics provide an opportunity to conduct an examination without the unpleasant procedure of swallowing the endoscope - it is replaced by a disposable capsule consisting of a video camera, a miniature battery and a sensor. As it moves along the gastrointestinal tract, it records information that will be transferred to a computer after processing and processed.
With all the advantages of this method, it is worth remembering the drawbacks: in addition to the high cost of the procedure, the difficulty lies in the fact that the capsule moves erratically and cannot specifically explore certain areas, as well as carry out a detailed fixation of the problems found.
Do not underestimate the importance of the gastroscopy procedure and try to replace it with other studies, because the most complete picture of the disease is very important for the correct treatment of any disease.
Usually a gastroscope examination It is performed in conscious patients. Before they are manipulated, sedatives are injected and the esophagus and root of the tongue are anesthetized with a strong anesthetic.
The procedure is carried out in the supine position, while the back should be absolutely straight. The instrument is inserted through the mouth or nose. Transnasal gastroscopy is less painful, but rarely used, because it does not allow simultaneous treatment.
Several years ago, a new method of gastroscopy appeared in the clinics. It is carried out without the use of a probe and is absolutely painless.
Research tool - A small camera in the form of an ordinary capsule. The patient swallows it and can immediately go home. The capsule takes 3 pictures per second and remembers them. After the miniature device comes out through the anus, the doctor will have information about the condition of the entire gastrointestinal tract.
This study has far fewer contraindications than classical methods. It can be carried out even to people with Lennox-Gastaut syndrome.
Capsule gastroscopy has 3 significant drawbacks:
- high price,
- incomplete information,
- There is no opportunity to carry out therapeutic actions.
When gastroscopy is contraindicated?
Gastroscopy is a very effective medical procedure, but not suitable for all patients.
It is strictly forbidden to conduct a study for people with severely curved spine, after a heart attack, with hemophilia, a high degree of obesity and endemic goiter.
Relative contraindications are considered:
- infectious diseases of the upper respiratory tract,
- aggravation of ulcers or gastritis,
- pathology of the esophagus,
- age less than 6 years.
Gastroscopy is performed with care by persons with severe mental disorders (schizophrenia, Lennox-Gastaut syndrome). Such patients may behave inadequately, their sudden movements can lead to serious injuries. In these cases, the decision on the study takes a doctor, focusing on the general health of the patient.
Gastroscopy with a capsule can be performed even for people with epilepsy (Lennox-Gasto syndrome), esophageal pathologies, and anesthesia allergy. The procedure is contraindicated only for people with bowel obstruction and young children.
Today, painless gastroscopy can be carried out in almost every clinic.