Endoscopy and its types. What is gastric endoscopy and how to prepare for the procedure? Preparing the patient for endoscopic examination of the stomach

Diseases of the gastrointestinal tract are often asymptomatic, but they progress, which complicates treatment and worsens the prognosis. Endoscopy, one of the most gentle types of predictive medicine services, allows you to look inside the digestive canal, examine and evaluate the condition of the mucous membrane, starting from the esophagus and ending with the deep parts of the intestine.

Characteristics of the method

Endoscopy of the stomach is also called gastroscopy. It is carried out using a device that looks like a flexible tube with an optical fiber inside to transmit the image to the monitor. The shooting is carried out by a miniature camera.

Today, new fiberscopes equipped with video systems have appeared. With them it is possible to obtain a higher quality picture and additional functions, for example, ultrasound examination. Video endoscopes help the doctor to clarify the preliminary diagnosis directly during the examination process.

Endoscopy is prescribed when the disease has not yet manifested itself. It is also carried out on the eve of complex abdominal operations to avoid possible complications. The patient can go home immediately after the procedure.

Endoscopy capabilities

The method allows you to examine the endothelium of the stomach in each of its sections and record what you see. Thanks to endoscopy, the patient’s condition is monitored and the effectiveness of the treatment is determined for its timely correction.

The following pathologies can be detected with an endoscope:

• neoplasms of various types;
• polyps;
• ulcers and erosions of the stomach;
• changes in blood vessels;
• gastritis, inflammatory processes, irritation of the gastric endothelium.

The lesion found by endoscopy may not be visible on x-ray or ultrasound. In parallel with the examination, a biopsy can be performed. The collection of stomach tissue is an almost jewel-like process, so it can only be carried out by an experienced doctor.

Endoscopy of the stomach is safe and painless if preparation for the procedure takes place without errors on the part of the patient and the gastroenterologist.

Endoscopy is a simple method, but not universal. A patient with an acute inflammatory process in the throat, burns in the esophagus, or high blood pressure may refuse the procedure (temporarily). The tap is removed after the patient’s condition improves.

Technical difficulties during endoscopy may arise in the presence of stenoses in the esophagus, as well as cicatricial narrowings in the stomach. In this case, the procedure is feasible using devices with a smaller fiberscope diameter, but severe cases of stenosis result in refusal to conduct the study.

Endoscopy is not possible in patients with:

• mental disorders;
• curvatures of the spine;
• severe form of bronchial asthma;
• aortic aneurysm;
• blood clotting disorders;
• high blood pressure grade 3.

In such cases, they resort to alternative instrumental diagnostic methods, for example, CT or ultrasound.

Planning a procedure requires the most serious consideration. The doctor must know about all the patient’s diseases, both acute and chronic, about existing allergic reactions, and about medications that are constantly taken. Pathologies that are contraindicated during gastroscopy deserve attention. Before manipulation, you will need to cure a sore throat and other throat diseases. The doctor approaches each specific case individually, weighing the pros and cons. In order for the preparation for an endoscopic examination of the stomach to be successful, the patient receives all the necessary recommendations from the doctor and learns in advance about the day of the examination.

Patient preparation

The procedure is usually prescribed in the morning. Therefore, you need to have dinner 10 hours before the procedure. The diet should consist of easily digestible foods.

For 1-2 days you should stick to the diet, excluding from the diet:

• coffee;
• fatty foods;
• hot spices;
• nicotine;
• alcohol and other products that irritate the gastric endothelium.

Otherwise, the research results may be inaccurate.

Some medications, such as anticoagulants, are excluded. Also, 2 days before the procedure, you should not take medications that affect the acidity of gastric juice, otherwise there will be problems determining its true values.

Instead of breakfast, you can drink 0.5 glasses of still water. To alleviate the condition, the patient can take Espumisan. To suppress anxiety, some take Seduxen. In case of increased anxiety, the patient may be given intravenous sedatives or antispasmodics. Before inserting the gastroscope tube, local anesthesia will be required. It is carried out by irrigating the area of ​​the nasopharynx and the initial part of the esophagus with a solution of lidocaine.

It is advisable for the patient to have a clean towel with him, as some patients develop excessive salivation. The duration of the study is 2 minutes. It can only be carried out by appropriately qualified doctors in a special room.

Carrying out the procedure

The patient is asked to lie on the couch on his side and hold the mouthpiece (a device that protects the endoscope). The gastroscope is passed into the oral cavity and swallowed by the patient at the right time. The process occurs without any problems, since the gag reflex is reduced under the influence of anesthetics.

With further penetration of the tube into the esophagus, the following are possible: lacrimation, belching, spasms in the pharynx. There is a deceptive feeling that you can’t breathe. In fact, this is not true, you just need to switch to breathing through your nose. The unpleasant sensations do not weaken or intensify. Having calmed down, all that remains is to endure them. In just a couple of minutes, the endoscope will leave the stomach. True, the numbness will remain for some time. The feeling of sore throat may persist until the end of the day. But after the gastroscopy procedure, not a trace will remain, except perhaps some unpleasant memories.

Complications after the procedure

Endoscopy is considered a fairly safe diagnostic method and complications after it are extremely rare.

They can be called:

• features of the patient's anatomy;
• insufficient preparation for the procedure on the part of the patient;
• low qualifications of the doctor allowed to conduct the study.

If the patient does not comply with the diet requirements, stomach contents may be released into the esophagus, enter the trachea, and develop aspiration pneumonia. If it was not known about the expansion of the veins in the stomach area, bleeding is possible. Rough and indelicate insertion of the endoscope may damage the mucous membrane, even to the point of perforation. This happens in 1% of patients; most are left with only some soreness in the throat area.

You can have a stomach endoscopy at any clinic. It is enough to get in line for an examination with a referral from a therapist. In private medical centers, this service costs from 1.5-3 thousand rubles.

The gastroscopy protocol will help the doctor choose the optimal course of treatment or conduct a more in-depth study of the detected pathology.

Most often, health problems begin at a time when a person does not even think about it. This is especially true for diseases of the stomach and other organs that make up the human digestive system. In order to somehow protect yourself, protect yourself and notice pathologies of the gastrointestinal tract in time, it is important to do an endoscopy of the stomach. Today, laparoscopic examinations of internal organs can be done in almost any clinic.

The term “endoscopy” itself (“endon” and “skopeo”) is translated from Greek as: “inside”, “exploring”. Using easily bendable tubes that are equipped with lighting and optical systems, you can examine the organs of the stomach. This helps to investigate even the most minor violations in a short time. Gastric endoscopy can be considered one of the most favorable and most frequently used diagnostic methods. Doctors will not prescribe any surgical interventions unless in the most extreme cases.

Endoscopy is a modern method of visual and instrumental diagnostics, thanks to which diseases of internal organs can be seen. The endoscope is the main research tool with which this procedure is performed. At one end it has an eyepiece that allows you to observe the picture of the affected area, and at the other there is a camera that transmits the image seen. With its help, qualified specialists can easily detect the problem at a very early stage of the disease and prescribe appropriate treatment in time.

Gastric endoscopy (EGD, esophagogastroduodenoscopy, gastroscopy) is a type of endoscopic examination in which the duodenum, mucous membrane of the stomach and esophagus are examined using an endoscope. This device is presented in the form of a flexible tube, inside of which a fiber-optic system is located. It is thanks to it that the doctor can see a complete picture of the internal organs of the stomach on the monitor, as a result of which he can print the received data on a printer.

Such a study is very important in order to find out the condition of the duodenum and stomach in case of suspected cancer. In addition, endoscopy of the stomach helps to examine the lumen of the esophagus, notice gastrointestinal bleeding in case of gastritis, esophagitis, gastroduodenitis, and establish peptic ulcer of the duodenum or stomach, if any are present in the patient’s body. Endoscopy of the stomach is also performed for additional examination in certain diseases, in order to further clarify the diagnosis.

Preparation for gastric endoscopy

However, this study can only be carried out based on the testimony of a doctor, who must have every reason to conduct endoscopy of the stomach, which will really help in further treatment. In addition, the doctor must be aware of all allergic reactions to medications and concomitant diseases, if they are present in a person’s daily life.

But before that, you need to undergo proper preparation for gastric endoscopy. Don't eat for several hours. Endoscopy should be performed exclusively on an empty stomach, so that food debris does not complicate the examination, which could later be subject to any doubts. Therefore, it would be a good idea to take the last meal before gastric endoscopy eight to ten hours before the examination, no later. A special endoscopy room is allocated for gastric endoscopy, and it is performed exclusively by a specially trained endoscopist.

If such a need arises, endoscopy can be performed under the influence of sedatives and by spraying an anesthetic drug, in which local anesthesia is given to the pharynx and the root of the tongue. Anesthesia can also be used, but it is done extremely rarely, in exceptional cases.

What should a patient do during gastric endoscopy? Firstly, he must behave calmly, evenly, breathing deeply. If necessary, straighten the folds of the mucous membrane. The doctor then pumps in some air and monitors the duodenum, stomach, and esophagus. He can perform a biopsy or endoscopic pH test, stop bleeding or remove polyps, small tumors and administer medications if the person needs it and has the appropriate symptoms. An endoscopy can only take a few minutes. But only after a day all the unpleasant sensations associated with this procedure completely disappear.

Modern technology allows endoscopic examination to be carried out absolutely safely and without difficulty. An exception to the rule may be some complications after the procedure. But such examples are a small percentage. These include perforation of the walls of the organ being examined, mental disorders, damage to the walls with the development of bleeding.

How to prepare for gastric endoscopy?

The rules of conduct before and after endoscopy, which the patient simply must know, have already been described. Now we will talk more specifically.

To do this you need to know the following rules:

• Endoscopy is performed on an empty stomach in the first half of the day;
• If the study is done in the afternoon, then it is important not to eat 7 hours before gastric endoscopy;
• It is allowed to drink water without gases in small quantities - no more than 50 ml;
• Preparing a patient for endoscopy also has its own characteristics, depending on the general condition of the patient and the nature of the study. It can be both planned and emergency.

If a person knows about gastric endoscopy in advance, then he has no right to eat for at least 4 hours before the examination. The time of the last appointment may vary; it is prescribed individually by the doctor. 3 hours before the procedure, the patient needs to take one Seduxen tablet or another tranquilizer. Half an hour before endoscopy, premedication is carried out using anticholinergic drugs (0.5-1 ml of 0.1% atropine sulfate solution combined with metacin or 0.2% platyphylline solution). For easily excitable patients, a dose of 2.5% diprazine solution in the amount of 30-50 mg is prescribed, and local anesthesia is administered 5 minutes before endoscopy. To do this, the patient sits on a chair, after which he must open his mouth deeply and stick out his tongue. After which, doctors wash the back wall of the pharynx and the root of the tongue and treat it with a 1-2% lidocaine solution. This is done in the form of rinsing or irrigation. Next, he is asked to make a swallowing movement to anesthetize the opening of the esophagus. After a few minutes, the patient feels numbness in the throat and some difficulty swallowing. These symptoms and the sensation of a foreign body inside it make it clear that anesthesia is working, and therefore gives a signal that the patient is ready for examination of the stomach. The question of gastric lavage is considered rather ambiguous, since this affects the mucous membrane, and the contents of the stomach can provide additional information.

1. For pyloric stenosis. The day before endoscopy, in the morning and evening, the stomach is washed until its contents literally become clean water.
2. With cardiospasm of 2 and 4 degrees.

The most favorable position for the patient during upper gastrointestinal endoscopy is considered to be on the left side. Sometimes the patient needs to change the position of his body (for example, turning on his stomach, on his right side, etc.). For this, in addition to a separate room, a special table must be allocated, in which the leg and head ends can be adjusted, raising or lowering them, as well as turning the patient in one direction or another.

So, a person who wants to have an endoscopy is placed on a table or couch, on his left side. His left leg should be straightened, and his right leg bent at the knee joint, and then brought to the stomach. The second option for the correct body position during gastric endoscopy should be as follows. Both legs need to be bent and pulled up, arms pressed to the body. An oilcloth pillow is usually placed under the head. The office must be darkened.

Emergency endoscopy is performed if it is necessary to urgently identify the causes of gastric bleeding or remove various foreign bodies of the stomach. To conduct a differential diagnosis of gastric diseases, identify acute surgical diseases, and establish the nature of pyloroduodenal organic or functional stenosis, gastroscopy is also prescribed.

If the patient suffers from diseases of the esophagus, which are associated with the inability to pass the endoscope into the stomach, then this study is contraindicated for him. In cases where there is an increased risk of perforation (for example, with a burn of the esophagus, scar structure, aortic aneurysm, etc.), emergency endoscopy of the stomach is also not recommended. A relative contraindication may include the serious condition of the patient as a whole, which is certainly associated with the presence of certain concomitant diseases. However, even with an acute heart attack or cerebrovascular accident, esophagogastroscopy may be justified, because they are diseases that can pose a threat to the patient’s life.

At the moment, there are only two absolute contraindications to performing gastroscopy under anesthesia - the patient’s dying state and the patient’s refusal to undergo the study.

Many patients are wary of this procedure. However, they have no reason to worry. The use of modern endoscopes can guarantee the relative safety of endoscopy. The only thing to be wary of is the most serious complications, in which damage to the walls of the organs being examined or perforation of the esophagus with a gastroscope occurs. But they are observed mainly, as mentioned above, in elderly patients or patients with unstable mental health, as well as with insufficient anesthesia and poor visibility. It is also worth mentioning the damage to the mucous membrane of the stomach and the gastroesophageal junction. There are even bleedings from these injuries, but they are not so terrible. They can be stopped independently or with the help of endoscopic hemostasis. Injecting a large amount of air into the stomach can also cause the patient not to feel very good. But the good news is that such unpleasant situations are extremely rare, most of which do not pose a great threat to the life and health of patients.

Endoscopy of the stomach for children

Children also have stomach pain, from which they often get painful sensations. In addition, all ailments of the gastrointestinal tract lead to slower growth and development. One of the most common problems is the child’s ingestion of foreign bodies, as well as stomach ailments characteristic of early childhood.

In such cases, experts believe that diagnostics and consultations for infants, premature babies and patients with various chronic diseases are simply necessary. Digestive system problems, acute and chronic diarrhea, periodic abdominal pain, etc., which are common in babies, can be avoided and prevented. Just like in time to provide treatment, diagnosis and monitoring of many problems. These include celiac disease, pancreatic diseases, chronic inflammation and infectious diseases of the digestive system, and inflammatory bowel diseases (IBD).

Modern equipment helps doctors identify and treat various diseases. You can do this using:

• gastroscopy;
• colonoscopy;
• impedansometry of the esophagus;
• dilation of the esophagus;
• removal of foreign bodies, polyps in the digestive system;
• liver and intestinal biopsy;
• endoscopy of the upper gastrointestinal tract.

Capsule endoscopy is one of the safest and easiest ways to obtain test results. As mentioned above, children should not be afraid of anything during capsule endoscopy of the stomach. This test does not cause any pain during or after it.

During capsule endoscopy, children aged 5 years and older swallow the video capsule on their own. If children are younger, between the ages of 1 and 5 years, they will need endoscopic assistance to swallow the video capsule. But, one way or another, it is recommended that children undergo gastric endoscopy if necessary, even on the advice of doctors.

Capsule endoscopy of the stomach

For those who don't want to stick a long, slippery "hose" inside themselves, an alternative procedure may be offered. It is much more pleasant than the first and is called “capsule endoscopy of the stomach.” It is prescribed when the patient needs to examine the esophagus and small intestine. To do this, the patient only needs to swallow a small plastic capsule, which is pre-equipped with everything important for the examination. This includes a special micro-video camera, micro-transmitter, antenna and batteries, which are designed for 8 hours of operation.

A disposable capsule can reproduce more than 50 thousand bright images, 2 photos per second, transmitted to a special device that is attached to the patient’s belt. The camera displays high-quality images, and, as a result, makes it possible to determine and make a diagnosis as accurately as possible. In short, with capsule endoscopy of the stomach, the capsule that the patient swallows goes through the same path as the food consumed every day.

This procedure causes absolutely no imbalance, pain or discomfort. When you expect results, you can do whatever you want, in a word, lead a normal lifestyle - run, eat, sleep... The only thing you can’t do is abuse fitness and hard physical work.

To decipher the results, the doctor must see and analyze more than 50,000 photographs. Due to the resulting picture, which consists of a film showing in which it is shown as if 24 frames per second. This entire period takes 1.5-2 hours. After which all received data appears on the screen and then appears on a form.

There are quite a few undesirable contraindications for examination using capsule endoscopy of the stomach in humans. These include: a difficult patient’s condition, intestinal obstruction. You don't need to spend hours preparing for the video capsule. It is enough to have the last meal 15-16 hours before the start of the study and the person is ready for it.

What are the advantages of gastric capsule endoscopy? It helps to find the original cause of ailments that recur periodically or areas of constant ailments, such as abdominal pain, diarrhea, bleeding or anemia in cases where no other methods work. For some chronic diseases of the gastrointestinal tract, this method helps determine the extent to which the small intestine is affected, or shows the result of treatment already carried out.

Description of the gastric endoscopy protocol

For gastric endoscopy, the description of the protocol must contain the name of the medical center, endoscopy room and or department. All personal data about the patient, including: gender, age, department, ward, category must be noted. Moreover, the apparatus and time of the study, and sometimes the date, must be indicated. The number of the study, the nature of the procedure (planned or urgent, primary or secondary), the proposed method of premedication and anesthesia must be indicated. If any transendoscopic interventions were performed, they must be described in detail. If the endoscopic examination was performed under general anesthesia, it is important to indicate the composition of the anesthesia team and the method of anesthesia that was used.

When conducting an endoscopic examination for emergency indications, the description of the protocol must necessarily contain not only the time of the procedure and the beginning of the procedure, but also the date and conclusions of the endoscopic examination protocol.

In the descriptive part, it is necessary to describe as fully and objectively as possible all the examined sections: the esophagus (including the cardiac sphincter), the stomach and the duodenum. There should be no “important” and “unimportant” points. In addition, evaluation parameters, for example, the lumen of the organ, its contents, the condition of the inner surface of the wall, its elasticity are a very important point in the description of the protocol during endoscopy of the stomach. It is also necessary to give a complete description of the motor activity of the organ, describe the changes, whether they are flat or deep, protruding or not. If focal lesions are identified, for any of them it is necessary to provide characteristics of such parameters as quantity, location, size, characteristics of the base, edge, and surrounding mucous membrane.

When describing the protocol, it is imperative to use uniform terminology. All definitions and terms should allow visual identification of the disease. At the same time, descriptions of the protocol for gastric endoscopy should be simple and easy to read.

The final part of the protocol should contain a brief summary of the results of gastric endoscopy. It is worth remembering that the endoscopic report is not the final diagnosis. In addition, it is absolutely important to write recommendations to the attending physician or the medical team on duty for further management of the patient, as well as the need for additional or repeated procedures.

Endoscopy of the stomach is a method of visual examination of the mucous membrane of the organ using special equipment. During the study, a biopsy can be taken for histological analysis and other therapeutic procedures can be performed. This is the most accurate method for diagnosing diseases of the initial gastrointestinal tract.

Indications for gastroscopy

Endoscopic examination of the stomach is carried out only as prescribed by a doctor. Basically, it is done for prophylactic purposes - to clarify the diagnosis. Using gastroscopy, you can obtain the following data:

• assess the condition of the mucous membrane of the larynx, esophagus and stomach;
• confirm or refute the diagnosis (gastritis, ulcer, polyp, tumor, etc.);
• clarify the localization of the inflammatory focus;
• find out the prevalence of the pathological process;
• determine the effectiveness of the prescribed treatment;
• take a tissue biopsy from the area of ​​the lesion or suspected tumor to make a differential diagnosis.

Endoscopy of the stomach is carried out not only for preventive, but also for therapeutic purposes, because in this case the following actions can be carried out:

• remove foreign body;
• inject medications directly into the mucous membrane of the organ;
• Modern devices make it possible to remove polyps and tumors of superficial localization.

Contraindications for the study

Endoscopy of the stomach has important diagnostic value. However, there are certain contraindications to its use, which are divided into absolute and relative.

It is strictly forbidden to perform gastroscopy on patients who are unconscious, with the development of acute myocardial infarction, cerebrovascular accident and in an agonal state. Contraindications also include chronic diseases of the cardiovascular and respiratory systems in the stage of decompensation. The examination is prohibited for patients who, due to anatomical and topographic changes in the esophagus - narrowing, contracture and other pathologies - cannot be given special equipment.

There are also relative contraindications to endoscopic examination of the stomach. These are stage 3 and 4 hypertension, exacerbation of coronary insufficiency, thoracic aortic aneurysm, serious condition of the patient, inflammatory processes in the nasopharynx and tonsils, mental illness and other pathologies. Fibrogastroscopy is possible after correction and stabilization of the underlying disease in order to avoid the development of complications.

Preparing for the study

During gastric endoscopy, preparation for diagnosis plays an important role in obtaining accurate and reliable data. Otherwise, there is a high probability that the doctor will not be able to examine in detail the area of ​​the organ mucosa that interests him due to the accumulation of food or mucus. As a result, you will need to undergo the examination again.

Diagnostics are usually prescribed the next morning, mainly from 8:00 to 10:00. This is due to the fact that gastroscopy is performed only on an empty stomach, and a person cannot always remain hungry until the middle of the day. After all, the treatment of many gastrointestinal diseases requires frequent meals.

You need to start preparing for endoscopic examination 2 days before the scheduled diagnosis. The patient must follow a diet - it is necessary to exclude fatty meat, dairy products, and alcohol from the diet.

On the eve of diagnosis, the patient is given a light and early dinner. The maximum permissible meal time is no later than 19:00. Fried, spicy, salty foods, fresh vegetables, nuts, seeds and chocolate should be excluded. It is advisable to have low-fat yogurt for dinner so as not to overload the organ with heavy food. Eating porridge, dietary fish or meat is allowed.

If the patient is undergoing treatment, it is imperative to notify the doctor who will conduct the diagnosis. After all, some medications can distort the results. These include activated charcoal and iron supplements, which should be discontinued.

Cigarettes and chewing gum are prohibited. They activate the production of gastric juice and mucus, making examination of the gastric mucosa much more difficult. In addition, they can strengthen the gag reflex, as a result of which this manipulation will bring a lot of unpleasant sensations.

Sensitive and nervous patients who are worried about the upcoming procedure are advised to take a sedative. This will help you relax and reduce mental stress.

On the day of the procedure, it is allowed to drink a small amount of weak sweet tea or still mineral water.

Local anesthesia during fibrogastroduodenoscopy

Gastric endoscopy was previously performed without anesthesia. However, at the moment, before the study, all patients are given local anesthesia. After all, the most unpleasant part of fibrogastroscopy is the insertion of an endoscope into the stomach, which has a rather large diameter.

The anesthetic is sprayed onto the root of the tongue, which effectively suppresses the gag reflex that appears when the device is advanced. Under the influence of the drug, there is a strong decrease in sensitivity and numbness of the tissues. The procedure is easy and painless.

The advantage of local anesthesia is its accessibility to the general public. It can be performed on an outpatient basis as it does not require special equipment.

Before administering the drug, the patient is tested for individual intolerance. Indeed, in the presence of an allergic reaction, there is a high risk of developing Quincke's edema, since the medicine is sprayed onto the mucous membrane of the throat and the root of the tongue.

The test is mandatory for patients who have predisposing factors to the development of a hypersensitivity reaction:

• tendency to allergies of various etiologies;
• history of atopic dermatitis or vasomotor rhinitis, bronchial asthma;
• registered allergic reaction to any drug.

Endoscopy of the stomach can be done under local anesthesia when performing a procedure for diagnostic purposes. After all, the medicine has a limited effect time, which is about 20 minutes. If gastroscopy involves a biopsy and other therapeutic measures, it is necessary to consider other methods of pain management.

General anesthesia

Examination under anesthesia is carried out only for strict indications. General anesthesia is not used solely at the request of the patient, since it has a significant negative effect on the human cardiovascular system.

If it is necessary to perform fibrogastroscopy under general anesthesia, endotracheal anesthesia is usually performed. A preliminary consultation of the patient with an anesthesiologist is mandatory in order to identify possible risks. Patients over the age of 40 must have their cardiovascular system examined, which is subject to increased stress during anesthesia.

Indications for general anesthesia include the following conditions:

1. Severe bleeding from the veins of the esophagus or blood vessels of the stomach. Carries a high risk of aspiration of respiratory tract contents.
2. Carrying out therapeutic actions during fibrogastroscopy, which take a lot of time and are accompanied by severe pain. Some manipulations, such as coagulation of bleeding vessels, removal of tumors, suturing of ulcers, can lead to the development of painful shock.
3. Pathology of the blood coagulation and anticoagulation system, as a result of which there is a high probability of developing massive bleeding.

The advantage of this type of anesthesia is that the doctor can not be distracted by the patient’s reactions, performing a detailed examination of the gastric mucosa and performing therapeutic or surgical manipulations.

Fibrogastroscopy under anesthesia can be carried out in a hospital setting, equipped not only with an operating room, but also with a resuscitation and intensive care unit.

For diseases of the gastrointestinal tract, FGDS is one of the mandatory and most informative research methods. There is no need to be afraid of endoscopy, because thanks to the results obtained, you can make an accurate diagnosis and prescribe the necessary treatment.

Diseases of the gastrointestinal tract are among the most common in the world. One of the main problems of such diseases is the delay in seeking diagnosis and treatment. Often, future patients of the hospital's gastroenterology department ignore the body's signals: pain in the abdomen, abnormal bowel movements, heartburn and other symptoms.

When the first signs of an abnormal state of the body appear, you need to consult a doctor and conduct an examination. Diagnosing the disease at an early stage allows it not to become chronic and allows for rapid treatment.

In addition, with the availability of endoscopic research methods in modern medicine, it will not be difficult to accurately diagnose diseases of the digestive organs in general, and the stomach in particular.

Endoscopic examination of the stomach: methods and indications

Fibrogastroduodenoscopy (FGS) is the most common method of internal examination of the esophagus, stomach and duodenum. In addition to being widespread, this method is the most effective in the timely diagnosis and treatment of gastritis and ulcers.

The FGS procedure is quite simple. The patient swallows a special “probe” with a camera, and the doctor conducts a visual inspection of the surface of the digestive organs. Additionally, it is possible to take internal organ tissue for analysis.

Indications for fibrogastroduodenoscopy are:

Signs of digestive disorders: vomiting, heartburn, diarrhea, constipation, bleeding;

Surgical treatment procedures: local treatment of ulcers, dilation of the esophagus (bougienage), (non-surgical dilation), removal of polyps;

Suspicion of diseases based on the results of conservative tests;

Assessment of intermediate and final treatment results;

Examination before surgery.

If there are indications, the attending physician will schedule a time for the examination. Before this, you need to undergo certain preparation - endoscopy of the stomach is carried out under certain conditions. Before directly inserting the “probe” into the patient’s esophagus, the doctor talks about the patient’s actions at the beginning of the procedure, during it and at the end. The main thing is to follow these recommendations and the discomfort will be minimal.

Preparation for gastric endoscopy

At first glance, it may seem that preparing for gastric endoscopy is a complicated procedure. In fact, it’s just a matter of following certain simple recommendations that will ultimately help the doctor make the most accurate diagnosis and prescribe the correct treatment. General recommendations for preparation:

The procedure is carried out on an empty stomach - at least 8 hours before the procedure you need to exclude food and drink;

Do not consume alcohol and tobacco the day before the procedure and on the day of the examination;

Consult with doctors of other specializations in case of heart and respiratory diseases;

Temporarily stop or reduce the dose (after appropriate consultation with your doctor) of blood thinning medications.

Stomach examination results

It has been experimentally proven that endoscopic examination of the stomach is the most accurate and objective. Based on the results of the examination, a detailed transcript of all anomalies and pathologies that were identified during the procedure is issued. Some endoscopy rooms provide a recording of the examination in HD format.

Obtaining objective data allows you to build the right treatment plan.

Endoscopy is a fairly informative method for diagnosing the digestive tract. In some cases, timely examination can even save lives. Endoscopy of the stomach is a diagnostic procedure that many who have consulted a gastroenterologist have encountered.

Hardware methods for examining the stomach and duodenum are the main link in the diagnosis of diseases of the digestive tract. The procedure for endoscopy of the esophagus and stomach allows you to examine the digestive organs from the inside. Modern endoscopists have devices with a flexible hose equipped with optics at their disposal.

In addition, innovative endoscopic methods for examining the gastrointestinal tract also involve the use of a capsule equipped with a camera. Once in the digestive tract, the camera takes high-quality images that are displayed on a special device. The patient does not experience any discomfort.

Indications and contraindications for gastric endoscopy

Endoscopic examinations of the gastrointestinal tract (gastrointestinal tract) are carried out only as prescribed by a doctor. This procedure may be diagnostic or therapeutic. Esophageal endoscopy is used to evaluate esophagitis (inflammation of the lining of the esophagus). And fibrogastroduodenoscopy (FGDS) also helps to identify various pathologies of the stomach or is used to detect other gastrointestinal diseases.

Gastrointestinal endoscopy is indicated in the following cases:

• abdominal pain of various etiologies;
• suspicion of cancer;
• symptoms of bleeding into the lumen of the stomach;
• anemia without an established cause;
• taking a biopsy sample for a peptic ulcer or when a stomach tumor is detected;
• inflammation of the gastric mucosa or the formation of ulcerative lesions in it.

In addition, endoscopic polypectomy may be performed. Removal of a polyp in the stomach is especially indicated if this neoplasm is of the adenomatous type. In addition, with the help of endoscopic manipulations, it is possible to stop hemorrhage inside the organ or locally introduce the drug into the pathological focus.

Endoscopy allows you to diagnose many gastrointestinal diseases, but patients with the following diagnoses should avoid it:

• epileptic seizures;
• certain pathologies or burns of the esophagus;
• acute coronary insufficiency;
• hypertensive crisis;
• exacerbation of bronchial asthma.

Also, the procedure is not carried out if there are allergic reactions to the antiseptics used to treat the equipment or to the anesthetic used in the diagnostic process. There may also be individual contraindications associated with other diseases.

How to prepare for gastric endoscopy

Preparation for the procedure for endoscopic examination of the stomach begins several days before the planned manipulation. The gastroenterologist or endoscopist will explain to the patient how to properly prepare, and will also give him a special reminder. Preparation for endoscopy of the esophagus and stomach should include the following rules:

1. 3-4 days before the procedure, you should stop taking medications that change the acidity of the stomach. If patients are forced to take any medications on an ongoing basis, this should be agreed with their doctor.
2. You need to review your diet 2 days before the endoscopy. It is important to avoid spicy or fatty foods, as well as alcoholic beverages.
3. 8-10 hours before diagnosis you should completely abstain from food. You can drink water, but in small quantities and without gases.
4. You must come for the examination on an empty stomach.

You should not smoke or chew gum before gastroscopy, as they stimulate the production of gastric juice and mucus, which will make it difficult to examine the mucous membrane. Proper preparation of the patient for diagnosis is the key to its successful implementation. Otherwise, there is a possibility that the doctor will not be able to thoroughly examine the pathological focus in the area of ​​​​which the lighting equipment passes, due to accumulated food or mucus.

How is gastric endoscopy performed?

Endoscopy of the esophagus or esophagoscopy is carried out using a special device inserted through the mouth. The procedure is performed under local or general anesthesia. The position of the patient’s body during the procedure depends on the type of anesthesia: sitting, lying on the back, side or stomach.
When conducting an endoscopic examination of the esophagus, stomach and duodenum or fibrogastroduodenoscopy (FGDS), there is the following algorithm:

1. The patient is placed on the couch, the pharyngeal ring is treated with an anesthetic, and then the patient is asked to hold the mouthpiece in his teeth and try to swallow several times.
2. The introduction of a fiber gastroscope with a fiber tube with optics begins. The diameter of the endoscope is usually 8 mm or more, depending on the age of the equipment in the endoscopy room.
3. The endoscopist examines in detail the mucous membranes of the digestive tract. If necessary, takes a biopsy sample for histological examination.
4. After the procedure, remove the probe with quick movements.

A basic examination of the mucous membrane lasts 5-7 minutes, and if a biopsy of the affected tissue is performed or therapeutic manipulations are performed, the procedure can take up to 20 minutes.

Features of endoscopy in children

Children from 6 years of age are allowed to examine the esophagus, stomach and duodenum with an endoscope with a diameter of 8 mm. For patients aged 3 to 5 years, manipulation is performed using endoscopes with a diameter of 5-8 mm. For children under 3 years of age, the procedure is performed through the nose using probes up to 4 mm.

As a rule, in pediatrics, FGDS is always performed using local anesthetics. The doctor sprays lidocaine into the throat or nose, and after numbness begins to insert the endoscope. The last meal should be 8 hours before the procedure, and if it is a baby, then at least 3 hours should pass after the last feeding.

FGDS allows you to assess the condition of the internal surface of the digestive tract. And if it is necessary to conduct a histological examination of tissues, then the endoscopist carefully performs a tissue biopsy from the pathological focus.

Use of anesthesia during gastric endoscopy

When planning gastric endoscopy, preparation also includes choosing the type of anesthesia. Local anesthesia is considered the safest type. Lidocaine is most often sprayed onto the root of the tongue, but provided that the patient does not experience an allergy from this drug. And in some cases, they resort to sedation, which relaxes, calms the patient and puts him into a light state of drowsiness.

Gastroscopy of the stomach under anesthesia (general anesthesia) is used in cases where it needs to be performed urgently or there is a possibility of stomach contents entering the upper respiratory tract. The stability of patients is usually not affected by local anesthesia. But after the procedure under general anesthesia there can be quite a lot of complications.

Endoscopy is a time-tested diagnostic method that is developing every year and allows patients to come for such a procedure with less fear. In this matter, the main thing is to undergo examination by a good endoscopist using modern equipment.