Endoscopic examination of the stomach and duodenum– “gold” standard in diagnosing data diseases internal organs. Esophagogastroduodenoscopy (EGDS) allows the doctor to examine the condition of the mucous membrane, perform a number of simple manipulations, including taking a piece of tissue for subsequent morphological examination. Despite the high safety of EGD, it is very important that the patient knows how to prepare for examination using endoscopy.
A woman undergoes esophagogastroduodenoscopy
General information about the procedure
EFGDS (esophagofibrogastroduodenoscopy) is carried out in a specially equipped endoscopic room. The main instrument that allows the procedure to be performed is a gastroscope. This is a long flexible probe with a video camera and a light bulb at its end. The resulting image is displayed on a display next to the doctor conducting the examination, and can also be recorded on any storage medium.
Endoscopy is a minimally invasive method for diagnosing diseases of the digestive system.
During an examination of internal organs, the doctor can determine pathological manifestations diseases manifested in the form of redness of the mucous membrane, formation ulcerative defects, bleeding or voluminous growth of benign or malignant neoplasms. In difficult diagnostic situations, it is possible to perform a biopsy followed by morphological analysis of the resulting sample and establish accurate diagnosis. In addition, the doctor can perform minor surgical interventions– stop minor bleeding from the vessels of the mucous membrane or remove a small polyp.
Gastroscopy is performed for patients with symptoms of diseases of the stomach and duodenum, such as nausea, pain syndrome in the upper abdomen, heartburn, feeling sour in the mouth, etc. In each specific case, only the attending physician determines the patient’s indications and contraindications for EGDS.
Gastroscopy allows detection at early stages of development a large number of diseases gastrointestinal tract, starting with acute gastritis, and ending tumor processes in the walls of the organ.
How to prepare for endoscopy?
Preparation for research using endoscopy should be comprehensive and carried out in absolutely all patients. Proper preparation includes:
- A mandatory conversation with the patient, during which the attending physician or endoscopist must explain to him the features of the upcoming examination, possible risks and rules for preparing for endoscopy. Such a conversation plays an important role in a person’s psychological adaptation to endoscopy, which significantly reduces the level of stress and makes the course of the study and the period after its completion easier. If the patient experiences increased anxiety, mild sedatives can be used the day before endoscopy.
- Each patient must undergo a clinical examination by a doctor, as well as undergo a series of tests: general analysis blood, general urine test, blood tests for hepatitis B, C and HIV infection. Such measures make it possible to identify hidden diseases which may cause complications during or after endoscopy, or pose a threat to medical personnel.
- An important point is to follow a diet aimed at accelerating the emptying of the stomach from food. In this regard, 1-2 days before the procedure, it is worth removing all “heavy” foods from your diet. These include: vegetables and fruits, fatty and confectionery etc. Also during this period you should not eat spicy, hot food with a lot of seasonings and spices. Such foods can cause temporary redness of the mucous membranes, which can be mistaken for gastritis.
- Patients should stop drinking alcohol and smoking. Alcohol also has a damaging effect on inner layer esophagus and stomach, and nicotine stimulates excessive mucus formation, which makes it difficult to examine organs.
Drinking alcohol before gastroscopy is prohibited
- 7-8 hours before endoscopy, the patient should stop eating. This time is enough to empty the stomach and duodenum, which is necessary to increase the information content of the endoscopic method.
- If a patient takes any medications, including those for the treatment of diseases of the gastrointestinal tract, he should tell his doctor about it.
- When using local or general anesthesia the patient must notify the attending physician about the presence of allergic reactions to medical drugs.
What to do after the procedure?
After the procedure is completed, you must continue to follow certain recommendations, which include:
- Limit food and drink intake for 30-60 minutes after endoscopy.
- If a biopsy has been performed, the patient should not eat hot, fatty or other “aggressive” foods for one to two days.
- When general anesthesia is used, the person is placed in a medical institution for 24 hours for continuous medical supervision.
After anesthesia, the patient is monitored
- If local anesthesia was used, the patient should not drive vehicles, make serious decisions, etc. for one hour.
- If any symptoms or unusual sensations occur, the patient should contact their healthcare provider immediately.
Proper preparation for endoscopy includes a complex of psychological, everyday and medical measures, which must be completed by the patient before endoscopy. Following them allows you to increase the efficiency of the examination, the information content of the data obtained and reduce the risks of developing undesirable consequences.
Upon examination, you can assess the strength and direction of the waves of gastric peristalsis. Waves of medium strength directed from the esophageal to the pyloric sphincter are considered normal. Their reverse direction indicates GERB. At the end of the examination, the condition of the pyloric sphincter is assessed. U healthy people it is closed. The reasons for its opening may be tumors in the lower lobe of the stomach or upper part of the duodenum, exhaustion of the body, duodenogastric reflux.
Examination of the duodenum
Normally, with FGDS it is possible to examine the bulbous space and evaluate the extra-bulbous region. Their appearance is not fundamentally different from other areas. The mucous membrane should have a pale pink color, be smooth and without defects.
When peptic ulcer or duodenitis, ulcerative formations or erosions appear on it, it thickens and becomes swollen.
An atrophic variant of duodenitis is also possible.
Complications and risks
Modern medicine was able to reduce the risk of various complications to a minimum. This was facilitated by the development of clear criteria regarding the indications and contraindications of the procedure, as well as a step-by-step protocol for its implementation. There are virtually no complications associated with the gastrointestinal tract. Most often, a reaction occurs from other systems, such as the cardiovascular and respiratory systems. And even they are, in fact, just reactions to stress and irritation. Therefore, good patient awareness and adequate doctor work can reduce their risk.
Esophagogastroduodenoscopy (EGD) is an examination of the upper gastrointestinal tract using an endoscope - a long thin flexible tube with a lens at the end. The doctor carefully examines the esophagus, stomach and duodenum. If necessary, he takes a smear or piece of tissue (biopsy) for further examination. A light fixture at the end of the tube allows you to clearly see inner surface gastrointestinal tract. Sometimes a video camera is connected to the device - in this case, the image can be captured on film and photographs taken. The information obtained is of great diagnostic value.
Early diagnosis of stomach cancer allows more than 90% of patients to be cured. That's why preventive examination digestive tract endoscope is of great importance.
How is EGDS performed?
Esophagogastroduodenoscopy is performed in outpatient setting. Before the study, the patient should not eat or drink. The examination usually lasts 10-15 minutes. To ensure that the patient does not feel sick when the instrument is inserted, his throat is treated before the procedure. local anesthetic. During endoscopy, the patient lies on his left side, the doctor usually stands opposite. There are esophagogastroduodenoscopes different sizes, they are also adapted for examining children.
In what cases is EGDS performed?
Today, endoscopy is a routine examination. This study is prescribed for frequent pain, a feeling of heaviness in the upper gastrointestinal tract, as well as for suspected damage to the gastric mucosa. This may be inflammation, peptic ulcer, malignant or benign tumor. The leading symptom is tarry stools. The patient often experiences general weakness, lack of appetite , paroxysmal pain in the upper gastrointestinal tract, sometimes weight loss. Painful swallowing, frequent heartburn and sour regurgitation suggest esophageal disease. If pain occurs after every meal, then this indicates a peptic ulcer of the stomach or duodenum. Examination of the esophagus and stomach in children is carried out to identify congenital anomalies and detect foreign bodies.
Using an endoscope, you can remove small growths of the mucous membrane and examine the place where the excretory ducts of the gallbladder and pancreas flow into the duodenum. Sometimes this way it is possible to eliminate obstructive jaundice caused by pinching of a stone in bile duct. If a pancreatic tumor is suspected, a contrast solution is injected and an x-ray is taken.
Esophagogastroduodenoscopy, like no other examination method, allows us to identify cancer on early stage. Patients at risk are regularly examined. During the examination, the image of the organ is compared with previously taken ones.
What is emergency EGD?
Emergency endoscopy is performed to quickly determine the source of bleeding, for example, in patients with large blood loss. Bleeding can occur as a result of rupture of esophageal varices, as well as in some liver diseases. At heavy bleeding from the stomach, inflammation of the ulcer or hemorrhagic inflammation of the mucous membrane can be assumed.
Is this procedure dangerous?
If an endoscopy is performed by an experienced doctor, then the study does not pose any danger. If tissue sampling is planned, to avoid possible bleeding the study is carried out in a hospital.
Read about FGDS and EGDS to understand the difference between these two studies of the stomach.
If the activity of the gastrointestinal tract is disrupted, patients are prescribed diagnostics using EGDS and FGDS. Both diagnostic methods based on general principles gastroscopy. What are these procedures and how do they differ from each other? Read on.
The procedures are designed to examine the duodenum, intestines and stomach. The main indications for diagnosis are the urge to vomit, discomfort in digestive organs, loss of appetite and weight, suspicion of gastritis, ulcers and cancer. The procedure is performed only by a qualified specialist in a specially equipped room.
EGDS and FGDS: differences
EGDS – esophagogastroduodenoscopy. Given endoscopic examination helps to carry out the necessary thorough inspection of all upper sections Gastrointestinal tract, duodenum and esophagus. It is the ability to study the esophagus that is the main difference between EGDS and FGDS.
FGDS – fibrogastroduodenoscopy. The procedure is performed to examine the stomach and duodenum. Diagnosis can be carried out using an eyepiece device or a video endoscope.
How does FGDS differ from EGDS? Both procedures allow the doctor to clearly see the condition of the mucous membrane of the internal organs of the gastrointestinal tract and identify any existing pathological changes. Assessment using both methods allows you to accurately determine the nature of the disease that has arisen, as well as the localization of the source of inflammation. During diagnostics, polyps can be identified and eliminated.
The duration of the manipulations is about 15 minutes. The procedure can be prescribed with therapeutic purpose for administering medications, applying clips and ligatures, performing vascular coagulation during surgery. After performing the procedures, no complications are observed.
Studies may be prescribed for uncontrolled belching and abdominal pain. The examination can detect stomach or intestinal ulcers, tumors, various pathologies. Diagnosis is also carried out by analyzing Helicobacter bacteria.
Carrying out endoscopy for the stomach is very useful, since today it is one of the most effective methods examination of this digestive organ for the purpose of its further treatment.
With this examination, the doctor can thoroughly examine the condition of the gastric mucosa, identify inflammatory or erosive processes in the walls, and the presence of tumors.
This method is much more informative and more accurate than conventional x-ray examination.
If you properly prepare for endoscopy and follow all the doctor’s instructions, then the examination will take place quickly and practically painlessly.
Endoscopy, indications and preparation
EGDS stands for esophagogastroduodenoscopy. This examination method is also called gastroscopy.
Examination of the stomach is carried out using an endoscope, which consists of a flexible tube, a camera at its end and a lens. The device is inserted into the patient through the mouth and then through the esophagus into the stomach.
Previously, conventional probes were used for such a procedure, and examination of the internal organs was extremely painful.
Currently thanks to modern technologies the diameter of the inserted tube decreased significantly, as a result of which, after examining the stomach, qualified doctor the patient experiences a maximum of mild discomfort in the throat, which is reduced by rinsing.
Esophagogastroduodenoscopy is usually prescribed if the patient has pain, nausea and vomiting, heartburn, belching, feelings of fullness or heaviness in the abdomen, which may be symptoms serious illnesses stomach.
All these conditions may be signs of the development of any diseases in the body, and endoscopy will help to detect them.
Before performing esophagogastroduodenoscopy, the patient must prepare properly, otherwise the doctor will most likely refuse to examine the stomach and prescribe it again the next day.
Preparing for endoscopy first of all involves performing it on an empty stomach, so the examination is usually scheduled in the morning.
In the evening of the previous day, you can eat until 8 pm; dinner should be light, contain easily digestible foods, and in no case should it contain dairy products or alcohol.
The best options for dinner are broth, fish, boiled meat, tea or jelly. Foods must have time to be completely digested before the stomach examination begins.
Sometimes endoscopy is performed in the afternoon, in which case breakfast is allowed light products, but no later than 8-9 hours before the examination of the stomach.
Smoking is prohibited before the examination because tobacco smoke promotes the production of mucus by the stomach walls, which makes examination difficult.
You can drink a little mineral water without gas, maximum 3 hours before endoscopy. It is also prohibited to take medications, especially those that need to be swallowed and washed down.
The only exceptions are for medications taken by injection or if taking the medication is vital.
Before endoscopy, you must consult a doctor and inform him about all existing diseases and health conditions, since this examination of the stomach has contraindications.
First of all, this applies to those who are prone to panic attacks, have heart problems, have recently had a heart attack, have infectious diseases, atherosclerosis or hypertension.
Also, EGDS is prohibited for patients in in serious condition or with a narrowed esophagus.
It is imperative to warn the doctor if you are allergic to lidocaine, since in most hospitals this is the drug used for local anesthesia.
At the beginning of the stomach examination, the person’s throat is treated local anesthesia to reduce pain.
Sometimes certain sedatives are administered intravenously to make the patient more relaxed.
After this, the person is placed on his left side and a plastic mouthpiece with a hole in the middle is inserted into the mouth, through which the endoscope tube enters the stomach.
The device passes through the esophagus and enters the stomach, after which air begins to be pumped into the organ to expand the walls, which allows you to examine their relief in more detail and detect deviations from the norm.
At this point the patient usually begins to discomfort, panic attacks are possible.
Thanks to the camera at the end of the endoscope medical staff can watch the image on a nearby monitor.
Sometimes, during endoscopy, a gastric biopsy is performed in parallel (samples of organ tissue are taken to check for the presence of cancer cells), removal of polyps, removal of various accidentally swallowed foreign bodies from the stomach.
In case of small internal bleeding in the stomach, EGD allows you to stop it without performing surgery.
It is also possible to take material for analysis for the presence in the stomach Helicobacter bacteria pylori
The procedure itself, in the absence of complications, usually lasts no more than 15 minutes.
After examination, the patient usually has a feeling of a lump in the throat and bloating in the abdomen due to the pumped air, but this quickly passes.
Due to the insertion of the endoscope through oral cavity You usually feel discomfort and a sore throat, which goes away after about a day.
The patient remains in the doctor's office for about half an hour until the anesthesia wears off.
During this time, the results of the endoscopy will be ready, the endoscopist will give them to the patient for a further visit to the gastroenterologist, who will advise on the condition of the stomach and further treatment detected diseases.
EGDS today is the best way stomach examinations.
The procedure allows you to identify most diseases of the gastrointestinal tract, study the condition of the walls of the organ, and simultaneously perform other operations, helping the doctor make a decision about eliminating the detected problems.
If the preparation for the examination was carried out correctly and no complications were observed during the examination, then the result of the endoscopy will be as informative and accurate as possible.
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