Gastroscopy
Gastroscopy is a type of endoscopic examination in which the mucous membrane of the upper gastrointestinal tract (esophagus, stomach, duodenum) is examined. Other alternative names are FGDS (fibrogastroduodenoscopy), EGDS (esophagogastroduodenoscopy), fibrogastroscopy. It is about the same survey, despite the variety of names. You can do a gastroscopy as prescribed by a doctor; you should not prescribe such a study yourself.
Currently, gastroscopy of the stomach is performed using a flexible fibrogastroscope, inside of which a fiber optic system is placed. Due to the mobility of the distal (end) section of the apparatus, it is possible to examine all areas of the mucous membrane of the esophagus, stomach and duodenum. Pain-free gastroscopy is a reality. This procedure can be both diagnostic and therapeutic in nature. Endoscopic operations on the gastrointestinal tract are becoming more and more popular, and sometimes they allow avoiding open surgical interventions (for example, bleeding from a stomach ulcer can be stopped by gastroscopy using various methods - coagulation, clipping).
It is possible to make gastroscopy of the stomach on an outpatient basis, the examination is widespread and is done almost everywhere (polyclinics, private centers). Most often, gastroscopy is prescribed for the patient's complaints of nausea, pain in the upper abdomen, changes in appetite. This examination surpasses all X-ray methods in terms of diagnostic accuracy, allows biopsy and medical manipulations. It is possible to perform gastroscopy for children of all ages.
Indications for gastroscopy
The indications for this examination are wide enough, with any suspicion of a disease of the digestive tract, the appointment of gastroscopy is justified.
- Pain in the upper abdomen, nausea, vomiting, heartburn;
- Signs of bleeding from the upper digestive tract (vomiting blood, loss of consciousness, characteristic stool - melena);
- Signs of poor food passage when swallowing;
- Suspicion of an oncological process (anemia, weight loss, lack of appetite);
- Diseases of other organs of the gastrointestinal tract, in which it is necessary to know the state of the gastric mucosa (for example, acute pancreatitis).
Contraindications
Contraindications for performing gastroscopy depend on the order in which the study is performed. There are practically no contraindications for emergency gastroscopy (for example, with profuse bleeding), and it can be performed even in a patient with acute myocardial infarction.
Contraindications for planned gastroscopy are:
- Severe cardiovascular failure, acute myocardial infarction;
- Acute violation of cerebral circulation;
- Severe respiratory failure;
- Recovery period after acute myocardial infarction or stroke;
- Aortic aneurysm, heart aneurysm, carotid sinus aneurysm;
- Heart rhythm disorders;
- Hypertensive crisis;
- Severe mental disorders.
If there are contraindications, the consultation of an appropriate specialist is required in order to assess the likelihood of negative consequences from the study and to assess its feasibility.
Preparation for gastroscopy of the stomach
For the study, a condition is required that it be carried out on an empty stomach. The last meal should be at least 6-8 hours before gastroscopy. Most often, the procedure is carried out in the morning, so it is enough that the patient does not eat or drink in the morning. If you have removable dentures, they must be removed before testing. In the study, it is important to correctly assess the mucous membrane of the gastrointestinal tract, therefore preparation for gastroscopy of the stomach is very important for the patient. Smoking is prohibited 2-3 hours before the examination. In the case of gastroscopy under anesthesia, the fasting period can be extended to 10-12 hours.
Anesthesia
Pain-free gastroscopy is the wish of all patients. Despite the fact that there is practically no pain during the study, most patients expect them from the manipulation. Usually gastroscopy of the stomach is performed after irrigation of the pharynx with a solution of a local anesthetic (lidocaine), this is done in order to reduce the patient's gag reflex. Sometimes, at the request of the patient (or according to indications), it is possible to conduct a study under general anesthesia (intravenous), but gastroscopy under anesthesia can not be performed on an outpatient basis in all patients.
Technique for gastroscopy
To carry out the manipulation, the patient lies on the table in the position on the left side, with slightly bent legs, the back should be straightened. Gastroscopy under anesthesia can also be performed in the supine position. After the introduction of the gastroscope into the oral cavity, the patient is asked to make a swallowing movement, which facilitates the movement of the apparatus into the esophagus. To suppress the gag reflex, the patient must maintain calm, deep breathing. Air is supplied through the gastroscope to straighten the folds of the gastric mucosa and fully examine the entire mucous membrane. The fear of suffocation during gastroscopy of the stomach is absolutely unreasonable, since nothing interferes with the patient's breathing.
Your doctor will carefully examine the inside of your esophagus, stomach, and duodenum, and take a biopsy (piece of tissue) if necessary. Medical manipulations are carried out by introducing additional instruments into the endoscope channel. Thus, it is possible to remove polyps (as well as submucosal neoplasms) of the esophagus, stomach or duodenum, stop bleeding from ulcers (acute and chronic), apply ligatures to varicose veins of the esophagus, and remove foreign bodies from the stomach cavity.
Gastroscopy for children
Gastroscopy for children has a number of features. Their mucous membrane is thin, vulnerable, rich in blood vessels, the muscular layer of the walls of the organs is poorly developed. Therefore, special endoscopes of a smaller diameter (only 6-9 mm) are used for children. In the younger age group (up to 6 years old), gastroscopy is performed under anesthesia. Children over 6 years of age do not need general anesthesia. An indication for anesthesia is a serious condition of the child or a significant duration of the study in time. Preparation for gastroscopy of the stomach in children does not differ in comparison with adults.
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