What is endoscopy of the stomach
When carrying out endoscopy( gastroscopy, fibrogastroscopy) through the oral cavity and esophagus, an endoscope is introduced into the stomach, which is a fiber-optic tube equipped with a camera with illumination. It is connected to the monitor, on which a picture is inserted from the camera eyepiece. During movement of the device through the larynx, esophagus, stomach, the doctor observes on the monitor all changes occurring in the organs, evaluates the defects.
Indications for endoscopy of the stomach
The method of gastric gastroscopy is used to diagnose a number of diseases( conditions), with a therapeutic purpose for therapeutic or operative manipulation. Endoscopic examination of the stomach is prescribed for:
- Prescriptions, clarification of the diagnosis( including suspected preclinical stage of the pathology) gastritis, stomach or duodenal ulcer, colitis.
- Detection of localization and prevalence of pathological processes.
- Control of the effectiveness of treatment( conservative or operational).
- Biopsies of affected tissue sites( with peptic ulcer disease, the presence of neoplasms).
- Diagnostics of the effects of peptic ulcer disease, revealing cicatrical and inflammatory changes in the gastric mucosa that cause pyloroduodenal stenosis.
- Establishment of causes of anemia of unknown origin.
- Definitions of the source of bleeding.
The procedure of gastroscopy allows you to quickly diagnose. Endoscopy of the upper gastrointestinal tract for medicinal purposes is used for:
- removal of a foreign body;
- stops bleeding;
- administration of drugs before surgical intervention in the gastric mucosa;
- removal of tumors, polyps in the cavity of the digestive system.
Contraindications
Endoscopic methods of GIT examination have a number of contraindications. The procedure is not performed if the patient has:
- Esophageal diseases( cancer, ulcer, constriction) due to the probability of perforation of the wall.
- Pulmonary and / or heart failure of the first-second degree.
- Varicose veins of the internal veins.
- Mental disorder.
- Heart attack, stroke, atherosclerosis.
- Hemorrhagic diathesis.
- Obesity.
- A pronounced general weakness.
Gastroscopy is not carried out with a categorical refusal of the patient from the examination. Do not appoint endoscopy, if the patient is at death. Before endoscopy, a comprehensive medication correction is mandatory. With care for indications, the endoscopy of the upper GI tract is performed for patients suffering from:
- gastric ulcer in the stage of severe exacerbation with the threat of perforation;
- chronic asthma;
- inflammation of the tonsils, pharynx, larynx;
- hypertensive disease of the third-fourth degree, angina pectoris.
Preparation for
In gastroscopy, preparation for endoscopy of the stomach plays an important role in obtaining reliable results. With improperly conducted preparatory measures, there is a possibility of difficulty in studying certain areas due to the accumulation of food or mucus. Planned endoscopy is prescribed for the morning, in the interval between 8:00 and 10:00.This is due to the fact that endoscopy is carried out on an empty stomach, and treatment of diseases of the digestive system requires frequent meals.
Preparation for gastroscopy begins 2 days prior to manipulation:
- From the menu it is necessary to exclude fatty meat, alcohol, dairy products.
- On the eve of a gastroscopy dinner should consist of easily digestible products and be no later than 19:00.
- Forbidden fatty, sharp, fried, salty dishes, chocolate, fresh vegetables, seeds, nuts.
- It is acceptable to use a small amount of low-fat meat or fish, cereal.
- Before using an endoscopic examination, a small amount of loose sweet tea or water without gas is allowed.
- Before going to bed before the endoscopy and 2 hours before the procedure, it is recommended to take 30 ml of antifoam( Espumizan) to get rid of excess gases in the stomach cavity.
If the patient undergoes medical therapy, it is necessary to warn the doctor, as some drugs may distort the results of gastroscopy. These drugs include iron preparations, activated charcoal. Before endoscopy these drugs should be discarded. Under the ban, cigarettes and chewing gums fall because they stimulate the secretion of gastric juice and mucus.
Patients with unstable behavior are prescribed anxiolytics( Diazepam, Relanium, Sibazon, Seduxen) to relieve anxiety and fear of passing gastroscopy. In the event that the patient experiences severe excitement about the impending endoscopy, or if sensitivity is increased, the patient is prescribed an injection of a sedative( Promedol).
Patient for 30 minutes before the onset of gastroscopy is administered Atropine sulfate to reduce motor activity and tone of the esophagus and stomach. Fibrogastroscopy in regular cases is performed under local anesthesia. Anesthetic( lidocaine spray) irrigate the oral cavity, the entrance to the esophagus. Before using the drug, the patient is tested for anesthetic to avoid an allergic reaction. To severely ill patients, general anesthesia is used.
Stages of endoscopy of the stomach
Endoscopic examination of the stomach is performed by placing the patient on the left side. The patient is asked to pull his right knee under his stomach, clasp his arms. A diaper is put under the head, a saliva tray is placed next to it. In the teeth, the patient is injected with a kapa, reminded that there is no need to prevent excessive salivation:
- The doctor begins to insert the probe into the esophagus and asks the examinee to do a swallowing prone motion: this is necessary to avoid getting the endoscope into the trachea.
- For the expansion of the folds of the stomach into the cavity, a portion of air is supplied. If obstacles are encountered in the course of movement of the endoscope, the doctor returns the device 0.5 cm back and neatly repeats the movement along the esophagus.
- After examining the gastric cavity, the diagnostician rotates the endoscope tube around its axis, moving the device to the duodenum.
- During a gastroscopy, a doctor can take photographs of areas of interest to him. At the end of endoscopy of the upper organs of the digestive tract, the device is slowly removed from the esophagus.
Features of the study of the stomach in children
Fibrogastroscopy in children is technically more difficult than in adults. When carrying out endoscopy, flexible probes are more often used, and for performing medical procedures - rigid with a wide cavity for the introduction of instruments. Endoscopic equipment is selected taking into account the age and width of the esophagus. Typically, children for endoscopy of the upper gastrointestinal tract use an endoscope with a width of no more than 0.6 cm.
In preparation for manipulating endoscopy in older children, special attention is paid to psychological preparation. Parents together with the doctors explain to the child the need for the procedure, its importance, tell about all the stages of gastroscopy.30 minutes before the gastroscopy, inject spasmolytic and, if necessary, sedation. Doses of drugs are selected depending on the age and weight of the child. Before the endoscopy, the oral cavity and the entrance to the esophagus are irrigated with an anesthetic( lidocaine).
When gastroscopy in children from birth to 2 months anesthesia is not performed. Children from 3 months to 6 years of age should undergo an endoscopic examination under general anesthesia because of unpredictability and difficulty in controlling behavior. The child is under the control of an anesthetist until the end of the anesthesia or sedative.
Fibrogastroscopy in children is carried out only on an empty stomach. The last meal of the baby should be at least 8-12 hours before the onset of gastroscopy. In infants, the time between the last meal and endoscopy should not be more than 6 hours. In the case of emergency gastroscopy, the remains of food from the stomach are removed using a special probe.
Complications after endoscopy of the stomach
After gastroscopy, complications are extremely rare, but the risk of their occurrence still exists. The cause of complications are improper preparation for endoscopy of the upper gastrointestinal tract and mechanical damage during passage of the endoscope. After a gastroscopy, you may experience:
- trauma, perforation of the upper organs of the gastrointestinal tract;
- allergic reactions to anesthetics used in fibrogastroscopy;
- cardiac rhythm disturbance during gastroscopy;
- aspiration pneumonia due to casting of vomit into the pulmonary system during fibroadastroscopy;
- of laryngotracheitis of traumatic genesis;
- pain in the throat;
- frequent eructations, flatulence, pain in the epigastric region.
In case of severe traumatic injury, reconstructive surgery may be required. Aspiration pneumonia needs antibiotic treatment. At the first signs of deterioration of health after endoscopic examination of the stomach, it is necessary to urgently seek emergency medical care and not to engage in self-medication.
Video
For examination of some internal organs, the endoscopy method is used, during which a special device - an endoscope - is inserted into the cavity of the organ under investigation through natural paths or by operating incisions, punctures. The endoscopic method of research is used in gastroenterology, pulmonology, gynecology, and surgery. Endoscopy of the stomach is the most informative and often used method of gastrointestinal examination. With the help of this method of diagnosis, specialists can assess the state of the lumen of the esophagus, stomach, duodenum.
