Emergency egds. Diagnostic esophagogastroduodenoscopy procedure. Preparing for gastroscopy in a dream

Along with the development of the pharmacological branch of medicine and the discovery of new data on the structure of the body, a huge role is played by the improvement of things that significantly facilitate the work of a doctor. Thus, these are various methods of radiation (fluorography, X-ray, computer, magnetic resonance or nuclear magnetic tomography, angiography), as well as direct visual diagnostics, including various soundings (fibrogastroduodenoscopy, esophagogastroduodenoscopy, uterine probe, coproscopy, capsule video endoscopy, and etc.

Method capabilities

Visual methods allow the diagnostician to directly see in real time the condition of many internal human organs. First of all, this applies to most parts of the food tube, that is, the pharynx, the walls of the esophagus, the stomach cavity, the small and large intestines, as well as the bile ducts and the gallbladder itself are subject to inspection. Thus, it is possible to directly examine the condition of these organs, identify erosions, inflammatory or ulcerative-necrotic changes, tumor processes, and also evaluate the degree of effectiveness of treatment using the resulting morphological picture or be guided by them during surgery. However, the capabilities of these methods are not limited to this, because with the help of probes you can also deliver medicine precisely, take portions of gastric or bile juice, as well as biopsies from various parts for analysis. Thus, the doctor will be able to get a complete picture of what is happening in the body, make a correct diagnosis in a timely manner and correctly prescribe treatment.

Advantages of endoscopy

Esophagogastroduodenoscopy (EGDS) is one of the probing methods that allows you to examine the esophagus, stomach and duodenum using a microcamera. Of course, there is another non-invasive method - an x-ray examination after taking a barium suspension in the form of porridge to contrast the mucous membrane. However, this method has rather limited capabilities and allows you to see only chemical burns, tumor processes, ulcers and erosions in the image. While an EGD examination can also reveal bleeding, take biopsies for microscopic analysis and examine the organs in more detail. Also, this technology allows you to assess the condition of the departments after the procedure, namely healing, integrity of sutures, bruises, remove foreign objects, and diagnose varicose veins of organs.

The essence of EGDS

Many patients who have received a referral from their attending physician for this examination often ask the question: “EGD, what is it?” The abbreviation usually frightens patients and even confuses those who have never encountered visual diagnostics before. So let's try to figure out how it works. Endoscopy of the stomach or other part of the gastrointestinal tract is carried out using a special probe - a flexible, controlled tube consisting of an elastic material and additionally having fiber optics (a kind of camera and light bulb) and manual control technology. This allows you not only to lower it along the gastrointestinal tract, but also to turn it to the sides or down to get a complete visual picture. After the examination is completed, the probe is carefully removed so as not to create iatrogenic mechanical damage to the internal membranes of the organs.

Precautions during the procedure

Since most patients, especially children, are afraid of this study, the doctor must explain to each of them before endoscopy that this, although unpleasant, is a very necessary method for maintaining their health. He should be told that there are probes of different diameters, it takes a little time (literally 20-30 minutes), and immediately before its introduction, the oral cavity is anesthetized using novocaine in the form of an aerosol. It is also necessary to suppress since the probe will irritate the baroreceptors of the pharynx. Therefore, if the patient feels a bitter taste in the mouth or slight swelling of the tongue, this is an absolutely normal reaction to the drug. In addition, after anesthesia, a mouthpiece is inserted - a sterile plastic device to protect the lips and teeth of the subject during insertion of the probe into the gastrointestinal tract.

Additional Research

In parallel with the direct examination, patients with diseases of the cardiovascular system are given a cuff to control blood pressure and an ECG is monitored, and in patients with respiratory failure in the diagnosis, a pulse is additionally measured. Endoscopy has other advantages over radiation. Preparation for the latter is practically not needed and only requires performing the procedure on an empty stomach, if it is early in the morning, or 6-24 hours after the last meal, the time depends on the preliminary diagnosis. Thus, anxious patients with hypersecretion of hydrochloric acid in the stomach require a longer preparation period, from 12 to 24 hours, as well as additional intravenous administration of sedative and analgesic drugs.

In this case, you should ask the patient in advance to come with an accompanying person, and also warn him regarding the EGDS method, that this can become quite traumatic for his internal organs if he does not follow the doctor’s recommendations on the technique of performing the procedure. And also immediately before the examination, it is necessary to remove contact lenses, dentures, and tight clothing. Additionally, the patient should be reminded that he will have excessive salivation during endoscopy, that this is also a normal manifestation of the body’s reaction, and therefore should not be prevented. And to collect saliva, a clean towel (usually brought from home) is placed under the examinee’s cheek, and, if necessary, an electric suction device is applied.

A procedure called esophagogastroduodenoscopy, or EGDS for short, helps to examine the lining of the esophagus and stomach. The study is carried out by introducing a special probe in the form of an optical tube equipped with a video camera into the human body through the oral cavity. Gastroscopy also involves taking a piece of tissue from the organ being examined - a biopsy, to determine the absence or presence of a malignant formation in the stomach. As a rule, it is done from the most suspicious places in the organ.

Such a diagnostic procedure will require careful preparation. It includes cleansing the gastrointestinal tract from the presence of gastric juice with mucus.

Preparation requirements before conducting the study:

1. Avoid drinking alcoholic beverages and spicy foods 3 days before endoscopy.

2. You should not eat 10 hours before gastroscopy.

3. Preparation includes mandatory avoidance of blood thinners.

4. Notifying the doctor about the presence of an allergic reaction to any medications.

When preparing for endoscopy, it is necessary to rinse your throat with an antiseptic in advance, thereby reducing sensitivity. This will make it easier to endure the most difficult initial moment of manipulation - penetration of the fiberscope. You may feel pain during the biopsy. But this procedure lasts only a minute, which does not require special preparation for it.

There is a risk of bleeding during polyp biopsy due to the presence of a dense network of capillaries. This can be avoided by stopping the use of non-steroidal anti-inflammatory drugs and aspirin. You cannot use agents that neutralize hydrochloric acid on the day of esophagogastroduodenoscopy. The reason is injury caused by the probe due to the lack of the necessary fluid.

The preparation process includes signing a paper on the patient’s consent to carry out the procedure with a discussion of the likely consequences and risks.

If you have enough time, try not to eat spicy foods, seeds, nuts and chocolate - at least 2 days in advance. The same applies to alcohol.
You can eat your last meal no later than 6 pm. And dishes should be made from easily digestible foods.
The day before endoscopy of the stomach, do not consume fiber, meat salads with mayonnaise, whole grain bread, fatty meats and fish, and cheeses.

Dinner should consist of a green salad with white chicken. You can eat steamed chicken cutlets, buckwheat porridge and low-fat cottage cheese. Legumes and pearl barley are not recommended.

On the appointed day, preparing the patient for gastroscopy includes:

1. Complete refusal to eat and drink. It is permissible to drink a small amount of water 4 hours before the procedure.

2. If the patient is taking medications in the form of capsules or tablets, you will need to refrain from using them so that nothing interferes with a thorough examination.

3. Stop smoking at least one day before endoscopy.

Examination of the stomach in this way is associated with an enhanced gag reflex. Therefore, it is very important to follow all recommendations in order to avoid unpleasant manifestations during gastroscopy.

In what cases is EGDS prescribed?

A review of the gastrointestinal tract is indicated in the presence of symptoms such as:

Bleeding in the stomach and intestines.
Vomiting blood.
Chair in the form of tar.
Retrosternal or epigastric pain.
Reflux esophagitis.
Dysphagia.
Anemia.
Stomach ulcer with duodenum.
The presence of foreign bodies in the esophagus or stomach.
Postoperative relapse.

With the help of EGDS, it becomes possible to bypass such studies as thoraco and laparotomy. The procedure can find small or insignificant lesions not detected by x-rays. Also, gastroscopy of the stomach allows you to remove soft and small foreign bodies that have entered the body by simple suction. And hard and larger ones are removed with special forceps and a loop (coagulation).

Contraindications

Depending on the order in which the examination is performed, there will be restrictions. For example, emergency gastroscopy of the stomach is done in almost any case, even with acute myocardial infarction.

But with a planned endoscopy of the stomach, there are certain restrictions:

Cardiovascular failure in a severe stage.
Acute myocardial infarction.
Severely disturbed cerebral bleeding.
Respiratory failure (severe).
The recovery period after a stroke or heart attack.
Aneurysm (carotid sinuses).
Disturbed heart rhythm.
Hypertension (crisis).
Severe mental disorders.

All these contraindications require medical consultation to assess the situation and determine the possible consequences - how advisable it is to conduct such an examination of the stomach.

Tips for patients

Before undergoing such a procedure, you must inform your doctor about the following factors:

1. The presence of an allergic reaction to medications. This is especially true for anesthetic and antiseptic drugs.

2. Diseases of the cardiovascular system with the adoption of appropriate remedies.

3. Pregnancy.

4. Diabetes mellitus with insulin use.

5. Previous operations and radiation therapy on the stomach.

6. Pathology of the blood and the use of drugs that act on its dilution and coagulation.

Clothing is also important - spacious and not easily soiled. Do not wear tight belts, tight sweaters, jewelry or costume jewelry. And don’t forget about moral preparation - don’t worry, be nervous or be afraid. It is best to arrive early for an endoscopy, but not too early, so as not to sit outside the office doors for a long time.

For gastroscopy, all previous test results, x-rays and other available examinations will be required. Bring a towel or wet wipes with you to the procedure to clean yourself up after endoscopy of the stomach.

How is gastroscopy performed?

To begin, the person is laid on the surface on his left side with his legs tucked to his stomach and his back straight. If esophagogastroduodenoscopy is performed under anesthesia, the patient lies on his back. After inserting the device into the mouth, the patient must swallow for better movement through the esophagus. To suppress vomiting, you need to breathe evenly and calmly. Air is supplied through a gastroscope to straighten all the folds of the stomach.

Many people have a fear of suffocation, but there is no need to be afraid of this - nothing interferes with normal breathing. Thanks to the introduction of additional instruments, it is possible to remove polyps with submucosal pathological formations in the stomach, esophagus or duodenum. The bleeding of ulcers in chronic and acute form is also stopped, a ligature is applied to the dilated veins and foreign bodies are removed.

Possible complications

Modern medicine has the latest equipment that makes it possible to perform endoscopy of the stomach as safely as possible with minimal risk. Statistics indicate a 1% incidence of complications in patients requiring medical attention. Such consequences include perforation, requiring surgical intervention. There is also a risk of hemorrhage resulting from damage to the wall of the organ being examined or during biopsy and polypectomy.

But all this is very rare. Therefore, the procedure must be done without refusing the appointment, especially in the presence of the above symptoms and indications. In this way, a serious and severe disease developing in the body can be prevented in the early stages.

Endoscopy of the stomach is a diagnostic method that can be used to examine the entire gastrointestinal tract. The second name of this examination is gastroscopy, it is carried out using a probe equipped with a miniature camera.

Today, esophagogastroduodenoscopy is the most effective diagnostic method. It helps to detect the presence of an inflammatory process, tumor formation or erosion. Previously, in order to conduct such an examination, conventional probes were used, which caused a lot of inconvenience and pain to the patient. However, today the diameter of the inserted instrument has significantly decreased in size, making the procedure completely painless.

Indications for EGDS

Absolutely any doctor can refer a patient for gastroscopy, but the main specialists are: gastroenterologist, therapist, oncologist and surgeon. There are many reasons to perform an endoscopy, but since the procedure is extremely unpleasant, people are referred for it only in cases of urgent need.

The main indications for which a patient is recommended to undergo esophagogastroduodenoscopy are:

pain in the chest area while eating;
anemia and weight loss for no apparent reason;
constant bitter taste in the mouth;
diarrhea;
the presence of a foreign body in the stomach.

In addition, the patient is referred for EGD with such signs as:

severe pain in the abdominal area;
frequent or persistent vomiting, nausea, heartburn, acid belching;
a feeling of heaviness in the stomach not only after eating, but also in a state of absolute rest;
flatulence.

Oncologists refer the patient for gastroscopy in case of suspected cancer of the esophagus or stomach, as well as to check for the presence of metastases. A gastroenterologist prescribes endoscopy in case of gastric or duodenal ulcer, for the purpose of prevention after treatment.

In order for the diagnosis to be more accurate, it is recommended to take a number of additional tests, namely blood, urine and feces, undergo a sound examination and do a test for the presence of the Helicobacter Pillory bacterium.

Existing contraindications

As with any other examination, there are a number of reasons why gastroscopy cannot be performed. Contraindications for endoscopy include:

varicose veins on the walls of the esophagus;
atherosclerosis;
acute heart failure or recent myocardial infarction;
high blood pressure;
swelling or narrowing of the esophagus;
the presence of any infectious diseases, hemangiomas.

In addition, gastroscopy is prohibited for patients with mental disorders due to the fact that it is unknown how the patient may behave during the procedure.

Preparing for the examination

Proper preparation for endoscopy plays a very important role, since it determines not only how successful and accurate the examination will be, but also how the patient will feel during the procedure. To prepare for endoscopy, you must not eat foods that cause gas for 12 hours before the procedure, and also not consume fermented milk and dairy products. It is advisable to eat something light during dinner - broth, boiled fish or meat, weak tea or jelly.

Do not forget that meat and fish should be only lean varieties. It is advisable to avoid alcohol, spicy, salty and fried foods three days before the procedure. On the day of the procedure, you must completely avoid eating. You can drink some water, but no later than 4 hours before the procedure. The procedure is usually scheduled for the first half of the day, but if EGDS is performed in the afternoon, you can have breakfast 8–9 hours before it starts. At the same time, do not forget that you only need to eat light food.

The use of medications that can affect acidity, enzymes and contraction of the intestinal and stomach muscles is strictly prohibited. Preparation also includes giving up cigarettes until the examination. Before going to bed, you can take some mild sedative, but only with your doctor's permission. If you are allergic to medications, you must notify your specialist.

An hour or two before the procedure, you should not take any medications, except those on which the patient’s life depends. If the doctor allows, you can take a sedative. This concludes the preparation for EGDS.

Directly during the procedure, the patient should try to relax as much as possible and not worry. Before the procedure, the patient is given local anesthesia - lidocaine, this will help smooth out discomfort and reduce the gag reflex. It is advisable to breathe deeply during the procedure, but a little less frequently than usual.

Before the manipulation, the doctor must be informed of factors such as pregnancy, diabetes, and gastric surgery. It is best to wear loose, non-marking clothes for the procedure and do not use belts. In order to bring yourself back to normal after the examination, you need to bring wet wipes or a towel.

Examination stages

Before starting the procedure, the patient should lie on his left side. In order to reduce the discomfort that occurs when the probe is inserted, the patient's pharynx is treated with lidocaine. Modern gastroscopes are very thin, so they can be inserted both through the mouth and through the nose, without fear of harming the patient’s health, and thanks to the miniature camera at the end of the gastroscope, everything that happens is immediately displayed on the monitor screen.

During the procedure, the doctor carefully examines the patient’s gastrointestinal tract, all changes are immediately recorded on video or photo. If necessary, a piece of tissue is removed for biopsy. During tissue extraction for analysis, the patient may experience pain, but this procedure lasts a maximum of 2 minutes, so it does not require additional preparation.

If a foreign body is present, it is immediately removed by suction, but if the object is large, then it is pulled out with forceps. If polyps are found, they can be removed immediately. After the examination, the gastroscope should be removed as slowly as possible, while the patient should exhale deeply and hold his breath for a while. The entire EGD procedure can take from 20 to 45 minutes in total.

Discomfort from the EGDS procedure can be minimized provided that the preparation was carried out based on all the doctor’s requirements, and in addition, so that the patient does not feel any discomfort, it is recommended to contact highly qualified specialists.

How to behave after the examination

If the examination went according to plan, then there is no need to follow any special regime. If there was no biopsy, the patient can eat within 1-2 hours after the examination. The effect of lidocaine usually wears off within 1–2 hours, and along with it the feeling of a lump in the throat disappears.

If during the examination the patient felt unwell, began to feel nauseous, tachycardia began and blood pressure rose, then the doctor will give the patient the necessary medication and suggest that he spend some time in a horizontal position.

Possible complications

The equipment used for esophagogastroduodenoscopy is equipped with new technologies, thereby minimizing the risk of any complications. The only consequence that can occur is perforation of the gastric tissue, which requires surgery to eliminate. However, these types of complications occur extremely rarely, so there is no need to worry about this.

Esophagogastroduodenoscopy (EGDS) allows you to examine the mucous membrane of the esophagus, stomach and proximal duodenum using a flexible fiber or video endoscope. It is indicated for gastrointestinal bleeding, bloody vomiting, tarry stools, chest pain or epigastric pain, reflux esophagitis, dysphagia, anemia, strictures of the esophagus and gastric outlet, peptic ulcer of the stomach and duodenum; it is also performed to remove foreign bodies of the esophagus and stomach and for postoperative relapses of diseases of these organs. Endoscopy often eliminates the need for diagnostic thoracotomy or laparotomy and can identify small or superficial lesions that cannot be detected by X-ray examination. In addition, EGDS, due to the possibility of performing pinch and brush biopsies, makes it possible to clarify the nature of the lesion identified during X-ray examination. Using EGDS, you can also remove foreign bodies, both small and soft in consistency by suction, and large and hard ones using a coagulation loop and forceps.

Target

Diagnosis of inflammatory diseases, malignant and benign tumors, peptic ulcer disease, Mallory-Weiss syndrome.
Assessment of the condition of the stomach and duodenum after surgery.
Urgent diagnosis of peptic ulcer and damage to the esophagus (for example, due to a chemical burn).

Preparation

The patient should be explained that endoscopy will allow examination of the mucous membrane of the esophagus, stomach and duodenum.
It is necessary to find out whether the patient is allergic to the drugs that are supposed to be used for pain relief, what drugs he is taking, clarify and detail his complaints.
The patient should refrain from eating for 6-12 hours before the test.
The patient should be warned that during the examination an endoscope with a camera mounted at the end will be inserted through his mouth, and also be informed who will conduct the examination and where and that it will last approximately 30 minutes.
When performing emergency endoscopy, the patient should be warned about the need to aspirate gastric contents through a nasogastric tube.
The patient should be warned that in order to suppress the gag reflex, the cavity of his mouth and pharynx will be treated with a solution of local anesthetic, which has a bitter taste and creates a feeling of swelling of the pharynx and tongue; it is necessary that the patient does not interfere with the flow of saliva, which, if necessary, is evacuated using an electric suction.
The patient should be explained that a mouthpiece will be inserted to protect the teeth and the endoscope, but will not interfere with breathing.
Before the study begins, an intravenous infusion system is set up, through which sedatives that cause relaxation are administered. If the procedure is performed on an outpatient basis, it is necessary for the patient to be accompanied home by someone after the procedure, since the administration of a sedative will cause drowsiness. In some cases, they resort to the administration of sedatives that inhibit intestinal motility.
The patient is warned that he may experience a feeling of pressure in the abdomen during manipulation of the endoscope inserted into the stomach and a feeling of distension when insufflating air or carbon dioxide. For anxious patients, 30 minutes before the study, meperidine or any analgesic is administered intravenously; atropine is injected subcutaneously to suppress gastric secretion, which may complicate the study.
It is necessary to ensure that the patient or his relatives give written consent to the study.
Before the examination, the patient must remove dentures, contact lenses and tight underwear.

Procedure and aftercare

The patient’s basic physiological indicators are determined and a tonometer cuff is attached to the shoulder to monitor blood pressure during the procedure.
ECG monitoring is carried out in patients with cardiac disease, and it is also advisable to perform pulse oximetry from time to time, especially in patients with respiratory failure.
When treating the oral cavity and pharynx with a local anesthetic spray, the patient, at the request of the doctor, must hold his breath.
The patient is reminded not to obstruct the flow of saliva from the corner of the mouth. A basin is placed next to the patient for spitting saliva and discarding napkins; if necessary, saliva is evacuated with an electric suction.

The patient is placed on his left side, his head is tilted forward and he is asked to open his mouth. The doctor passes the end of the endoscope through the mouth and into the throat. When the endoscope passes the posterior wall of the pharynx and its inferior constrictor, the patient is asked to slightly extend his neck, while his chin should not deviate from the midline. Then, under visual control, the endoscope is passed through the esophagus.

When the endoscope is inserted into the esophagus to a sufficient depth (30 cm), the patient's head is tilted towards the table to drain saliva from the oral cavity. After examining the mucous membrane of the esophagus and cardiac sphincter, the endoscope is turned clockwise and advanced further to examine the mucous membrane of the stomach and duodenum. To improve visibility during the examination, you can insufflate air into the stomach and irrigate the mucous membrane with water and suck out the secretions.

You can install a camera on the endoscope to take pictures; if necessary, measure the size of the changed area, insert a measuring tube.

By introducing biopsy forceps or a brush, you can obtain material for histological or cytological examination. The endoscope is slowly withdrawn, re-examining suspicious areas. The resulting tissue samples are immediately placed in a 10% formaldehyde solution, smears are prepared from the cellular material and placed in a Coplin vessel containing 96% ethanol.

Warning. When monitoring the patient, special attention should be paid to symptoms of perforation. With perforation of the cervical esophagus, pain occurs when swallowing and when moving the head. Perforation of the thoracic esophagus causes pain behind the sternum or in the epigastrium, which increases with breathing and body movements; perforation of the diaphragm is manifested by pain and dyspnea; Gastric perforation causes abdominal and back pain, cyanosis, increased body temperature and fluid accumulation in the pleural cavity.

Be aware of the danger of aspiration of gastric contents, which can cause aspiration pneumonia.
Basic physiological parameters should be determined periodically.
The appearance of a gag reflex is checked by touching the back wall of the throat with a spatula.
Intake of food and liquids can be allowed only after the gag reflex has recovered (usually 1 hour after the test). You should start by drinking water, then light food.
The patient should be warned about the possibility of belching with insufflated air and a sore throat for 3-4 hours. Throat tablets and gargling with a warm 0.9% sodium chloride solution can alleviate a sore throat.
If pain occurs at the site where the IV is connected, warm compresses are prescribed.
Due to the administration of sedatives, patients should refrain from drinking alcohol for 24 hours and from driving for 12 hours. When performing the study in an outpatient setting, ensure that patients are transported home.
The patient should be warned to tell the doctor immediately if they experience difficulty swallowing, pain, fever, tarry stools, or bloody vomiting.

Precautionary measures

When tissue samples are taken, they should be immediately labeled and sent to the laboratory.
Endoscopy is a relatively safe test; perforation of the esophagus, stomach or duodenum is sometimes possible, especially if the patient is restless or does not comply with the doctor's instructions.
Endoscopy is generally contraindicated in patients with Zenker's diverticulum, large aortic aneurysm, recent ulcer perforation or suspected perforation of a hollow viscus, as well as hemodynamic instability and severe respiratory distress.
Endoscopy can be performed only 2 days after X-ray contrast examination of the gastrointestinal tract.
For patients with carious teeth, it is advisable to administer antibiotics before the study.

Warning. You should pay close attention to the possible side effects of sedatives (respiratory depression, apnea, hypotension, sweating, bradycardia, laryngospasm). It is necessary to have equipment for resuscitation measures, as well as antagonists of narcotic analgesics, in particular naloxone, at the ready.

Normal picture

Normally, the mucous membrane of the esophagus is yellowish-pink in color and has a delicate vascular network. The pulsation of its anterior wall at the level of 20.5-25.5 cm from the incisors is due to the close location of the aortic arch. The mucous membrane of the esophagus at the level of the esophagogastric junction passes into the mucous membrane of the stomach, which is orange in color. The transition line has an irregular shape. Unlike the esophagus, the gastric mucosa has a pronounced folded structure and the vascular network is not visible in it. The duodenal bulb is recognized by the reddish color of its mucous membrane and several low longitudinal folds. The distal part of the duodenum has a velvety appearance and pronounced circular folds.

Deviation from the norm

Endoscopy in combination with histological and cytological examination makes it possible to diagnose acute or chronic ulcers, benign or malignant tumors, inflammatory processes (esophagitis, gastritis, duodenitis), as well as diverticula, varicose veins, Mallory-Weiss syndrome, esophageal rings, stenosis of the esophagus and pylorus , hiatal hernia. Endoscopy can also reveal gross disturbances of esophageal peristalsis, for example with achalasia, but in this regard manometry is a more accurate research method.

Factors influencing the result of the study

The patient is taking anticoagulants (increased risk of bleeding).
Failure to comply with the requirements for the study.
Late delivery of tissue samples to the laboratory.
Lack of proper contact with the patient makes the study difficult.

B.H. Titova

"What is esophagogastroduodenoscopy" and others

The need for examination of the stomach arises in various situations. One of the first-priority studies is esophagogastroduodenoscopy, abbreviated as EGDS. What is esophagogastroduodenoscopy and how to properly prepare for the procedure in order to get an effective result the first time?

The purpose of an endoscopy is a detailed examination of the mucous membrane of the upper digestive system, which is done through endoscopic examination. We are talking about the esophagus, stomach and adjacent segment of the duodenum. To do this, a flexible endoscope with a small diameter is used, which is inserted through the mouth and passes through the esophagus.

Preparation for an EGD study may be required in the following situations:

1. Abdominal pain of unknown cause, heartburn, belching, vomiting and nausea are present.

2. There is often a feeling of heaviness or fullness in the stomach and abdomen.

3. There is a loss of appetite and significant weight loss.

4. A swallowing disorder or difficulty passing food has been diagnosed.

5. Causes of concern include pain in the area behind the sternum or in the upper abdomen.

6. Discomfort is caused by the appearance of a bitter or sour taste in the mouth, bad breath.

7. Diarrhea often bothers me.

8. There is a chronic cough.

Thanks to a sufficiently gentle endoscopic examination of endoscopy, today it is possible to effectively and in the shortest possible time (which is extremely important for effective therapy) to diagnose duodenal or gastric ulcers, identify polyps in the large intestine, and identify developing cancer at an early stage.

The main advantage that EGD of the stomach gives in comparison with traditional X-ray examination is the accuracy of detecting inflammatory changes in the mucosa, developing or scarring ulcers, which has increased several times. If preparation for esophagogastroduodenoscopy is associated with suspected oncology, in addition to a visual examination of the mucous membranes, a biopsy is required to clarify or refute the diagnosis. Tissue for biopsy is taken using a special instrument, without any unpleasant sensations.

Also, during endoscopy it is possible to remove polyps, remove accidentally swallowed foreign bodies, stop minor bleeding, which makes it possible to exclude open abdominal operations. Sometimes the purpose of the procedure is to widen a narrowed area of the esophagus or stomach, or to take material to test for the presence of Helicobacter pylori, a bacterium that causes diseases of the gastrointestinal tract.

Indications for endoscopy include:

1. Differential diagnosis of pathologies of the digestive system. We are talking about peptic ulcers, gastritis, diverticulitis, pyloric stenosis and other disorders.

2. Monitoring the process of treating gastrointestinal diseases.

3. The need for dynamic monitoring of patients suffering from chronic gastrointestinal pathologies.

4. Symptoms suggestive of internal bleeding.

5. Postoperative period of treatment of the esophagus, stomach or duodenum. High-quality preparation for the examination and a carefully performed procedure make it possible to diagnose complications as early as possible and identify pathological changes in the mucous membrane.

Endoscopy of the stomach is contraindicated in the following situations:

The patient is in serious condition.
Atherosclerosis is clearly expressed.
You have recently had a myocardial infarction or been diagnosed with heart failure.
Acute surgical pathologies or infectious diseases have been identified.
There are tumors in the mediastinum or the esophagus is significantly narrowed.
With the development of hemangiomas or hemophilia.
If there are varicose veins in the area of the esophageal veins.
For severe hypertension.
If you have mental illness.

Preparatory activities

Preparing the patient for gastroscopy includes the following activities.

1. The day before endoscopy.

If the examination is scheduled for the next day, dinner the night before should take place no later than 8 pm. At the same time, the menu is allowed to include only light foods that will not complicate digestion. After dinner, you should not consume dairy products.

2. In the morning on the day of the examination.

Further preparation is to exclude breakfast in any form, and you should also not smoke. It is allowed to drink only plain still water in small quantities, unless the doctor has given any instructions regarding fluid intake. The procedure can be carried out exclusively on an empty stomach, so it is prescribed mainly in the first half of the day. If gastroscopy is scheduled for the afternoon, a light breakfast is allowed provided that the examination takes place at least 8-9 hours later.

3. After endoscopy.

After endoscopy of the stomach, eating and drinking is allowed no earlier than 10 minutes later (as soon as the feeling of a lump in the throat disappears). If the study was accompanied by a biopsy, only warm food is allowed on this day, and cold and hot foods are prohibited.

For outpatient gastroscopy, the doctor recommends staying in the office for 5 minutes or even half an hour until the anesthetic substance stops working. During the procedure, the intestines are filled with air that provides improved vision, so slight bloating may occur. The insertion of the endoscope may cause an unpleasant sensation in the throat that will last no more than a day.

As for the results, they are communicated to the patient immediately after the procedure, with the exception of the biopsy, which takes 6 to 10 days to obtain data.

If the preparation before the EGDS study was carried out according to the recommendations, you can count on the maximum reliability and information content of this method. If an inflammatory process is detected in the stomach or foreign formations on the mucous membrane, additional tests and examinations are done so that the overall picture is extremely clear. With the results of gastroscopy, you must contact your attending gastroenterologist, who will determine further diagnostic and treatment tactics.