Preparation for esophagogastroduodenoscopy includes: Esophagogastroduodenoscopy is a highly informative method for examining the gastrointestinal tract. Possible complications of the procedure

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 products.
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.

Endoscopic examination of the stomach and duodenum is the “gold” standard in diagnosing diseases of these 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 the internal organs, the doctor can determine the pathological manifestations of diseases, manifested in the form of redness of the mucous membrane, the formation of ulcerative defects, bleeding, or the volumetric 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 an accurate diagnosis. In addition, the doctor can perform minor surgical interventions - to 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 in the upper abdomen, heartburn, a feeling of sourness in the mouth, etc. In each specific case, only the attending physician determines the patient’s indications and contraindications for EGDS.

Gastroscopy makes it possible to detect at the early stages of development a large number of diseases of the gastrointestinal tract, starting with acute gastritis and ending with 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: a general blood test, a general urinalysis, blood tests for hepatitis B, C and HIV infection. Such measures make it possible to identify hidden diseases that 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 products, 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 the lining of the esophagus and stomach, and nicotine stimulates excessive mucus production, 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 warn the attending physician about the presence of allergic reactions to medications.

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 using general anesthesia, the person is placed in a medical facility for 24 hours for constant 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 set of psychological, everyday and medical measures that 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. In 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.

In the case of a 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 has been 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 is one of the modern effective methods for studying the mucous membranes of the upper parts of the human digestive system. This diagnostic method allows you to identify diseases of the stomach, esophagus, and duodenum of various natures. Let's figure out what the EGDS method is based on, how to prepare for the study, and how to decipher the results.

The essence of esophagogastroduodenoscopy

The study can be either planned, recommended in advance by a doctor, or emergency. It is performed using a fiberscope - a flexible probe with an attached small lamp and video camera.

The main advantage of endoscopy over conventional x-ray examination, which was common earlier, is the ability to several times more accurately identify inflammatory processes in the mucous membranes, developing or already scarring ulcers.

If the preparation of endoscopy is prescribed due to suspected cancer of the stomach or esophagus, during the procedure the specialist may also perform a biopsy - tissue sampling for subsequent analysis. The biopsy does not cause additional discomfort to the patient.

Also during the procedure, the doctor has the opportunity to remove polyps, accidentally swallowed small objects, blood clots after bleeding, etc. This makes it possible to exclude abdominal surgery.

Indications for EGDS

The study is performed to determine the nature of such symptoms:

loss of appetite;
unexplained weight loss;
chest pain;
pain in the upper stomach;
a feeling of acidity or bitterness in the mouth;
belching;
chronic heartburn;
quick feeling of fullness in the stomach;
bad breath not associated with poor dental health;
causeless vomiting;
diarrhea with black contents;
problems swallowing food;
disturbances in the passage of food through the esophagus;
regurgitation of ingested food;
chronic cough;
chronic intestinal diseases.

Contraindications for carrying out

Esophagogastroduodenoscopy is prohibited in the following situations:

serious condition of the patient;
myocardial infarction;
post-infarction state;
infectious and acute surgical diseases;
manifestations of atherosclerosis;
abnormal narrowing of the esophagus;
heart failure;
hemophilia;
varicose veins of the esophagus;
mental disorders.

The procedure is performed only by specially trained endoscopists who have been trained in gastroscopy.

How to prepare for EGD of the stomach

You cannot begin research without special preparation. Incorrect preparation or lack thereof can lead to the fact that the results of the procedure will be incorrect and the doctor will not be able to make the correct diagnosis and prescribe the correct treatment.

The main condition for esophagogastroduodenoscopy is the absence of food mass in the stomach and duodenum. That is why the patient must refuse to eat at least 9-12 hours before the procedure.

If the procedure is scheduled for the morning (or the first half of the day), dinner the day before should take place no later than 20-00. It is advisable to eat only light, quickly digestible foods. Boiled egg whites, slimy porridge with water, and chicken broth cooked on the breast work well.

You should avoid salty, sweet, fatty, pickled, spicy foods, baked goods, fast food, flour, citrus fruits, fresh apples, etc. It is unacceptable to drink alcohol and smoke.

In the morning before undergoing the procedure, the patient is strictly prohibited from:

There is;
drink;
chew gum;
smoke;
brush your teeth.

If esophagogastroduodenoscopy is scheduled for the afternoon (although this is extremely rare), the patient is allowed a small light breakfast no later than eight o'clock in the morning. It is best to discuss the menu with the doctor who is specifically treating you.

Also, before endoscopy, the use of various medications that prevent blood clotting is unacceptable. This applies not only to oral drugs, but also to those administered intramuscularly, intravenously, subcutaneously, etc.

What to take for the procedure

You need to take with you to the clinic:

clean sheet or diaper;
shoe covers;
towel;
referral to endoscopy;
previous analysis of esophagogastroduodenoscopy (if any);
outpatient card.

Immediately before EGDS, you need to remove jewelry from your neck, tie, scarf, and glasses. If the patient has dentures or dentures, these should also be removed temporarily.

How is EGDS performed?

The research methodology itself is as follows:

To ensure the effectiveness of the procedure and reduce discomfort, the patient’s pharynx is treated with a local anesthetic spray. Subsequently, for greater relaxation, the patient may be given an additional anesthetic intravenously;
The subject lies down on the couch on his left side. He clamps the mouthpiece in his teeth to prevent uncontrolled teeth clenching during the examination;
The doctor carefully inserts the fiberscope into the esophagus, then into the stomach and duodenum. Air is introduced through the device in order to straighten the lumen of the organs and thereby facilitate examination;
The specialist alternately examines the mucous membrane of the esophagus, then the stomach and duodenum.

During the examination, the patient feels the urge to vomit, salivation increases, and belching may occur. Preparation for endoscopy is also important in order to avoid vomiting during the procedure.

To reduce discomfort during the examination, the patient is advised to take deep breaths and exhales.

The duration of this procedure is only 1-3 minutes.

An incorrectly performed EGD procedure can lead to complications. However, this happens quite rarely. Possible complications include mechanical injuries to the mucous membrane of the stomach and/or esophagus.

Complications from the respiratory and cardiovascular systems are also possible. The risk group includes elderly people, as well as patients with pulmonary pathology, heart failure or stenosis.

If there was food in the patient’s stomach before esophagogastroduodenoscopy, during the procedure it can enter the respiratory tract, and this, in turn, can lead to asphyxia or subsequent pneumonia.

After the examination, the person feels pain or a burning sensation in the larynx. Less commonly, patients experience pain in the stomach area. As a rule, these unpleasant symptoms disappear on their own a day after the study.

The patient can drink and eat food after a few hours, but it should be as gentle as possible.

Interpretation of the results of esophagogastroduodenoscopy

The study is analyzed by a gastroenterologist. Typically, during the procedure itself, the research process is displayed on a computer or TV monitor and recorded. If necessary (at the request of the patient), the data can be printed. This is done to be able to take the images for reading to another specialist or to conduct a medical consultation.

Using the data obtained from endoscopy, the following problems can be identified:

hiatal hernia;
voluminous benign or malignant formations (polyps, cancer, papillomas);
the presence of scars, narrowings, strictures of the stomach, esophagus;
obstruction of the esophagus and/or stomach;
protrusion of muscle walls;
gastritis, peptic ulcer;
gastroesophageal and duodenogastric reflux;
pathological changes in the mucous membrane (erosion, inflammation, ulcers, hypertrophy, atrophy, etc.).

Perform a comparative analysis, focusing on the norms of indicators in the study.

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 are based on the general principles of 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 the 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. This endoscopic examination helps to carry out the necessary thorough examination of all upper gastrointestinal tracts, 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 the pathological changes present. 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 also be prescribed for therapeutic purposes for administering medications, applying clips and ligatures, and performing coagulation of blood vessels during surgery. After performing the procedures, no complications are observed.

Studies may be prescribed for uncontrolled belching and abdominal pain. The examination allows you to detect stomach or intestinal ulcers, tumors, and various pathologies. Diagnosis is also carried out by analyzing Helicobacter bacteria.