Egds that shows. What is esophagogastroduodenoscopy (EFGDS). Contraindications for endoscopic examination

Esophagogastroduodenoscopy is a diagnostic procedure aimed at identifying problems in the esophagus, stomach and duodenum. A flexible thin hose is inserted through the mouth opening into the endoscope, on which the camera is installed. Such a study allows you to study the digestive organs in more detail. During esophagogastroduodenoscopy, it is possible to determine any changes, assess the condition of the organs, and, if necessary, obtain material for a biopsy or an analysis for the presence of Hp. In medicine, EGDS is used not only for examination, but also in therapeutic measures (drug administration, blood stopping, removal of polyps and foreign bodies).

Esophagogastroduodenoscopy

Examination of the doctor takes place on the couch. The patient is turned on the left side and through the mouth, while inhaling, a special tube is inserted into him, at the end of which a camera with illumination is installed. During the procedure, a gag reflex often occurs. To prevent the urge to vomit, the patient is offered to calm down and relax, and before the introduction of the endoscope, the throat is treated with an anesthetic. With abundant saliva, it is not worth swallowing or stopping it; for this, a handkerchief or towel is placed under the corner of the lips. If the patient cannot cope on his own, a special electric pump is used.

Throughout the time, discomfort in the abdomen is observed, but this is considered the norm. In order for the procedure to go smoothly, it is necessary to prepare for it psychologically and follow all the requirements of the doctor, not to panic. The diagnostic takes about 20 minutes.

The question often arises, what is the difference between FGS, FGDS, EFGDS, EGDS and videogastroscopy? Let's take a look at the main differences:

Fibrogastroscopy - a procedure for internal examination of the stomach cavity;
Fibrogastroduodenoscopy - examination of the stomach and duodenum;
Esophagogastroduodenoscopy - an examination of the esophagus is also included.
Videogastroscopy is different in that during this procedure a recording is made on a special video surveillance camera;

Indications and contraindications

Any medical manipulation, in particular FGDS and EGDS, has its own contraindications that you need to know. Procedures such as gastric endoscopy are rarely prescribed without serious suspicion of pathology. The most common indications for diagnosis are:

Sudden weight loss;
Diarrhea;
Heartburn;
Nausea;
Vomit;
The presence of blood in the vomit;
Chest pain;
The presence of a foreign body;
Research in the postoperative period to monitor the condition of the operated organ;

Contraindications:

Patient refusal;
Diseases of the cardiovascular system;
Respiratory diseases;
Mental disorders;

Preparation for the procedure

Preparation for esophagogastroduodenoscopy includes a number of activities. It is necessary to prepare for it in advance both physically and psychologically. The right attitude is the key to a quick and painless study.

This method of research may require the results of previous analyzes, if any. It is advisable to have a towel or napkins with you. When choosing clothes for the EGS office, give preference to a simple, loose cut, without belts and belts. You also need to know:

Before a scheduled examination, you should follow a diet for some time (no spicy, harmful, heavy food);
The day before the examination, have a light dinner and before 6 pm;
Before the procedure, you can not smoke, eat breakfast, brush your teeth;
The day before the event, you need to exclude any medicines in capsules;
Be sure to warn the doctor if there have been cases of allergic reactions to drugs and painkillers;

After esophagogastroduodenoscopy (EGDS), it is not recommended to consume food and water, at least for 10 minutes until the feeling of a lump in grief disappears completely. At first, belching of air or numbness in the region of the root of the tongue is possible, but these symptoms disappear quickly and should not cause any concern in patients. The results of gastroscopy (EGDS) are reported immediately after the examination and if problems are found, the patient is referred to a gastroenterologist.

Consequences of egds

After gastroscopy, discomfort remains in the throat area, which disappears after a couple of days. Sometimes there are consequences associated with individual intolerance to anesthesia. Less common are problems due to improper insertion of the endoscope, in such cases it happens:

Damage to the lining of the pharynx, larynx, esophagus, or stomach;
Punching of the stomach;
Bleeding;

Despite the possible complications, do not be afraid and postpone the procedure indefinitely. Remember: diseases of the gastrointestinal tract are very similar, and the diagnosis, made on time and correctly, directly affects the success and speed of recovery of the patient. Modern esophagogastroduodenoscopy allows the diagnostician to see the full picture of the course of the disease and correctly prescribe treatment. Please note that if the next day, after the examination, you find yourself with the following symptoms, this is an occasion to talk to your doctor again:

Temperature rise;
Pain in the digestive system;
Vomit;
Black feces or bloody stools;
Pain in the respiratory area;

Conclusion

Having understood in detail what esophagogastroduodenoscopy is, it is easier to calm down and relax. If you tune in correctly and follow all the instructions of the doctor, then you will not find any consequences after the procedure. EGDS is performed by experienced specialists. Modern equipment allows you to conduct research with minimal risk to health.

Every day, hundreds of people turn to gastroenerologists. The task of doctors is to establish the correct diagnosis as quickly as possible and prescribe the necessary treatment. Such a study is an undoubted assistant in this matter. Take care of your health and visit the doctor on time. With timely treatment, it is possible not only to cure the existing diseases faster and not to start the existing diseases into a chronic form, but also to prevent diseases such as cancer.

Discussion: 2 comments

Even in Western films about alien attacks, I have not seen such atrocities, because the worst fantasies of American science fiction writers can not be compared with the "invention" of Soviet medicine, bastards!

Without this examination, it is impossible to determine the condition of the stomach, esophagus and intestines and the content of bacteria that cause diseases. I had to do this examination more than once. What to do if it hurts. It's okay, Unpleasant, yes, no one died from this.

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Endoscopic examination of the stomach and duodenum is the "gold" standard in the diagnosis of 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 EGDS, it is very important that the patient knows how to prepare for an examination using endoscopy.

Woman undergoing esophagogastroduodenoscopy

General information about the procedure

EFGDS (esophagofibrogastroduodenoscopy) is carried out in a specially equipped endoscopic room. The main tool that allows you to carry out the procedure 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 next to the doctor conducting the study, and can also be recorded on any storage medium.

Endoscopy is a minimally invasive way to diagnose diseases of the digestive system.

During the 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 volumetric growth of benign or malignant neoplasms. In difficult diagnostic situations, it is possible to conduct a biopsy followed by a morphological analysis of the obtained sample and the establishment of an accurate diagnosis. In addition, the doctor can perform minor surgical interventions - stop minor bleeding from the vessels of the mucosa or remove a small polyp.

Gastroscopy is performed in patients with symptoms of diseases of the stomach and duodenum, such as nausea, pain in the upper abdomen, heartburn, sour taste in the mouth, etc. In each case, only the attending physician determines the indications and contraindications for the patient to endoscopy.

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 EGDS?

Preparation for the study 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, the possible risks and rules for preparing for EGDS. Such a conversation plays an important role in the psychological adaptation of a person to endoscopy, which significantly reduces the level of stress and facilitates the course of the study and the period after its completion. If the patient experiences increased anxiety, mild sedatives may be used the day before the EGD.
Each patient must undergo a clinical examination by a doctor, as well as pass a series of tests: a complete blood count, a general urinalysis, blood tests for hepatitis B, C and HIV infection. Such measures can reveal hidden diseases that may cause complications during or after endoscopy, or pose a threat to medical personnel.
An important point is the observance of 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 the 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 products can cause temporary redness of the mucous membranes, which can be mistaken for gastritis.
Patients should stop taking alcohol and smoking. Alcohol also damages the lining of the esophagus and stomach, and nicotine stimulates excess mucus production, making it difficult to see the organs.

Drinking alcohol before gastroscopy is prohibited

7-8 hours before EGDS, the patient should stop eating. This time is sufficient to empty the stomach and duodenum, which is necessary to increase the information content of the endoscopic method.
If the patient is taking any medication, including for the treatment of diseases of the gastrointestinal tract, he should tell his doctor about it.
When using local or general anesthesia, the patient should warn the attending physician about the presence of allergic reactions to medications.

What to do after the procedure?

After the procedure is over, you must continue to follow certain recommendations, which include:

Limit food and drink intake for 30-60 minutes after endoscopy.
If a biopsy was performed, then the patient should not eat hot, fatty and other "aggressive" foods for one to two days.
When using general anesthesia, a person is placed in a medical facility for 24 hours for constant medical observation.

After anesthesia, the patient is monitored

If local anesthesia was used, then for one hour the patient should not drive vehicles, make serious decisions, etc.
If any symptoms or unusual sensations occur, the patient should immediately contact their doctor.

Proper preparation for endoscopy includes a set of psychological, household and medical measures that must be performed by the patient before endoscopy. Following them allows you to increase the effectiveness of the survey, the information content of the data obtained and reduce the risks of developing undesirable consequences.

Esophagogastroduodenoscopy is an endoscopic examination in which the condition of the esophagus, stomach, and duodenum is assessed. During the procedure, an endoscope (flexible hose) is used, which is inserted into the digestive tract through the oral cavity.

Esophagogastroduodenoscopy is superior to radiography in the accuracy of the information obtained in the diagnosis of the following diseases:

inflammatory processes in the mucosa;
ulcerative lesions;
neoplasms.

EFGDS helps to identify pathological processes in the stomach, duodenum. Also, the specialist has the opportunity to identify deviations in the functioning of these organs. With the help of esophagogastroduodenoscopy, you can take a biopsy to clarify the form of the pathology, its etiology. Also, this procedure is used not only for the diagnosis of the disease, but also for other medical purposes.

Esophagogastroduodenoscopy is carried out if it is necessary to introduce medications into the cavity of a certain organ, to urgently stop bleeding, to eliminate small foreign bodies. In most cases, this research method is prescribed for the primary diagnosis of pathology, as well as for regular monitoring of the effectiveness of the prescribed course of treatment.

Attention! Esophagogastroduodenoscopy allows you to accurately identify ulcerative defects, the exact location of the damaged areas, the degree of the pathological process.

This method of research helps to carry out the following activities:

Clarify the number, intensity of ulcerative lesions, the exact location, parameters, the presence or absence of inflammation in the area of the affected mucosa.
Treatment with the introduction of various instruments of medications, as well as laser irradiation of the affected area.

Indications for the procedure

Usually, esophagogastroduodenoscopy is prescribed for people when they go to the doctor with complaints of abdominal pain, frequent nausea, vomiting, heartburn, and problems with swallowing food. This diagnostic study is the most optimal way to identify the causes of hemorrhage from the upper gastrointestinal tract.

Often, EFGDS is performed after surgical operations on the gastrointestinal tract to quickly identify possible complications resulting from intervention in the structure of the affected mucosa. This method is much more effective than radiography, as it allows not only to visually examine the mucous membrane, but also to take a biopsy. If the doctor has to take a biopsy, a special tip is put on the endoscope in advance. The patient does not experience discomfort.

During the procedure, a flexible endoscope must be used. Additional instruments are used if it is necessary to remove polyps, remove foreign bodies, and also stop bleeding. Due to the fact that these measures can be carried out with the help of an endoscope, the patient avoids surgical operations. When performing some manipulations, for example, expanding narrowed areas, patents may experience discomfort.

Attention! To prevent the onset of pain syndrome, medical anesthesia is applied in advance.

Deviations in which EFGDS may be required:

Pathologies	Peculiarities
Pain syndrome of unknown etiology, frequent occurrence of heartburn, vomiting	If using less radical methods it was not possible to find out the cause of persistent nausea, belching after eating, the doctor may also recommend this study.
Chronic heaviness in the stomach, feeling of fullness in the abdomen	Immediately after a meal or regardless of the meal
Decreased appetite causing a person to lose weight	Examination is necessary if you have lost more than 2 sizes
The patient cannot swallow properly, experiences discomfort, while the dependence of the problem on the work of the brain has not been established	It is important to conduct a study if a person indicates problems with the passage of contents through the esophagus
Pain behind the breastbone or in the upper abdomen	May indicate chronic pathological processes in the gastrointestinal tract
Frequent occurrence of a foreign taste in the mouth, an unusual smell	Symptoms are felt when breathing or talking
Diarrhea, other stool disorders	Caused by constant intake of low-quality food
Cough	In the absence of respiratory problems

A person can get the results within 20-25 minutes after the examination, which is necessary for the prompt appointment of effective therapy. In most cases, doctors are able to conduct an examination without damaging the walls of the stomach. The decision to administer pain medication during the examination period is extremely rare.

Attention! With the help of EFGDS, doctors can not only detect ulcerative lesions of the mucosa, polyposis, but also oncological diseases that are in the early stages of development.

The most common indications for EFGDS:

Differential diagnosis of gastrointestinal diseases. With the help of this diagnostic study, it is possible to identify not only ulcerative lesions, but also diverticulitis, pyloric stenosis, and other abnormalities that can become chronic and cause significant harm to the entire body.
Determining the effectiveness of various methods of treatment, monitoring the implementation of therapy.
Regular inspections carried out according to plan. FGDS is often performed to monitor changes in the state of the mucosa in chronic pathologies of the digestive system.
Lack of appetite, pallor of the skin, other symptoms indicating the presence of bleeding in the stomach.
Assessment of the risk of possible development of complications after surgery on the stomach, esophagus or other organs of the gastrointestinal tract.

In order to get maximum efficiency in the implementation of EFGDS, it is necessary to properly prepare for the procedure, as well as come to an appointment with a specialist who will perform a high-quality examination, determine any pathological abnormalities in the structure of the mucosa.

Who is contraindicated for EFGDS?

Deviations in which it is desirable to postpone the procedure or completely refuse to carry it out:

The general serious condition of the patient, improper functioning of vital organs.
Atherosclerosis in an acute form.
A heart attack that occurred recently, heart failure in the acute stage.
Disorders requiring surgical treatment.
Infectious diseases in the active phase.
Large tumors in the structure of the gastrointestinal tract, a strong narrowing of the esophagus.
Hemophilia.
Varicose veins in the gastrointestinal tract.
Hypertension, occurring in an acute form.
Psychical deviations.

How to prepare for the procedure?

In order for EFGDS to be carried out successfully, it is necessary to perform standard activities the day before the procedure, as well as in the morning.

Preliminary preparation

The day before the examination, it is necessary to adjust the daily routine. Do not make even small meals later than 20:00. During the day, eat only those foods that are easily digested, quickly excreted. Avoid dairy products completely.

What to do in the morning?

Do not eat breakfast, and smoking is also completely prohibited. If you are very thirsty, drink water in a minimum amount. To avoid complications, the procedure is carried out exclusively on an empty stomach. Usually a trip to the doctor is planned for the morning. If the examination is scheduled after 14:00, you can have a small breakfast, but only if the procedure will take place in 8-10 hours.

Diet

For 3 days prior to the study, it is necessary to adhere to a slag-free diet. It is advisable to consult with your doctor in advance to choose the exact menu. You can adjust your diet on your own. It is necessary to abandon black bread, various greens, legumes, mushrooms, seeds, in particular, products in the structure of which they are contained, for example, kiwi, grapes.

Attention! You can not take drugs that contain iron, also refuse activated charcoal. Watch your diet carefully so as not to cause indigestion.

Among the priority dishes are broth, boiled chicken, fish. It is advisable to use cheese, white bread, butter. You can eat cookies in moderation. If you are constipated, use laxatives such as Duphalac, Forlax, Microlax.

How is EFGDS performed?

Sometimes, before the procedure, doctors suggest performing anesthesia of the pharynx. For this, local anesthetics are used. In order not to experience discomfort during the study, as well as to relax, the specialist may suggest administering an anesthetic intravenously. The drug and dosage are selected exclusively by the doctor, usually an anesthesiologist is invited for this purpose.

The patient must move to a special couch. Often doctors advise to turn on the left side. The endoscope does not interfere with breathing movements.

Attention! Usually the procedure can be completed in a maximum of 2 minutes.

If the examination was carried out with the use of an anesthetic, the patient is in the office for up to half an hour, since it is necessary to wait for the end of the effect of the anesthetic. Sometimes there is a feeling of bloating due to the fact that when the endoscope is inserted into the gastrointestinal tract, air can enter. There is a risk of discomfort in the throat, usually it passes during the day. After the procedure, you must eat food no later than 21 hours later.

Esophagogastroduodenoscopy (EGDS) - a detailed examination of the mucous membrane of the esophagus, stomach and duodenum is carried out using a special gastroscope probe, to which a lamp and a video camera are attached.

With the help of equipment it is possible:

take high quality pictures;
zoom in, remove the image;
do a test for bacteria, the cause of duodenal ulcers and stomach;
identify inflammation of the mucous membranes at the initial stage;
do a biopsy without causing discomfort;
avoid surgical intervention if any items are swallowed;
remove polyps;
perform a visual inspection of the mucous membrane of the digestive system.

Esophagogastroscopy helps to study in detail the cause of the disease and begin to fight in the near future. This diagnostic procedure has the short name of gastroscopy, sometimes called esophagoduodenoscopy.

Gastroscopy shows the peculiarities of the work of the mucous membrane of the digestive organs and reveals changes in the abdominal organs. The endoscopist examines the peculiarities of the gastrointestinal tract. Thanks to the study, doctors are able to diagnose the slightest changes and prevent the development of more serious diseases. After all, a violation of the functioning of the mucous membrane of even one organ leads to a disruption in the work of other digestive organs, to a decrease in efficiency.

During the examination by the EGDS method, diagnoses are studied:

esophagitis (inflammation) of the mucous membrane of the esophagus;
ulcerative lesions of the gastrointestinal tract;
the presence of neoplasms;
enlargement of the veins of the esophagus;
gastritis;
hernia of the esophagus;
achalasia of the cardia, when the upper and lower sphincter does not function properly;
inflammation of the diverticula;
duodeno-gastric reflux (DGR);
Barrett's syndrome;
mucous colitis;
acute pancreatitis.

Methodology for the EGDS procedure

It is carried out as follows:

The procedure to reduce discomfort and gag reflex includes the use of painkillers. It is performed under general and local anesthesia. This simplifies the examination, the patient does not feel discomfort and does not interfere with the procedure. Anesthesia is prescribed when, in addition to the examination, it is necessary to undergo additional long-term procedures. It is important to take into account the presence of allergic reactions in patients to the elements that make up anesthesia. Anesthesia is administered by an anesthesiologist, who is called upon to correctly select the drug and the amount administered. If there are risks associated with the use of anesthetic drugs, the procedure is prohibited.
The patient lies on the left side, a mouthpiece is inserted into the mouth so that the lips do not compress during the procedure.
The endoscopist smoothly inserts the gastroscope and proceeds to examine first the esophagus, then the stomach and its antrum, and lastly the duodenum.
Air is supplied through special equipment to straighten the folds, which makes it easier to inspect.

To reduce the patient's pain, deep breathing movements are performed. The procedure takes 3 minutes. After esophagogastroduodenoscopy, discomfort in the larynx is possible.

At the end of the study, in the absence of negative consequences and a biopsy, food is taken after two hours. If complications arise during the procedure, the patient will be given medication and you need to lie down until the condition improves.

Classification of fibrogastroduodenoscopy

The research method of fibrogastroduodenoscopy is divided into areas:

Planned treatment and diagnostics.
Emergency procedure.

Planned treatment includes diagnostics to determine the disease of the gastrointestinal tract.

An emergency procedure includes the removal of foreign bodies from the stomach and abdominal cavity, diagnosis for acute pain.

Factors to be considered for the study

For the study take into account:

mucous membrane of the stomach, intestines;
the presence of erosion, inflammation;
the presence of neoplasms and taking a sample for histological microexamination;
reduced passage of food through the esophagus;
study of ulcerative lesions of the stomach, intestines.

Possible complications after gastroscopy

EGDS is performed by a competent specialist. Otherwise, this leads to deterioration: to microtrauma of the mucous membrane, to malfunctions of the vascular system, lungs, to an increase in pressure.

If food is present in the stomach during the procedure, it will enter the lungs, leading to asphyxia or pneumonia.

Preparation for the study of EGDS

To undergo EFGDS, you need to prepare in advance. The examination is carried out on an empty stomach early in the morning, the last meal is no later than 9 pm. The esophagus, stomach, and duodenum must be empty for examination. The last dinner should not contain dairy products and carbonated drinks, you can not take medications and refrain from smoking, it is recommended to take a sedative medicine. Before the procedure, remove glasses and all accessories from the neck.

During the procedure, do not worry, the anesthetic will muffle the discomfort. If the preparation for the EGDS study is done according to the requirements, the procedure is smooth and painless.

If preparation is prescribed to check for the presence of oncological diseases, EGDS is combined with a biopsy, material is taken for histological examination. During the procedure, the patient does not experience discomfort.

Take with you:

clean diaper;
change of shoes;
referral to the procedure;
medical card.

It is necessary to warn the patient in advance to come with an escort if help is needed.

Indications and contraindications for the procedure of esophagogastroduodenoscopy

Various doctors offer to undergo an EFGDS examination, but you should not go through it without the need, the procedure is not pleasant. Basically, the problems associated with the stomach and intestines are solved by a gastroenterologist.

Indications for esophagogastroduodenoscopy (EFGDS):

loss of appetite;
nausea and vomiting;
feeling of heaviness, pain and swelling of the abdominal cavity;
difficulty in swallowing;
suspicion of oncological diseases;
control of rehabilitation and recovery.

Contraindications to EFGDS

severe mental disorder;
recent infectious diseases;
angina;
attacks of bronchial asthma;
circulatory disorders.

Deciphering the results of gastroscopy

To decipher the results of the survey, you need to decide what the indicators are in the norm, and make a comparative analysis. For each digestive organ, norms are established.

Indicators of the norm of the digestive organs of a healthy person:

The mucous membrane of the esophagus. Pay attention to color and texture. In a healthy person, the color of the esophagus should be pink or red, and the composition of the structure should be fine-fibered, the length of the esophagus should be 25-30 centimeters.
Stomach. It has a brighter color than the esophagus, usually red. One side of the stomach is smooth, a small amount of mucus is allowed. The other side has a folded appearance.
The mucosa of the duodenum. This is a small tube, with a circumference of up to 3.5 centimeters. Sheath color is light pink. There is one fold, two ducts - bile and pancreatic. The ducts are connected to the gallbladder and to the pancreatic gland.

Indicators of the organs of the stomach, intestines with pathology

Indicators cause concern if found during the examination.

With gastritis, the mucous membrane of the stomach swells, pinpoint hemorrhages or erosions, a significant amount of mucous substance and an increase in the number of folds on the membrane are found.
With a stomach ulcer, the study immediately reveals ulcerative formations, their shape and color characteristics. Ulcers usually have the form of a convex roller, the bottom of the ulcer contains a white coating.
In the presence of a tumor or cancer of the stomach, longitudinal folding is observed, the color of the mucous membrane becomes white or gray. During the study, if there are neoplasms, they are immediately visible, even small ones up to 1 mm.

It is important to realize that the decoding of the results of gastroscopy is done by a qualified specialist in order to avoid making mistakes. There are many pathological changes that only the attending physician sees.

Advantages of EGDS in comparison with other methods of examination of the gastrointestinal tract

Esophagogastroduodenofibroscopy is one of the effective methods for examining the esophagus, the lining of the stomach and duodenum. There are other methods for examining the mucous membrane, but the difference between them is significant, since they have limited capabilities.

Advantages of gastroscopy:

diagnostics of education at the initial stage;
take pictures and watch videos at the same time;
combine two procedures at the same time: diagnostics and taking material for a biopsy;
identifies difficult-to-diagnose diseases.

Gastroscopy is intended for every person who wants to check the state of health, as this equipment is available in many clinics. This study is also carried out for therapeutic and prophylactic purposes. This method can allow to identify the most serious diseases in the early stages of development.

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Classmates

The gastrointestinal tract is a kind of laboratory, on the correct operation of which the saturation of the whole organism with useful and necessary substances for life depends. In the event of a failure, most vital processes are disrupted. Nowadays, gastroenterological problems haunt many.

There are many reasons for the development of such diseases: frequent stress, malnutrition, serious psychological disorders and polluted ecology. But as a rule, patients are in no hurry to seek help from gastroenterologists. When this still happens, then in the course of a comprehensive examination, the patient may be prescribed esophagogastroduodenoscopy.

At the end of the century before last, endoscopic examination of internal organs began to be practiced, but the equipment was so imperfect that this method was abandoned for many years. And only in the 60s of the last century they remembered it and began to actively develop it. Patients have heard various terms and they are not always clear to people without a medical education. Therefore, more often than others, such a question sounds - what is it?

Esophagogastroduodenoscopy (EGD) is an examination of the esophagus, stomach, and duodenum using a flexible endoscope. It is more common for many to call such a study - EGDS gastroscopy. In fact, we are talking about the same diagnostic technique. If, during the manipulation, the esophagus is not examined, then they speak of fibrogastroduodenoscopy (FGDS).

Gastroenterologists widely practice the use of such endoscopic methods for therapeutic and diagnostic purposes. Modern endoscopes are equipped with various types of flexible glass fibers and additional devices that allow you to perform the following manipulations during the study:

examination with biopsy (taking a biopsy for histological examination);
assessment of urease activity for Helicobacter pylori in vitro in a biopsy;
targeted therapy of parts of the affected organ (ulcer, erosion);
sampling of biomaterial to identify pathogens;
extraction of small foreign bodies;
cauterization with locally applied electric current;
stop bleeding;
microsurgery (resection of a polyp, a small tumor).

Esophagogastroduodenoscopy is performed in such cases:

the need to diagnose diseases of the upper digestive tract;
the patient often experiences pain behind the sternum, complains of a violation of swallowing and a burning sensation in the esophagus;
violation of the evacuation of food from the stomach against the background of scarring of the initial section of the duodenal bulb or the pyloric section of the stomach;
suspicion of the presence of an oncological process in the upper digestive tract (the patient is rapidly losing weight, there is a persistent decrease in hemoglobin);
suspicion of bleeding from the veins of the esophagus against the background of portal hypertension;
determination of the source of bleeding in the stomach and duodenum;
diagnosing a through defect of a hollow organ or the spread of a pathological process outside the organ against the background of peptic ulcer;
diagnosis of traumatic injuries and detection of foreign bodies in the upper digestive tract.

This method makes it possible to detect diseases at the initial stage of development, while other diagnostic methods are not always able to do this.

Training

Before going to the endoscopy room for manipulation, you need to figure out how to prepare for EFGDS. It all starts with a conversation with your gastroenterologist, during which various issues that may concern the patient or doctor should be clarified. The patient must psychologically tune in to the procedure, so he has the right to find out in detail what will happen to his body during the diagnostic process, which he will feel how long it will last and what informational value such an examination has.

It is the patient's responsibility to provide the physician with their medical record and report any chronic illnesses and any history of hypersensitivity, as this may affect the use of drugs during the study. Correction of diseases potentially dangerous for esophagogastroduodenoscopy should be made. As a rule, special attention is paid to the cardiovascular and respiratory systems. Diseases of these organs can lead to serious complications.

Direct preparation is as follows. The patient must adhere to a special diet. Two days before EGDS, food that can injure the mucous membrane (spicy dishes, seeds, nuts) should be excluded, and sparing, easily digestible food should be preferred. You will also have to give up alcohol. The last meal should take place 12 hours before the scheduled manipulation.

Take the drugs recommended by the gastroenterologist. Most often appoint Espumizan. This is necessary to reduce gas formation and remove them from the digestive tract. This technique will not only reduce discomfort during the procedure, but also reduce the time of the study. Particular attention should be paid to clothing. It is better to give preference to those elements of the wardrobe that fasten with buttons, and do not wear through the throat. Clothing should be comfortable and not branded.

Refusal of perfumery. Even if the patient does not suffer from allergies, then one should think about the medical staff or other patients who will also do an endoscopy.
Smoking before the diagnosis should not be. Nicotine increases the gag reflex and increases the amount of mucus in the stomach, making examination difficult.

Conducting research

To reduce discomfort during the procedure, as well as to weaken the gag reflex and the urge to cough, an antiseptic in liquid form is used. When applied to the mucous membrane, its action begins very quickly, and at the end of the manipulation, it also stops its action quite quickly.

A special mouthpiece is inserted into the patient's mouth, which will protect the teeth and endoscopic equipment from biting. It is recommended to remove removable dentures first. A sedative may be given to reduce nervousness and fear. Therapeutic and diagnostic esophagogastroduodenoscopy is performed with the patient in the lateral position, preferably the left one.

After the anesthetic begins to act, the procedure is performed according to the following plan:

A flexible endoscope is gently inserted through the patient's mouth, overcoming the esophagus, stomach and into the duodenum. Air is supplied to the equipment to facilitate viewing of the mucosa by expanding the lumen of the organs.
In order not to interfere with the advancement of the endoscopic equipment, the patient must be absolutely still. At this point, he needs to concentrate on his breathing, which should be deep and slow.
The task of the endoscopist is to carefully examine the mucosa of all upper organs of the digestive tract. If necessary, a biopsy can be taken for further histological examination.
If EGDS is not only diagnostic in nature, then in the process a narrowed section of the esophagus can be expanded, small foreign bodies, polyps, and small tumors can be removed.
In order not to provoke the urge to vomit, it is better to abstain from food for an hour after the manipulation. The duration of the study is from 5 to 20 minutes.

Patient reviews

Before doing such a procedure themselves, people want to know reviews about EGDS from those who have already experienced this.

When conducting an EGDS study, the quality of the equipment and the experience of the endoscopist are of great importance. The technical characteristics of modern endoscopes allow you to examine all parts of the esophagus, stomach, duodenum, examining even the most difficult areas. If you discard all fears, then you can diagnose various diseases at an early stage or make sure that everything is in order with the body. And it's worth it.

Early diagnosis of diseases of the gastrointestinal tract is an important element in the prevention of oncological pathologies of the stomach and intestines, the prevalence of which reaches approximately 30.1% among all patients with diagnosed malignant tumors. Some diseases of the intestines and stomach, for example, atrophic gastritis or perforated ulcer, are considered precancerous conditions, and early detection of these diseases significantly increases the chances of a favorable prognosis for future life and health.

There are several methods for diagnosing the digestive tract (radiography, breath tests, ultrasound, intragastric pH-metry), but the main method for effective and early diagnosis is esophagogastroduodenoscopy.

EGDS is the most informative method for diagnosing the gastrointestinal tract

Esophagogastroduodenoscopy - what is it

Esophagogastroduodenoscopy (abbreviated as gastroscopy or EGDS) is an examination of the mucous membranes of the digestive tract, which is performed using a fiber-optic device in the form of a long flexible tube.

The gastroscope is inserted into the patient's gastrointestinal tract through the mouth, so the procedure requires some preparation, which may also include medication correction. With the help of fiberoptic or optical gastroscopes, it is possible to obtain data on the state of the mucous membranes, the presence of erosive lesions and ulcerative defects, to identify signs of inflammatory processes (hyperemia, swelling, the presence of bleeding areas).

With the help of EGDS, various defects of the stomach can be detected

During the examination, the doctor may also perform a biopsy of pathologically altered areas in order to exclude the risk of a malignant course of certain diseases, as well as to determine the histological nature of the existing formations. Endoscopy allows you to identify the presence of cysts, polyps, tumors, their location, size and shape, which makes it possible to draw up a protocol for primary therapy for various tumor formations.

With the help of the procedure it is possible to identify cysts, polyps and tumors

With esophagogastroduodenoscopy, the central sections of the digestive tract are examined, which include the esophagus, the pyloric part of the stomach, as well as the bottom and body of the organ, and the duodenal intestine (duodenum). This type of examination is used not only for diagnostic purposes, but also has many other possibilities, for example:

local administration of drugs;
removal of foreign bodies;

Removal of a foreign body from the stomach

You can track the dynamics of ulcer scarring

Important! In some tumors of the gastrointestinal tract, EGDS allows you to make a preliminary conclusion about the stage of cancer (to confirm and clarify the diagnosis, a tissue biopsy is required, followed by a histological examination of the biomaterial).

What does stomach cancer look like on EGD?

Indications for appointment

Esophagogastroduodenoscopy is included in the list of mandatory diagnostic procedures for suspected inflammatory, tumor or destructive pathologies of the gastrointestinal tract. This diagnostic method is also used to detect hidden bleeding in the presence of appropriate symptoms (bloody vomiting, black tarry stools, abdominal pain of high intensity).

The main indications for which a therapist or gastroenterologist prescribes EGDS are:

abdominal pain localized in the upper or central part of the abdomen, unspecified etiology;
a quick feeling of fullness after eating or, conversely, a feeling of hunger after eating (a possible symptom of peptic ulcer);

Sometimes after a short period of time after a hearty meal, a person feels hungry.

In some cases, the appetite is completely lost.

An unpleasant taste of bitterness appears in the mouth

There is a feeling that there is a foreign object in the throat

Note! Esophagogastroduodenoscopy can be used as an auxiliary diagnostic method for some pathologies related to gastroenterology, for example, systemic allergies or neurotic disorders. About 35% of pathologies of the gastrointestinal tract can develop against the background of a stress factor (gastritis, irritable bowel syndrome, duodenitis, etc.), so gastroscopy can be included in the diagnostic protocol in patients undergoing examination for functional disorders of the central nervous system.

Pathologies of the stomach can develop against the background of stress and excessive nervousness.

How is the study going

Gastroscopy can be performed in a 24-hour or day hospital setting in a gastroenterology room equipped with a gastroscope (in accordance with the order of the Ministry of Health, each gastroenterologist's office should have two fiber-optic or optical devices with biopsy kits).

Gastroscopy is performed by a gastroenterologist using a special apparatus.

Before the procedure itself, premedication is carried out (preliminary drug preparation of the patient). It consists in conducting local anesthesia with a solution of lidocaine 10%.

The procedure is preceded by local anesthesia with lidocaine.

To date, this drug is considered the most effective for pain relief for the purpose of diagnostic manipulations in the oral cavity, but if there is an allergy, the doctor can replace it with ultracaine or novocaine.

Sometimes for anesthesia use "Ultracaine"

The drugs are sprayed onto the root of the tongue, after which the patient experiences numbness, indicating a “turn off” of the receptors located in the oral cavity. Before starting manipulations, it is important to inform the doctor about allergic reactions to any drugs, since if an allergy develops, severe consequences are possible: laryngeal edema, laryngospasm, asphyxia.

If a person is allergic to any anesthetic drugs, severe swelling of the larynx may develop.

Further actions are performed according to the generally accepted algorithm

The patient is laid on the couch, and a mouthpiece (a device with a hole in the middle) is placed in the mouth, which must be tightly clamped with the lips.

The doctor gradually inserts the tube into the patient's mouth

Due to the air supply during the procedure, you can clearly see the pathology of the esophagus

During the procedure, pictures are taken for further study.

Esophagogastroduodenoscopy also allows measuring the acidity of the gastric and duodenal space, which facilitates the diagnosis of suspected peptic ulcer or hyperacid gastritis.

The measurement is carried out under visual control, using a special probe, which is inserted through the instrumental part of the gastroscope.

What pathologies can be found

Esophagogastroduodenoscopy is the most informative diagnostic procedure that allows you to detect a large number of diseases and pathologies at an early stage, so you should not refuse to undergo it.

Table. What pathologies can be diagnosed with gastroscopy

Foreign bodies in the stomach or esophagus

Atony of the stomach (impaired motor and evacuation function)

Important! Esophagogastroduodenoscopy can also detect symptoms of some infectious diseases of the gastrointestinal tract, such as syphilis or tuberculosis. If these pathologies are suspected, a biopsy and a histological examination of the biological material are mandatory.

Contraindications and risk factors

Endoscopic examination of the gastrointestinal tract may not be performed in all patients. Despite the fact that the procedure is considered relatively safe, in a certain group of patients, esophagogastroduodenoscopy can cause severe complications, so the limitations for the procedure are:

stenosis (narrowing) of the aortic valve;
severe anemia (hemoglobin level ≤ 80 g/l);

Severe anemia is a contraindication for EGDS

What is prothrombin time

In heart failure, EGDS cannot be diagnosed.

The high-risk group includes elderly and senile patients, persons with respiratory diseases, pathologies of the heart and blood vessels, as well as patients with pathologies of the central nervous system.

What complications may arise

The risk of complications during endoscopy is about 1.9-5.4%. This is a low figure, but it is impossible to completely exclude the possibility of serious consequences, therefore, during the procedure, as well as during the preparation period, the patient must fully comply with the instructions of the doctor and other medical workers.

During the procedure, you must follow all the commands of doctors to avoid complications.

Table. Possible complications during gastroscopy

Important! There is evidence of mental health problems associated with EGDS in children aged 5 to 10 years. There is still no scientific evidence that esophagogastroduodenoscopy can affect the psyche, but this possibility cannot be ruled out. For this reason, if there are strict indications, in childhood, the procedure is performed under sedation or general anesthesia.

For children, EGDS is rarely performed and only under general anesthesia.

Preparation rules

The main step in preparing for the study of the gastrointestinal tract is to follow a diet that excludes foods that can stimulate gas formation or enhance the processes of putrefaction and fermentation. These products include:

carbonated drinks (including beer and kvass);
alcoholic drinks;

Alcohol should be avoided a few days before the procedure.

Whole milk can cause unwanted fermentation and bloating

Cakes and pastries contribute to bloating and flatulence

It is better to exclude oatmeal and some other cereals from the diet a few days before the endoscopy

It is necessary to follow a diet for 1-2 days before the procedure. The last meal should take place no later than 20 hours before the procedure, and the products for dinner should be light (the ideal option is a cottage cheese casserole with fruit puree or poultry soufflé).

On the eve of the diagnosis, you need to have dinner with something light, for example, cottage cheese casserole

On the day of the study, you can not eat anything, smoke, chew gum. It is allowed to drink a small amount of water (about 150-250 ml), but no later than 2 hours before endoscopy.

Is it possible to do esophagogastroduodenoscopy in pregnant women

Despite the fact that pregnancy is not included in the list of contraindications for EGDS, this type of examination can be performed only if there are serious indications that threaten the life of the woman or the health of the fetus. This is due not only to a possible increase in the symptoms of toxicosis, but also to possible infection, the cause of which is poor-quality treatment of the premises or insufficient sterilization of instruments. It should also be taken into account that the introduction of a gastroscope can provoke an increase in uterine tone, therefore, endoscopy during pregnancy is contraindicated in uterine hypertonicity, the threat of premature birth or spontaneous abortion. In other cases, the procedure can be carried out if the benefits significantly outweigh the possible risks.

EGDS is not prescribed for pregnant women, as this can cause uterine tone

Esophagogastroduodenoscopy is not very pleasant, but in most cases a necessary procedure for diagnosing diseases of the esophagus, stomach and duodenum. If you properly prepare for the examination, the risk of discomfort, discomfort and possible complications will be minimal, therefore, patients who are indicated for EGDS should follow the instructions and prescriptions of the doctor who will conduct the study.