How to prepare for gastric EGD? Recommendations, procedure

Diseases of the digestive system occupy one of the leading places in modern society. To diagnose such disorders, a number of techniques and procedures are used, one of which is fibrogastroduodenoscopy, or FGDS. Everyone who has come across such a study knows that it is quite unpleasant and requires preliminary diagnosis to obtain accurate results. How is the research carried out, and what is the physical and psychological preparation?

What is fibrogastroduodenoscopy?

The purpose of the procedure is to examine the inside of the stomach and duodenum. For this, a tube with a special apparatus (endoscope) at the end is inserted into the patient's esophageal passage through the oral cavity, with the help of which the internal organs are visualized.

EGD makes it possible to accurately assess the work of the gastrointestinal tract and its anatomical structure, detect changes, determine the location and scale of pathological processes (hemorrhages, benign and malignant tumors) and timely start treatment.

Indications and contraindications

Indications for performing EGD include disorders of the digestive process, manifested by heaviness in the epigastric region, nausea, heartburn, pain, bloating and other symptoms. The study is recommended for patients with suspected peptic ulcer disease, gastritis, tumors in the stomach and esophagus, bleeding from the digestive tract. EGD allows not only diagnosing diseases and pathologies, but also, if necessary, taking tissue samples for biopsy.

Since fibrogastroduodenoscopy is considered a rather complex diagnostic procedure, for it the patient's consent is required (if a person categorically refuses to diagnose, EGD is not spend).

In addition, there are a number of pathologies and diseases in which its implementation is prohibited:

• myocardial infarction in the acute stage, any violations of cardiac activity;
• pronounced pathologies of the respiratory system;
• diseases that can provoke a displacement of the esophagus (aortic aneurysms, tumors);
• esophageal stenosis;
• curvature of the spinal column;
• stroke;
• an increase in the thyroid gland;
• severe bronchial asthma;
• blood clotting disorders;
• pregnancy.
  

  EGD during pregnancy is not performed

Relative contraindications include acute inflammatory processes of the pharynx and larynx, an increase in lymph nodes in cervical region, hypertension and angina pectoris, as well as some mental disorders when the patient is unable to control his body.

Contraindications to FGDS are of a relative nature - in emergency cases (ingestion of a foreign subject, which carries with it a threat to the patient's life, severe bleeding), the procedure can be performed in the presence of serious diseases. The attending physician can correctly balance the risks and benefits of diagnostics.

Preparation for FGDS

In order for the procedure to deliver a minimum of discomfort and give accurate results, the patient needs to properly prepare for its implementation.

A week before the diagnosis, it is necessary to exclude from the diet all products that can cause irritation of the mucous membrane, exclude the use of alcohol and not smoke. This allows you to achieve a normal level of acidity and makes it easier to perform EGDS.

Some medications can adversely affect the condition of the gastrointestinal tract and distort the results of diagnostics, therefore, taking medications should, if possible, be abandoned, or replaced with others after consultation with the attending physician a doctor. You can give injections or take medications in the form of drops.

On the eve of the study, food should not be eaten. Normally, it is excreted from the stomach for 8 hours, but seeds, oatmeal, nuts, chocolate and others indigestible foods remain in the cavity for several days, which makes it difficult to carry out diagnostics.

If FGDS is scheduled for the morning, you can have dinner no later than 18-20 pm, and the dishes should be light and nutritious (buckwheat porridge, chicken meat, stewed vegetables).

Sometimes the diagnosis is prescribed for the second half of the day - then the patient can eat a light breakfast, but the interval between the meal and the procedure should be at least 8 hours. Drinking any drinks, including water, is also prohibited: the recommended interval between drinking and FGDS is 5 hours.

The psychological attitude also plays an important role - EGD is an unpleasant procedure, but it should be endured for the sake of your own health.

Video: Can I drink water, smoke or brush my teeth before gastroscopy?

How is FGDS carried out?

You should come to an appointment at a medical institution in advance in order to have time to tune in to the FGDS mentally. The study consists of several stages and lasts on average about 15-20 minutes.

1. Before inserting the probe, you should loosen the trouser belt and unfasten the top buttons on the clothing in order to reduce the feeling of shortness of breath. The doctor gives the patient a local anesthesia, which consists in applying a solution of lidocaine to the root of the tongue to eliminate the gag reflex.
   

   Lidocaine

2. The patient lies on his left side, a plastic ring is inserted into his mouth through which a tube with an endoscope will be inserted.
3. At the time of the introduction of the probe into the esophagus, it is necessary to make a swallowing movement, and subsequently refrain from such movements, although this will not be easy. To reduce discomfort, you should remain calm and breathe evenly through your mouth.
   

   The tip of the gastroscope is inserted into the mouthpiece

4. As soon as the device is in the stomach, the doctor will turn on the air supply to straighten the organ and begin the examination. The patient at the moment needs to refrain from vomiting, otherwise the procedure will have to be postponed to another day.
   

   Basic rules of behavior during fibrogastroduodenoscopy

5. A few minutes later, when the diagnosis is completed, the tube is taken out, and the patient receives an appropriate conclusion.

The most difficult thing to carry out the procedure is for children - for small patients, the device is inserted through the nose, and for children older through the mouth (just like adults), but a thin tube with a diameter not more than 4 mm.

In extreme cases, when conducting EGDS, short-term anesthesia can be used, but in urgent need it is not, since the study is absolutely painless, although it delivers certain unpleasant Feel.

Decoding the results

After the study, the results are deciphered, on the basis of which a diagnosis is made and treatment or additional tests are prescribed.

Do not forget that only a doctor can correctly interpret the results of fibrogastroduodenoscopy.

Diagnostic criterion	Indicators
Assessment of the condition of the esophagus	The color of the inner surface of the organ and its patency are assessed. The presence of adhesions, neoplasms and erosion, which are absent in a normal state, is established
Evaluation of the cardia (the junction of the esophagus into the stomach)	The walls of the organ should close normally - if the term "gaping" is used in the decoding, this may indicate reflux disease
Stomach assessment	The color of the stomach surface, the presence of tumors, ulcers and bleeding, as well as their size and level of health hazard are assessed
Evaluating internal content	The liquid inside the stomach has a transparent hue with mucus impurities. Discoloration, excessive secretion, dark blotches and other similar phenomena are considered a sign of pathology.
Gatekeeper score	This part of the esophagus must be passable, free from deformities or other defects. In the presence of scars or abnormalities, it is necessary to establish their cause and stage

In the absence of changes or minor pathologies, a person can go home. If, during the EGD, diseases that threaten health or life were identified, the patient needs hospitalization and emergency treatment.

Possible complications after EGD

In most cases, EGD is normally tolerated by patients, but sometimes after the study, patients have complications of varying severity. It is normal to have a little discomfort or slight pain in the stomach area, especially if the procedure was accompanied by the collection of a sample of the mucous membrane for biopsy. Sore throat, hoarseness and numbness in the larynx are also possible. They go away on their own within a few days and do not require medical intervention.

Serious complications, which are manifested by fever, frequent vomiting, loose black stools and severe pain, require immediate medical attention.

One of the most common complications after EGD is bleeding from the esophagus, which occurs when certain diseases (for example, varicose veins of the gastrointestinal tract) or due to damage to the walls endoscope. This usually occurs in cases where the patient made sudden movements during the procedure, as well as in the elderly because of the anatomical features of the digestive organs. Minor bleeding does not require treatment and will go away on its own.

Due to improper preparation for FGDS (eating food on the eve of the study), it can cause the development of aspiration pneumonia. It occurs as a result of poorly digested food entering the respiratory tract. The disease is manifested by a dry cough, a slight increase in temperature and weakness, and as progression, the patient has a separation of foamy sputum, severe fever and sensation choking.

Aspiration pneumonia is a dangerous ailment that requires immediate treatment.

How to behave after FGDS?

There are no specific recommendations for the behavior of patients after the procedure. To give the irritated esophagus time to calm down, you should refrain from eating and drinking for 1.5-2 hours, and during the day do not eat hard and spicy foods, do not drink alcohol.

It is also better to refuse to drive vehicles and perform hazardous work - local anesthetics used for FGDS can affect the reaction rate.

If there are no unpleasant sensations or manifestations of complications, after 24 hours you can return to your usual way of life (taking into account medical recommendations). Pain in the stomach can be relieved by antispasmodics (No-shpa, Miverin), and pharmacy lozenges and warm drinks can help relieve discomfort in the throat.

Alternative methods of diagnostics of the gastrointestinal tract

In the presence of contraindications or in cases where the patient is panicky afraid to swallow the probe, you can resort to alternative methods for diagnosing diseases of the esophageal tract. These include ultrasound and x-rays, as well as pH metry and video capsule endoscopy.

Ultrasound examination allows you to identify gastritis and ulcers, X-ray - to determine stomach neoplasms, and pH-metry allows you to judge the state of the gastrointestinal tract by the level of acidity. The optimal alternative to FGDS is video capsule endoscopy. It is carried out using a special capsule, which the patient must swallow, and after it leaves the body, the data is deciphered and the diagnosis is made. The main disadvantage of this technique is the high cost and inaccessibility - not every clinic has in its arsenal the means for conducting research.

Despite the presence of other diagnostic methods for detecting gastrointestinal pathologies, fibrogastroduodenoscopy remains one of the most accurate and safe. If the doctor insists on EGD, patients should heed his recommendations - this is will help maintain the health of the esophagus, and proper preparation for diagnosis will minimize unpleasant Feel.

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