Why is it prescribed and what results does FGD with biopsy give? Preparation and consequences of the procedure. Gastroscopy (fgds, endoscopy) Rehabilitation and possible complications

Gastroscopy of the stomach is an informative method for diagnosing gastrointestinal diseases, which is also known as fibrogastroduodenoscopy (FGDS). The examination is carried out according to a single method, but may differ in a set of additional manipulations. For the diagnosis of inflammatory and ulcerative diseases of the gastrointestinal tract, along with gastroscopy with tests for Helicobacter pylori, FGDS with biopsy is widely used.

The technique, known as gastroscopy with biopsy, combines two types of examinations: an overview procedure and taking a fragment of the gastric mucosa for subsequent laboratory research. This research method is accompanied by special tests that allow us to establish in more detail the cause of gastritis or peptic ulcer within the framework of FGDS. Also, a tissue sample for analysis becomes a source of information about the nature of pathological changes, most often of a tumor nature, at the cellular level.

Gastroenterologists note that a gastric biopsy as part of gastroscopy is more informative than a breath test. Examination of tissues obtained during FGDS allows us to identify the sources of problems against the background of tumors, inflammation and ulcerations, while checking exhaled air for special gases allows us to establish the presence of the HP bacterium (Helicobacter pylori), but does not provide an idea of the causes of non-bacterial diseases.

Technically, gastroscopy with biopsy sampling is done in the same way as conventional FGDS. For this, a gastroscope is used, which, in addition to a light source and a camera, is equipped with special tools: forceps or a loop for separating a piece of mucous membranes, as well as a coagulator, with which the doctor cauterizes wounds on the mucous membrane after taking a biopsy.

Why do they take a biopsy during FGDS?

A biopsy or collection of biological tissue is considered a very informative analysis when it is necessary to establish the nature of cellular changes. In gastroenterology, biopsy during gastroscopy plays a major role in the diagnosis of various pathological processes:

benign neoplasms;
malignant neoplasms on early stages development;
inflammatory processes.

The main difference between this analysis of the internal gastric lining is point studies, since a biopsy is taken only from lesions that have undergone unfavorable changes. The obtained material is examined through various analyses:

microscopic;
histological;
cytological.

In a word, a comprehensive check of the biopsy (material taken during FGDS) gives the doctor more detailed and detailed information about the condition of the mucous membranes digestive tract.

Important! A biopsy taken during gastroscopy allows us to make a differentiated diagnosis, that is, within the framework of one study, determine the true source of unpleasant symptoms indicating Helicobacter pylori infection, malignant tumor or polyposis.

What does a biopsy show?

The main value of a biopsy during FGDS is the possibility of obtaining a detailed diagnosis. For each disease, the study allows us to determine the following indicators:

At inflammatory process(gastritis, duodenitis) - the nature of inflammation (catarrhal, fibrinous, necrotic, phlegmatic), type of process (acute or chronic), type (associated with Helicobacter pylori or abacterial, autoimmune, chemical, granulomatous or idiopathic, hyperacid or anacid).
For gastric ulcers - the type of ulcers (bacterial, erosive or other origin), the stage of their development.
For benign neoplasms, the risk of polyps degenerating into cancerous tumors is determined.
For malignant neoplasms, the type of malignant cells, their origin and tendency to proliferate and metastasize.

In addition to the characteristics of the disease, a biopsy taken during FGDS shows the gastroenterologist the main ways to solve health problems.

How to prepare for gastroscopy of the stomach with biopsy

Standard preparation for gastroscopy with taking a biopsy differs little from preparatory measures for a survey FGDS. The main goals of preparation are to reduce the risk of bleeding and empty the stomach of food particles. The patient will have to switch to easily digestible food with low content sugars, particulates and insoluble fibers, avoid taking certain medications.

Important! Before performing a gastroscopy and taking a biopsy, you need to inform your doctor about all medications that you take regularly.

Despite the similarities in the main points, preparation for fibrogastroduodenoscopy of the stomach with the collection of biomaterials has some features. For example, you need to start preparing for the examination not 2-3 days before a regular gastroscopy, but about a week before the examination. Before the main preparation for FGDS, you need to take tests for blood clotting and stop taking antibiotics.

How to test for Helicobacter pylori during FGDS

To detect Helicobacter pylori, you can perform a rapid test during gastroscopy. It is similar in technique to a breath test, as it determines the concentration of carbon dioxide released by bacteria living in the biopsy specimen. This gas is produced by Helicobacter as a result of the breakdown of urea into simpler elements with the release of CO2.

To carry out FGDS for Helicobacter with biopsy, standard equipment (gastroscope) with biopsy forceps is used. Before insertion of the device, use local anesthesia. Next, a special mouthpiece is inserted into the oral cavity, fixing the jaws in open position, and inserts a gastroscope.

After examining the stomach, pathological foci are identified. It is from them that the doctor will take material that will allow qualitative analysis for Helicobacter pylori. Using special forceps, the doctor separates a fragment of the mucous membrane, removes it and transfers it to the laboratory. The damaged stomach lining coagulates if bleeding is noticeable. If the bleeding is insignificant, no special treatment of the wound is required; the doctor completes the gastroscopy and removes the gastroscope.

Detection of Helicobacter during FGDS with biopsy occurs in laboratory conditions using a microscope with 360-fold magnification, and not during material collection. The material is examined under a microscope, in which all microorganisms living on the gastric mucosa are visible. It is quite simple to differentiate friendly microorganisms from Helicobacter, since the latter has a spiral shape and additional antennae for penetration into the thickness of the mucous membrane. If necessary, a specific test for Helicobacter pylori can be performed, during which the biopsy obtained from FGDS will be placed in a special medium.

Good to know! If the test for Helicobacter during FGDS is positive, this almost completely eliminates the possibility of a false result.

Rehabilitation and possible complications

Complications after gastroscopy are extremely rare. The most common problem that patients encounter is a sore throat due to minor injuries to the mucous membrane. If you have a weakened immune system or poor hygiene, a sore throat may develop. In addition, minor abdominal cramps may be felt during the first day.

Note! If FGD with biopsy is performed by a qualified specialist, there is a risk of infection intestinal infection, bacteria that cause ENT diseases and other health problems are excluded.

According to gastroenterologists, most of the complications after gastroscopy with biopsy are caused by non-compliance with recommendations on nutrition and exercise regimen. In addition, the patient can harm his health if he takes medicine for abdominal discomfort. To prevent this from happening, it is important to scrupulously follow your doctor’s advice.

What can you eat after the procedure?

Eat well after FGDS of the stomach possible only after 6-8 hours. Before this, you can drink some slightly warmed water or juice diluted in half with water. It is advisable to start eating after FGDS with biopsy with the most light, nutritious and easily digestible dishes:

pureed cottage cheese;
natural yogurt without additives;
slightly cooled broth;
pureed liquid porridges;
oatmeal or milk jelly.

By the end of the first day after FGDS, you can eat more complex and satisfying dishes: soups in vegetable and chicken broths with the addition of noodles, rice or vegetables. It is highly advisable to thoroughly grind foods or even prepare puree soups or cream soups. As a second course, after gastroscopy with biopsy, you can eat vegetable purees, cutlets or balls of minced meat or fish well beaten in a blender.

Important! Dishes should contain a minimum of salt, aromatic herbs, spices and fat.

After gastroscopy, it is advisable to drink frequently, but little by little. Plain water, herbal or green tea, compotes from dried fruits, fresh or frozen berries, jelly, skim milk or natural ones are ideal. fermented milk drinks without additives.

Stomach pain after gastroscopy

Gastroenterologists note that the stomach hurts after a biopsy during FGDS in almost all patients. The reason for this phenomenon is simple and understandable - injury to the mucous membranes of the organ. Normally, the pain in the stomach is mild, reminiscent of a spasm or mild pain. It can worsen after eating too cold or hot foods. Let loose unpleasant symptom in the first days after gastroscopy, enveloping drugs (Almagel) or antispasmodics will help.

If the pain after gastroscopy is increasing and does not subside 2 days after FGDS with biopsy, you should immediately consult a doctor. Other symptoms that should cause alarm include fever, blackened stool, vomiting blood or tarry vomit. Such cases are subject to urgent medical intervention with the patient placed in the intensive care unit.

For gastric pathology, methods for making an accurate diagnosis are as follows:

macroscopic examination of the mucous membrane on the walls of the affected organ - gastroscopy;
microscopic examination - biopsy, cytological and histological analysis of biopsy material (pieces of selected affected tissue).

Description of methods

Gastroscopy of the stomach, called FGDS, involves a visual examination of the lumen and mucous membrane of the digestive tract (esophagus, stomach, duodenum). For this purpose, a special flexible probe in the form of a tube is used, equipped with a camera and optical system. Gastroscopy can be of a purely diagnostic nature or used for the purpose of performing a biopsy - taking samples of affected tissue for subsequent examination. Advantages of the method:

A thin elastic tube, equipped with a modernized control system, allows you to study in detail the entire surface of the gastrointestinal mucosa.
Detection of all superficial wall destructions not visualized by radiography.
Determining the cause of gastrointestinal bleeding.
Detection of malignant and benign growths in the stomach.
Tracing malignancy (malignancy) of tumors.
Tracing the development of peptic ulcer disease.
Taking a biopsy sample while performing a biopsy.

Biopsy is a diagnostic technique that involves taking a small piece of tissue from the mucosa or a suspension of cells from a tumor. The biopsy is sent for analysis, which is carried out under a microscope to detect malignant cells in the epithelium, determine their etiology, and the degree of damage to the organ. Based on the results, a decision is made on the need surgical intervention. Exists general classification for gastrobiopsy into 2 types, differing in technique:

sighting;
blind.

Gastrobiopsy of the stomach

The manipulation is carried out by introducing a special biopsy probe (gastroscope) to take a biopsy from the inner gastric wall. To perform the selection, special knives or vacuum tubes can be used to suction (aspiration biopsy) tissue particles or a suspension of cells. Gastrobiopsy is rarely accompanied by complications.

Sighting

The procedure is performed with a special reusable device - a fibrogastroscope. The device is equipped with a device for multiple targeted sampling. Advantages of the device:

special flexibility, which facilitates insertion of the device into the lumen of the organ;
minimizing discomfort;
Images High Quality and clarity;
the ability to examine the distal end of the stomach through controlled bending of the device.

The process is negatively affected only by severe deformation and severe stenosis of the organ cavity.

Blind

The manipulation is performed using a probe without visual control. This technique is also called search technology. The method must be performed by a specialist high level, since there is a risk of severe injury to the mucous membrane.

Indications

FGDS is necessary when it is required:

differential diagnosis chronic gastritis and ulcers, polyps and cancer;
localization of bleeding;
cancer detection;
confirmation/refutation of radiography results for symptoms of gastric dyspepsia;
clarification of the condition of the mucous membrane in case of previously appeared pathologies of other organs and systems.

A biopsy is needed if the presence of:

tumors in the digestive system (determination of the type and degree of cancer/precancer);
acute and chronic gastritis;
mucosal ulcers (differentiation from cancer);
damage in the epithelium;
Helicobacter bacteria, which cause digestive dysfunction.

The method is used to assess the condition of the gastric epithelium after surgery.

Contraindications and risks

Gastroscopy with biopsy is not performed in the following cases:

the patient's serious condition, including shock;
critical hypertension;
clotting disorder;
obstruction of the esophagus, intestines;
acute heart attack and stroke;
mental disorders;
acute bronchial asthma (mild and moderate severity);
severe bronchial asthma;
inflammation of the larynx and ENT organs;
acute infections and inflammations;
severe organ burns digestive system caustic chemicals.

Sometimes it is possible to perform FGDS for these diseases for health reasons and in a hospital setting. If available stomach bleeding, the procedure is carried out no earlier than 12 days from the moment of its relief.

Before prescribing FGDS, clinical and radiological studies are carried out to identify gastric pathologies contraindicated for manipulation. Possible complications of gastroscopy and biopsy:

General malaise, manifested by bloating, belching, soreness, dryness in the larynx. The discomfort goes away on its own.
Infection in the gastrointestinal tract.
Injury to the esophagus, stomach varying degrees difficulties.
Bleeding. They usually go away on their own if the patient has not taken Aspirin or Warfarin before.

Symptoms of complications:

breathing problem;
chest pain;
bloody vomiting;

Preparation

The patient must be prepared psychologically. To do this, the doctor describes in detail the stages and sensations during the manipulation. The patient must be hungry, since the manipulation is performed on an empty stomach. You should not drink anything 2 hours before the procedure to avoid a gag reflex.

If you have allergies and other serious pathologies (heart failure, heart attack, aortic aneurysm, diabetes, epilepsy, complications after operations). The procedure is not performed during an exacerbation of any disease, so it will be necessary to additional tests. In a hospital, preparing a patient involves:

removal of dentures;
complete bowel and bladder emptying;
taking sedatives;
wearing protective clothing.

Preparation at different times

The following general recommendations are expected to be implemented:

For three days, do not eat spicy foods or drink alcohol.
Do not eat anything for 10 hours before the procedure.
Do not take blood thinning drugs (Aspirin, Paracetamol), NSAIDs.
Immediately before the procedure, you should rinse your throat with an antiseptic.

During gastroscopy in the morning, you should:

do not eat from 22:00 the night before;
do not drink in the morning;
do not use medications.

When diagnosing in the evening:

do not eat 8 hours before the procedure;
Drink water for the last time 2 hours before the procedure, and take sip of still water throughout the day;
no smoking for 3 hours.

cleaning the stomach from secretion, mucus, blood;
diet;
minimal water consumption;
refusal of exercise.

Anesthesia

In preparation for anesthesia, patients may be offered to take muscle relaxants, which will help the body better absorb the anesthesia. There are 3 types of anesthesia:

Local anesthesia is the safest. The main requirement is to clean the throat of germs and viruses with antiseptics (Midazol, Propofol) in order to prevent subsequent inflammation. Advantages:
- minimum complications;
- lack of thorough preparation;
- ease of use - irrigation of the larynx after sanitation.
Superficial medicated sleep (sedation) with forced relaxation of the esophageal muscles.
General anesthesia and deep sedation via laryngeal mask airway. The patient falls completely asleep. The procedure is complex due to the need to use breathing and tracking devices.

Procedure

Gastroscopy is performed in the endoscopy room. For this purpose, an endoscope is used, made in the form of a thin fiber optic tube of sufficient flexibility for reusable use. Before the procedure, the probe must be sterilized. At the end of the endoscope there is a lighted camera.

The doctor carefully inserts a probe through the mouth into the esophagus and stomach. This is done in most cases under X-ray control. If necessary, the probe is advanced into the duodenum and intestines. The image from the camera is transmitted to a large monitor and recorded on removable media. The diagnosis is made by examining the video sequence.

According to indications or unscheduled (if pathological areas are detected), a biopsy is performed. If necessary, emergency measures can be taken, such as stopping vascular bleeding or removing polyps.

Patient's feelings

Although the procedure is painless, discomfort is possible. To facilitate the manipulation, the patient may be offered:

sedative for increased nervousness;
irrigating the pharynx with an antiseptic solution to improve the passage of the endoscope;
plastic mouthpiece to prevent the probe from being bitten.

When air is supplied to expand the walls of the esophagus and stomach, the patient may feel discomfort. Mild pain in the throat after gastrobiopsy disappears on its own after some time.

Complications

Gastrobiopsy is a proven and well-established manipulation approved for use on children. Complications are rare. The most severe is considered to be rupture of the wall of the esophagus, stomach and bleeding during biopsy.

After anesthesia

An allergy to the local anesthetic is possible due to individual intolerance to the drugs used.

After manipulation

The human factor is the main cause of complications, which is caused by:

rough insertion of the endoscope;
inappropriate behavior of the patient;
neglect of contraindications for carrying out.

Types of complications:

wound, cracks, abrasions;
damage to the thoracic and abdominal parts of the esophagus and stomach;
esophageal rupture;
gastric perforation.

They can occur when the lumen of an organ is inflated with the presence of a large tumor, a deep penetrating ulcer with air, or wounded by a gastroscope. Tears and perforations are urgently repaired surgically. Bleeding may occur after a biopsy, but this is extremely rare.

Recovery

After gastroscopy, you should not eat for 2 hours or until the local anesthesia wears off completely. After general anesthesia for restoration nervous system it takes more than 24 hours. During this time, you cannot drive a car, operate complex equipment and automated processes, or engage in activities that require attention.

After gastrobiopsy, the patient is under medical supervision for an hour to three. Complex manipulations are performed in a hospital under long-term supervision. After the procedure, you need to eat food at room temperature in semi-liquid form for at least 24 hours.

results

The results of gastroscopy are given to the patient on the day of the procedure. Medical forms provide a complete description of the pathology seen or age-related changes. The biopsy report is issued in 10-14 working days.

The patient can receive a digital video recording with printed photographs. Together with the description and biopsy results, this will make it easier for the treating doctor to make the correct diagnosis. Gastroscopy with biopsy allows you to diagnose any type of tumor at an early stage with the possibility of minimally invasive removal with an endoscope without abdominal surgery.

Gastric biopsy - procedure, risks

A biopsy is the removal of a small fragment of the stomach lining for subsequent chemical analysis.

The procedure is usually performed with classical fibrogastroscopy.

The technique reliably—with an accuracy of 97%—confirms the existence of atrophic changes and allows one to confidently judge the benign or malignant nature of neoplasms in the stomach.

Procedure technology: how and why is a biopsy performed during FGDS?

Obtaining high-quality material for laboratory research became a routine diagnostic technique only in the mid-twentieth century.

It was then that the first special probes began to be widely used. Initially, the collection of a tiny piece of tissue was not done precisely, without visual control.

Modern endoscopes are equipped with fairly advanced optical equipment.

They are good because they allow you to combine sample collection and visual examination of the inner lining of the stomach.

Nowadays, not only devices are in use that mechanically cut off material, but also electromagnetic retracting devices of a fairly advanced level. The patient does not have to worry that a medical specialist will blindly damage his stomach.

A targeted biopsy (usually carried out as part of FGS) is prescribed when it comes to:

various focal gastritis;
suspected polyposis;
identification of individual ulcerative formations;
suspected cancer.

The standard process of fibrogastroscopy is not too lengthened by taking a sample - in total, the process requires 7-10 minutes.

There is no need to prepare separately for the procedure; standard preparation for FGDS is sufficient.

What are you risking by going for a biopsy? Isn't it harmful?

The question is logical. It’s unpleasant to imagine that something will be cut off from the stomach lining.

Professionals say that the risk is almost zero. The instruments are miniature; it is not even necessary to observe asepsis during the procedure.

The muscle wall is not affected; the tissue is taken strictly from the mucous membrane. Subsequent pain and even more so, full-fledged bleeding should not occur. Standing up almost immediately after taking a tissue sample is usually not dangerous. The examined person will be able to go home calmly.

Then, naturally, you will have to consult a doctor again - he will explain what the answer he received means. "Bad" biopsy - serious reason for concern.

If alarming laboratory data is received, the patient may well be referred for surgery.

Contraindications for biopsy

suspected erosive or phlegmonous gastritis;
physiologically determined probability of a sharp narrowing of the esophagus;
lack of preparedness at the top respiratory tract(roughly speaking, a stuffy nose that forces you to breathe through your mouth);
Availability additional illness, which is infectious in nature;
a number of cardiovascular pathologies (from high blood pressure before a heart attack).

In addition, a gastroscope tube should not be inserted into neurasthenics or patients with severe mental disorders. They may react inadequately to the sore sensation in the throat caused by the introduction of a foreign body.

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Differences between FGDS and gastroscopy

In the treatment of any disease, correct diagnosis is key. For stomach problems, the most informative method is gastroscopy. But few people know that there are several types of this examination. In particular, patients often confuse the designations FGS and FGDS. Let's figure out how FGDS differs from gastroscopy, and in what cases each of the procedures is indicated.

The key difference between gastroscopy and FGDS is additional research duodenum.

When talking about gastroscopy, they usually mean fibrogastroscopy, abbreviated as FGS. The essence of the examination is that a special probe is inserted into the stomach through the esophagus, at the end of which there is a video camera. The probe is flexible and has a light source, which allows the doctor to assess the condition of the gastric mucosa and identify even the slightest pathological changes. When the doctor's examination of the stomach area is completed, the probe is carefully removed in the same way as it was inserted.

With gastroscopy, you can not only diagnose the patient, but also carry out some simple manipulations. For example, take a biopsy for further laboratory testing. Also, with FGS it is possible to remove stomach polyps and stop vascular bleeding.

FGDS refers to fibrogastroduodenoscopy. This is the same research method, but it studies the condition of not only the stomach, but also the duodenum. Similar to conventional fibrogastroscopy, an umbrella is inserted into the patient, but it is also advanced into the intestines, which makes it possible to evaluate the biliary tract and problems in this area. FGDS is necessary for suspected gastroduodenitis and the presence of neoplasms in the duodenum.

Thus, the assumption that gastroscopy and a study designated FGDS are the same procedure is erroneous. "Duodenum" means duodenum in Latin. Accordingly, fibrogastroduodenoscopy is a more complete examination that allows diagnosing diseases of this part of the digestive system.

Technology

Gastroscopy is a very unpleasant procedure for the patient. There is no pain, but many people find it psychologically difficult to swallow the probe. In such cases there may be vomiting reflex. Therefore, local anesthesia is often performed: the larynx is treated with lidocaine, which blocks sensitivity and allows the gastroscope to be swallowed without discomfort.

During the examination, the patient must lie on his left side, and the probe is held in place with special mouthpieces. Excessive salivation occurs; this is normal and should not be a cause for concern. A towel and a bin near the couch are provided for its removal. The image from the camera at the end of the gastroscope is displayed on the monitor, and the doctor assesses the condition of the stomach, taking notes and screenshots.

FGDS is carried out in two stages. First, the gastric mucosa is examined, and then the probe is lowered deeper into small intestine. Examination of the stomach is mandatory, since data from the duodenum will not give a complete clinical picture. Accordingly, FGDS is a longer procedure.

After completing the examination, you must carefully remove the gastroscope. Many people consider this stage the most unpleasant during gastroscopy. Removing the probe may cause gagging, so the emotional state of the patient and proper preparation to the procedure.

Preparation for gastroscopy

There is no difference in preparation for FGS and FGDS. The most important requirement is to refrain from eating for 12 hours. Gastroscopy is usually performed in the morning. Therefore, it is enough to refuse breakfast and take dinner no later than seven to eight in the evening. It is advisable to eat liquid food for dinner, for example, broth or jelly. You should also avoid cigarettes, as nicotine can trigger the gag reflex.

There are no such strict restrictions regarding fluid intake. It is necessary to stop drinking only two hours before gastroscopy. In addition, it is recommended not to eat heavy food two days before surgery. The diet before FGS and FGDS should contain only easily digestible foods.

Foods that can be eaten include boiled meat, chicken and fish, broth, dairy products, boiled or vegetable stew, weak tea. Brown bread, raw vegetables and fruits, nuts, mushrooms, herbs, legumes, berries, seeds, and jam are not recommended. Based on the characteristics of your condition, your doctor will give specific recommendations on diet on the eve of gastroscopy. Such restrictions must be observed because full stomach will make a reliable and thorough examination impossible. This is also necessary to avoid vomiting when swallowing or removing the gastroscope.

Modern equipment is structurally adapted to minimize discomfort during gastroscopy. Therefore, you should not be afraid of it; on the contrary, calmness and a positive attitude are important. Clothes should be loose enough and not constrict abdominal cavity or chest. To make breathing easier, you can unbutton the top buttons of your shirt, and also unfasten or remove the belt on your trousers. If you wear lenses or dentures, it is recommended to remove them in advance. During the examination, breathe calmly and deeply through your mouth, try to avoid swallowing movements.

Indications and contraindications for FGS and FGDS

In terms of technology, there are apparently no differences between FGS and FGDS. The only difference is the time and scope of the examination. But their indications differ. In some cases, simply studying the gastric mucosa is enough, and in some situations a duodenic study is added to it. Let's look at situations where one or another procedure is necessary.

Eat general indications for endoscopy:

pain in the abdomen, localized in the upper part, as well as in the lower chest;
discomfort in the epigastric region;
bloating;
nausea or vomiting;
heartburn;
belching and sour taste in the mouth;
difficulty swallowing;
sudden weight changes without visible reasons, sudden loss or gain of body weight;
suspicion of gastritis or stomach ulcer;
suspicion of malignant neoplasms;
internal bleeding;
analysis for the presence of the bacterium Heliobacter.

FGDS is performed if there are additional indications:

suspicions of bile duct disease, including malignant neoplasms;
suspicion of duodenal ulcer;
bleeding in the upper sections small intestine.

FGDS is also done in combination with x-ray examination of the bile ducts and pancreas. Using an endoscope, a dye is injected, after which an x-ray is taken. This procedure is called retrograde cholangiography.

Despite the differences in indications for gastroscopy and FGDS, they have common contraindications:

diseases of cardio-vascular system, including differences blood pressure, hypertension;
illnesses respiratory system, including bronchial asthma in the acute stage;
bleeding disorders and hemophilia;
severe weakness and painful fatigue;
nervous disorders and mental illnesses, neuroses;
severe internal bleeding.

The examination should be prescribed by the attending physician, having first ensured that there are no contraindications. He will also give recommendations on preparation for the procedure and nutrition.

Conclusion

Conventional gastroscopy and FGDS are no different in their methodology; the same equipment is used. FGDS is a more complete two-stage research method, which is used for suspected diseases of the small intestine and biliary system. She could be part complex diagnostics work of the pancreas and bile ducts. Pain in the abdominal area can be caused by completely different diseases, and even to a good doctor It is not always easy to determine the source of the problem. Therefore, during FGDS, both the stomach and the upper intestine are examined. This allows you to get a more complete picture of the patient’s condition and exclude suspicions of diseases of other organs. But it’s also not worth carrying out such diagnostics without reason. If the attending physician, guided by the clinical picture and test results, suspects a problem in the stomach, then he will prescribe gastroscopy, not FGDS.

Gastroscopy is a modern diagnostic procedure that allows for a thorough examination of the initial parts of the small intestine, the mucous part of the esophagus, as well as the stomach itself. In addition, during a gastroscopy examination, the doctor may perform a biopsy of a suspicious area of tissue. What does it represent this process?

What is a biopsy?

Biopsy is also a method diagnostic study. This happens as follows. The doctor takes a piece of tissue from the suspicious organ in order to subsequently examine it in detail under a microscope and make an accurate diagnosis on this basis.

Indications for taking a biopsy during gastroscopy

Taking a biopsy during a gastroscopic examination is usually used in the following cases:

1. Tumor formations in the stomach;
2. Tumor formations in the esophagus;
3. Gastritis in acute or chronic form;
4. Dyspepsia;
5. Damage to mucous membranes gastrointestinal tract;
6. Gastroesophageal reflux disease;
7. Chronic heartburn.

Contraindications for biopsy during gastroscopy

Bleeding disorders;
The patient's weakened state of health;
Hemorrhagic diathesis;
Atrophic gastritis;
Gastric perforations;
Tendency to allergic reactions;
The patient's fear of possible bleeding.

How is a biopsy taken during a gastroscopic examination?

Taking a biopsy during a gastroscopic examination of the esophagus and gastrointestinal tract organs is carried out using medical device– endoscope. To do this, special small tweezers are inserted into the flexible tube of the endoscopic probe, with the help of which tissue is collected. After this, the resulting material is sent to the laboratory, where it is treated with paraffin, making it hard, and cut. Next, the tissue plates are examined by a specialist, who determines the cause and nature of possible tumor formation.

Why is a biopsy performed during gastroscopy?

Gastroscopy and biopsy are two complementary diagnostic procedures allowing to obtain the most accurate results regarding the condition of the patient’s esophagus, stomach and intestines. Combining these methods allows the specialist to make the most correct diagnosis and avoid medical errors, which will lead to the prescription of the wrong course of treatment and harm the patient’s health. Modern medical equipment allows both doctors and patients to save their time and nerves by combining a gastroscopic examination with taking a tissue biopsy. It is very convenient and functional. Typically, a gastroscopy biopsy is prescribed in the following cases:

During a gastroscopic examination, tumor formations were discovered in the gastrointestinal tract and organs of the digestive system.
The doctor is not confident in the results of gastroscopy and wants to use another diagnostic option to create a complete clinical picture.
If you suspect serious pathology

Thus, a biopsy during gastroscopy is an extremely common procedure that allows a gastroenterologist to establish the most accurate diagnosis. For this reason, modern capsule gastroscopy, which does not provide the opportunity to take a biopsy, is still inferior in popularity to traditional gastroscopic examination.

Duration of the examination: 10-20 minutes.

Conclusion preparation time: 10-20 minutes.

Price: from 3,450 rub.

Results of the procedure: the condition of the mucous membrane is assessed during a visual examination. If material is collected for histological or cytological examination, laboratory data are provided within 5-7 days.

Unlike fibrogastroduodenoscopy (FGDS), gastroscopy (EGDS, esophagogastroduodenoscopy) allows you to visually examine not only the mucous membrane of the stomach and duodenum, but also the esophagus. The examination is carried out using an endoscope, which is a flexible probe with a built-in video camera, which allows the doctor to receive an image on the screen. The information obtained using gastroscopy allows you to make an accurate diagnosis and choose an adequate treatment method. For a more accurate diagnosis of the disease, during the research process, using special instruments, it is possible to take samples of the mucous membrane (biopsy) for subsequent examination of their structure under a microscope.

Experienced specialists at SM-Clinic will make gastroscopy as comfortable as possible for the patient.

Equipment for gastroscopy has high sensitivity. The doctor can detect changes on the surface of the mucous membrane of internal organs that are only a few millimeters in size. During the procedure, not only a visual inspection is performed, but also, if necessary, tissue samples are taken for laboratory testing.

The main differences between gastroscopy FGS, FGDS and the EGDS method

Conventional gastroscopy or FGS (fibrogastroscopy) is an examination in which only the stomach is examined. A probe with a video camera is inserted into it through the esophagus. It is flexible and equipped with a light source, so the doctor can assess the condition of the gastric mucosa as thoroughly and accurately as possible. After inspection, the probe is removed in the same way in which it was inserted. This method allows you to perform not only diagnostics, but also some simple manipulations. For example, do a biopsy to perform further research in the laboratory, remove polyps in the stomach, stop bleeding of blood vessels.

FGDS can be done to study not only the condition of the stomach, but also the duodenum. This examination is also performed using a probe, but it is inserted further into the intestines. FGDS of the stomach and duodenum allows you to identify problems in the biliary tract and assess the condition of the mucous membrane of the examined organs. Diagnosis is prescribed for suspected gastroduodenitis, as well as for the presence of neoplasms in the duodenum.

During EGDS (esophagogastroduodenoscopy), the mucous membrane of all upper gastrointestinal tracts is examined. The doctor examines not only the stomach and duodenum, but also the esophagus.

Prices do not differ for FGS, FGDS, EGDS. The most informative method is considered to be esophagoduodenoscopy, which allows accurate diagnosis condition of the gastrointestinal tract.

"Gastroscopy in a dream"

At SM-Clinic, patients have the opportunity to undergo gastroscopy in their sleep. Not used for the procedure general anesthesia, in our clinic, gastroscopy is performed under the most comfortable conditions of sedation - 10-minute medicinal sleep using special drugs. Modern drugs, created for research under sedation, are not classified as narcotic analgesics. Endoscopy during sleep is carried out under the supervision of an anesthesiologist, who carries out an individual selection of the drug and its intravenous administration.

The patient sleeps during the procedure without experiencing any unpleasant sensations, and upon waking up immediately after its completion, he does not feel any discomfort.

This is how all types of endoscopic examinations and manipulations are carried out in Europe, including FGS and FGDS, because when the patient is calm and does not interfere with the examination, the doctor carries out the necessary set of diagnostics as quickly, accurately and efficiently as possible. Our doctors received additional training and advanced training during internships in Japan. Gastroscopy at SM-Clinic is carried out at the level of world standards.

Advantages of gastroscopy at SM-Clinic

SM-Clinic specialists completed internships in the largest medical centers gastroscopy in Europe and Japan. Clinical practice allowed them to acquire not only the skills to use all the functions of modern equipment, but also valuable practical diagnostic experience.

In ninety-nine cases out of a hundred, the endoscopist detects a pre-tumor condition or the onset of a tumor, which allows emergency treatment and restoration of health. The gastroscopy method is a unique opportunity of its kind to clarify a preliminary diagnosis using an internal examination. No x-ray examination provides as much valuable information as the use of endoscopy.

SM-Clinic's gastroscopic equipment, from sensitive sensors and a flexible fiber-optic cable for inserting a probe to a high-resolution monitor for visualizing the resulting image, meets all modern requirements.

SM-Clinic specialists will provide qualified assistance in removing minor defects, which allows in some cases to avoid surgical intervention.

When conducting endoscopic examination SM-Clinic specialists can perform additional diagnostic procedures:
- tissue sampling for biopsy;
- test for Helicobacter pylori;
- test for lactase deficiency.

Purpose of gastroscopy

EGDS method indispensable in diagnosing diseases of the esophagus, stomach and duodenum: esophagitis, GERD, gastritis, all forms of peptic ulcers and other tumors in the early stages, unlike other methods that only diagnose late stages development of the disease.. With the help of a modern endoscope, polyps and erosions are not only detected, but also effectively treated.

Additional functions of the endoscope allow the following: healing procedures:

injections or spraying with medications,
removal of polyps,
stop bleeding,
treatment of vascular diseases and lymphatic system,
solving the problem of narrowed lumen of the esophagus,
insertion of a special probe designed to deliver the nutritional mixture into the stomach.

Indications for gastroscopy

The reasons for doing a gastroscopy may be:

pain, heaviness in the stomach after eating or pain on an empty stomach,
constant, debilitating heartburn,
profuse belching
“unreasonable” weight loss or lack of appetite,
frequent nausea and vomiting,
unpleasant taste sensations.

WHO statistics indicate an increase in the number of malignant neoplasms of the gastrointestinal system of people all over the world, therefore, after reaching the age of 45, it is recommended to regularly undergo preventive endoscopy, the price of which is many times lower than the cost of treatment.

Contraindications and restrictions

Direct exclusion factors for gastroscopy are:

critical stenosis that does not allow insertion of the device tip,
mucosal burns chemicals,
track damage foreign bodies,
mediastinitis - purulent or serous inflammation of the tissue, life-threatening,
dissecting aortic aneurysm,
thinning vessel walls,
acute phase of myocardial infarction or stroke.

Restrictions are imposed on endoscopy if the patient suffers from:

pronounced curvature of the spine,
a goiter of impressive dimensions,
severe form cardiopulmonary failure,
recorded mental disorders,
hemophilia.

Preparing for gastroscopy in a dream

The most informative and correct performance of esophagogastroduodenoscopy is possible only with complete removal all foreign substances that may distort the picture. Therefore, gastroscopy is usually performed on an empty stomach, with a preliminary 8-12-hour interval of abstinence from food and water. An exception is made only for emergency gastroscopy, during which tube gastric emptying is performed.

After an X-ray examination of the gastrointestinal tract using contrast agents, up to three days should pass before EGD.

Before starting the procedure, the endoscopist informs the patient about the purpose of the study and explains the features of the manipulations. Gastroscopy is performed after the patient has been put into medicinal sleep.

The endoscope and all instruments undergo multi-stage disinfection in antibacterial solutions, which completely eliminates the transfer of infection.

How is gastroscopy of the stomach performed?

The patient lies on his left side and “swallows” the endoscope, which the doctor inserts into the esophagus and then into the stomach using a flexible fiber-optic system. Within 10-20 minutes of the patient's medicinal sleep before he wakes up, the doctor has time to conduct a diagnosis and, if necessary, take samples for a biopsy. The extensive experience of SM-Clinic diagnosticians eliminates the possibility of damage to the mucous membrane during manipulations.

Gastroscopy results

The endoscopist makes the first conclusions as a result of a visual examination during manipulations. Based on the condition of the mucous membrane, he confidently diagnoses gastritis, peptic ulcer, colitis, and by changes in its color and the presence of swelling - the presence of tumor diseases. On these points, the specialist gives the patient a written conclusion with a schematic representation of the location of the identified defects.

According to statistics, 65-70% of the world population suffers from diseases of the gastrointestinal tract, for the diagnosis of which FGDS with biopsy is often used. This allows you to select the most appropriate treatment, assess the condition of the glandular tissues based on the sample taken, and timely identify pathological formations in the mucous membrane: ulcerative lesions, tumors, growths, etc.

Indications for the study

Without consultation with a leading physician and gastroenterologist, a biopsy during gastroscopy is not prescribed or performed.

Indications for the procedure:

suspicion of the development of Helicobacter microflora, diagnosing the spread of infection;
painful ulcerative defects;
damage to the stomach by Crohn's disease;
the need for monitoring and diagnosing tumor growth or ulcerative process;
detecting oncology of the gastric mucosa.

Preparation for the procedure

The doctor must study the indications, mentally prepare the patient: talk about possible risks, the process of conducting FGDS and about recovery period. A few days before fibrogastroduodenoscopy, it is necessary to avoid foods and drinks that irritate the mucous membrane and complicate the digestion process: alcohol, soda, spicy, fatty, sour or hot foods. 4 hours before the procedure, you should not eat or drink, or use medications that reduce hemastosis.

Carrying out FGDS

It is carried out with special attachments, which facilitates diagnosis.

The patient is offered anesthetic local action, for example, a spray with lidocaine, to prevent the gag reflex and pain. After the drug has taken effect, the patient is placed on his left side and a thin probe with a camera at the end, a light source and a special biopsy device is inserted into the esophagus. If neoplasms are visually detected on the mucous membrane, a sample is taken by cutting off a small fragment or by suctioning out the required number of cells. The procedure generally lasts up to 40 minutes. At the end of fibrogastroduodenoscopy, the probe is carefully removed, and a fragment of the mucous membrane is analyzed by staining. After FGDS, you can eat only after 2-4 hours. It is advisable to drink warm water in small sips.