How can you examine your stomach without swallowing an umbrella? How to check the stomach and what tests are needed for this. Clinical and biochemical types

How to check the stomach from the inside without gastroscopy if this procedure is contraindicated?

During gastroscopy, an endoscope probe is inserted into the stomach cavity, which allows you to examine the organ from the inside using lenses.

The procedure itself is unpleasant, so local anesthesia is performed when performing it, and children under six years of age and people with severe mental disorders are given anesthesia.

Probing is the most common method of examining the stomach; many have experienced or heard from others about the pain of gastroscopy and are very nervous if the doctor prescribes this examination.

However, now there are alternative methods examination of the stomach from the inside. How you can check a patient’s stomach without gastroscopy, you will learn by reading this article.

Gastroscopy has the only absolute contraindication This is the patient's dying state.

In addition, if gastroscopy is required for heavy bleeding in the stomach, there are practically no contraindications for the procedure; it can be done even in case of an acute heart attack.

But if gastroscopy is planned, then there are a number of contraindications for its use, which include:

• Aortic aneurysm, since there is a risk of its rupture;
• Myocardial infarction, cardiac and respiratory failure, stroke - in this case, the underlying disease that threatens the patient’s life is treated, and gastroscopy is done later;
• Hemophilia, hemorrhagic diathesis - with these diseases any injuries are dangerous, since it is difficult for the patient to stop the bleeding. The probe, moving through the larynx and esophagus, inevitably causes mechanical damage;
• Hypertension 3 degrees;
• Inflammation of the tonsils, stomach ulcer with threat of perforation, enlarged lymph nodes neck and mediastinum, tumors of the mediastinum, esophagus;
• Anatomical features of the patient that make it impossible to insert a probe: goiter, kyphosis, scoliosis, narrowing of the junction of the esophagus into the stomach.

Gastroscopy using a capsule

You can check your stomach without painful sensations and injuries if, instead of a probe, you swallow a special small capsule that easily slides down the esophagus and remains in the stomach for several hours.

Inside the capsule there is a sensor-video camera.

How to check the stomach with a capsule?

Before swallowing the capsule, do not eat rough food or foods that cause increased gas formation: legumes, cabbage, black bread.

You should also not drink alcohol - this is necessary so that the mucous membrane on the walls of the stomach is at least partially restored. The capsule is swallowed on an empty stomach and washed down with water.

The device remains in the stomach and intestines for eight hours, while it records everything in its path. At this time, the person does not experience any discomfort.

After 8 hours you need to return to the medical facility and take readings. The sensor will transmit images to a computer, and the doctor, after viewing the video, will be able to make a diagnosis.

In the near future, the device will leave the body on its own without causing any inconvenience to the patient.

The advantages of the method are obvious: the patient does not experience any discomfort, and the study itself, compared to conventional gastroscopy, allows one to obtain a more complete picture.

The procedure has no contraindications. Unfortunately, there are disadvantages - the device is not cheap.

In addition, if the study reveals polyps or bleeding, the capsule will not be able to help, since it is intended only for diagnosis.

After this, you will still have to resort to the classic method - gastroscopy.

Desmoid test

An expensive capsule can be replaced with a bag filled with methylene blue dye powder, but the information content of such a study is several times lower.

This method is suitable for determining the activity of gastric juice.

Methylene blue - safe for human body dye, which, after entering the stomach, is absorbed into the blood and then removed from the body by the kidneys.

The test determines how much dye has been removed. So, if the first portion of urine is blue-green, this means that the stomach secretes a large number of of hydrochloric acid.

Check the stomach with x-rays, ultrasound and MRI

An X-ray of the stomach allows you to check the functioning and identify structural abnormalities of this organ.

In this way, you can check the stomach for peptic ulcers, tumors, evaluate the parameters of the stomach, its shape and size.

X-ray machines are available in most medical institutions, so this examination is available to everyone.

Ultrasound and MRI, like x-rays, are radiation methods research, but these are more modern methods based on the use not of X-rays, which can pose a threat to the patient’s health, but of safe ultrasonic waves, radio waves and magnetic fields.

X-ray progress

The patient drinks a glass of water-barium suspension. The mixture has a chalky taste, and the consistency resembles liquid sour cream.

After this, the radiologist checks on the monitor the changes that have occurred in the esophagus and stomach. The result will be a series of radiographs that allow a detailed examination of the organ being examined.

The procedure is carried out on an empty stomach and takes 20–40 minutes.

A plain radiograph is taken before administering the contrast agent. abdominal cavity to check and rule out emergency conditions: intestinal obstruction, perforation of the stomach or intestines. The conclusion will be ready in half an hour.

Contraindications to x-rays are the first trimester of pregnancy and heavy stomach bleeding. Barium should not be taken if you have an allergic reaction to iodide preparations.

Ultrasound examination

Ultrasound is now a very popular method; ultrasound diagnostic rooms are available in many medical institutions.

An abdominal ultrasound is performed to check whether internal bleeding and tumors. The examination allows a good look at large organs, such as the stomach.

The method is completely safe and can be used even during pregnancy at any stage, but it does not allow obtaining layer-by-layer images of tissue, and in some cases they help in making a diagnosis.

Ultrasound is often used not for diagnosis, but to check the diagnosis, since the method cannot guarantee accurate results.

If a detailed examination is needed, doctors prefer to check the stomach using gastroscopy or prescribe a referral for an MRI.

Magnetic resonance imaging

The disadvantage of this method is its poor availability. MRI equipment is expensive - several million dollars.

It is installed in specially equipped rooms, so not every hospital or medical center can conduct such studies.

But MRI helps to make a diagnosis if this cannot be done using another method for some reason.

The results of the tomographic examination are processed computer program, which eliminates the possibility of omissions on the part of medical personnel.

Contraindications for MRI of the stomach are pregnancy, since the procedure requires the introduction of a special substance into the bloodstream.

The study cannot be carried out if there are foreign metal objects in the body: prostheses, implants.

So, gastroscopy is not the only method of examining the stomach, but it is optimal in terms of price-availability-information content.

In addition, with gastroscopy, you can not only do a visual examination of the stomach, but also take a biopsy and carry out certain healing procedures. This explains the high popularity of the method.

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 gastric mucosa 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 internal organs 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 membranes of all upper sections Gastrointestinal tract. The doctor examines not only the stomach and duodenum, but also the esophagus.

Prices do not differ for FGS, FGDS, EGDS. Most informative method is considered 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 minutes of medicated sleep using special drugs. Modern drugs designed for research under sedation are not considered 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 experience diagnostics


• 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. None X-ray examination does not provide 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 The endoscope allows the following treatment procedures to be performed:

• injections or spraying with medications,
• polyp removal,
• 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 show an increase in the number malignant neoplasms 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,
• delaminating 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,
• fixed 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 X-ray examination gastrointestinal tract with the use of 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 disease, colitis, and based on 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.

The purpose of examinations of the gastrointestinal tract is based on the symptoms presented by the patient, and for the purpose of control and prevention of diagnosed chronic diseases Gastrointestinal tract. Indications for diagnostic procedures may include: difficult and painful digestion (dyspepsia), regular nausea, vomiting, heartburn, stomach pain, suspicion of cancer.

Today, the most accurate examination of the gastrointestinal tract is fibrogastroduodenoscopy. During FGDS, the gastroenterologist has the opportunity to assess in detail the condition of the mucous membrane of the stomach and duodenum, and make the only correct diagnosis. The difficulty of the examination lies in the inability of some patients to swallow a flexible hose equipped with a video camera.

Many people ignore the procedure precisely because of the discomfort. Therefore, it would be useful to find out how to check the stomach without gastroscopy in order to promptly diagnose this or that pathology. In addition to the vegetative prejudice to FGDS, there are a number of contraindications to its implementation: a history of impaired hemostasis (blood clotting), bronchial asthma, gag hyperreflex.

In such cases, other methods of examining the stomach are prescribed. Diagnosis of diseases and abnormalities in the functioning of the stomach is carried out in three main areas: a physical complex of measures, laboratory test patient tests, examination using medical diagnostic equipment, alternative endoscopy.

Easy diagnostics

Simple diagnostic methods are mandatory for use when a patient complains of acute stomach, nausea and other symptoms of stomach diseases.

Physical examination

Physical measures are carried out at a doctor’s appointment, the results depend on the qualifications of the medical specialist. The complex includes:

• studying the anamnesis, assessing symptoms from the patient’s words;
• visual examination of mucous membranes;
• feeling painful areas of the body (palpation);
• palpation in a specific body position (percussion).

Based on the results obtained from such an examination, it is extremely difficult to diagnose the disease. The doctor may suspect the presence of a pathology, but more is needed to confirm it. deep methods research.

Microscopic laboratory diagnostics

Laboratory methods consist of taking samples from the patient for further study and evaluation of the results. Most often, the following physical and chemical studies are prescribed:

• general urine analysis;
• coprogram (stool analysis);
• clinical blood test. The number of all types of blood cells (erythrocytes, leukocytes, platelets) is counted and the hemoglobin level is determined;
• gastropanel. This analysis blood is aimed at studying the condition of the gastric mucosa. Based on its results, the following is determined: the presence of antibodies to Helicobacter pylori bacteria, the level of pepsinogen proteins produced, the level of the polypeptide hormone - gastrin, with the help of which the acidic environment in the stomach is regulated;
• blood biochemistry. Installed quantitative indicators bilirubin, liver enzymes, cholesterol and other blood elements.

Blood collection for clinical analysis carried out from a finger

Analyzes help identify inflammatory processes and other disorders of organs and systems. If the results differ significantly from standard indicators, the patient is prescribed an instrumental or hardware examination.

Application of hardware techniques

Examination of the stomach without gastroscopy is carried out with the participation of special medical devices. They record the condition of the mucous membrane, density, size and other parameters of the organ, and transmit information that is subject to subsequent decoding by a specialist.

• x-ray examination(using contrast);
• CT and MRI (computer and magnetic resonance imaging);
• EGG (electrogastrography) and EGEG (electrogastroenterography);
• Ultrasound (ultrasound examination).

During a gastric examination using a hardware method, all manipulations are performed without direct intervention in the body, without damaging the external tissues of the body (non-invasive). The procedures do not cause pain in the patient.

Significant disadvantages of the method include low information content in the initial period of the disease, exposure to X-rays that is unsafe for health, and side effects from taking a barium solution.

X-ray with contrast

The method is based on the use of X-rays. To improve visualization of the stomach, the patient drinks a barium solution before the examination. This substance plays the role of contrast, under the influence of which soft fabrics acquire the ability to absorb x-rays. Barium darkens organs digestive system in the image, which allows you to detect possible pathologies.

X-ray helps in determining the following changes:

• incorrect location of organs (displacement);
• condition of the lumens of the esophagus and stomach (enlargement or narrowing);
• non-compliance of organs with standard sizes;
• hypo- or hypertonicity of organ muscles;
• niche in the filling defect (most often, this is a symptom of peptic ulcer disease).

CT scan

Essentially, this is the same X-ray, only modified, with expanded diagnostic capabilities. The examination is carried out after first filling the stomach with liquid for a clearer view.

In addition, an iodine-based contrast agent is injected intravenously to highlight blood vessels on the tomogram. CT is usually used when tumor processes of oncological etiology are suspected. The method allows you to find out not only whether a patient has stomach cancer and its stage, but also the degree of involvement of adjacent organs in the oncological process.

The imperfection of diagnosis is the patient's exposure to radiation x-rays, possible allergic reactions to contrast, as well as the inability of CT to completely and in detail study the digestive tract, since its hollow tissues are difficult to diagnose using CT. The procedure is not performed on women during the perinatal period.

MRI

The prerogative aspects of MRI include the use of magnetic waves that are safe for the patient and the ability to determine the initial stage of gastric cancer. Besides, this diagnostic prescribed for suspected ulcers, intestinal obstruction and gastritis, to assess the adjacent lymphatic system, and detect foreign objects in the gastrointestinal tract. Disadvantages include contraindications:

• body weight 130+;
• the presence in the body of metal medical supplies (vascular clips, pacemaker, Ilizarov apparatus, implant prostheses inner ear);
• quite high cost and inaccessibility to peripheral hospitals.

Examination of the gastrointestinal tract on a magnetic resonance imaging scanner is often performed with contrast

EGG and EGEG

Using these methods, the stomach and intestines are assessed during peristaltic contractions. A special device reads impulses of electrical signals that come from organs when they contract during the digestion of food. It is practically not used as an independent study. Used only as an auxiliary diagnostic. The disadvantages are the long time period of the procedure (about three hours) and the inability of the electrical device to detect other gastrointestinal diseases.

Ultrasound

Ultrasound diagnostics of the stomach is most often carried out as part of comprehensive examination abdominal organs. However, unlike the indicators of other organs (liver, pancreas, gallbladder, kidneys) it is not possible to completely examine the stomach. There is no full picture of the organ.

In this regard, the list of diagnosed diseases is limited:

• abnormal change in organ size, swelling of the walls;
• purulent inflammation and the presence of fluid in the stomach;
• limited accumulation of blood in case of organ damage with rupture of blood vessels (hematoma);
• narrowing (stenosis) of the lumen;
• tumor formations;
• protrusion of the walls (diverticulosis) of the esophagus;
• intestinal obstruction.

It is advisable to carry out an ultrasound examination of the abdominal organs annually

The main disadvantage of all hardware diagnostic procedures is that a medical specialist examines only external changes stomach and adjacent organs. In this case, it is impossible to determine the acidity of the stomach and to collect tissue for further laboratory analysis (biopsy).

Addition to hardware diagnostics

Additional method is Acidotest (taking a combined medical product to establish approximate gastric pH values). The first dose of medication is taken after bowel movement Bladder. After 60 minutes, the patient takes a urine test and takes the second dose. An hour and a half later, urine is collected again.

Before testing, it is forbidden to eat food for eight hours. Urine analysis reveals the presence of dye in it. This allows you to roughly determine the acidity of the stomach without gastroscopy. The acid test does not give 100% effectiveness, but only indirectly indicates a reduced (increased) level of acidity.

Alternative endoscopy

The closest to FGDS in terms of information content is capsule endoscopy. The examination is carried out without swallowing the probe, and at the same time reveals a number of pathologies that are inaccessible to hardware procedures:

• chronic ulcerative and erosive lesions;
• gastritis, gastroduodenitis, reflux;
• neoplasms of any etiology;
• helminth infestations;
• inflammatory processes in the small intestine (enteritis);
• cause of systematic digestive disorders;
• Crohn's disease.

The diagnostic method is carried out by introducing a capsule with a tiny video camera into the patient’s body. There is no need for instrumental introduction. The weight of the microdevice does not exceed six grams; the shell is made of polymer. This makes it easy to swallow the capsule with enough water. The video camera data is transmitted to a device installed on the patient’s waist, from which the doctor takes readings after 8–10 hours. At the same time, the rhythm of a person’s usual life does not change.

Capsule for endoscopic examination of the stomach

The capsule is removed naturally during bowel movements. Significant disadvantages of the technique include: the inability to perform a biopsy, the extremely high cost of the examination. All gastrointestinal diagnostic methods include preliminary preparation body. First of all, this concerns nutritional correction.

The diet should be lightened a few days before the examination. Hardware procedures can only be performed on an empty stomach. The stomach can be checked using any method that is convenient and not contraindicated for the patient. However, the palm in terms of information content, and therefore maximum accuracy of diagnosis, remains with FGDS.

Content

A replacement for FGS (fibrogastroscopy) is gastroscopy of the stomach without swallowing the probe, which is performed without the use of a tube. Such modern way checking the condition of the patient's gastrointestinal tract is considered safer, indicated when panic fears patient before swallowing a probe with optical system. It also allows for a more accurate examination of the gastrointestinal tract.

What is gastroscopy of the stomach

In medical terminology, gastroscopy of the stomach is understood as a type of endoscopic examination. The procedure involves a visual examination of the walls of the esophagus, stomach and duodenum using a gastroscope - an endoscopic probe. The latter is a thin flexible tube with an optical system. The procedure is not the most pleasant and is accompanied by discomfort, so a replacement was invented - an examination of the stomach without gastroscopy.

How to check your stomach without swallowing a tube

The advantages of classic light bulb gastroscopy are the ability to take tissue for biopsy or cauterize bleeding throughout the gastrointestinal (GI) tract. For those patients who are afraid of the classical procedure due to negative reviews or has contraindications to it, an alternative to FGDS has been developed:

• capsule endoscopy;
• virtual colonoscopy;
• CT scan stomach cavities;
• replacement with X-ray contrast examination;
• electrogastrography and electrogastroenterography (special devices are used).

Gastroscopy without swallowing the probe

Popular modern method is capsule gastroscopy or video pill. This is a less invasive way to examine the gastrointestinal tract, which conducts an examination and shows the results very accurately. What differs from gastroscopy with swallowing a probe is that it provides more information about the condition small intestine and the ability to detect diseases at early stages. After such an examination of the digestive tract, a correct diagnosis can be made.

Instead of a conventional camera, biomarkers are built into the capsule, tuned to respond to specified substances. The body is examined more slowly. A research option is to swallow a capsule measuring 11*24 mm with a built-in sensitive video sensor. He takes several thousand frames, from which the doctor makes a conclusion about diseases.

Indications for gastroscopy

Like the classic FGS procedure, Painless gastroscopy of the stomach without swallowing the probe is performed for the following indications:

• detailed study of the mucous membrane of the stomach, esophagus, duodenum;
• suspicion of tumor, bleeding, stomach ulcer;
• treatment of diseases of gastritis, duodenitis, esophagitis;
• clarification of the diagnosis of pathology for allergies, neuroses;
• detection of stomach acidity.

• cardiac ischemia;
• hypertension;
• pronounced curvature of the spine;
• aortic aneurysm;
• a history of cerebral infarction or stroke;
• varicose veins of the esophagus;
• narrowing and ulcer of the esophagus;
• hemophilia;
• hemorrhagic diathesis;
• obesity;
• exhaustion;
• endemic goiter of the thyroid gland.

Advantages and disadvantages

Examination of the stomach with this method has the advantage of eliminating the need to swallow the tube (reducing fear and panic attacks in patients before manipulation), high information content, elimination of discomfort and pain without anesthesia. The diagnostic procedure is suitable for those people for whom classical FGS with tube insertion is contraindicated. The disadvantages of capsule endoscopy include the following factors:

• the procedure is expensive;
• there is no possibility to collect material for a biopsy;
• it is impossible to specifically examine the pathology of the stomach walls;
• there is no possibility of carrying out therapeutic measures– removal in the presence of polyps, stopping gastric bleeding.

Contraindications

There are contraindications for performing gastroscopy without swallowing a flexible probe:

• impaired swallowing function (dysphagia);
• age up to 12 years;
• pregnancy;
• elevated vomiting reflex;
• closing the lumen of the gastrointestinal tract (organ obstruction);
• the presence of a pacemaker and an implant powered by electricity, neurological electrical stimulators;
• intestinal obstruction due to the presence of a mechanical obstruction, impaired peristalsis;
• narrowing of the intestine due to fistulas and strictures (openings and closed spaces).

Preparation

Before undergoing capsule endoscopy, the patient must perform a number of actions to facilitate the procedure:

• within two days, start eating only liquid or solid food;
• do not consume cabbage, legumes, alcohol, milk, fresh baked goods, carbonated drinks;
• take medications that reduce flatulence 24 hours before;
• on the evening before the study, to cleanse the intestines, take the medicine “Fortrans” - from 16.00 to 20.00, drink a liter of suspension (one sachet per liter);
• stop eating food altogether within 12 hours;
• the procedure lasts 6-8 hours, the capsule is washed down with plain water, taken on an empty stomach;
• During the procedure, you can play sports, but do not make sudden movements or lift weights;
• after a certain time, which is prescribed by the doctor, the patient comes to the hospital to remove the capsule; this must be done naturally.

How does the procedure work?

Once in the esophagus, the capsule begins to work and take photographs. For eight hours it moves through the gastrointestinal tract along a natural trajectory. During this, the patient is in the hospital or at home, without performing heavy loads. There is no discomfort during the procedure. The doctor receives data from her notes, after which after 1-2 days the capsule leaves the body naturally. The diagnosis obtained by this method is highly accurate.

Price

You can perform an analogue of FGS - gastroscopy without swallowing a probe to examine the stomach in the usual free clinics upon doctor's prescription and if you have a compulsory health insurance policy, or in private hospitals. Approximate prices for the capsule method of checking the gastrointestinal tract in Moscow:

Video

Modern medicine offers wide choose diagnostic procedures that allow the most complete examination of the stomach. All methods are conventionally divided into the following types: physical, clinical, instrumental diagnostics. Each type of research and method allows you to obtain a certain picture and general analysis and decoding the results to make a diagnosis.

Diagnostic methods

Methods for examining the stomach are prescribed and carried out by a gastroenterologist based on the patient’s complaints about indigestion, abdominal pain, heaviness, bloating, heartburn, belching, and stool disorders.

The most common and effective traditional methods stomach examinations - esophagogastroscopy (EGD), fluoroscopy with contrast. Modernized, modern procedures that allow for a more accurate examination of the stomach include CT and MRI. Today medicine offers alternative options diagnosing gastrointestinal diseases, such as video pill, electrogastrography and electrogastroenterography.

Depending on the type and power of the device, you can examine all organs of the gastrointestinal tract (esophagus, stomach, duodenum), take biomaterial for histology and cytological analysis. Methods for examining the stomach can be used in combination in complex cases, or only some of them can be prescribed.

First, the doctor analyzes the complaints, examines the patient, palpates and listens to his abdomen.

All manipulations performed by a gastroenterologist are combined into three large groups:

1. A physical examination, when the doctor analyzes complaints, examines the patient, palpates and listens to his abdomen, determines how much the epigastric region hurts.
2. Laboratory tests that suggest research biological fluids and patient tissues for hemoglobin, general and biochemical parameters.
3. Hardware techniques, when the patient is examined using certain devices, instruments and instruments.

Physical methods

The first way to make a diagnosis is to talk with the patient and perform a physical examination. It is carried out in several stages:

1. Conversation, history taking, analysis of the patient’s complaints, especially the nature of the pain.
2. General examination: evaluates appearance patient, changes in skin color and structure. Pallor skin, exhaustion, cachexia speak of cancer, advanced pyloric stenosis, and lack of hemoglobin. Grayish skin, anorexia, and a doomed look signal a stomach ulcer, bleeding, and decreased hemoglobin.
3. Survey oral cavity. Caries indicates infection, lack of teeth indicates poor digestion. The condition of the tongue is also used to diagnose the disease:
   • clean, moist - an ulcer in remission;
   • grayish coating, bad smell- acute gastritis;
   • dry tongue, acute abdomen - peritonitis, perforation of deep erosions, acute pancreatitis, lack of hemoglobin due to bleeding;
   • atrophic, smooth surface - stomach cancer, chronic gastritis with low acid content in gastric juice;
   • ulceration - poisoning with acids, alkalis.
4. . In severely malnourished patients, the contours of the stomach are visualized, which can be used to determine pyloric stenosis, gross peristalsis, and tumors in the organ. When palpating, it is determined how much the epigastrium hurts, an acute abdomen, irritation or tension of the peritoneum are detected.
5. Percussion. In a certain position of the body, for example, when you need to lie down and raise your arms up, conditions are created under which noises, splashes, high or low tympanitis are heard from the stomach.
6. Auscultation. Listening allows you to evaluate the peristaltic sounds of the intestines and stomach.

Based on a physical examination, the doctor makes a preliminary diagnosis and can determine priority methods in order to conduct a more detailed examination of the stomach and duodenum.

Clinical and biochemical types

The laboratory examination technique involves taking blood samples (they are given from a finger and a vein), urine, feces, followed by their examination for specific parameters, in particular, hemoglobin.

Blood is analyzed in two ways:

• standard, when it is necessary to assess the degree of inflammation, anemia, determine the level of total hemoglobin and blood particles (erythrocytes, platelets, lymphocytes);
• biochemical, when assessed as low or high level bilirubin, amylase, hemoglobin, ALT, AST, general characteristics of the blood serum. You should also take samples of biomaterials for cytology, histology and other specific tests.

A urine test allows you to judge the general condition of the body. For example, if the diastase level is increased, pancreatitis is suspected; if urobilin increases, jaundice is suspected.

Stool analysis can determine the presence helminthic infestation, giardiasis, detect occult blood. The quality of digestion is also assessed. If you submit the material for culture, you can determine the state of the colon microflora.

Ultrasound examination of the stomach

The first instrumental, probe-free method for examining the stomach when the stomach hurts is ultrasound. However, ultrasound allows one to assess the condition of only the terminal, exit zones of the organ due to the peculiarities of its location and filling. Consequently, ultrasound allows us to examine part of the stomach, the duodenal bulb, the pyloric canal and cave, areas of the lesser and greater curvature, and the sphincter in the pyloric region. Advantages:

• ease of tracking peristalsis;
• duplex scanning;
• multi-positionality;
• high speed of the procedure.

X-ray

The method is carried out using a contrast agent in the form of a suspension of barium sulfate. Before the procedure, the patient drinks a solution that slowly fills the gastrointestinal tract. As the sulfate passes through, they are made x-rays different departments. Decoding is carried out according to the following indicators:

• shape of a filled stomach;
• organ contours;
• uniformity of contrast distribution;
• structure, motor activity of the gastrointestinal tract.

Based on the combination of symptoms, peptic ulcer, tumor, gastritis, and evacuation dysfunction are diagnosed.

The most accurate data can be obtained by radial fluoroscopy on the condition of the laryngeal part, narrowing of the esophagus, diaphragm, codial parts and curvature of the stomach. Flaws:

• limited information content;
• constipation, difficulty passing hard, discolored stool.

Gastropanel

The methods are the fastest and most effective options for preliminary diagnosis of gastric pathologies. Gastropanel (cytology, histology) includes a set of safe tests that detect:

• dyspepsia;
• Helicobacter infection;
• atrophic form of gastritis.

At the same time, the risks of transformation of stomach diseases into cancer, peptic ulcer in the curvature, into severe atrophic forms with anemia with low hemoglobin, osteoporosis, pathologies of the heart, blood vessels, and central nervous system are assessed.

The essence of gastropanel diagnostics is research venous blood patient under a special program. The result includes decoding and comparison of indicators with standards, detailed description and treatment recommendations, graphical diagrams of possible risks of developing severe illness and complications.

Probing, endoscopy, biopsy

Introduces research methods secretory function stomach. This procedure allows you to obtain samples and evaluate the contents of the stomach according to a number of parameters: acidity, enzymatic activity, etc. For this, a special thin, flexible tube is used, which is inserted through the patient’s mouth into all organs of the gastrointestinal tract. Depending on the diagnostic purposes, the contents of the stomach and duodenum are selected from different parts.

During gastroscopy, colonoscopy or esophagogastroduadenoscopy of the stomach, a visual assessment of the condition of the organ is performed using an endoscope - a probe with an optical tube, at the end of which there is a video camera and a lighting device. Using the procedure, superficial changes in the mucosa are detected that are not visualized by other methods. Goals of traditional gastroscopy or colonoscopy:

• differential diagnosis of neoplasms;
• recognition of the early stages of malignancy;
• tracking how deep erosion heals;
• identifying sources of blood loss;
• conducting biopsy histology;
• choice of treatment regimen.

During the manipulation, tissue samples are taken from the gastric walls for biopsy with cytology and histology, which involves examining tissue if polyposis or organ cancer is suspected. The main advantage is the ability to determine the onset of a malignant process at an early stage.

Alternative Methods

Until now, to visualize the entire gastrointestinal tract, in particular the stomach, it was necessary to use unpleasant procedures involving swallowing a gastroscope. But the main advantage of such a device is its versatility, which consists in the ability to conduct an internal examination, take a biopsy for cytology with histology, carry out treatment (stopping bleeding that causes a drop in hemoglobin) or minor operations, for example, to remove small polyps.

• capsule endoscopy;
• CT (virtual colonoscopy/gastroscopy);
• X-ray contrast examination;
• electrogastrography (EGG) and electrogastroenterography (EGEG).

"Video Pill"

Capsule endoscopy is a minimally invasive, probe-free option for examining the gastrointestinal tract in real time. Advantages:

• more accurate data and breadth of assessment of the condition of the mucosa and walls;
• the ability to detect diseases in the early stages;
• absolute absence of pain;
• possibility of choice optimal scheme treatment.

The essence of the procedure:

• the patient absorbs an 11x24 mm capsule equipped with a video sensor and goes home;
• as it passes, the device captures several thousand frames.

You need to start the manipulation on an empty stomach, after which you can eat regular food. The operating time of the capsule is 6-8 hours. During this time, it is allowed to lead a normal lifestyle, with the exception of playing sports and performing sudden movements. At the end of the specified time, the patient returns to the hospital to transfer data from the device. The capsule itself leaves the body naturally after a few days. Flaws:

• the impossibility of approaching the suspicious area for a more detailed examination;
• inability to take a biopsy for histology.