Help fgds. Correct interpretation of the FGDS conclusion and the established norm: how to decipher what the doctor said? Fgds conclusion norm

Fibrogastroduodenoscopy is an internal examination of the esophagus and stomach using an endoscope. A FGDS certificate may be needed for the military registration and enlistment office upon admission to the service, to confirm the health group at an educational institution or to receive a ticket to a sanatorium.

Tasks and methods of fibrogastroscopy

The FGDS procedure allows you to identify such pathologies of the stomach and esophagus as gastritis, peptic ulcer or cancer. When the study is needed according to indications in the presence of epigastric pain or other problems, EGD is really worth doing. But if a medical document is required only to comply with the formalities, it is better to buy a certificate of gastroscopy in order to avoid discomfort.

The main problems that the patient faces during endoscopic examination of the stomach:

• severe discomfort when swallowing the tube;
• the need to refuse food intake 8-12 hours before FGDS;
• vomiting reflex;
• the use of local anesthetics to suppress the reflex, to which an allergic reaction may develop.

Data on the passage of FGDS

After the study, the information is entered sequentially in the form: first, a description of the esophagus, then the stomach, etc. Usually, the endoscopist describes the type of mucous membrane, patency, the contents of all departments, peristalsis and the shape of the holes. At the end of the form, a conclusion is made on compliance with the norm or identified pathologies. If you buy a ready-made FGDS certificate, you can choose according to the situation what data will be entered there.

For example, in order to receive a deferral for military service or to be sent to a sanatorium for rehabilitation, you can buy a conclusion with a detected pathology. For successful hiring, on the contrary, they buy a certificate from the FGDS with a conclusion on the absolute norm. In some cases, when the procedure is of practical importance (before surgery or to clarify the diagnosis), it is definitely worth going through.

Benefits of obtaining a ready FGDS certificate

It is beneficial to buy an FGDS certificate with the desired diagnosis for several reasons:

• no need to stand in a long queue or spend thousands of rubles on an unnecessary examination in a private clinic;
• the ability to avoid discomfort during the conduct and preparation for the study;
• no need to allocate a whole day and adjust to the time of the specialist;
• guarantee of obtaining the desired conclusion in the certificate.

By filling out an application online, you can buy the necessary document with free delivery by courier to the specified place at any chosen time. All data from the order are entered on the original form with the seal of the medical institution and the signature of a real specialist. We offer to buy a certificate of gastroscopy at an affordable price, not exceeding the cost of the examination itself in the clinic. We guarantee the legitimacy of the document and the confidentiality of cooperation.

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Despite the fact that information about medical research is not hidden, many potential patients still have difficulty familiarizing themselves with the procedures due to the complexity of medical equipment and the vagueness of doctors' prescriptions. Therefore, the questions: “Is preparation for gastroscopy of the stomach required, and what should be done before the examination?” may remain undisclosed. With that in mind, let's clear up the misunderstanding.

What is gastroscopy of the stomach

Gastroscopy is an instrumental method for examining the mucosa of the organs of the upper gastrointestinal tract, in particular the stomach, using a gastroscope. Another name for the survey is FGS. The upper GI tract includes:

1. Esophagus.
2. Stomach.
3. 12 duodenal ulcer.

Hence the full name of the procedure - EGDS (esophagogastroduodenoscopy). This examination is performed by an endoscopist.

With the help of a video endoscope, the doctor can:

• Detail individual problem areas of the mucosa of the organ.
• Take material for biopsy.
• If a tumor is detected at the initial stage of its development, remove a fragment of the mucosa.

A tiny piece of tissue obtained from a biopsy is enough to verify the presence of pathology. It is necessary to distinguish another method - FGDS (fibrogastroduodenoscopy). Its difference consists only in the absence of examination of the esophagus.

Indications for gastroscopy

This diagnostic method is best used to confirm and differentiate various pathologies of the stomach. For example:

• Chronic gastritis.
• Suspicion of a tumor of the stomach.
• Polyps.
• Stomach bleeding.

Symptoms for which there is a direct indication for gastroscopy:

• Pain that occurs in the epigastrium (pit of the stomach) associated with eating. Pain appears either on an empty stomach, or a couple of minutes after eating.
• With frequent manifestation of heartburn.
• Frequent belching with a sour taste.
• Frequent nausea, with possible subsequent vomiting of previously taken food.
• Chronic feeling of heaviness and distension of the abdomen after eating.

Obviously, there are contraindications, namely:

• Symptoms of a hypertensive crisis.
• Violation of the heart rhythm.
• Recent or current myocardial infarction, stroke, or cardiovascular insufficiency.
• Deep mental disorders of behavior that do not allow the procedure.
• Decompensation of the respiratory system.
• Aortic aneurysm.

How to prepare for gastroscopy of the stomach?

Briefing before the procedure can be carried out by both a gastroenterologist and an endoscopist.

Since a fasting period of at least 6-8 hours is required before the study, it is carried out in the morning on an empty stomach. Rarely, gastroscopy is performed with the use of narcotic analgesics. Then the period of refusal of food and liquid is recommended to be increased according to the recommendations of the anesthesiologist.

Gastroscopy technique

Today, the patient, depending on the level of service, can be offered several options for such a diagnosis:

1. Relatively cheap conventional method, but with some innovations. In almost all people, the process of swallowing even the thinnest endoscope hose causes a gag reflex. Doctors use certain drugs to eliminate this problem, for example:

• Means for relaxing the nervous system.
• Medicines for anesthesia of the pharyngeal ring (lidocaine).
• Muscle relaxants.

2. The second technique differs in that the patient can refuse a bunch of drugs and anesthesia, and simply conduct a study in a dream. For this, short-acting hypnotics are preliminarily prescribed. This approach is absolutely harmless and has practically no contraindications.

3. More expensive, but more comfortable - diagnostics using special disposable capsules. This device is equipped with:

• Color mini video camera.
• Flashlight.
• Mini radio transmitter.
• Battery supply (provides 6-8 hours of work).

This method gives an adequate picture of what is happening in the patient's gastrointestinal tract. No special training is required, all you need is:

1. Swallow the pill with plain water.
2. Then she records everything she goes through on video, sending the data to a special reader.

The main advantage is that the capsule shows the mucosa of the entire gastrointestinal tract from the esophagus to the rectum. The method also has disadvantages - the inability to take a smear or biopsy.

Diet before examination

Preparation for the diagnosis of the gastrointestinal tract always provides for a diet, and it, in turn, requires the exclusion from the diet (for two days) of certain products:

• Saturated with vegetable fats (seeds, linseed oil, etc.).
• Alcoholic drinks.
• Coffee.
• Dark chocolate.
• Spicy food.

In the evening before the examination, you should have a good dinner, without using the above products. This time, steamed dishes, salads and other easy-to-digest foods are suitable for food.

Photo: Superficial gastritis

The results of gastroscopy of the stomach, their interpretation

The description of the study and the conclusion on the results are made by the endoscopist (and only a gastroenterologist can prescribe treatment and referral for diagnosis).

For example, the conclusion might be something like this:

1. We pass freely.
2. The color of the mucosa is pink.
3. The cardiac sphincter does not fully contract.

1. The dimensions of the lumen are within the normal range.
2. The lumen contains a moderate amount of mucus.
3. The size of the folds is within the normal range.
4. The mucosa is moderately hyperemic.
5. The gatekeeper is passable.

duodenum 12:

1. No deformations were found in the bulb.
2. The color of the mucosa is pink.
3. Postbulbar departments without changes.

Conclusion: Superficial gastritis (hyperemia testifies to it - reddening of the gastric mucosa). Insufficiency of the cardiac sphincter.

Which doctor should be consulted?

After reviewing everything described above, you can get an idea of ​​​​what gastroscopy means, and which specialist you need to contact. With symptoms indicating damage to the digestive tract, a person should first of all contact a gastroenterologist, who, in turn, writes out a referral to an endoscopist.

Patients who are aware of their problem, if desired, are examined more often and at their own discretion, in order to ascertain the positive dynamics of treatment. But such people are usually well aware of what is included in the examination and how to prepare for it.

Prices

Approximate prices for services:

• Gastroscopy - 2700 rubles.
• Gastroscopy under anesthesia - 5500 rubles.
• Gastroscopy in the evening - 2200 rubles.
• Gastroscopy in the evening and under anesthesia - 5000 rubles.

Additional services that can be provided during the study:

• Test for - 1100 rubles.
• Biopsy — 1200 rub.
• Collection of material for histology - 2000 rubles.

Project consultant, co-author of the article: Ovchinnikova Natalya Ivanovna| Gastroenterologist, Hepatologist, Infectionist
Experience 30 years / Doctor of the highest category, Candidate of Medical Sciences

Education:
Diploma in General Medicine, Novosibirsk State Medical Institute (1988), Residency in Gastroenterology, Russian Medical Academy of Postgraduate Education (1997)

Fibrogastroduodenoscopy is one of the most accurate and affordable methods for diagnosing diseases of the gastrointestinal tract. Based on the results of FGDS, it is possible to identify even such difficult-to-diagnose diseases as cancer and metastases in the stomach, hyperplastic changes in the mucous membranes of the gastrointestinal tract and erosive and ulcerative processes, as well as determine the nature of unpleasant symptoms. FGDS is also used to clarify the diagnosis.

Visually established changes, including at the cellular level, revealed as a result of organ biopsy within the framework of FGDS, help to draw the right conclusions. The source of this information is the description of the conclusion, which is compiled by the attending physician on the basis of the result compiled by the endoscopist. For ordinary patients, this document is as incomprehensible as a letter in Latin. This article contains information that will help you understand what is considered normal and what refers to pathology in the results of gastroscopy.

The standard conclusion of gastroscopy contains a description of each of the investigated departments. For FGDS, this is the esophagus, stomach and duodenum 12. Almost all pathologies affecting these organs are described in the results of gastroscopy in accordance with the order of detection, that is, starting with changes in the esophagus and ending with signs of diseases in the duodenum.

What changes can be mentioned in the conclusion of gastroscopy as a pathology:

1. Hyperemia of the mucous membranes. Redness indicates an inflammatory process that the doctor can detect in different parts of the digestive tract. Such an item will contain the conclusion of FGDS for gastritis (hyperemic foci are localized in the stomach), duodenitis (hyperemia is localized in the duodenum 12) or esophagitis (hyperemia of the mucous membranes in the esophagus).
2. Ulceration of the mucous membranes. Pathological foci are described as rounded neoplasms with a depression in the center and a protruding border along the edges. According to the degree of formation of such a region, acute and chronic peptic ulcer disease differ. So, with an ulcer with a weakly pronounced border, FGDS reveals an acute process, and in a chronic course, the edge is denser and higher.
3. Hyperplasia of the mucous membranes, which are described in the conclusion of the FGDS as the presence of a cylindrical epithelium in places where there should be a squamous epithelium. Such changes are observed in pancreatitis with duodenal reflux in the lower part of the gastric sac, as well as in esophageal reflux in the esophagus. Without fail, the FGDS conclusion indicates the degree of changes, for example, that the mucosa is moderately hyperplastic, or that the foci of hyperplasia are extensive.
4. Atrophy of the mucous membranes, that is, thinning of the endothelium lining the organs. Such changes in the results of gastroscopy are often evaluated as indirect signs of pancreatitis if they are found in the duodenum, as Barrett's disease with lesions of the mucous membranes of the esophagus, or as a sign of chronic atrophic gastritis with localization of foci in the stomach.
5. Changes in the anatomical structure of organs - narrowing (strictures) and dilatation (expansion), perforations (a through hole in the wall of an organ) or diverticula (a protrusion in the wall of an organ in the form of a sac). In the conclusion of gastroscopy, their size and localization are indicated.
6. Neoplasms - polyps of the esophagus, polyps and cancer of the stomach, polyps of the duodenum 12. In the results of FGDS, the endoscopist indicates their localization, takes photographs and pinches off part of the neoplasms for histology.
7. Atypical mucous lake - a digestive secret, colored green, pink or red. Green color on FGDS images indicates duodenal reflux, and red shades indicate bleeding.

In addition, the sphincters that separate the sections of the gastrointestinal tract are diagnosed. The doctor in the conclusion of FGDS describes their structure, assesses the tone and ability to close and open. In the presence of pathologies, valve insufficiency is most often indicated in the results of gastroscopy.

Is it possible to see stomach cancer on EGD?

Even if neoplasms are detected that look like cancer, no specialist will unequivocally state that the patient is sick with stomach cancer. In most cases, they are visible on the surface of the mucous membranes, however, it is impossible to visually distinguish a benign polyp from a malignant cancerous tumor, especially if it has just begun to grow.

Good to know! If the neoplasm is small, but there is a suspicion of cancer, a biopsy is taken during gastroscopy. In the future, the tissue is examined in the laboratory, and based on these results, a final diagnosis is made.

Only an experienced specialist, who has hundreds or even thousands of gastroscopy procedures, can visually determine cancer. Another option for making a diagnosis without histology and cytology is advanced cancer. So, with cancer of the intestine and stomach at 2 and later stages, a network of blood vessels feeding the tumor is visually visible. Starting from stage 3, the tumor body may show signs of destruction, that is, its surface differs markedly from ordinary polyps.

Cardia insufficiency on EGD - what is it

The cardiac sphincter, located at the bottom of the esophagus, has the shape of a rosette, the edges of which are tightly closed. If gastroscopy shows that the edges of the sphincter do not close tightly enough, its insufficiency is diagnosed.

Other signs may also support this diagnosis. For example, insufficiency of the cardia is accompanied by damage to the mucous membranes in the lower part of the esophagus. In addition to hyperemia, ulcers, foci of hyperplasia or atrophy can be observed on them.

Important! Insufficiency of the cardiac sphincter in the absence of therapy can provoke cancer of the esophagus, so it is important to identify the disease in time and treat it.

What does a normal conclusion look like?

The results of gastroscopy, during which no pathological changes were detected, contain the same items as if they were present. In this case, the FGDS conclusion indicates the phrase “without pathologies” or describes the current state of the organs.

What do normal results of gastroscopy of the stomach, esophagus and duodenum look like:

• mucous membranes are normally even, shiny, have a pronounced folded structure and are painted in a pale pink color;
• the mucous membranes of the duodenum 12 are velvety, matte, painted in a pale pink color, moderately moistened;
• mucous lake - transparent, slightly covers the folds;
• the sphincters separating the stomach from the intestines and esophagus are in good shape, when pushing the gastroscope through them, a slight resistance is felt, they completely close;
• the vascular pattern in all parts of the gastrointestinal tract is the norm, if it is weakly expressed, there are no protruding veins;
• the elasticity of the walls is normal, peristalsis is preserved.

In addition, the size and structure of the organs are indicated in the conclusion of the gastroscopy. They differ depending on the build, sex and age of the patient, so there is no single standard of normal values.

How long are the results of FGDS valid

The standard validity period of a gastroscopy conclusion depends on the purposes for which the study was conducted. If it is carried out as a preventive measure and early detection of pathologies in the absence of complaints about the state of the gastrointestinal tract, gastroscopy can be performed once a year. The conclusion will be the same. However, if there are complaints about the functioning of the digestive tract, the previous results of FGDS may not be considered at all, and the patient will be scheduled for a second examination.

In the presence of chronic diseases, the result of gastroscopy remains valid for up to six months. The same number take into account the conclusion on FGDS in cancer. In preparation for surgery, when undergoing a course of treatment and the need to monitor its effectiveness, the results of gastroscopy of the stomach are valid for 30 days.

The EGD technique is aimed at identifying inflammatory, ulcerative and traumatic lesions of the mucous membranes of the upper gastrointestinal tract, and is also a key method for early cancer diagnosis.

In some cases, EGD of the stomach is performed in order to remove benign formations, take a small piece of tissue for a biopsy and urgently stop intracavitary bleeding. Due to such a variety of diagnostic and therapeutic effects, FGDS is the most commonly prescribed procedure in gastroenterological practice..

What does FGDS show and how to decipher the diagnostic protocol?

What does FGDS show

Gastroscopy is performed using a special device, which consists of a long flexible tube - endoscope- with a video camera attached to it and a computer console, which displays a video image of the patient's internal organs. The endoscope is inserted through the oral cavity and moves through the esophagus and stomach, up to the end of the duodenum.
Throughout this path, the doctor evaluates the condition of the mucous membranes, liquid contents and the presence or absence of neoplasms.

A properly conducted study of the stomach FGDS allows you to identify such pathological conditions as gastritis, colitis, gastric ulcer, esophagitis, duodenitis. It should also be understood that FGDS has been the "gold standard" in the diagnosis of gastric and duodenal cancer for quite a long time, allowing to detect oncology in the early stages of development. This significantly increases the chances of patients for a positive outcome of therapy!

The NEOMED clinic offers its patients to conduct a study FGDS using modern expert-class equipment, as well as under the supervision of an experienced certified endoscopist, which will ensure the reliability of the results of the study.

The cost of EGD in our medical center is so affordable that it will be absolutely affordable for any patient. In the clinic operate regularly advantageous offers for videogastroscopy.

FGDS decoding

If the EGD procedure is performed without the use of general anesthesia or medical sleep, during the study, the doctor comments on what he saw in order to provide the patient with the opportunity to familiarize himself with the results of the diagnosis. In this case, additional decoding of the study protocol, as a rule, is not required. The patient reports the results to his/her attending physician, who develops a therapy strategy and makes recommendations.

If, at the time of the examination, the person was in a state of medical sleep, it becomes necessary to decipher the diagnostic indicators. It should be remembered here that the entire diagnostic manipulation consists of three main stages.

Examination of the esophagus. Normally, the esophagus is a tube 25-30 cm long, which has four consecutive constrictions. The color of the walls should be light pink, and the structure of the tissues should be fine-fibered. If the protocol indicates the presence of bright red areas or inclusions, this may indicate the presence of inflammatory processes. The tube of the esophagus has a longitudinal folding, forming a muscle pulp at the end, in the form of a rosette, which must be closed. Seals and thickening of tissues indicate the development of neoplasms and require additional tests.

Examination of the stomach. The color of the walls of the stomach can normally range from pale pink to intense red. The walls should be described in the protocol as smooth, shiny, covered with mucus. The stomach also has longitudinal folds, which are more pronounced along the greater curvature of the organ. The presence of white crater-like inclusions, which are characteristic of a stomach ulcer, as well as thickening of the walls, which may indicate the development of an oncological process, is unacceptable. If FGDS reveals stomach cancer, the study protocol will describe the size, shape, and location of the tumor. With proper preparation for the procedure of gastroscopy of the stomach, a small amount of gastric juice is allowed, which can be taken for chemical analysis.

Examination of the duodenum. The diameter of the duodenum of a healthy person is from 3 to 3.5 cm. The length usually does not exceed 40 cm, although there may be slight deviations. The intestinal tube has one fold, on which the pancreatic and bile ducts are located, indicated in the FGDS protocol as large and small duodenal papillae. The first is often described as Vater's papilla. By analogy with the esophagus and stomach, the walls of the duodenum should not contain thickening and bright inclusions.

In addition to all of the above, the protocol for the study of EGD always contains a characteristic of gastrointestinal motility, which in a healthy person should be characterized as normal.

Medical clinic NEOMED will become the best institution for undergoing an EGD diagnostic procedure in St. Petersburg, due to optimal prices, qualified medical personnel and high-precision modern equipment.

When during the examination the doctor prescribes fibrogastroduodenoscopy (FGDS), patients often experience fear, and the news itself is very unpleasant.

Many people are afraid to conduct EGD, but, despite some features of the study and its disadvantages, this method is one of the most effective and informative for detecting gastrointestinal diseases. Therefore, it is important to know what FGDS can show, how the results are performed and deciphered.

What does the doctor see?

FGDS is often confused with a similar study called FGS, but the latter can only analyze the stomach and its organs, and FGDS allows you to conduct a study not only in the stomach, but also in the duodenum. A similar diagnosis is carried out using an endoscopic device. In other words, this is a tube with a small camera at the end, which is inserted into the patient's oral cavity and lowered inside for a detailed examination of the organs and walls of the mucosa. EGD is used to visualize the internal organs, the picture is displayed on the computer monitor thanks to the installed camera.

As a result of such a diagnosis, FGDS may be the last study that is prescribed to confirm the diagnosis. The interpretation of the results can only be carried out by a competent doctor. Often, this method of research is used in order to identify diseases in the early stages and prevent them from developing into more serious pathologies. In addition, if neoplasms were noticed, then they can be quickly cured or removed with the help of FGDS.

When EGD is performed, the doctor will be able to see the entire surface of the esophagus and stomach on the computer screen. The specialist examines the mucosa, as well as its deformation and other changes. According to the data obtained, the doctor can conclude that the passage of organs is possible. If inside the patient bleeding begins or has begun earlier, then thanks to FGDS it will be possible to establish its exact place, in addition, the doctor will be able to immediately eliminate the bleeding. Using the equipment, the doctor will see the following:

• All possible neoplasms in the esophagus or stomach, which are dangerous.
• The place of localization of polyps, scars and other pathologies, whether the walls of the mucosa are normal.
• Bacteria, for example, Helicobacter pylori, which can cause gastritis or ulcers, and with already developed pathologies, such a bacterium can only aggravate the situation.
• An already developed ulcer, as well as the threat of perforation.

After the study of FGDS, the patient will be issued a special certificate, which will be written in detail about the state of the gastrointestinal tract.

Study preparation

In order for the doctor to conduct EGD normally, it will be necessary to prepare for the diagnosis. Preparation allows not only to facilitate the work of the doctor himself, but the patient will also experience less discomfort, and the procedure itself will be faster. The general preparatory rules are as follows:

By adhering to such simple rules, it will be possible to prepare for EGD of the stomach on your own, and make the study quick and with minimal discomfort.

Indications and contraindications

Although FGDS is a very effective study, this method has its own contraindications and indications. All of them are presented in the table:

Indications for FGDS:	Contraindications to FGDS:
If a person has esophagitis (inflamed walls of the esophagus).	When the patient has a narrowing of the esophagus.
Inspection is necessary for people over 40 years old. In this case, FGDS is performed every year to prevent and detect gastrointestinal diseases.	If there is intestinal obstruction.
With gastritis in any form of leakage.	FGDS is not performed for pregnant women, but in rare cases it is possible. Only the doctor can say for sure, depending on the course of pregnancy and the position of the fetus.
If the patient has varicose veins.	Strong inflammatory processes of the gastrointestinal tract.
In the presence of burns of the stomach in different ways.	It is forbidden to conduct a study in case of a heart attack or stroke.
With reflux disease, when hydrochloric acid is released into the esophagus and injures its walls	With failures of cerebral circulation.
In the presence of neoplasms that carry and do not carry a danger to humans.	Mental disorders and diseases.
With perforation of the ulcer, as well as during bleeding.	Diagnosis is not carried out for problems with the respiratory system or due to tonsillitis and other diseases.
If the patient has pyloric stenosis.	With aortic aneurysm.
With severe pain, vomiting and other symptoms that appear for unclear reasons and last for several days.	It is forbidden to do EGD if the patient has weakness, the general condition is poor and constantly worsens.
	EGD is not performed if the patient's body weight is below or above medical standards.
	The study is contraindicated in pulmonary insufficiency

Important! Not always contraindications can be very strict. In some critical situations, the doctor may perform an EGD, but before doing so, the risks will need to be assessed. If the risk is not high, then the use of such a diagnostic method is allowed.

Deciphering the results

After the study, only the attending doctor can decipher the information received and establish the correct diagnosis. The patient himself, according to the results of the diagnosis, cannot establish the diagnosis. Despite this, some important indicators should be noted, namely their significance, this is especially important for serious diseases that threaten not only the general condition, but also life. After the examination, the patient is issued a certificate, which indicates the following data:

Knowing the main features of the EGD study, it is worth noting that such a diagnostic method is needed and very informative. Thanks to FGDS, pathologies that have just begun to develop can be detected, while they can be quickly cured or removed surgically.

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Indications

FGDS is prescribed to patients only according to real indications:

• pain in the peritoneum of unknown origin;
• reasonable suspicion of the possibility of foreign objects entering the esophagus;
• long-lasting heartburn;
• regular vomiting;
• swallowing disorder;
• unexplained weight loss;
• loss of appetite;
• causeless anemia;
• , liver or gallbladder;
• preparation for surgery;
• the presence of hereditary diseases (ulcers or);
• during medical examination for those who have either a stomach ulcer;
• to monitor the effectiveness of the treatment of ulcers, gastritis or other pathologies;
• after removal of the gastric polyp 4 times a year;
• to perform a polypectomy.

In the event that a person has any problems with the abdomen in its upper sections, it is recommended to perform EGD of the stomach.

What does the method show?

This diagnostic study allows visualization of the stomach cavity. At the same time, the most valuable information is data on the state. It will help to determine whether there is chronic inflammation or more severe defects in this area. What does this technique show in pathology? Of course, changes in the mucous membrane, which can be expressed both very little and quite strongly. Depending on the visual picture, the doctor performing the study will advise you to contact one or another specialist.

Every year the technical equipment of endoscopic rooms improves. As a result, the specialist sees a sufficiently high-quality image when performing EGD of the stomach. The photo of the mucosa has a high resolution and allows you to notice even the slightest changes.

When should research be done?

Currently, a fairly common technique is EGD of the stomach. What does this method show? The presence or absence of problems with the upper digestive tract. Therefore, the passage of this procedure is shown primarily to those who have any problems in this area.

The most common symptom that makes patients agree to perform this not the most pleasant procedure is pain in the upper sections. In addition, those who are constantly suffering from heartburn often seek referral for gastric EGD.

In addition to planned indications for this study, there are also emergency ones. We are talking about those cases when the doctor suspects the presence of internal bleeding.

Another good reason to undergo this procedure is unreasonable weight loss.

Where can I get FGDS?

Currently, this procedure is performed in a large number of a wide variety of medical centers. Among them are large public clinics, and private centers, and hospitals. At the same time, there is no consensus on where it is really better to carry out this examination. It all depends on the novelty of the equipment and the level of training of the doctor. Many recommend undergoing fibrogastroscopy in specialized hospitals for the reason that here, immediately after the examination, the patient can be hospitalized in the gastroenterological department and rational treatment of a particular disease can be carried out.

Who is doing the research?

There is a separate category of doctors who perform EGD. What this study shows, the endoscopist knows better than others, because it is he who performs it. This doctor is engaged in various manipulations using high-tech equipment, including fibrogastroscopy.

The profession is relatively rare. The specialization of an endoscopist is most often received either by surgeons or resuscitators.

If you wish, you can sign up for this specialist yourself. And most often, patients are not eager to undergo fibrogastroscopy, so they are referred to it by therapists, surgeons or gastroenterologists.

How is FGDS performed?

Currently, such a study is performed using a fibrogastroscope. First, the patient will be told how to prepare for gastric EGD. One of the main conditions is that a person does not eat food from the evening before the procedure. This is necessary for the reason that the stomach cavity must be empty, otherwise the endoscopist simply will not see anything. It is for this reason that it is so important to tell patients how to prepare for gastric EGD.

After a person has come to the endoscopist's office, he should lie down on his side. This greatly facilitates the passage of the probe. If the patient has a pronounced gag reflex, local anesthesia of the oral cavity is performed. In addition, there is also transnasal. What does this type of procedure show? The same as conventional fibrogastroscopy, but the patient's discomfort will be less pronounced.

What diseases can be detected by FGDS?

The most common finding in the process of conducting this study is the inflammatory process of the gastric mucosa - gastritis. In fact, after 20 years, it is present in almost everyone. A more serious finding is an ulcer. Its danger lies in the fact that it is able to bleed and even perforate the wall of the stomach completely. In case of signs of such complications, emergency EGD is performed. A stomach ulcer, among other things, can degenerate into more serious diseases.

Much more alarming is the discovery in the cavity of the stomach of one or another tumor process. An unpleasant finding is also a polyp of the stomach. If something similar or just an inflamed area of ​​​​the mucosa with signs of a change in structure is found, the doctor, most likely, with the consent of the patient, will take a biopsy. Subsequently, samples of the removed tissue are sent for pathocytological examination. The result will allow you to say exactly what exactly this or that modified section of the gastric mucosa is.

The value of fibrogastroscopy

The main objective of this procedure is the diagnosis of various. In addition, the implementation of fibrogastroscopy allows you to perform small in volume, but very significant for the preservation of the patient's health procedures. First of all, we are talking about the removal of polyps, as well as endoscopic hemostasis.

The implementation of this procedure made it possible to significantly increase the detection of various types of tumor processes at relatively early stages of their development. As a result, patients receive rational treatment in a timely manner, and their prognosis for the future is much more rosy.

Who will report the results?

After performing the procedure, the endoscopist usually talks about the results of the procedure to the patient in only two or three words. Deciphering the FGDS of the stomach is the task of the attending doctor. So it is necessary to ask him about the results of the study. In the event that after such a procedure the doctor recommends hospitalization in a specialized department, then you should not refuse it. Otherwise, the patient may have serious problems, and he will still end up in a specialized hospital.

FGDS is short for fibrogastroduodenoscopy. This is the name of the diagnosis of the digestive system, carried out using a gastroendoscope. This device provides a high-quality and reliable image of the abdominal organs, which allows you to make an accurate diagnosis and prescribe the right treatment.

When conducting FGDS of the stomach, it is often limited to the name "gastroscopy", which means examination of the stomach.

The name of the procedure is decoded as follows:

• The prefix "fibro" means the characteristic of the probe used for diagnostics. It is made up of optical fiber. Recently, a videoscope has also been used. It allows you to display a video image of the digestive tract organs on the monitor.
• The "gastro" part of the word means that the stomach is examined during this procedure.
• Part of the word "duodeno" means that the duodenum, the beginning of the intestine, is examined.
• The end of the word "scopy" means that the doctor examines the organs of the abdominal cavity with the help of a probe.

Often this procedure is also called fibroesophagogastroduodenoscopy. This means that during the examination, the esophagus is examined.

FGDS diagnostic

A gastroenterologist prescribes FGDS in all cases when it is necessary to examine in detail the mucous membrane of the stomach, as well as the esophagus and duodenum. Without FGDS, it is impossible to conduct a high-quality and reliable diagnosis of gastrointestinal diseases.

A procedure is prescribed for the diagnosis of diseases such as:

• Inflammatory conditions of the gastric mucosa, including acute and chronic gastritis with normal, reduced and increased acid-forming ability of the stomach;
• Inflammation of the duodenum of various etiologies and degrees of complication;
• Esophagitis;
• Reflux esophagitis;
• Peptic ulcer of the stomach and duodenum;
• Suspicion of the tumor process of the intestine.

• All people over forty years of age, regardless of the presence or absence of complaints;
• Everyone who has a burdened history (the presence of cancer in relatives, the presence of harmful factors at work, the use of alcohol and spicy food).
• Anyone who has complaints about the condition of the stomach, such as heartburn, nausea, belching, etc.
• Anyone who has undergone stomach surgery.
• Persons who constantly take glucocorticosteroids or non-steroidal anti-inflammatory drugs.
• The patient has gastroesophageal reflux disease.

FGDS preparation

Before performing FGDS, the patient must prepare. A few days before the planned examination, it is necessary to stop taking any medications, except for those prescribed by the doctor and they cannot be canceled. And 12 hours before the examination procedure, you should not take food and water. This is necessary so that a gag reflex does not occur when a foreign body enters the stomach, to facilitate examination (because the remnants of food in the stomach make it difficult).

The doctor must be warned about the presence of an allergy to drugs. This will eliminate the possible risks from the operation.

You can learn more about preparing for EGD of the stomach from this article.

FGDS procedure

The examination should be carried out only in a special room. It necessarily contains a fiberscope, as well as a monitor.

The patient is placed on the couch, on the left side. The doctor inserts a probe into the patient's mouth. There is no need to be intimidated by the insertion of the probe: it is similar to a thin cable. In some cases, the probe can also be inserted through the nose. This probe passes through the pharynx, then enters the esophagus, then reaches the stomach and finally the duodenum.

The entire examination of the stomach lasts no more than 10-15 minutes. After the procedure is completed, the probe is removed from the stomach. The patient does not need to be afraid of such a procedure. It is painless, but some patients may still experience discomfort. To do this, the doctor uses drugs that relieve the throat. For clarity, we recommend to look at:

EGD video

Some gastroenterologists use superficial anesthesia during the procedure. It induces shallow sleep, which can eliminate all unpleasant symptoms and emotions during EGD. Such anesthesia is used for restless patients.

EGD of the stomach what shows

Gastroscopy is a fairly reliable method for diagnosing the condition of the stomach. On the monitor you can see the following pathological conditions of the gastric mucosa:

• Mucosal changes. Since the image displayed on the monitor is very clear and of high quality, an experienced doctor can often determine the cause of acute gastritis. But with such a disease, it is very important for the patient to prescribe the required treatment.
• Before the probe enters the stomach, the doctor can examine in detail the condition of the esophagus, especially the presence of polyps or any other neoplasms in it.
• The nature of changes in the gastric mucosa during chronic gastritis.
• The site of localization of polyps or stomach cancer.
• The site of damage to the gastric mucosa by the bacteria Helicobacter pylori.
• Risk of perforated gastric ulcer.
• Pylorus states.
• The presence of erosions on the surface of the gastric mucosa.

The images obtained using FGDS are reliable, of high quality and are the basis for making a diagnosis. Thus, the patient can receive high-quality treatment.

FGDS contraindications

Contraindications for FGDS are cases when the patient has an acute respiratory disease, influenza, tonsillitis. In these cases, FGDS is unacceptable.

At the same time, indications for FGDS are cases when you need to see a doctor:

• There is an increase in temperature above 38 degrees Celsius.
• Vomiting appears with an admixture of blood (it then has the color of coffee grounds).
• There is a black stool (this indicates that it contains blood).
• Having severe pain in the abdomen.

These signs are signals of a serious complication that is observed after EGD. In this case, urgent medical attention is needed. You can find a list of doctors with reviews and ratings to the left of the article, and make an appointment with them there. In addition, under the article there is a list of clinics where you can undergo the FGDS procedure.

Gastroscopy is a diagnostic procedure used to examine the esophagus, stomach, and duodenum. Conduction is carried out inside the abdominal cavity, which allows you to examine the mucous membranes of the digestive organs. Gastroscopy is a fairly general concept, which includes different types that differ in the place of examination. So, the most well-known method for diagnosing pathologies associated with the digestive system is FGDS or fibrogastroduodenoscopy. This method allows you to simultaneously examine the stomach and duodenum 12. Despite the high information content and safety of the procedure, there is a possibility of complications after FGDs. However, first things first.

Gastroenterologist Mikhail Vasilyevich:

“It is known that for the treatment of the gastrointestinal tract (ulcers, gastritis, etc.) there are special drugs that are prescribed by doctors. But we will not talk about them, but about those medicines that you can use yourself and at home ... "

Historical digression

The ancestor of gastroscopy is Kussmual, who in 1868 first applied this method of examining the gastric mucosa in practice. After a while, the scientist Schindler introduced to the world such a thing as a "flexible gastroscope", equipped with advanced optics. Over time, such a device has only improved. 1957 was marked by the release of the first gastroscope with a controlled bend, which made possible a circular panoramic view. And finally, at the beginning of the 20th century, an instrument was released that projected the resulting image through small bundles of glass fibers. Such a device is called a "fibrogastroscope".

A modern gastroscope is a device designed to examine the mucous membranes of the digestive organs. The device is made in the form of a flexible and long tube, the end of which is equipped with a video camera and backlight. During the diagnostic process, the tube is inserted into the organ through the oral cavity. More recently, a biopsy gastroscope has been developed that allows for multiple targeted biopsies. This model is of high quality, informative, and less painful.

Indications and contraindications

Indications for gastroscopic examination are the following factors:

• painful sensations localized in the area of ​​the substrate, which are directly related to eating;
• frequent manifestations of heartburn;
• vomiting, in which blood impurities are found in the vomit;
• frequent belching, accompanied by a sour taste;
• frequent bouts of nausea, subsequently turning into a gag reflex with food consumed the day before;
• appearing regularly.

Sometimes this diagnostic method becomes impossible to use. Then we are talking about the following contraindications:

• severe respiratory failure;
• heart rhythm disturbances;
• serious forms of mental disorders;
• strokes.

Preparation for the examination

And FGS are quite serious, requiring some preparation, on which the degree of information content of the diagnosis will subsequently depend:

1. A couple of weeks before the diagnosis, aspirin or iron-containing medications are stopped.
2. Often, gastroscopy is accompanied by taking samples of tissue structures of organs for a biopsy, which can lead to slight bleeding. In order to reduce the risk of bleeding, it is recommended to stop taking non-steroidal anti-inflammatory drugs. A similar requirement applies to medicines that help reduce blood clotting or thin it.
3. 8 hours before the start of the procedure, a starvation diet is provided. It also prohibits the use of liquids. During this period of time, the stomach is completely cleansed of food, which allows you to more fully and accurately examine the internal cavity of the organ. Also, the absence of food minimizes the likelihood of a gag reflex.
4. On the appointed day of the examination, it is recommended to completely abandon the use of tobacco products.
5. Before starting the procedure, you should visit the toilet.

Conducting gastroscopy

Gastroscopic examination requires the preliminary use of a special anesthetic, made in the form of a spray, which is used to treat the root of the tongue in order to eliminate pain and cough. The technique of such a diagnostic technique is reduced to the following actions:

1. The working end of the endoscope is treated with a special gel composition, which subsequently provides better sliding of the tube.
2. A mouthpiece is inserted into the oral cavity, which prevents damage to the probe by the teeth. In this case, the patient is placed on the left side.
3. Through the hole in the mouthpiece, the probe is gradually inserted into the mouth until it reaches the larynx.
4. Next, it becomes necessary to swallow the tube.
5. After the penetration of the endoscope inside, a detailed study of the state of the digestive organs begins, the results of which are displayed as an image on a computer monitor.

The average duration of the procedure is 15 minutes. Immediately after the endoscopy, the diagnostic results are announced. The exception is cases when histological studies of tissue samples taken from the digestive organs are necessary.

Complications of gastroscopy

Serious complications and unpleasant consequences after EGD are quite rare, but there is a possibility of their development. Complications after gastroscopy can be as follows:

• heart rhythm disturbances during the examination;
• inflammation of the pulmonary system on the background of aspiration;
• laryngotracheitis, which is traumatic in nature;
• injury to the walls of the organs under study;
• perforation of the stomach or esophagus, which is extremely rare;
• entry of the endoscope into the trachea;
• an allergic reaction to an anesthetic drug.

For this reason, after the patient's condition is normalized at the end of drug sleep, his general well-being is monitored. For this, pulsation values ​​are measured, as well as monitoring the level of oxygen saturation of the blood.

Consequences of gastroscopy

It is also likely that some consequences will develop after an endoscopic examination:

1. One of the unpleasant ones is damage to the jaw. This phenomenon often occurs with loose teeth.
2. Sometimes it is possible to experience a feeling of squeezing in the throat cavity that occurs after insertion into the endoscope. At the end of the procedure, pain remains in the corresponding area.
3. It is also possible to complain of increased bloating, pain in the stomach and frequent belching.

The consequences and complications of gastroscopy are minimized if the recommendations for preparing for the procedure are followed correctly.

Elimination of consequences

Despite the possible side effects, some of them can be managed:

Pain in the stomach

Painful sensations in the organ occur due to the air that is pumped into the stomach in order to smooth the mucosa. In most cases, pain and discomfort do not need special treatment, as they pass on their own after a couple of days.

Sore throat

They occur during swallowing and can manifest as a feeling of numbness, which is accompanied by the appearance of hoarseness in the voice. This phenomenon is one of the most common consequences of gastroscopy, which may be due to mechanical damage during the passage of the endoscope. In this case, it is necessary:

• exclude panic moods, since there is a high probability of normalization of the condition within a couple of days;
• in order to alleviate the condition, use absorbable lozenges;
• rinse the throat with warm water with the addition of a few drops of iodine and a pinch of soda;
• try to talk less
• with persistent signs of pain and dryness, take a teaspoon of sea buckthorn oil before a meal;
• in the absence of allergic sensitivity to honey before going to bed at night, use it;
• eat soft and warm foods.

Click on the image to enlarge it

After gastroscopy

At the end of the gastroscopic examination, it is not recommended to drive a vehicle, since sedatives administered during the study contribute to lethargy and lethargy for some time. If local anesthesia was used, then there are no contraindications to driving.

For one hour after the end of the procedure, you should also refrain from smoking. As for eating and drinking, this should not be done until the feeling of numbness in the throat disappears, as well as the appearance of a swallowing reflex and sensitivity of the tongue.

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Method capabilities

EGD is the "gold standard" in the diagnosis of diseases of the esophagus and stomach. May be used for diagnostic or therapeutic purposes. The diagnostic value of the method is invaluable, since it is possible not only to examine the walls of the stomach from the inside for diseases, but also to conduct a tissue biopsy, that is, “pinch off a piece” of the affected tissue with further examination of the material under a microscope. In addition, during gastroscopy, therapeutic manipulations can be performed, for example, to stop bleeding or remove a small polyp in the mucous membrane of the organ.

Advantages of the method:

- high level of information
- absence of tissue trauma,
- safety and almost complete absence of complications,
- painlessness
- the possibility of performing several diagnostic manipulations in one procedure (for example, confirming the diagnosis of a stomach ulcer, conducting an acid test, testing for Helicobacter pylori and taking a biopsy),
– the possibility of carrying out in a polyclinic, without hospitalization in a hospital, if there are no emergency indications,
- ubiquitous equipment of modern medical institutions.

Disadvantages of the FGDS method

The disadvantages include only the presence of a slight discomfort when swallowing the probe, but this factor can be omitted, given how important information the patient will receive in return about the state of his stomach.

Varieties of FGDS

One of the varieties of gastroscopy is video EGD - this is a study in which the doctor examines the stomach cavity not only with his eyes, but also with the help of an enlarged image transmitted to the TV in the office. This allows you to better see the smallest details in the mucous membrane, and give the protocol of the video examination on the hard drive to the patient. Currently, each gastroscopy procedure is recorded by a miniature video camera at the end of the gastroscope.

If, for some reason, the patient cannot be examined through the oral cavity, he may be offered transnasal EGD - the introduction of a probe through the nose. With this method, the subject does not experience a gag reflex and can talk with a doctor, which is mainly for patients with severe urge to vomit when the root of the tongue is irritated or with neurological disorders of the act of swallowing.

If it is impossible to perform a conventional gastroscopy in people due to severe fear and discomfort, for example, in children or the elderly who flatly refuse the procedure, it is possible to perform EGD under anesthesia. To do this, in the presence of contraindications, the subject is given intravenous anesthesia with the patient immersed in drug-induced sleep for several minutes or more.

Indications for gastroscopy

Diagnosis of diseases:

– examination of persons over 40 years old,
- esophagitis - an inflammatory process in the esophagus,
- gastroesophageal reflux disease (GERD) - reflux of acidic stomach contents into the esophagus,
- Varicose veins of the esophagus with cirrhosis of the liver,
- Mallory-Weiss syndrome - bleeding on the mucous membrane of the border between the esophagus and stomach due to indomitable vomiting in alcohol poisoning,
tumors, strictures (unions) and adhesions of the esophagus,
- burns of the esophagus thermal and chemical,
- stomach ulcer,
- symptomatic stomach ulcers with the use of certain drugs (non-steroidal anti-inflammatory drugs - diclofenac, aspirin, ketorol, nise, steroid hormones - prednisolone, dexamethasone, etc.),
- acute and chronic gastritis,
- tumors and polyps of the stomach,
- stomach cancer,
- complications of peptic ulcer - gastric bleeding and perforated ulcer,
- pyloric stenosis (pyloric stenosis) - cicatricial narrowing of the outlet section of the stomach,
- ulcers, tumors and cancer of the duodenal bulb,
- duodenitis - inflammation of the duodenal bulb,
- cancer of Vater's nipple - a malignant tumor of the formation into which the bile ducts and the pancreatic duct open on the back wall of the 12th duodenum.

Medical manipulations:

- dilatation (expansion) of cicatricial strictures of the esophagus,
- the introduction of a sclerosing ("sticking") solution into the varicose veins of the esophagus in case of bleeding from them - sclerotherapy,
- removal of foreign bodies from the esophagus or stomach, as well as bezoars from hair clots when they are eaten in large quantities (the disease is called trichophagia), or small phytobezoars (food lumps from the remains of grapes consumed in large quantities, berry seeds, etc. ),
- the imposition of clips or electrocoagulation of vessels at the site of gastric bleeding,
removal of polyps, small tumors,
- monitoring the effectiveness of treatment.

Contraindications for FGDS

The study is not recommended for diseases such as:
- acute myocardial infarction, acute stroke,
- acute heart failure and chronic at a late stage,
- sudden paroxysm of rhythm disturbances,
- aortic aneurysm in the thoracic and abdominal regions,
- hemophilia (pathology of the blood coagulation system),
- acute infectious diseases, diseases of the upper respiratory tract - tonsillitis, tonsillitis, pharyngitis,
- severe malnutrition or significant obesity of the patient,
- mental illness in the acute phase, however, EGD can be performed for urgent indications with intravenous anesthesia after consulting a psychiatrist.

Preparation for EGD for the patient

In order to prepare for the procedure, the patient should come to the examination on an empty stomach. The last meal should be no later than 7-8 hours before the study. On the morning of the FGDS, you should not even drink water.

A few days before the procedure, the patient must stop eating spicy food and alcohol, and also stop smoking, as this has an irritating effect on the gastric mucosa. If the patient constantly takes some medications, for example, aspirin, non-steroidal drugs or anticoagulants (warfarin, phenylin, etc.), he should discuss with the doctor the possibility of completely canceling them for several days, due to the fact that when the blood is “thinned” with With these drugs, you may have more bleeding during the biopsy, if needed.

How is the EGD procedure performed?

FGDS can be performed in a clinic or in a hospital. In the department, gastroscopy is prescribed for patients who are already being treated or examined there. That is, there is no need to specifically hospitalize the patient for gastroscopy for one day. It is possible that hospitalization will be needed after the results of the examination. In addition, EGD can be done at your own expense in private medical centers offering relevant services.

There are planned and emergency gastroscopy. The planned one is carried out in the clinic or in the department of endoscopic diagnostic methods of the hospital, if the clinic does not have the appropriate equipment. Emergency is carried out, as a rule, in a hospital where the patient is delivered for urgent indications, for example, if bleeding or perforation (perforation) of a stomach ulcer is suspected.

After the patient is escorted to the FGDS room, he is invited to come in and sign an informed consent. This is a document in which the patient voluntarily agrees to the procedure, and also signs in the column where it is said that he was informed about the technique and possible complications of the manipulation.

Next, the nurse suggests that the patient lie down on the couch on the left side, after which the doctor irrigates the oropharynx with an anesthetic spray, such as lidocaine. If the patient has an allergic reaction to anesthetics, he must warn the doctor about this without fail. A couple of minutes after the anesthetic takes effect, the doctor suggests wrapping your teeth around a mouthpiece that prevents injury to the teeth and mucous membrane of the lips.

The next stage is the introduction of a gastroscope through the oropharynx into the esophagus. This lasts for a few seconds and can cause quite noticeable gagging. The patient at this time should make a swallowing movement, as if swallowing the probe, at the doctor's command, and then breathe evenly, calmly and deeply. After that, it is impossible to swallow without a doctor's command, and the nurse removes the accumulated saliva with an electric suction.

After the probe enters the stomach, air is supplied so that the mucosal folds straighten out, and it can be better examined. Next, the doctor conducts a visual examination, after which he removes the probe from the oral cavity. The duration of the entire procedure is no more than 5-10 minutes, if medical manipulations are not performed. In these cases, the time of gastroscopy can be up to half an hour.

After the procedure, unpleasant sore sensations in the oropharynx may appear, which disappear on their own after a couple of hours.

Transnasal gastroscopy is carried out according to the same technique, with the difference that the probe is inserted through the nose without causing discomfort and vomiting.
After the patient is allowed to get up from the couch, he is escorted back to the department if he is already hospitalized, or asked to wait outside the office if the examination is carried out in the clinic. Then the conclusion is transferred to the attending physician or given to the patient in the hands.

If the examination does not reveal diseases requiring emergency care and hospitalization, such as bleeding, the patient is allowed to go home. In the event that any diseases are detected that allow for planned treatment in a polyclinic or planned in a hospital, the issues of treatment and further additional examination are decided by the attending physician who sent for gastroscopy.

Deciphering the results of gastroscopy

There is no need for the patient to independently understand medical terms, since all results should be interpreted only by the doctor who conducted the study and the attending physician. But below will be given some of the indicators obtained during gastroscopy.

So, on the form after the name of the medical institution, the study number and the patient's data, the following results will be presented:
- Esophagus - the patency and color of the mucous membrane is assessed, normally the esophagus is passable, and the mucous membrane is pink in color. The presence or absence of strictures, adhesions, tumors, ulcerations and other elements that should not be normal is assessed.
- Cardia (the place where the esophagus passes into the stomach) - closes or not, it should normally close. Non-closure (gaping) of the cardia may indicate gastroesophageal reflux.
- Stomach - normally, the folds of the mucous membrane straighten out, the mucous membrane is pink, without ulcers and tumor-like formations. If there is a source of bleeding, ulcers or tumors, their location and size are evaluated. Peristalsis (muscle contractions that help move the food bolus) is also assessed, which is normal. Can be raised or lowered.
- The contents of the stomach are normally transparent, there may be a small amount of mucus. When bleeding, there is an accumulation of fluid of a dark or scarlet color. When bile is thrown (duodenogastric reflux), the contents are represented by dark green bile.
- Pyloric department (pylorus) - normally not changed and passable, with a cicatricial or tumor lesion, their nature and size are described.

Photo of the pyloric part of the stomach through a gastroscope

- Duodenum - normally not changed, with pathological elements, their main characteristics are also given.

Are gastroscopy complications possible?

Complications during the procedure are extremely rare, less than 0.07% of patients. These include:

An immediate allergic reaction (urticaria, Quincke's edema, anaphylactic shock) to an anesthetic drug.
Prevention is a careful collection of an allergic anamnesis, and the notification of the doctor by the patient that he had previously had similar cases.
Treatment - the provision of emergency care in accordance with the standards for the use of an anti-shock kit, which is included in the package of each FGDS room.

Perforation (perforation) of the esophagus is an extremely rare but extremely dangerous condition that can be fatal if diagnosed after 24 hours. Therefore, each patient should be aware of the symptoms, which include hoarseness, subcutaneous emphysema (accumulation of air under the skin) on the face and neck, pain in the neck, chest and back that is atypical for the patient, swallowing and breathing problems.
Prevention - extremely careful introduction of the gastroscope into the esophagus. If a burn or cicatricial fusion of the walls of the esophagus is suspected, the doctor should stop trying to further insert the gastroscope if a significant obstacle to the introduction is felt the first time.
Treatment - surgical, adequate pain relief, antibiotic therapy, parenteral nutrition (using intravenous nutrient solutions).

Bleeding from the vessels of the formation during its biopsy - may develop with an increase in blood clotting time due to the intake of anticoagulants, aspirin, paracetamol and other drugs.
Prevention - timely withdrawal of drugs a few days before the procedure only in agreement with the attending physician.
Treatment - hemostatic therapy (vikasol, aminocaproic acid, ascorutin) only as prescribed by a doctor.

In conclusion, it must be said that the reluctance of patients to undergo such an examination is often caused by the false idea that the procedure is rather painful and causes considerable discomfort. In fact, this diagnostic method is one of the most informative, and unpleasant sensations are forgotten within a few hours after the procedure. Therefore, if a patient is prescribed an examination by a doctor, it should be performed, because gastroscopy is of great benefit for the timely diagnosis of dangerous diseases of the gastrointestinal tract.

Therapist Sazykina O.Yu.

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On the regularity of the conduct, the validity of the conclusion

The easiest way to get used to it, being in childhood. And if you need to regularly monitor the condition of the examined organs, then there is nothing terrible in this. In addition, people who are predisposed by heredity, as well as after identifying any diseases earlier, need to remember that FGDs have a limited shelf life, therefore the FGD protocol can operate and it is recommended to re-manipulate 1-2 times a year.

Those who were prescribed an examination before the operation can provide a sample of their study, because the validity period of the FGDS analysis is for a calendar month. This is important, because during the intervention for an ulcer, its exacerbation can occur, which is fraught with large blood loss.

What should be in a standard document?

Often, during the examination, they issue a conclusion of the FGDS norm for all parameters. It is especially pleasant after such a procedure. So, after a long description of all the features, starting from the entrance to the esophagus, with all the sphincters and the condition of the walls, the document contains the conclusion of the FGDS. Ideally, it will be indicated that there are no pathologically altered phenomena in the stomach or not detected, as well as in 12PC (duodenum).

As an introduction, you can give an example of how the direct FGDS protocol looks like a sample with good performance:

Esophagus

The entrance to the esophagus is normal in shape, then it is indicated how many cm from the incisors. Upper esophageal sphincter in good shape. Passability of the esophagus is free, the shape of the lumen, normal caliber, the state of mucus, walls (in N - elastic, pale pink, smooth, shiny). The shape of the lower esophageal sphincter is normal, the tone is preserved. The distance from the incisors to the dentate line is 35 cm.

Stomach

The distance to the entrance is 36 cm, in the area of ​​the hiatal constriction. Next, gaps with narrowing are indicated, normally it should be normal, caliber. Elasticity of the walls of the stomach. The color in the area of ​​the lumen, as an option, is straw, as well as the presence of mucus, during the procedure on an empty stomach, the amount is small. The mucosa can be with folds, the height of which is average. They can straighten out when air is supplied. On the body of this digestive organ, the color is pink, with a smooth, shiny, dim vascular pattern. The shape of the antrum is normal. The condition of the walls is elastic with the preservation of peristalsis. The color of the mucosa is normal, without enhanced vascular pattern. The shape of the pylorus is rounded, the state is closed.

Duodenum

Normally, during this examination, the shape of the lumen in a 12-pc bulb is normal, with a normal caliber. The condition of the walls is elastic, with preserved peristalsis. It is allowed to fill the lumen with a small amount of bile. The color of the mucosa can be pale pink, the structure is granular, the vascular pattern is slightly noticeable. Features of the postbulbar departments are ideally not detected.

This is how the main parameters may look after FGDs in conclusion. Of course, for various diseases, including gastritis, slightly different parameters will be indicated.

You can study another sample for comparison:

Or another option:

According to FGDS, a decent expiration date is given so that you can have time to go through all types of services, without loss of time. And while a really cherished conclusion, you can continue to be examined for a comprehensive treatment or a scheduled operation. And it can be related not only to the gastrointestinal tract, but also in terms of gynecology and other other body systems.