EGD – what is this examination?
Fibrogastroduodenoscopy, or reduced EGD endoscopic examination of the stomach and duodenum, widely used in clinical practice for the diagnosis of diseases of the upper digestive system. The procedure is suitable for a large number of people, as children and adults, and is carried out using a special probe with a video camera. However, for carrying out fibrogastroduodenoscopy in a patient should be appropriate indications and no contraindications. Only in this case study may be successful with a small risk to health. Holding EGD should be carried out with proper preparation of the patient and according to certain rules specified in the clinical protocols. In connection with the prevalence of diseases of the gastrointestinal tract, it is recommended that everyone know the information about this procedure.
Many patients wonder, how is EGD? Information about this can be obtained from your doctor.
Using fibrogastroduodenoscopy (EGD) allows you to quickly identify sources of intraventricular hemorrhage, making an accurate diagnosis with a biopsy, and is an indispensable method in the determination of tumor pathology.
EGD of the stomach and duodenum are shown in certain clinical situations and in certain diseases:
- Various types of esophagitis (chemical, infectious, etc.).
- Expansion of the venous plexus of the esophagus in portal hypertension and other conditions.
- Violation of the tonus of the muscular wall of the esophagus (diverticula, extensions of the lumen, or achalasia).
- Acute and chronic gastritis.
- Ulcers disease stomach and duodenal ulcers.
- Tumor benign or malignant nature.
- Reflux of stomach contents into the esophagus.
Fibrogastroduodenoscopy is shown when the patient has the following complaints:
- Pain in the epigastric region or in the lower part of the chest, arising from or aggravated after meals, or after rest in a horizontal position. Also the indication for EGD are «hungry» pain occurring on an empty stomach.
- Disturbance of swallowing, often associated with pathology of the esophagus.
- Heartburn and burping are possible symptoms of gastroesophageal reflux disease or gastritis.
- Bloating in the upper abdomen or a feeling of heaviness in the epigastric region.
- Loss of appetite with sharp emaciation.
- Clinical manifestations of anemia, which developed in a short time may indicate gastric bleeding, especially in patients with gastric ulcer.
Adherence to these readings allows you to use the EGD of the stomach only where required, thereby increasing the information content of the medical procedure and excluding her rash purpose.
Contraindications to the study
Like any research method, EGD has contraindications to, which are traditionally divided into two large groups:
- the absolute, in which fibrogastroscopy should not be undertaken in any case;
- relative in which the research is dangerous, but the risk of complications is low. In this case, it is possible to use the procedure when it is needed in a specific clinical situation.
Contraindications it is necessary to abandon the survey and choose the same methods of diagnosis.
Absolute contraindications to EGD the following:
- Decompensated diseases of the cardiovascular and respiratory system (myocardial infarction, different types of stroke).
- Severe curvature of the spine.
- Pathological processes in the mediastinum, which could lead to the change of position of the esophagus (tumor, fibrosis, aneurysm of thoracic aorta, etc.).
- Disturbances in the blood coagulation system.
- Stenotic lesions of the esophagus.
- Exacerbation of asthma or status asthmaticus.
Relative contraindications to this study are the following:
- Inflammatory changes in the pharynx and larynx, including in lymphoid formations.
- Coronary heart disease in the form of angina.
- Disturbances in the psychic sphere.
Division contraindications for EGD is relative, as any pathological process may be complicated by decompensation and life threatening emergencies functions. When such examinations of the stomach and upper small intestine must be considered as indications for EGD, and contraindications.
Necessary preparation for the examination
In order to EGD went quickly and without complications, correct patient preparation for study. In violation of this aspect of the survey significantly increases the risk of negative consequences during the procedure, and in the long term.
Basic training consists of the following aspects:
- EGD involves considerable mental discomfort. In this regard, the attending physician must discuss the study with the patient and explain all the risks and nuances of the survey. If there is increased excitability of the patient, and possibly the use of sedatives or, in cases of extraordinary anxiety, tranquilizers.
- Diagnostic examination (clinical examination, General blood and urine tests) allow you to check the contraindications and to identify situations that could affect the results of EGD.
- If the patient has diseases of internal organs, it is necessary to stabilize them for using pharmacological agents (antihypertensive, antiarrhythmic and other drugs).
In addition to these events, is shown holding and local training:
- Within two days before the gastroscopy, the patient is not recommended to eat fried, spicy foods, heavy foods, which leads to flatulence. Patients should abstain from drinking alcoholic beverages, and 4 hours before the procedure and Smoking.
- If the research is conducted in the morning, in the evening the patient should not eat food, and 2-3 hours prior to EGD do not drink the water. Such measures are needed to cleanse the stomach and duodenum from the food of the masses and reduce the likelihood of nausea and vomiting.
- If the patient showed elevated gag reflex, it is possible to use local anesthetics (Lidocaine, tetracaine, etc.).
Following such simple guidelines allows you to enhance procedures and to reduce the risk of complications.
Examination of planned patients, most often held in the morning. Always EGD is performed in a specially equipped endoscopy room. After the patient familiar with the procedure, will provide anaesthesia of the mucous membranes of the mouth, it is put on a special table. The patient while lying on your left side, keeping the back straight. To prevent the clamping jaws in the mouth to put the mouthpiece through which is introduced a small tube of fibrogastroscope. To prevent the gag reflex, people need to relax and breathe through the nose.
After the probe enters the esophagus, the doctor begins to carefully assess the condition of the mucous membranes, gradually pushing the endoscope further. When injected into the cavity of the stomach it is necessary to carefully examine all its parts. In this case the attending physician is the description of what he saw of the picture. In the mucosa is well visible the different pathological changes: inflammatory process, the growth of benign or malignant tumors, bleeding from the vessels, etc.
If necessary, can be carried out biopsy of the suspicious area for histological analysis, or performed a small surgical operation in the removal of polyps or stop bleeding.
After completion of the procedure, the doctor gently removes the fibergastroscope and assesses the patient’s condition. In the absence of any complications the person may leave the medical facility.
The following indications and contraindications to the study and adherence to the protocols EGD to minimize the risk of negative effects, but in rare cases, complications do occur.
The most common complication is discomfort or minor pain syndrome in the course of the esophagus or in the throat, which is associated with mechanical irritation of the mucous membranes of the localization. Much more rarely, may develop bleeding when damage to the inner layer of an organ or even a perforation of its wall. This situation requires beginning emergency treatment measures for prevention of disease progression.
Complications most often associated with breaches of the procedure or with the concealment of a patient existing diseases.
With the development of complications it is necessary to stop the procedure and begin treatment of the pathological process. Timely, therapeutic intervention helps to prevent the occurrence of life-threatening conditions.
EGD of the stomach and duodenum is considered the gold standard for the diagnosis of diseases of these organs. The possibility of direct visual assessment of the mucosa, as well as conducting morphological studies, allows you to set the correct diagnosis at the earliest stages of the disease, which is extremely important for their effective treatment.