Home Grape Is it necessary to do gastroscopy for prevention? Pros and cons of gastroscopy under anesthesia. Is there a risk of infection during gastroscopy?

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Is it necessary to do gastroscopy for prevention? Pros and cons of gastroscopy under anesthesia. Is there a risk of infection during gastroscopy?

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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Name " gastroscopy "derived from the Latin word" gaster", which means " stomach"and the Greek word" skopeo" – "observe, consider". Gastroscopy is a variant of endoscopic examination of the gastric mucosa using a special device - gastroscope . In the medical literature you can also find such a term as esophagogastroduodenoscopy (EGDS ), which, in essence, is the same research method, only in addition to the gastric mucosa, it allows you to examine the internal membranes of the esophagus and duodenum.

A little history of the development of gastroscopy

The founder of gastroscopy is Kussmaul, which was first put into practice in 1868 this method studies of the gastric mucosa. Later, thanks to a little-known scientist at that time Schindler, in medical practice the concept of a bendable gastroscope appeared, which was equipped with an improved optical system. Over time, the gastroscope device became more and more advanced. In 1957, the first gastroscope was released with a controlled bend, allowing a circular panoramic view of the area under study. The culmination of the development of gastroscopy was the discovery of a completely new type of gastroscope, called fibrogastroscope, in which the image is realized through small bundles of glass fibers, the thickness of which does not exceed the thickness of a human hair.

Gastroscope

Gastroscope – a special device designed to examine the mucous membrane of the upper digestive tract, and in particular the stomach. It is an elastic, thin and long tube equipped with a fiber-optic system inside and a lens at the end. This tube is inserted through the mouth into the esophagus and stomach, and then into the duodenum. A fibrogastroscope model was developed, intended for multiple targeted biopsies, called biopsy gastroscope. This model makes the method higher quality and more informative and less painful.

Gastroscopy capabilities

Thanks to the easily controlled bending of the end of the gastroscope, equipped with a lens, gastroscopy allows you to study in detail all areas of the gastric mucosa. This makes it possible to identify all kinds of surface changes that are not distinguishable on x-ray photographs, it also allows you to establish the cause of gastric bleeding, diagnose benign and malignant tumor formations of the stomach on early stages, monitor the healing process of stomach ulcers.

Indications for gastroscopy

gastroscopy is necessary for differential diagnostics for any stomach disease: peptic ulcer, chronic gastritis, polyps, malignant tumor stomach
diagnosing the source and cause of gastric bleeding
exclusion or confirmation of stomach cancer
the presence of symptoms of gastric pathology in the absence of radiological signs of the disease
diseases of certain organs, in the presence of which it is necessary to know the state of the gastric mucosa

Contraindications to gastroscopy

All existing numerous contraindications are divided into two large groups:

Absolute

respiratory failure
advanced form of atherosclerosis
previous myocardial infarction or stroke
aortic aneurysm
diseases of the nervous system
severe cachexia, general weakness
obesity II – III degree
hemorrhagic diathesis
endemic goiter
narrowing of the esophagus, esophagospasm
esophageal ulcer
varicose veins of the esophagus
malignant neoplasms of the esophagus
scoliosis, kyphosis, lordosis
mediastinal neoplasms
inflammation of the mediastinal organs
narrowing of the upper ( cardiac) parts of the stomach

Relative

hypertension in stage III
angina pectoris
acute sore throat, laryngitis, pharyngitis
esophagitis
minor esophageal diverticula
acute and chronic ( in the acute stage) gastritis
stomach ulcer complicated by perforation of its walls
severe neurasthenia
enlarged cervical lymph nodes and mediastinal nodes

Preparing the patient for the study

Gastroscopy is performed according to strict indications established by the attending doctor. It is carried out in specially equipped rooms by endoscopists. The specialist must have information about whether the patient is allergic to medications, as well as about existing chronic diseases. The study is carried out in the morning strictly on an empty stomach. A complete abstinence from food is required for 8 to 10 hours before gastroscopy. 30 minutes before the start of the procedure, the patient is given premedication, which consists of administering a sedative drug subcutaneously. In most cases, lidocaine is used as such a drug, atropine sulfate. Sometimes, if the patient is too excited, it is necessary to inject him subcutaneously promedol. To anesthetize the root of the tongue, it is used as a local anesthetic. dicaine solution, which lubricates the throat and top part esophagus or the drug is sprayed using a spray bottle. In rare cases, the use of general anesthesia cannot be ruled out, which requires intravenous administration of the drug. Evidence of the onset of local anesthesia of the root of the tongue is a feeling of numbness in the throat and difficulty swallowing that arose shortly after the anesthesia.

Gastroscopy technique

The patient is placed on a specially prepared table on his left side with his back strictly straight. He clamps his teeth on the mouthpiece, designed to insert the endoscope tube through it into the patient's mouth, then the patient relaxes his throat, simulating a swallow. Thus, the entrance to the esophagus expands due to the upward movement of the root of the tongue and larynx. It is at this moment that the specialist quickly inserts the gastroscope tube into the esophagus. In this case, the distal end of the gastroscope is given an angle of inclination ranging from 70 to 90 degrees, which makes it possible to bring it as close as possible to the natural anatomical curvature of the oropharynx. Calm and deep breathing helps the patient prevent the development of the gag reflex and reduce discomfort. The gastroscope tube, when inserted into the esophagus, should be located in the center, avoiding contact with the side walls, which can cause a stop in the advancement of the endoscope or perforation of the esophageal wall. After the gastroscope tube has passed through the esophageal orifice, it then easily moves along the esophagus and penetrates into the stomach cavity without encountering any obstacles on its way. For the most informative research The gastric mucosa is filled with air, which helps straighten all gastric folds.

During the examination, the gastroscope must be continuously rotated around its axis, pushed forward a little and pulled back out; these movements will allow you to study in detail all areas of the gastric mucosa. In each fixed position of the gastroscope, four directions are examined: above, below, in front, behind. At the same time, an image is recorded, as well as a photo or video, if necessary. If there are indications, it is possible to perform a biopsy of the gastric wall and some therapeutic techniques, for example, stopping gastric bleeding, administering medicines, removal of polyps, etc. Upon completion of the procedure, the gastroscope is smoothly removed from the esophagus. The entire procedure, from the moment the device is inserted until it is removed, takes about two minutes. After completing the manipulation, the patient needs to rest for 20–30 minutes, after which he is sent to the ward under the supervision of medical personnel. The patient is not recommended to get out of bed for 1.5 - 2 hours and refuse to eat.

Decoding the results obtained

A clearly visible detailed image of the area under study is transmitted from a photo or video camera of the endoscopic apparatus ( gastroscope) on the TV screen installed at the bed of the patient being studied, or is recorded in the computer memory. If necessary, the resulting image can be printed.

Gastroscopic picture of the gastric mucosa of a healthy person

The mucous membrane of a healthy stomach under normal conditions has a color from pale pink to bright red. The anterior wall of the stomach is lined from the inside with a smooth, shiny mucous membrane, which is covered with a small amount of mucus. The mucous membrane of the posterior wall forms numerous folds, delimited by grooves. The pylorus of the stomach is not difficult to recognize. It is represented by a cone ending in a dark rounded hole. When the pylorus is open, a round black cavity appears in the image; when its walls begin to contract, the folds formed by the mucous membrane take on the appearance of an asterisk. If the gastroscope does not have an easily bendable distal end, then absolutely all areas of the gastric mucosa cannot be included in its field of view, therefore, the areas invisible in the image are called “silent zones” and they make up about 25% of the total area.

Gastroscopic picture of the gastric mucosa with gastritis

Changes in the gastric mucosa depend on the form of gastritis and the degree of its manifestation. Most characteristic features gastritis are swelling and hyperemia ( redness) of the gastric mucosa, bulging folds, pinpoint hemorrhages visible on the surface of the mucosa, the presence of mucus.

Gastroscopic picture of the mucous membrane of a stomach ulcer

The image of the mucous membrane clearly shows the ulcer crater, which has the shape of a cone, limited at the edges by a roller protruding above the surface of the mucosa. The edges and bottom of the ulcer crater become bright red. A mucous, purulent or fibrinous layer of plaque is found on the surface of the ulcer, giving it a whitish color.

Gastroscopic picture of stomach cancer

It is very typical for a cancerous tumor to smooth out the folds formed by the gastric mucosa. Second characteristic feature is a change in the color of the mucous membrane, it becomes whitish-gray.

Consequences of gastroscopy

The consequences of gastroscopy include an unpleasant feeling in the throat, which disappears without a trace after 2 to 3 days.

Possible complications of gastroscopy

Complications occur in extremely rare cases. They may be related to the method of anesthesia used and the technique used to conduct the study. The first group includes body reactions that arise as a result of the patient’s individual intolerance to certain substances that make up anesthetic drugs. Complications arising from violations of gastroscopy technique appear a little more often. For example, they arise in cases of forced, inaccurate insertion of an endoscope, when examining patients who have absolute or relative contraindications to gastroscopy, or when performing manipulation on a patient who behaves inappropriately.

In such cases, the following complications are possible:

abrasions and cracks in the mucous membrane of the pharynx, larynx, esophagus, stomach
wounds and sometimes trauma to the pharynx
injuries to the esophagus ( the most dangerous is a rupture of the esophagus)
damage to the esophagus by osteophytes of the cervical vertebrae ( occurs only in older people)
gastric perforation
bleeding ( the most rare complication)

Before use, you should consult a specialist.

What contraindications does gastroscopy have? Paradoxically, patients often ask this question not out of concern for their health, but in the hope of avoiding an unpleasant procedure. This is not entirely correct: a gastroscopic examination is necessary for a more reliable diagnosis and treatment of the disease, but it is still worth familiarizing yourself with the types of FGDS (fibrogastroduodenoscopy or FGS - fibrogastroscopy) and in what cases this study cannot be done.

It is customary to distinguish 2 types of gastroscopic examination:

planned;
emergency.

Planned

This includes all procedures to clarify the diagnosis in the following cases:

digestive disorders;
frequent pain in the abdomen or epigastric region;
clarification of the etiology of anemia (hidden gastric bleeding may be the cause);
control of treatment of stomach diseases;
preventive examination to identify early pathologies of the digestive system.

Preparation for a planned FGDS is always carried out in advance, taking into account general state the patient’s health and the presence of relative or absolute contraindications.

Emergency

There are cases when, in order to preserve health or save a person’s life, it is necessary to carry out FGS on an emergency basis, without preliminary preparation patient.

Such cases include:

Hit foreign body into the stomach or esophagus. Removal foreign objects carried out through the esophagus using a gastroscope.
Stomach bleeding. FGDS allows not only to determine the cause and intensity of blood loss, but also, in some cases, to stop bleeding through a fiberscope.
Intraoperative FGS, which allows identifying a pathological focus before emergency surgery. In some cases, it is possible to avoid surgery and eliminate the pathology using a gastroscope.

It is noteworthy that even myocardial infarction and other acute cardiac pathologies do not serve as an absolute contraindication for emergency intervention: a council of 3 specialists can permit gastroscopic intervention for stroke, heart attack and others severe conditions, if this is necessary to save the patient’s life.

Unlike planned gastroscopy, emergency gastroscopy has almost no contraindications; it is only inappropriate to perform it in the agonal and preagonal state of the patient.

Absolute contraindications for planned FGDS

If, in severe conditions, gastroscopy is performed urgently to save the life and health of a person, then planned gastroscopy is necessary to monitor treatment or clarify the diagnosis: if necessary, in order not to cause harm to the patient, it can be replaced by other examination methods.

Gastroscopy is prohibited under the following conditions:

heart diseases accompanied by rhythm disturbances (irritation of the wall of the esophagus with a probe passing through it can provoke a rhythm disorder);
recent stroke (ischemic or hemorrhagic);
angina at rest;
cardiovascular or cardiopulmonary failure;
exacerbation of COPD (chronic obstructive pulmonary disease) or bronchial asthma;
neoplasms or aneurysms in the mediastinum, in which a change in the configuration of the esophagus occurs (displacement or partial compression);
decreased blood clotting (hemophilia, thrombocytopenia);
recent myocardial infarction;
severe deformities of the spine in the thoracic or cervical regions;
esophageal stenosis;
severe hypertrophy of the thyroid gland.

Another absolute contraindication for routine gastroscopic examination would be refusal of medical intervention. The patient can always write a refusal to undergo gastroscopy.

Relative contraindications for FGS

This group includes 2 types of conditions:

permanent;
temporary.

Permanent

This group includes diseases for which FGDS is not recommended; this type of examination can only be carried out if absolutely necessary.

Such pathologies include:

angina pectoris;
Stage 3 arterial hypertension;
rhythm disturbances;
myocardial ischemia;
late period of rehabilitation after a heart attack or stroke;
acute condition due to mental illness (such patients, if indicated, undergo FGS under general anesthesia);
chronic respiratory diseases accompanied by respiratory failure;
enlarged lymph nodes in the throat and neck.

Temporary

Such contraindications to planned FGDS, as a rule, arise for various reasons.

It could be:

acute infection of the pharynx and upper respiratory tract(tonsillitis, tracheitis, bronchitis);
infectious lung diseases (pneumonia);
hypertensive crisis (the procedure can be performed only 3 days after stabilization of blood pressure);
pregnancy (during pregnancy, such intervention is undesirable, but it is noted that most women in interesting position gastroscopy is well tolerated);
contrast radiography of the stomach (it is allowed to do FGDS only after complete removal of the radiopaque substance from the patient’s intestines, which occurs on days 3-4).

In case of relative contraindications, the advisability of conducting a gastroscopic examination is determined individually. Sometimes the procedure is postponed for several days until the patient’s condition improves (for respiratory tract infections or to remove the contrast agent from the body), and in some cases (ischemia or angina) the procedure can be replaced with ultrasound or another more soft look examinations.

Despite a number of contraindications, gastroscopy is considered one of the most reliable and effective methods diagnosis and treatment of gastric pathologies. If there are no conditions in which this type of research is prohibited, then it is not recommended to refuse the procedure.

When you first hear about the need to undergo gastroscopy, anxiety grows inside and a lot of questions arise:

A why is gastroscopy needed?

Should I do it?

Is gastroscopy harmful?

There are several purposes for which gastroscopy is performed.

GOAL 1 – PREVENTIVE

Gastroscopy is worth doing just so that you can sleep peacefully and be completely confident that your stomach is healthy.

When we hear the word “oncology” or “cancer,” we involuntarily shudder and pray that trouble will bypass us and our loved ones. And we don’t even suspect that in the early stages, when cancer is 100% curable, this insidious enemy does not manifest itself in any way. And when it makes itself felt, it may turn out to be too late and you will have to seriously fight for your life and health.

But in order to be safe, you need so little - once a year, set aside just half an hour to talk to the doctor and conduct an examination.

Take care of yourself and your loved ones!

GOAL 2 – DIAGNOSIS OF THE DISEASE

If you feel any ailments from the gastrointestinal tract, then, as they say, God himself ordered to visit a doctor and undergo an examination - gastroscopy of the stomach.

Gastroscopy of the stomach- This the only reliable way make an accurate diagnosis and prescribe effective treatment. No alternative diagnostic methods can give you this.

The indications for examination for diagnostic purposes are quite extensive.

These are classic symptoms of gastrointestinal distress, such as:

heartburn, nausea, belching, bitterness in the mouth or acidic taste, bad smell from mouth;
pain when swallowing food or liquid, lump in the throat, difficulty passing food;
heaviness, pain in the upper abdomen, hunger pain, pain after eating, stomach pain and pain in the back;
vomit, especially with blood or black (you should contact here see a doctor immediately!);
bloating, diarrhea/constipation (or their alternation), abdominal cramps, streaks of blood, black stools;
pain and heaviness in the right hypochondrium, pain in the lower abdomen on the right or left side, pain near the navel, rashes on the skin;
decreased or loss of appetite, change in the taste of familiar foods, heightened feeling thirst;
sharp pain, sudden weight loss without visible reasons, low hemoglobin(anemia) and constant weakness.

And even worries that you may not directly associate with digestive problems, for example:

chest pain;
anemia;
chronic cough, you notice that food or liquid often goes down the wrong throat.

If you find any of these symptoms, then:

GOAL 3 – MONITORING THE COURSE OF THE DISEASE AND THE PROGRESS OF TREATMENT

If you have been diagnosed and are undergoing treatment, then, if necessary, the doctor may prescribe a repeat gastroscopy.

This will allow you to see what the dynamics of the healing process are, whether you need to adjust the therapy, or make sure that everything is fine with you now.

GOAL 4 – CARRYING OUT THERAPEUTIC MANIPULATIONS

During a diagnostic gastroscopy, if necessary, the doctor can perform a biopsy - take a small piece of tissue for analysis.

GOAL 5 – BEFORE MOST ELECTIVE SURGERY

Yes, yes, don’t be surprised, but you may be prescribed gastroscopy as part of the standard preparation package for planned surgery.

IS GASTROSCOPY HARMFUL?

People with diseases gastrointestinal tract, especially their chronic forms, are regularly examined using an endoscope. Sometimes patients have a reasonable question: how often can a gastroscopy be done and what consequences might there be? In fact, a foreign object penetrates into the human body, causing not the most positive sensations and emotions. And due to the high reliability of the research results, doctors sometimes (according to patients) “abuse” the prescription of gastroscopy. Which frequency of gastroscopy Isn't it harmful to health?

Doctors say: when the study is performed by a doctor of sufficient qualifications, good equipment and in compliance with the established procedure, gastroscopy is absolutely harmless.

Patients may have a question: how to make sure that a specialist is suitable for this job and does it correctly? You need to understand that such positions are filled by highly qualified specialists with experience in the diagnosis and treatment of diseases of the gastrointestinal tract. Random person will not get into the office with an endoscope.

Therefore, the decision on the need and frequency of gastroscopy accepted only by the attending physician. IN special cases(exacerbation of the ulcer) the procedure can be performed several times a day. Having in hand a complete picture of the symptoms and the results of other studies and tests, the doctor makes a decision. Gastroscopy is necessary not only to record the initial state of the disease, but also to understand the dynamics and intermediate results of treatment. At the end of treatment, an endoscope examination is also performed to obtain objective treatment results.

Of course, the patient may refuse to undergo such a procedure. But you need to be objective and understand that the doctor will not just prescribe gastroscopy. If it is appointed, then there are good reasons for it.

Contraindications for gastroscopy

Doctors may limit the frequency of gastroscopy during periods of severe exacerbation. chronic diseases digestive system. But this is rather an exception and doctors resort to it if the objective picture of the course of the disease is already clear. This is done solely out of a desire not to cause additional discomfort to the patient, who is already suffering from an exacerbation of the disease. But there are also a number of restrictions that mandatory will be taken into account by the doctor. They can be classified as conditionally absolute restrictions, since consultation with doctors of other specialties may be required.

There are few such restrictions:

Problems with the cardiovascular system;
mental disorders;
being in rehabilitation.

Various chronic cardiovascular diseases require consultation with a cardiologist from the attending physician. It may turn out that minor heart problems may become a basis for refusing gastroscopy, even if the disease does not outwardly bother the patient. The decision in such cases is made in consultation with the cardiologist.

People suffering from mental illness. The procedure may cause unpredictable reactions, and the patient may cause physical harm to himself. In such cases, the doctor tries to limit himself to an ultrasound examination.

The rehabilitation period is a limitation due to the fact that the human body is recovering from the consequences of other diseases and it is better to try to postpone the not-so-pleasant gastroscopy procedure. The patient must be honest about his chronic and acute diseases so that the attending physician understands the need and timeliness of gastroscopy.

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FGS, or simply gastroscopy, is a most unpleasant procedure, according to most. As soon as you listen to the negative impressions shared by those who have gone through the FGS, you yourself will not want to go to it. But in vain. Last year alone, 32 operations were performed on time, which helped avoid the development of stomach cancer and save people's lives. The candidate will be discussed about the benefits of FGS and false fears. medical sciences, Head of the Endoscopy Department at the Regional Clinical Hospital Elena Olevskaya.

Very often, the feeling of fear and hostility towards this procedure, with which most patients come to us, interferes with its implementation and enhances this negative effect. It seems to me that by realizing the need for endoscopy, trusting the doctor and his professionalism, you can overcome your fear, pull yourself together and come. The benefits of this examination are much more significant than all our fears! What is it for? Endoscopy involves examining not only the stomach, but also the intestines and bronchi, if required. Of course, people turn to us for various reasons, but first of all, this type of research concerns the issues of early oncological diagnosis, because in case of doubt, a correct and timely diagnosis can save not only health, but also life. For example, endoscopy is the only method that can “see” stomach cancer in the early stages before serious structural changes have occurred and a tumor has developed. Identifying a pre-cancerous condition means that a person will definitely be cured and forget about this disease, there is statistical confirmation of this .

A few days ago I returned from Japan, which is considered throughout the world to be the founder of endoscopy. Mortality from stomach cancer was in first place there. The population literally died from this disease. As a result, the fight against gastrointestinal oncology has become a matter of national importance. The Japanese have raised endoscopy to unprecedented heights and attracted wide public attention to the problem of this disease and the need for examination.

It is customary for us to undergo fluorography before hiring - it is also customary for them to undergo fluorography FGS procedure during the employment process. And there is no hostility, there is no feeling that “I don’t like it and I won’t go there,” there is a feeling that this is the key to life. I would really like for South Urals residents to consider this procedure mandatory, then, I think, many problems could be avoided.

We have all necessary equipment for a qualitative examination of patients: being in Japan, I naturally wanted to compare the levels of development of this type of diagnosis. And I note that the results of the comparison pleased me: maybe the level of development of endoscopy in our country is not yet so high, but we are moving in the right direction.

– Elena Rafailovna, how can you reassure those people who are afraid of undergoing this procedure?

– By and large, there is no reason to be afraid! We have excellent specialists who have been performing this procedure for decades: out of 11 doctors, 9 are with highest category. They try to smooth out the impression of an unpleasant procedure, well at least kind words! Calmly, without shouting or hassle, the doctor will explain the essence of what is happening, then tell you what was found out during the examination. Imagine that from functional changes in the stomach you can understand a lot about... a person’s character, his habits and lifestyle!

Enters into conversation doctor of the endoscopy department Olga Naumenko:

– I think it would be more correct not to intimidate people, but to emphasize the importance of this procedure and explain how much their habits and character affect their health. Excessive nervousness and unreasonable fears lead to functional changes. Once you look into a person’s stomach, it immediately becomes clear what it really is like! For example, a duodenal ulcer indicates that a person is stressed and overly nervous. Patients whose cardial rosette does not close in the stomach, or there is a reflux of bile into the stomach, or the same ulcer, are usually very emotional people with a labile psyche (frequently changing mood). Bile reflux occurs, for example, in people who are anxious and overly suspicious. For women, this symptom is also very characteristic, just like cardia rosette insufficiency. All the many years of experience and the knowledge that we possess allow us to instantly understand what is inside a person in the literal and personal sense! Moreover, given his character, it is possible to predict now what diseases may befall him.

– What equipment do you use?

– All our equipment is very High Quality. All modern endoscopy is “fiber”: the endoscope is able to see thousands of fibers that make up the organ under study, and, accordingly, structural changes in it. In addition, all endoscopy equipment is based on digital technologies, which allows you to obtain unique image quality. We can literally download the image captured during the study onto a flash drive, and the person will be able to monitor his own condition independently, comparing the data obtained.

Modern endoscopes are so advanced that we get a chance to thoroughly examine the structure of the fibers of the stomach, see, for example, a tumor that has begun to grow and prevent it in time further development, you can also enlarge the image and thoroughly examine the entire surface of the stomach. This is the so-called “magnifying” endoscopy.

We have research methods that allow us to use a dye that reacts only to altered stomach cells (normal cells are not stained) to see the affected lobes of the organ, which will be subjected to detailed analysis rather than examining the entire stomach. Dyes in endoscopy have made it possible to take a step forward in determining the acidity of the stomach.

Previously, for this, doctors needed to carry out a “probing” procedure, when the stomach was pumped out for two hours. gastric juice and by examining the resulting liquid, they got an idea of the acidity. This was a rather long and painful process for the patient, but now the endoscopy procedure using dyes makes it possible to determine acidity in a matter of minutes.

This procedure is especially convenient for children: there is no longer any need to traumatize their psyche with a frightening probing procedure. These and other functions are available in the “extra-class” devices used by the endoscopy department of the Regional clinical hospital, fortunately, owns it.

In addition, for the last six months we have been able to conduct research with a new device, which, in addition to endoscopy, also provides ultrasound functions. The procedure itself is not much different from conventional endoscopy: in the same way, an endoscope is inserted into the esophagus and stomach, but if conventional endoscopy allows you to see only the surface of the stomach, then a sound study allows you to examine all the walls of the stomach and see the smallest changes in them. The importance of such studies is difficult to overestimate when diagnosing early oncology.

– What are the indications for endoscopy and FGS in particular?

– Now endoscopy is prescribed very widely, and this is correct, in my opinion. Even patients who are being prepared for any type of surgery are required to undergo this examination. Because if, for example, a person has an ulcer, and he faces a big surgery, which in itself is a serious stress for the whole body, in this case, medications that reduce the risk may be needed possible complications in ulcer patients. If the patient needs to be operated on urgently, the ulcer can be sealed using endoscopy to avoid possible gastric bleeding in this case. If the operation can be postponed a little, the patient is treated, after which a final examination is prescribed, and only after that we return to the issue of surgical intervention.

Also an indication for FGS, in addition to the fact that it is useful procedure, can be any discomfort in the gastrointestinal tract, including banal heartburn, pain, any symptom that causes anxiety - this is a reason to consult a doctor. Oddly enough, but patients with anemia (decreased hemoglobin levels) should also undergo an endoscopy examination. In situations where a person has not had blood loss as such, but the hemoglobin level continues to fall, the gastrointestinal tract should be examined using gastroscopy. After all, one of the reasons low level red blood cells may well have some forms chronic gastritis, in which iron, no matter in what quantities it enters the body, is not absorbed by the walls of the stomach. It is with the help of endoscopy and biopsy (“pinching off” a microscopic piece of the affected area of the stomach) that you can determine the shape of gastritis and all the accompanying data and, as a result, get rid of the disease.

The next advantage of FGS is the safety of the study. Many patients are alarmed that the procedure is performed with an endoscope, and this device is not disposable. It cannot be disposable because it is a very expensive device. Naturally, the feelings of patients who are concerned about their own safety are understandable, because now even when they come to a manicure salon, many are interested in the question of how and with what preparations instruments are treated, but here we're talking about O internal organs. Some patients even tend to come first for the procedure in the hope that the endoscope will be “cleaner.” I assure everyone responsibly that all devices are processed accordingly: they are kept in the machines for the prescribed number of minutes and in a solution of the required consistency. The chances of causing harm and spreading infection from one person to another are reduced to zero.

– What should we do for those who, under any pretext, do not agree to go through this procedure? Is there any alternative methods research?

– Endoscopy is the only serious method for examining the gastrointestinal tract. There are, of course, patients who, no matter how much you persuade them, will never agree to FGS; it is psychologically difficult for them to overcome the barrier to such a seemingly unpleasant procedure. There are patients for whom it is impossible to undergo this study for health reasons, for example, serious heart disease. In the described cases, we resort to the help of an anesthesiologist: we carry out the necessary studies under anesthesia so that there is no “violence against the individual.” Now there are all conditions for conducting so-called comfortable endoscopy. There are no cases when this examination cannot be carried out.

– How often should FGS be performed?

– Speaking about the frequency of the procedure, I would recommend that everyone undergo endoscopy once a year, and those who suffer from any gastrointestinal diseases, patients at risk, need to be under the constant supervision of a doctor. As for our department, we do everything in our power: we invite patients to an appointment, call, recommend that they undergo the next examination. Such methods of work are only for Last year made it possible to carry out 32 operations to remove those areas of the stomach in which structural changes had already begun that could develop into cancerous tumor.

– Is any special preparation needed before the gastroscopy procedure?

– A thorough three-day preparation is necessary only before examining the intestines, which are cleaned in advance. For this purpose, there are special medications that the patient takes with big amount water. The intestines spontaneously cleanse themselves, and the next day we invite the person for examination. Gastroscopy (examination of the stomach) and bronchoscopy (examination of the lungs) do not require any additional preparation, much less medication. You just need to come in the morning on an empty stomach.

– Elena Rafailovna, sensitive issue…

- All clear! Many people are embarrassed by the fact that regurgitation, gag reflex and similar phenomena occur during endoscopy. Very in vain, actually! Neither the doctor nor the sister will be embarrassed by this. The fact is that this is a normal reaction to the FGS procedure: after all, in order to examine the stomach, which in the “empty” state is fold to fold, and expand it for inspection, they fill it with air using an endoscope, all folds are smoothed out, and then we We can easily carry out the examination. And it is clear that every person, someone in to a greater extent, someone in a smaller position will reflexively try to get rid of this air. People are terribly embarrassed by what they publish various sounds, but that's absolutely normal! No one will shame you for this, you don’t need to feel any awkwardness in this situation. Doctors understand that this is a natural process!

Of course, the patient needs to understand the importance of endoscopy so as not to consider this procedure unpleasant. The quality of the examination also depends on how ready the patient who comes for the examination is to interact with the doctor. It is very important. Of course, no one will force anyone. It depends only on the person himself how healthy he will be, how many years he wants to live and in what condition. A doctor can only help you in your quest to take care of yourself.