How to check the stomach without swallowing a probe: alternatives to traditional gastroscopy

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Among diseases of the digestive system, pathologies of the esophagus receive special attention. This is due to the trend of increasing precancerous diseases based on existing chronic pathologies of the organ.

How to check the esophagus in order to make a timely diagnosis of a particular pathology and receive adequate and timely treatment? This issue will be discussed in this article.

Treatment of diseases of the esophagus is one of the most complex surgical interventions of modern surgery. This is explained by the topography of the organ and the close location of the organs bordering it. The more the role of such an event as a high-quality diagnosis of the esophagus increases .

• 1 Diagnostic methods
• 2 Esophagoscopy
• 3 Chromoscopy of the esophagus and stomach
• 4 FGS of the esophagus
• 5 Radiography
• 6 Computed tomography
• 7 Ultrasound
• 8 Useful video
• 9 Laboratory research
• 10 Relevance of timely and high-quality diagnostics

Contraindications for examination

Indications for gastroscopy are quite wide. It allows the doctor to obtain important information about the condition of the esophagus, stomach, duodenum, identify pathological changes in them and take tissue sections for analysis . The study is recommended for any complaints that may be associated with dysfunction of the upper digestive tract. However, not all patients are prescribed this diagnostic procedure, even if it is needed.

There are a number of contraindications to FGDS :

• pathology of the esophagus, in which it is impossible to insert a probe into the stomach or there is a high risk of damage to the wall of the organ (scar strictures, burns);
• mediastinal tumors , mediastinitis;
• severe kyphoscoliosis (curvature of the spine and displacement of the chest organs makes it difficult to insert an endoscope);
• severe cardiovascular or respiratory failure;
• shock of various origins;
• acute cerebrovascular accident;
• complicated myocardial infarction in the acute period;
• suspicion of perforation (violation of the integrity) of the organ.

also undesirable to use gastroscopy in pregnant women and people with the following diseases:

• acute infections;
• acute inflammation of the upper respiratory tract;
• glaucoma;
• unstable angina;
• hyperthyroidism.

Contraindications from the last list are considered relative. This means that it is better to refuse the procedure, but in extreme cases the doctor may prescribe it.

Please note: In each specific situation, the need to use gastroscopy is determined by its diagnostic value. If a patient develops a life-threatening condition and it is impossible to help him without FGDS, then it is carried out without paying attention to contraindications.

Radiography

X-ray examination of the esophagus and stomach is performed on an empty stomach. Before the procedure, the patient drinks a special contrast agent (barium sulfate in solution). When conducting the study, attention is paid to the features of the contours of the organ, its peristalsis, the relief state of the mucous membrane, and the degree of functionality of the sphincters.

The method is informative in diagnosing neoplasms in the esophageal tube and stomach and is actively used in pathologies of these organs.

Read more about this study in this article.

Biopsy

This is a diagnostic procedure that is performed on tissue samples from the affected organ, in this case the esophageal tube. Cytological examination of tissues is performed under a microscope mainly to identify cancer cells. At the same time, specialists not only give an opinion about the presence of cancer cells, but also determine whether they belong to a particular type of tumor.

In addition to oncology, a biopsy of the esophagus makes it possible to diagnose some autoimmune pathologies, infectious diseases, and precancerous conditions . After the biopsy, the patient is not recommended to take hot or traumatic food for the mucous membrane of the organ for 24 hours.

In what cases are there no analogues?

Among the indications for gastroscopy, there are several particularly important ones, in the presence of which it cannot be avoided :

• gastrointestinal bleeding (vomiting "coffee grounds" or black stools);
• bleeding from varicose veins of the esophagus (bloody vomiting);
• foreign bodies in the esophagus or stomach.

This is due to the fact that in such cases FGDS is performed not only for diagnostic purposes, but also for therapeutic purposes. it is not possible to eliminate the problem using other methods , it is impossible to replace the procedure.

It is also important to perform gastroscopy in patients with suspected gastric cancer and the need for a biopsy . After all, the patient’s management tactics depend on the results of the study.

Contraindications to gastroscopy

Gastroscopy is not the most complex examination method, however, as with any medical procedure, there are certain contraindications:

With caution, the gastroscopy procedure is prescribed to patients with acute inflammatory processes in the nasopharynx, enlarged cervical and retrosternal lymph nodes, large diverticula of the esophagus (deformations of the organ wall with “saccular” bulging of its layers), as well as children under 6 years of age. Young patients are given general anesthesia and the gastric mucosa is examined with a thin probe (no more than 4 mm in diameter).

Anesthesia and sedation

If performing gastroscopy is difficult due to the psychological status of the patient or the presence of epilepsy or organic diseases of the central nervous system, then the study is best carried out under sedation or intravenous anesthesia.

For everyone else, this may be a good way to get through the procedure without unnecessary worry and stress. Sedation for EGD is widespread throughout the world. Read more about it in our article.

General anesthesia is often used in young children, which makes the procedure easier tolerable and easier.

Is gastroscopy possible without swallowing the probe?

In order to answer this question, you need to understand - what is gastroscopy? Translated from ancient Greek “γαστήρ” - stomach and “σκοπέω” - I look. Of course, classic gastroscopy without swallowing a probe is impossible , because it involves examining the stomach from the inside using an endoscope.

Currently, there are other methods for examining the stomach that allow visualization of the organ without penetrating into the cavities of the human body. They, of course, cannot completely replace FGDS, but with their help you can obtain useful information about the anatomy of an organ and its functional activity:

• assess the condition of the stomach wall , its inner surface;
• identify changes in the relief of the mucous membrane, the presence of neoplasms;
• characterize his motor activity and much more.

Help Using probeless methods, it is impossible to perform any diagnostic or therapeutic procedures, such as biopsy, analysis of gastric acidity, removal of polyps , etc.

What can be replaced?

If the patient has contraindications to FGDS, the doctor prescribes an examination using alternative methods. It is considered advisable to combine several diagnostic procedures to obtain more accurate data and prevent errors at the diagnostic search stage.

Sometimes patients themselves look for an alternative to gastroscopy, experiencing discomfort or fear of the study. In such cases, it is better to coordinate your actions with your doctor and choose a diagnostic method together . After all, to make a diagnosis in each case, a different amount of examination may be required. Below we list the main alternative studies and briefly discuss each of them.

How to check the esophagus without swallowing the intestine?

Transnasal route of administration

The principle of transnasal gastroscopy
In people with a clearly defined gag reflex , as well as in children, the endoscope can be inserted through the nose. This method allows you to avoid irritation of the root of the tongue and all the unpleasant symptoms associated with it. This is written in detail in a separate article.

Using a thin probe

The diameter of modern endoscopes does not exceed 6-8 mm. But, if necessary, thinner probes - 3-5 mm - can be used for research. They are indispensable in pediatric practice; if necessary (for example, in case of difficulties when inserting an endoscope into the gastrointestinal tract), they can also be used in adults.

Video capsule

This is the first painless method of high-quality visualization of all parts of the digestive tube, which does not require additional sedation of patients and is characterized by a high level of safety.

Its essence lies in the introduction of a special video capsule into the body, which, moving through the gastrointestinal tract along with its contents, takes a series of pictures that are transmitted to a recording device.

Initially, it was used only for diagnosing intestinal diseases, but thanks to improvements in equipment, it is now successfully used to diagnose pathologies of the esophagus and stomach. Read about video capsule endoscopy here.

FGS of the esophagus

How to check the esophagus and stomach using fibrogastroscopy? This is the most valuable method for diagnosing the upper parts of the digestive system, including the esophagus. Indications for fibrogastroscopy are:

• inflammatory pathologies of the esophageal tube and stomach;
• peptic ulcer of the stomach and duodenum ;
• monitoring of neoplasms in the esophagus and stomach.

In addition to the diagnostic task, FGS also solves therapeutic problems. Along with a diagnostic examination of the walls of the esophageal tube, stomach and duodenum, biomaterial can be collected for histological examination during the procedure. In case of bleeding, a hemostatic operation is performed - coagulation of the bleeding vessel. Small polyps are also removed.

The whole procedure takes a few minutes. Preparation for it consists of refusing food 8-12 hours before the start. How to check the esophagus and stomach without gastroscopy?

There are methods that do not use invasive instruments:

• computed tomography and MRI;
• X-ray examination;
• Ultrasound;
• impedance measurement of the esophagus;
• biopsy;
• esophageal tube manometry;
• laboratory research.

Probeless methods for endoscopic examination of the gastrointestinal tract

Ultrasound

Ultrasound diagnosis of diseases of the stomach and intestines is a relatively new phenomenon in gastroenterology, as it was previously used only for examining parenchymal organs (liver, spleen, kidneys, pancreas) and bile outflow tracts.

The method is safe and informative. Ultrasound allows you to visualize the organ through the anterior abdominal wall and provides the doctor with a spatial image of it in different projections.

Usually ultrasound is prescribed in any case as an addition to FGDS. It is excellent as the first stage of examining the gastrointestinal tract system and can identify emergency cases . A detailed analysis and comparison of these two methods: FGDS and ultrasound can be read here.

X-ray

X-ray techniques are widely used to detect pathology of the gastrointestinal tract. They are distinguished by their accessibility, ease of use, and sufficient information content , but, at the same time, they are associated with radiation exposure.

Some of them are carried out with contrast enhancement, which puts additional stress on the body and causes unwanted reactions. X-rays are most often prescribed for emergencies in hospitals . A detailed comparison of stomach X-rays and FGDS can be found in this article.

CT and MRI

Computed tomography and magnetic resonance imaging are prescribed in gastroenterology as additional research methods when there is a need to confirm the diagnosis or clarify the nature of pathological changes, as well as when a tumor process is suspected.

Computed tomography (CT) exposes body tissue to radiation that is several times higher in dose than conventional radiography. MRI has certain limitations in use. You can learn more about this in a separate article.

Electrogastroenterography

The method is absolutely safe and non-invasive. It is used in clinical practice to assess the motor function of the stomach and intestines by recording the electrical potentials emanating from them. The absence of contraindications and side effects makes it possible to prescribe it to different categories of people - young children, seriously ill patients, pregnant women.

Preparation for gastroscopy

In order for the study to cause minimal discomfort to the patient, and to provide the specialist with maximum information for diagnosing diseases of the esophagus and stomach, it is necessary to properly prepare for the procedure. First of all, inform the doctor about the presence of allergies to medications and inform about the constant use of medications. It is also very important to name existing chronic diseases - problems with the heart, lungs, blood.

You should collect tests in advance, without which the doctor may refuse the study:

8 hours before gastroscopy, you should completely avoid eating. Dinner should be light. It is prohibited to have breakfast in the morning. For 3 days, hot, spicy and fatty foods, strong tea and coffee, alcohol, nuts, chocolate, baked goods, citrus fruits, legumes, as well as taking medications (except for vital ones, for example, for diabetes) and any traditional medicine (chamomile or mint tea, etc.). Before the procedure, the stomach and intestines must be “clean” to ensure good passage of the probe. Smoking is prohibited several hours before the procedure, as this addiction can provoke gag reflexes. Immediately before the examination, it is necessary to empty the bladder. If the patient has dentures installed, he must remove them before the procedure. Dental structures interfere with the passage of the gastroscope. You will also have to take off your jewelry and glasses. On this day, it is not recommended to brush your teeth during your morning hygiene routine. Substances contained in toothpastes can have a negative effect on the level of acidity of gastric juice. You can rinse your mouth with warm boiled water.

Gastroscopy is not contraindicated during menstruation. It is advisable that the patient notify doctors about her condition, as severe nausea and false pain may occur. Such symptoms will interfere with a full examination of the patient.

Patients with diabetes are prescribed gastroscopy in the morning, so that half an hour after its completion they can take medications and have a snack to avoid coma.

Other

Desmoid test

It is a simple way to tentatively diagnose pathological conditions associated with achlorhydria (lack of hydrochloric acid in gastric juice). For this purpose, the patient swallows a thin rubber bag with methyline blue, tightly tied with catgut. If there is free HCl in the stomach, catgut dissolves and the dye enters the body and is excreted in the urine, based on the color change of which a conclusion is made.

Gastropanel

a complex of laboratory tests
to diagnose stomach diseases

To do this, blood is taken from a vein, in which the content of gastrin (a hormone produced in the stomach), pepsinogen types 1 and 2 (precursor of the gastric enzyme - pepsin), and antibodies to H. Pylory are determined.

What pathologies can be identified?

Various alternative diagnostic methods reveal signs of many diseases of the gastrointestinal tract, but often cannot confirm the diagnosis due to the lack of biopsy and morphological examination.

Table 1. Diagnostic capabilities of each method.

Recommendations for the patient after gastroscopy

After the examination, carried out under anesthesia, you should not drink alcohol! Food and water can be taken 1-2 hours after gastroscopy. Food and drinks should not be hot. In the next few days, preference should be given to lighter dishes with a soft consistency without seasonings and spices - fermented milk products (soft cottage cheese, yogurt, fermented baked milk), cream soup, oatmeal or semolina porridge. The patient is also recommended to lie down for about 30 minutes after the examination. During the first 24 hours, you should rest more and avoid physical activity, refusing to visit gyms and fitness clubs. It is advisable to take a short walk through the park.

If, while following all the rules of daily routine and nutrition, the patient experiences pain in the gastrointestinal tract for more than three days, constipation or diarrhea, the attending physician should be notified. It is possible that some complications arose during the procedure.

Gastroscopy helps doctors identify various diseases of the gastrointestinal tract. Compared to other methods of examining patients, gastroscopy is the most informative. Serious complications during the procedure are extremely rare. Gastroscopy is performed even on young children and pregnant women. Proper preparation and attitude of the patient will facilitate the examination, reduce discomfort, help establish a diagnosis or adjust the treatment regimen for gastrointestinal diseases.

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Price

The cost of examining the stomach using the above methods in the Russian Federation varies depending on the region, the prestige of the clinic and the qualifications of the specialist and equipment.

The price for the same procedure can differ significantly in the center of the capital and on the outskirts. Therefore, if there is a need to undergo examination in private clinics, it is better to familiarize yourself with their capabilities and pricing policy in advance.

Table 2. Cost of FGDS and other studies in the Russian Federation (in rubles).