How can it be easier to undergo an FGDS and undergo the procedure without problems: learning to swallow the intestine so that it is easy to check the stomach, does it hurt and how to survive the insertion of the tube?

Description of the procedure

Fibrogastroduodenoscopy (FGDS) is a technique for endoscopic examination of the upper digestive system

(stomach, duodenum, esophagus). To carry it out, a special probe is used, which is equipped with a miniature camera and a manipulator.

In modern endoscopy, the image is displayed on a special screen. Acidity is also constantly monitored. FGDS usually includes a test for the presence of Helicobacter pylori infection

If necessary (for example, long-term existence of an ulcer, the appearance of neoplasms, chronic inflammatory processes), the examination is supplemented by a tissue biopsy with cytological examination

in a specialized laboratory.
An FGDS certificate is the basis for diagnosing diseases of the stomach, duodenum or esophagus.
It allows you to visualize changes in the mucous membrane that are difficult to see on CT or MRI. It is based on the results of FGDS that one can distinguish gastritis, peptic ulcer or malignant process

.
The study is of particular importance for highly specific rapid diagnosis of Helicobacter pylori infection.
Fibrogastroduodenoscopy is prescribed if the patient has the following symptoms:

aching pain in the upper abdomen, which intensifies after eating or drinking (especially alcoholic or carbonated);
sensations of discomfort in the epigastrium ;
the occurrence of nausea, single vomiting;
burning behind the breastbone or heartburn;
decreased appetite and subsequent loss of body weight;
tendency to constipation or diarrhea.

Typically, FGDS is carried out after the patient is examined by a doctor and undergoes basic laboratory tests.

What is FGDS

FGDS (fibrogastroduodenoscopy) is a method of examining the surfaces of the esophagus, stomach and the beginning of the duodenum using an endoscope. In gastroenterology it is considered the most informative method for making and clarifying the diagnosis.

The examination is carried out with a thin flexible probe 8-11 mm thick, which is inserted through the mouth and esophagus into the stomach. The image is projected onto the screen. There is a type of examination where a probe is inserted through the nose.

Advantages of the FGDS method:

information content;
safety;
no pain;
easy to carry.

The design of the device allows for diagnostics, taking tissue samples for analysis, and performing surgical manipulations at the time of the procedure.

Is it painful to have a gastroscopy?

Most patients who have undergone FGDS in the traditional way, if asked to describe their feelings from the procedure, call it unpleasant. To reduce the severity of these sensations, a local anesthetic is used, which is applied to the back wall of the oropharynx.

.
However, it does not always save the patient from discomfort. The most common complaints
from patients:

nausea;
a feeling of discomfort in the neck, behind the sternum or in the abdomen;
increased salivation;
belching;
feeling of lack of air;
panic attacks;
aching or cutting pain in the neck or abdomen.

Oddly enough, pain syndrome is relatively rare. It is possible in the presence of acute pathology (for example, exacerbation of peptic ulcer disease in young patients), complications (wall perforation) or careless examination, however, swallowing the intestine to check the stomach is unpleasant. The main thing is to behave correctly during the procedure and listen to the doctor’s recommendations.

How can I make the procedure easier?

The correct approach to fibrogastroduodenoscopy can significantly improve the patient’s well-being during the procedure. Below are the main recommendations that make FGDS absolutely painless.

Choosing the right doctor

Choosing a qualified doctor with a friendly approach to his patients can significantly reduce anxiety before the procedure, as well as reduce the severity and frequency of side effects.
A good approach from a specialist relieves anxiety and helps the patient relax. This allows the procedure to be carried out without unnecessary trauma (for example, scratching the throat), since the probe advances more easily.

In clinical practice, there are situations when, due to low professionalism, the doctor applies the wrong or insufficient anesthetic . Also, some medical professionals do not explain the essence of the procedure, possible risks, and nuances of patient behavior.

Important The doctor must carefully explain the nuances of preparing for the study, as well as select the most appropriate method of performing the procedure (nasal insertion of a probe, sedation or anesthesia) for a particular patient.

Psychological attitude

Many patients are scared and anxious; they do not know how to withstand a stomach examination. Some people generally cannot tolerate such procedures and do not know what to do or how to pass the FGDS.

It is usually scary to do research due to the lack of reliable information about FGDS, as well as reviews from friends. And if the patient is sure that he will be in pain during the procedure, then the risk of this complaint increases significantly, even if the study went without complications.

It is important to have contact between the doctor and the patient

. This will help make the procedure easier. He must be ready to answer all questions that arise, as well as give truthful and objective information about why FGDS is performed, what its value is and how you can avoid the occurrence of side symptoms.

There is no need to be afraid or ashamed belching, increased salivation or an attack of nausea occurs during the procedure .

These symptoms, to varying degrees of severity, bother most patients, but they are not a sign of the development of complications and quickly disappear after the diagnosis is completed . It is important to remember that medical staff encounter this every day, and therefore, for example, frequent belching does not bother them at all .

Before the procedure begins, the patient is given a small mouthguard that protects the probe from the teeth . In modern clinics, it is selected according to the diameter of the endoscope and the size of the patient’s oral cavity.

The procedure is performed with the patient lying on his side

.
During FGDS, the probe passes through the oral cavity, oropharynx, larynx, esophagus and enters the lumen of the stomach. The doctor examines the condition of the mucous membrane, conducts acidity measurements, as well as a test for Helicobacter pylori infection . If necessary, a biopsy is performed.
Please note: The total duration of the procedure does not exceed 10-15 minutes (if the doctor takes tissue, it can take up to 20-30 minutes).

Phytotherapy or medications tune in correctly to FGDS and eliminate anxiety.

The importance of proper preparation

Proper preparation for FGDS can significantly reduce the severity of side symptoms (especially vomiting) and increase information content. Therefore, on the day of the study, the patient should not eat. The last meal should optimally be no later than 10 hours before the test. For 2 hours, limit the intake of drinks - tea, coffee and even plain water.

To increase information content (especially if a Helicobacter pylori infection is suspected), special medication preparation is required.

It is necessary to discontinue medications that may affect the result - antisecretory agents, antacids, antibiotics, Bismuth preparations and some other medications.

Therefore, when prescribing a study, you should always warn the doctor about the presence of concomitant pathologies and medications taken.

Breathing feature

Before starting the procedure, the doctor must explain to the patient how to breathe correctly during FGDS. Breathing should be through the nose

, deep and smooth.
In this case (despite popular belief) there is no need to swallow
while moving the endoscope through the oropharynx and larynx. When you swallow, your larynx contracts, you touch the endoscope, and the doctor advances it. This leads to microtraumas of the throat and after the procedure you may feel that your throat hurts. Also, during the procedure you will feel that you cannot control the situation and panic.

That’s why it’s so important to relax and trust the doctor , breathe calmly, and burp calmly. This way you will not harm your body and will allow you to complete the procedure faster.

Following these recommendations will help the patient to adjust himself, promote calm and prevent sudden movements, therefore reducing the risk of injury and serious side effects.

Contraindications for FGDS

Although the FGDS procedure is informative and without it it is sometimes difficult to make a diagnosis, it cannot always be carried out. There are conditions when research is contraindicated:

narrowing of the esophagus due to neoplasms and physiological reasons;
narrowing of the stomach;
signs of intestinal obstruction;
severe stomach bleeding;
mental illness in the acute stage;
protrusion of the walls of the esophagus;
aortic aneurysm;
myocardial infarction;
stroke;
disturbances in the functioning of the heart;
immediately after a hypertensive crisis;
bronchial asthma;
strong gag reflex;
enlarged thyroid gland;
severe upper respiratory tract diseases;
severe anemia, obesity;
blood clotting disorder;
colds when the procedure is impossible (nasal congestion, cough, laryngeal swelling, high temperature).

Methods for painless passage

In the last decade, techniques have begun to be actively used that can significantly reduce discomfort or even painlessly undergo gastroscopy of the stomach:

Sedation
.
Sedation will help you survive FGDS calmly without fear. The patient is injected intravenously with a drug from the group of benzodiazepines, after which he falls asleep . The procedure is widely carried out and makes it easier to endure unpleasant sensations and painlessly perform FGDS of the stomach for adults and children. A few minutes after completion of the study, the patient wakes up. In an hour he can go home. The risk of side effects is low.
Anesthesia
(general anesthesia).
Used more rarely under the supervision of an anesthesiologist. The patient is given several drugs for pain relief, but mechanical ventilation is not required. Usually performed before planned surgery.
Capsule endoscopy
.
This is an innovative technique in which the patient does not have to swallow the tube. Instead, it swallows a small capsule-shaped chamber
that travels all the way through the digestive system. The image is recorded and then viewed by a doctor without any problems. Among the disadvantages of capsule endoscopy is the impossibility of a more thorough examination of the changed area of the mucosa, conducting a Helicobacter test or biopsy. Helps those who cannot undergo the standard FGDS procedure.

Insertion of a probe through the nose is also used.

(transnasal technique).
This technique provides a more comfortable FGDS
, since it causes nausea much less often and does not affect hemodynamic parameters (which is important for patients with cardiovascular diseases).
A probe with a significantly smaller diameter is used - 5.4 mm
(standard - 11 mm). When asked whether it is painful to do gastroscopy of the stomach in this way, many patients answer negatively.

Some diseases can be diagnosed using less unpleasant procedures: x-rays of the stomach and ultrasound of the abdominal cavity. In this article we have presented all the alternative methods of FGDS.

Preparation

If the patient is worried about the upcoming procedure, he can practice proper breathing at home.

To do this you need:

Find a quiet place where you can be alone.
Position yourself on your left side.
Insert any object resembling a mouthpiece between the upper and lower jaws.
In this position, take a deep breath through your nose, while drawing in your stomach.
Exhale through the nose, completely relaxing the abdominal muscles.
Try not to worry or think about anything distracting at this moment.

The duration of the workout should be at least 5-10 minutes. If it is difficult to cope with anxiety even at home, the training time can start from 1 minute and gradually increase it.

Possible consequences

After completion of the procedure, patients may have the following complaints:

aching pain in the epigastrium (upper abdomen), neck or behind the breastbone, which may intensify after swallowing;
weakness, dizziness , headaches, drowsiness (if drug sedation was used);
cough (entry of stomach contents into the respiratory tract due to improper preparation of the patient);
allergic reactions (to anesthetic);
heartburn or burning sensation;
increased saliva production ;
loss of appetite;
palpitations or increased blood pressure (due to activation of the sympathetic nervous system);
nausea that gets worse when eating or drinking water.

Important The severity of these complaints greatly depends on the qualifications of the doctor, as well as on the method of conducting the diagnostic procedure.
They usually go away completely within a few hours. Recommendations after the procedure:

Diet . After completing the FGDS, you cannot eat for another 30 minutes (and if a biopsy or sedation was performed, then 2 hours). The first meal should consist of simple foods and dishes: porridge, lean meat or fish, yesterday's bread, dry cookies, hard cheese, honey.
Peace. Avoid increased physical and emotional stress during the day. Some people feel completely fine after the procedure and are ready to get back to work. But some people feel quite weak, like after a slight poisoning. If you have the opportunity to schedule your sleep after the procedure, take advantage of it.

Fibercolonoscopy (FCS)

Fibercolonoscopy is an endoscopic method that makes it possible to visualize the condition of the mucous membrane of the large intestine. This method is safe and allows you to diagnose diseases of the entire intestine, from the rectum to the cecum.

Colonoscopy is a safe procedure without complications. But in some cases, bleeding may occur - after a biopsy or removal of polyps.

Indications for FCS

The main indications for intestinal examination include:

irritable bowel syndrome (constipation, frequent bowel movements, abdominal pain, flatulence, incomplete bowel movements, heaviness in the intestines),
blood in stool
anemia of unknown nature,
weight loss,
poor appetite, weakness.

Contraindications to FCS

FCS intestinal examination cannot be performed in the following cases:

cardiopulmonary failure,
hypertension 3rd degree,
stroke,
severe form of ulcerative colitis, Crohn's disease,
peritonitis,
adhesive disease,
acute stage of inflammation of the anal and perianal area (hemorrhoids, thrombosis),
early period after surgery.

Carrying out a colonoscopy in such cases can be life-threatening for the patient.

Preparing for the FCC

To successfully carry out a diagnosis, preparation is necessary. Preparations usually begin 2-3 days before the procedure.

Preparatory measures include a slag-free diet, washing and additional means - Fortrans. When using Fortrans, a drug that helps cleanse the intestines, preparation for the fibrocolonoscopy procedure is easier and more thorough. It is enough to use the instructions supplied with the drug.

After FCS you can eat and drink.

If you feel your intestines are full of gases and you cannot get rid of the remaining air in the usual way, it is recommended to drink 8-10 tablets of activated charcoal, having first dissolved them in half a glass of warm water.

It is advisable to lie on your stomach for several hours after the examination.

How is the FCC procedure carried out?

Fibercolonoscope is a device that examines the rectum. It is a flexible bundle with many light-conducting fibers. They transmit an image that the doctor observes through the eyepiece.

For the examination, the patient must remove all clothing below the waist and lie on his left side, pulling his knees to his chest. The colonoscope is inserted through the anus and, gradually moving it along the intestines, the cavity is examined.

Duration

procedures: up to 30 minutes.

It is usually easily tolerated; a feeling of flatulence and the urge to defecate may occur.