Question answer

Gastroscopy for ENT diseases

Laryngitis, tracheitis, pharyngitis and tonsillitis are clear contraindications to FGDS. These diseases are characterized by inflammation of the mucous membrane of the larynx and pharynx, which becomes extremely sensitive to the effects of irritating factors. A fiberscope is a hose of a certain diameter, which during the procedure somehow touches the walls of the larynx and esophagus. At best, this can aggravate the inflammatory response, and at worst, cause severe spasm, which can trigger the development of acute respiratory failure - a life-threatening emergency that requires emergency medical attention. Fortunately, this happens extremely rarely, however, all rooms where gastroscopy can be done are equipped with a first aid kit with the necessary medications.

One of the important factors ensuring a complete and safe endoscopic examination is proper patient preparation.

All preparation for endoscopy can be divided into general and local .

General preparation for endoscopic examinations (carried out in three areas):

Psychological preparation. Includes explaining to the patient the goals and objectives of the upcoming study, the need for it to be carried out to make a correct diagnosis and further successful treatment; For people with a labile psyche, to relieve negative emotions, feelings of fear and normalize sleep, the prescription of sedatives, sleeping pills, sedatives, and tranquilizers is indicated (you can ask your doctor to prescribe these medications). Correction of disturbed homeostasis parameters. First of all, this applies to the cardiovascular and respiratory systems, from which the most severe complications can be expected during the study.

Conditions such as severe angina pectoris, various types of arrhythmias, high blood pressure, severe respiratory failure require mandatory competent correction for several days before the study. Be sure to warn your doctor about the presence of diseases and conditions that may affect the choice of preparations for the study. These are hypersensitivity, allergies to drugs used in endoscopy (local anesthetics), the presence of glaucoma (atropine is contraindicated), cholelithiasis (the use of magnesium sulfate as a saline laxative solution is contraindicated), pregnancy, etc.

Local preparation for endoscopy (includes two main areas): Since a relative contraindication for FGDS is inflammatory diseases of the upper respiratory tract (ARD, tonsillitis, cracks, seizures, etc.). First you need to undergo treatment, and then do an FGDS.

Cleansing hollow organs. Insufficient cleansing of the gastrointestinal tract from contents makes it difficult to fully examine the organs being examined, which is necessary to assess the nature of the pathological process and its extent, which is of fundamental importance for making a diagnosis and carrying out therapeutic manipulations. Gastroscopy must be performed on an empty stomach. When conducting a study in the morning, the last meal is a light dinner on the eve of the study no later than 19:00. If the study is carried out in the afternoon, dinner should also be no later than 20.00 and not abundant; in the morning on the day of the study - a light breakfast (tea, porridge, bun) and after 6 - 8 hours the study can be carried out (that is, for 6 - 8 hours before the study, do not eat or drink liquids).

How to prepare mentally?

This may sound strange, but the night before your procedure, you can mentally “talk to yourself.”

Tell yourself that an unpleasant procedure awaits you, that a gag reflex is possible, ask your body to prepare for the fact that a tube with a camera will be shoved down your throat. Explain to yourself that this is a necessity for a quality examination. This is necessary so that this procedure does not come as a surprise to your body and organism. Ask your body to prepare mentally and physically for this procedure.

If you are afraid, then think about what you are afraid of. It seems to me that most fears are related to:

1. With pain during the FGDS procedure itself. The most unpleasant moment during an FGDS examination is the insertion of a tube through the throat. At this moment, you do not feel pain because your throat will be treated with lidocaine. This is a pain reliever and is quite effective. The only thing you can feel is pressure on your throat, which lasts no more than two seconds.

2. With gagging during examination. Alas, most likely this moment will be inevitable for you. But we can immediately assure you that you will definitely not vomit, provided you follow the recommendations before preparation. Everything is simple here, the stomach is empty. You may feel a little nauseous during the procedure, this is normal. Imagine that you have been poisoned and feel a little nauseous. This is roughly what it feels like. Sometimes you will experience gag reflexes, this is also normal. Imagine that you pressed something on the root of your tongue and you felt the urge to vomit. Almost the same sensations. But they are not permanent. I think we are all familiar with gagging. There will be no new sensations here. You all know there is no pain in this. It's just unpleasant.

In fact, this is where the whole unpleasantness of the procedure lies. You may cry during the examination. It's not scary. You will just lie there and at some point you will notice that a tear has rolled down your face. This is not accompanied by pain or burning in the eyes. Tears flow because the receptors are affected.

3. With fear of lack of oxygen. In this case there is definitely no cause for concern. You will have enough oxygen at any second of your time. You can breathe through your nose and mouth, and you can swallow saliva. But swallowing will be accompanied by an unpleasant sensation of a tube in the throat.

Gastroscopy for a runny nose

Acute rhinitis is also a contraindication to FGDS. If the runny nose is chronic, then it is necessary to discuss with your doctor the justification for using vasoconstrictor drugs in the form of nasal drops during the procedure.

It should be taken into account that some decongestants can potentially slightly increase blood pressure, which will negatively affect the well-being of a patient with vascular diseases. It is possible to develop palpitations and even a panic attack during gastroscopy. That is why even nasal drops should be prescribed by a doctor if the patient is to undergo an FGDS.

If a cold is accompanied by an increase in body temperature, then no diagnostic procedures are carried out until the state of health returns to normal.

Indications for FGDS

Due to the wide range of possibilities of the FGDS procedure of the stomach, there is a fairly large list of indications for this medical procedure. The doctor will prescribe an FGDS if you notice the following symptoms:

• Abdominal pain of any location;
• Constant nausea and frequent vomiting;
• Difficulty swallowing;
• Unreasonable fluctuations in body weight;
• Anemia;
• Excruciatingly painful heartburn.

As noted above, FGDS can be used both for diagnostic purposes and as a therapeutic technique. The diagnostic procedure of FGDS of the stomach is the most informative method for determining the following pathologies:

• Gastritis;
• Colitis of various etiologies;
• Stomach ulcer;
• Neoplasms, both malignant and benign;
• Dyskinesia of the gallbladder;
• Esophagitis;
• Duodenitis.

An indication for therapeutic fibrogastroduodenoscopy may be the need to remove polyps and erosions, as well as foreign objects in the stomach. FGDS allows excision of a small area of ​​tissue for microscopic examination and biopsy, which makes it possible to accurately make a diagnosis and develop a competent treatment strategy. In addition, in rare cases, gastroscopy of the stomach may be prescribed on an emergency basis to stop intracavitary bleeding.

Question answer

Olga: (2020.02.20)

How to behave correctly during FGS so that it goes away painlessly?

Expert answer:

Olga, hello.

What is the right question to ask: a lot depends on the patient’s behavior during this study. We have prepared a detailed article on this matter and posted it on our center’s website. You will find detailed recommendations in it, including how to properly prepare for the study. Link to article: VIDEOGASTROSCOPY (FGS)

Excerpts from an article on the question asked:

How is Videogastroscopy (FGS, FGDS, EGDS) performed?

During the procedure, the patient lies on his left side with his knees bent. To reduce discomfort during therapy, the patient's nasopharynx is irrigated with a ten percent lidocaine solution. The flexible endoscope is inserted into the oral cavity through a plastic mouthpiece fixed between the teeth. After introducing the gastroscope into the oral cavity, the patient needs to make a swallowing movement to facilitate the advancement of the device into the esophagus. Relaxation and calm breathing help suppress the gag reflex that occurs during the procedure, which also makes the entire procedure easier for both the doctor and the patient.

A few words about “unpleasant sensations” . When performing an endoscopy, the patient experiences the following “indescribable” sensations:

• Nausea and gag reflex (The same sensations occur when examining the throat with a spatula or the handle of a spoon);
• Feeling of a “lump” in the throat (As if you chewed something poorly and choked when trying to swallow it. Very reminiscent of a piece of kebab that got stuck for a while);
• In rare cases, there may be pain as a result of spasm of the upper esophageal sphincter and pharyngeal muscles;
• Distension, bloating and heaviness in the abdomen are a consequence of insufflation (filling) of the stomach with air;
• There may be sensations of movement or movement inside the abdomen (Arise when advancing and manipulating the endoscope);
• Sometimes there is a feeling of lack of air - these sensations are of a subjective nature (the endoscope does not block the airways and air flows freely into the lungs).

No other sensations arise during EGDS. The whole range of sensations is strictly individual and depends on many factors. But if you behave correctly, listen to the prompts of the medical staff and prepare well for the examination, then the procedure takes place with the minimum necessary amount of time and a minimum of discomfort.

!!!How should you behave during EGDS:

1. Prepare well for your research. The procedure is carried out strictly on an empty stomach, the last meal is possible 6-8 hours before the examination, this will allow the endoscopist to examine the entire surface of the mucous membrane as efficiently and quickly as possible. At the same time, detect even minimal changes on it. An empty stomach also reduces the gag reflex and nausea. 2. When passing the endoscope through the mouth and throat, try not to touch it with your tongue. 3. Try to breathe deeply and evenly through your mouth, do not freeze or stop breathing: deep and even breathing calms and reduces nausea. This is the main technique to facilitate research. It is better to breathe directly through the mouth, since during the examination itself it is difficult to switch breathing, and when breathing through the nose, reflex swelling of the mucous membrane and mucus secretion occurs, as a result of which the nose becomes stuffy and breathing becomes difficult. 4. Hug your stomach tightly, do not swing your arms. This will help you focus on breathing and will not interfere with the endoscopist conducting the examination. 5. Try not to resist the endoscope or interfere with medical personnel. Thus, you will significantly reduce the procedure time and improve its quality. Also try not to burp air: the time for insufflation will decrease, and therefore the entire procedure. 6. Only point 1 concerns everyone who performs endoscopy under anesthesia: an empty stomach will help avoid vomiting and aspiration, and will also significantly improve the quality of the examination.

IMPORTANT: Preparation for the study

1) Video gastroscopy is performed on an empty stomach (12 hours of fasting before the procedure is recommended, minimum 8 hours).

2) There is no special diet before the procedure. It is recommended not to eat heavy foods (fried, fatty, spicy), foods that cause bloating (cabbage, legumes, etc.) the evening before the procedure.

3) It is advisable not to smoke at least 2 hours before gastroscopy, since smoking provokes the formation of gastric juice and can increase discomfort.

4) If the patient needs to take medications, this can be done no later than 4 hours before the procedure, with a small amount of water. You must inform your endoscopist about taking the drug.

You can sign up for the FGS on this website in the “Make an Appointment” section (you leave a request and phone number, the registrars will contact you and offer to choose a convenient time) or at the reception desk of the medical appointment department by phone 8 (3902) 242-008, 242- 048.

We are waiting for you at the address: Abakan, st. Taras Shevchenko, 85.