Esophagogastroduodenoscopy

Esophagogastroduodenoscopy (EGD) is a diagnostic method based on the visualization of the mucous tissues of the duodenum, stomach and esophagus. The study is performed using a small video camera on a flexible endoscope probe.

Diagnostic algorithm

To weaken the gag reflex and reduce discomfort, the oropharyngeal mucosa is irrigated with a solution of lidocaine before the procedure. It quickly has an effect on the mucosa, and after the procedure, the function and sensitivity of the mucous membranes are instantly restored. Local anesthesia allows you to suppress the gag reflex and coughing fits that interfere with the study during the introduction of the endoscope into the esophagus. In order to protect the teeth and the endoscope, a special mouth guard is used, which does not allow arbitrary adhesion of the teeth and biting of the device. It is recommended to remove removable dentures in advance. Some patients are advised to take a sedative to relieve anxiety.

The procedure is carried out in the position on the left side, after the anesthetic drug has begun to act. With slow, smooth and accurate movements, the diagnostician inserts the endoscope first into the esophagus, and then into the stomach and duodenum. In order to make it easier to diagnose mucous membranes, air is supplied to the endoscope. The diagnostician carefully examines the condition of the mucous membranes, if necessary, a biopsy can be taken using an endoscope. The resulting tissues are subjected to histological examination to exclude serious pathologies. EGDS helps to carry out bougienage of a narrowed area of ​​the esophagus or, if necessary, to remove a foreign body.

After diagnosis, eating is not recommended for another 5-6 hours, so as not to cause vomiting. The duration of the procedure can vary from five to twenty minutes.

Preparing for diagnostics

In order for the procedure to go without complications, it is recommended to properly prepare for it. It is not recommended to eat food for 12 hours before the start of the study. Before the procedure in the diagnostic room, the patient signs a special agreement for its implementation. On the day of the study, it is not recommended to smoke and take medication.

Feelings and experiences

Local anesthesia makes it difficult to swallow, but all these discomforts quickly pass after the study. At first, the endoscope may be felt to be interfering with breathing, which may trigger a panic attack. To calm down, it is recommended to breathe deeply through the nose. Discomfort can create air that will bulge the esophagus, stomach, and intestines. A biopsy is a completely painless procedure. Reception on the eve of the diagnosis of sedatives will help to calm down and transfer all actions without worries and panic. The gas injected into the stomach is excreted from the body quickly and without negative consequences.

Purpose of diagnosis

Esophagogastroduodenoscopy is prescribed to patients with the following clinical symptoms:

• black loose stools or vomiting with bloody impurities;
• frequent regurgitation after eating;
• feelings of satiety after eating a small amount of food;
• heaviness in the stomach;
• heartburn;
• unreasonable anemia;
• pain in the upper abdomen;
• difficulty swallowing;
• unexplained rapid weight loss;
• prolonged vomiting and nausea;
• cirrhosis of the liver;
• Crohn’s disease.

Risks of the procedure

During the procedure, there is a minimal risk of perforation of the stomach (in the presence of a covered perforating ulcer), esophagus or duodenum. Prolonged bleeding may occur at the biopsy site. According to statistics, complications during the procedure make up no more than one percent of cases.

Complications are eliminated through surgical intervention and as quickly as possible.

Contraindications for the procedure

There are a number of limitations for the procedure: severe chronic heart failure, diseases of the esophagus that make it impossible to insert the endoscope into the stomach (scarring of the esophagus or the presence of adhesions makes it difficult to pass the endoscope). A relative contraindication for the procedure is the general serious condition of the patient for a number of reasons.

The combination of esophagogastroduodenoscopy with other studies

It is recommended to perform an abdominal ultrasound before starting the procedure to determine the localization of problems. If ultrasound needs to be performed after esophagogastroduodenoscopy, it is prescribed at least a day later, since air must leave the body (air prevents the passage of ultrasonic waves). Esophagogastroduodenoscopy and colonoscopy can be performed on the same day with short breaks between diagnostics – it all depends on the patient’s well-being.

Caution to the procedure

Possible adverse reactions to the anesthesia and sedatives used (laryngospasm, bradycardia, sweating, hypotension, apnea, respiratory depression, etc.). It is important to be prepared for the necessary resuscitation actions.

Factors affecting the diagnostic result

The final results can be affected by: timely delivery of the taken tissue samples to the laboratory for research; improper preparation of the patient or ignoring the rules of preparation; the patient’s use of anticoagulants (a high percentage of bleeding).

Results and their interpretation

In the conclusion of the diagnostician, the condition of the mucous tissues, the presence of pathologies and diseases are indicated.

Esophagus – length from 25 to 28 centimeters. There are 4 constrictions along its entire length. The condition of the mucosa: light, with a fine-fiber structure.

The stomach is pink mucous, with a smooth and shiny surface with mucus. In the lower part of the stomach, there is a small volume of gastric juice and longitudinal folds up to 5 mm thick.

The duodenum has a tubular shape with a diameter of 3-3,5 centimeters. The length of the intestine can vary from 24 to 31 centimeters. The color of the mucosa is pale pink. On the mucosa there is only one longitudinal fold with large and small duodenal papillae, over which the common pancreatic and bile ducts are located.

Esophagogastroduodenoscopy is an informative method for diagnosing the gastrointestinal tract.

Sources of