FGDS protocol sample. Correct interpretation of the FGDS conclusion and the established norm: how to decipher what the doctor said? How is gastroscopy performed

But an experienced doctor is able to make an accurate diagnosis, guided by the method of comparison with the mucous membrane without pathologies.

It looks like this:

• the color of the mucous membrane ranges from red to pale pink;
• even with an empty stomach, there is always a little mucus on the surface of the walls;
• the front wall looks smooth and shiny, and the back wall is covered with folds.

With gastritis, ulcers, stomach cancer, deviations from the norm appear, which neither x-ray nor ultrasound will record. But gastroscopy will definitely reveal them: in case of gastritis, an increased amount of mucus, swelling and redness of the epithelium, local minor hemorrhages are possible. In case of an ulcer, the surface of the walls is covered with red spots, the edges of which have a whitish coating, indicating the presence of pus.

Gastroscopy analysis validity period

In case of stomach cancer, the back wall of the stomach is smoothed out, and the color of the mucous membrane changes to light gray.

How often can gastroscopy be done?

In life, there are often situations when we do not attach importance to certain symptoms that indicate the presence of pathology, and when a diagnosis is made, we begin to intensively look for ways to get rid of, undergoing consultations and examinations with different specialists. In the case of gastritis, no doctor will undertake treatment without receiving accurate information about the state of the mucous membrane.
And there are often cases when, after undergoing gastroscopy, a new specialist can send a patient for a second examination to make sure that no significant changes have occurred since then.

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The gastroscope consists of a hollow elastic tube in which a fiber-optic cable is located with an optical and illumination device at the end. Through the oral opening and esophagus, the hose is inserted into the stomach cavity for a thorough examination.

Through the cable, the image is transmitted to the eyepiece or monitor screen, and the doctor conducting the examination has the opportunity to study the state of the epithelium in different parts of the stomach by turning and moving the tube in the desired direction.

Is gastroscopy harmful from the point of view of the condition of the esophagus and stomach walls in contact with a solid foreign object? Before the procedure, the gastroscope is thoroughly disinfected, so the likelihood of introducing an external infection is extremely low (no more than when eating fruits, bread or vegetables).

It also makes it possible to more thoroughly examine the condition of the organs, and, if necessary, make a biopsy. In order to put the patient into a state of drug-induced sleep, doctors use the latest generation of the drug PROPOFOL (Diprivan).

It is worth noting that it does not include narcotic substances, and the duration of action is minimal, which is quite enough for a survey.

How long does a gastroscopy take?

How a gastroscopy is performed, how long such an examination takes - these questions are often asked by patients to a gastroenterologist. Gastroscopy is a method of examining the esophagus, stomach and the beginning of the duodenum through a special optical instrument, which is administered orally to the patient.
This instrument is called an endoscope. The tip of the device is gently passed through the esophagus to the stomach and small intestine.

In addition, people who are predisposed by heredity, as well as after identifying any diseases earlier, need to remember that FGDS has a limited shelf life, therefore the FGDS protocol can operate and it is recommended to repeat manipulation 1-2 times a year.

Whoever has been assigned an examination before the operation can provide a sample of his research, because the validity of the FGDS analysis is within a calendar month. This is important, because during the intervention with an ulcer, its exacerbation can occur, which is fraught with large blood loss.

What should be in the document according to the norm?

Often, during the examination, a FGDS conclusion is issued, the norm for all parameters.
This is especially pleasant after such a procedure.

Gastroscopy certificate term

You can study another sample for comparison: Or another option: According to the FGDS, the expiration date is decent, so that you can have time to go through all types of services, without wasting time.

This is important, because during the intervention with an ulcer, its exacerbation can occur, which is fraught with large blood loss. What should be in the document according to the norm? Often, during the examination, a FGDS conclusion is issued, the norm for all parameters.

This is especially pleasant after such a procedure.

So, after a lengthy description of all the features, starting from the entrance to the esophagus, with all the sphincters and the state of the walls, the document contains the conclusion of the FGDS.

Ideally, it will be indicated that pathologically altered phenomena in the stomach are not detected or not detected, as in 12PK (duodenum).

The validity of the gastroscopy certificate

We answer 95.51% of questions.

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The conclusion issued after the FGDS in writing confirms the state of the digestive organs examined during this procedure. You need to understand that the validity of any analysis may be limited.
So do not delay and start collecting forms as soon as possible. It is important to correctly interpret it so as not to be misled about your own health. Best of all, this can be done by the attending gastroenterologist in order to take further measures to treat the existing pathologies.

Many patients, due to common fear, do not dare to go to the examination for a long time.

FGDS certificate term

In any case, the appointment of this procedure can occur repeatedly, and the lack of knowledge in which cases and how often gastroscopy of the stomach can be done is very disturbing for many patients.

As for the contraindications to the appointment of esophagogastroduodenoscopy (the official medical name for gastroscopy), there are few of them:

• some heart disease;
• narrow in comparison with the standard entrance to the stomach;
• obesity 2 - 3 degrees;
• hypertension;
• kyphosis / scoliosis;
• a history of stroke / heart attack;
• congenital / acquired blood diseases.

How is gastroscopy performed

An instrument that allows you to examine the state of the inner walls of the stomach (and, if necessary, the duodenum 12) is a kind of endoscope.

Expiry date of FGDS certificate

Attention

The liver, spleen and other organs have long been examined by ultrasound methods. Such a study is much safer than an X-ray.

The helplessness of ultrasound in front of air and other gases, which can accumulate in abundance in the areas under study, can significantly distort the results, or even make ultrasound useless.

It should be noted that ultrasound methods are less unpleasant than gastroscopy, but also less functional: no therapeutic effect with ultrasound can be produced.

But there will be no unpleasant consequences after them either.

Info

The study is carried out in a special room equipped with a monitor and a fiberscope. The order is:

• The patient is placed on his left side on a couch, a probe resembling an elastic cable is inserted into his mouth or nostril, a mouthpiece.
• Breathing should be as calm as possible.
• The tube runs along the pharynx, into the esophagus and stomach.
• During the procedure, the doctor can take a photo on the screen or observe the state of organs from the inside using a video camera at the other end of the tube.
• The probe is then removed smoothly.

The practice of the method can be unpleasant, so sometimes the patient is given pain relief, anesthesia, or short-term anesthesia.

The latter option is preferable for EGD in children or neurasthenics.

The most unpleasant moment for the patient may seem to be the introduction of a tube into the throat and esophagus - sometimes there is vomiting, a feeling of lack of air. There is no such thing with anesthesia, there will only be a psychological factor of discomfort.

Esophagus

Fibrogastroduodenoscopy of the esophagus, a long tube of about 25 cm, is performed to study the state of the organ.

Its purpose is to carry a coma of food into the stomach. In the esophagus there are three parts (cervical, thoracic, abdominal) and three narrowing of the relief (at the beginning, at the level of the trachea and diaphragm). In the wall of the esophagus, the mucous and submucosa, muscle and adventitia layers are secreted.

Normally, the cavity of the esophagus is light pink in color, its walls are even without erosions, ulcers.

In the esophagus, there are two sphincters - the upper and the lower. These are muscles that contract independently and control the passage of food from the pharynx to the esophagus or from the esophagus to the stomach.

• after the instruction to take a few sips and completely relax the larynx, the introduction of the endoscope begins and its lowering until it reaches the entrance to the stomach (the most unpleasant moment is the transition from the oral cavity to the esophagus, during which a natural vomiting occurs);
• then the doctor begins to turn the gastroscope, which allows you to examine the condition of the gastric cavities from all sides (the viewing angle of the device, as a rule, does not exceed 150 degrees).

Duration of the procedure

An experienced doctor, when conducting gastroscopy for the purpose of diagnosis, takes 12-15 minutes to examine the entire inner surface of the stomach, however, in some cases, it may be necessary to perform a biopsy (taking a sample of epithelial tissue for laboratory studies) or other therapeutic manipulations (for example, the administration of medications).

Who did you do there? Can I take all tests at a paid clinic and bring them? How much did the operation cost? And how did you agree? Money in the hands of the doctor? Or a contract? I just know that your result was .. Here we will hand over the SG in July. In September on vacation and after I will come and probably will.

Already a lump in the throat got stuck ((

I think to come to the family clinic for a fee for two days to collect tests there .. And then at 31 GB. Although in the family, too, the girl wrote what she did, everything was done to her in the world. there are some kinds of operations, but the amount is such .. I haven't read about the CM Clinic yet.

And in the hospital there is a kapets soviet union hospital? Or a normal attitude? Terms?

Normally, the sphincters close completely, preventing food from being thrown back (reflux). If the work of the lower sphincter is disturbed, then hydrochloric acid enters the esophagus, corroding its walls. As a result, redness, erosion, ulcers, inflammation are formed.

The optical probe used for gastric FGDS helps to see even micronutrients on the surface of the mucous membrane, diffuse and local inflammatory processes, polyps, neoplasms, and the place of bleeding. The latter can even be stopped. If neoplasms are found in the esophagus, the doctor will take a biopsy with a special cutting instrument and forceps. Some soreness may be felt when cutting.

Stomach

The gastric FGDS procedure is necessary to study the structure of the organ. It is an enlarged part of the alimentary canal that connects to the esophagus and duodenum.

The order will be processed immediately and will go straight to work. It doesn't take long to execute. In an emergency, you can order an urgent execution of a gastroscopy certificate. Our courier will deliver the finished document at a convenient time for the customer.

What doctors need to go to the hospital to get a certificate about gastroscopy

Certificate name Price (RUB) Certificate of gastroscopy 1300 Certificate from a gastroenterologist 1000 Certificate of health 700

Samples of a certificate of gastroscopy

It is common for me, like all students, to sometimes walk with couples. But we are very strict with truancy, therefore, without a good reason, it is better not to skip, out of harm's way. A friend advised your site to buy a sick leave if necessary.

EGD is a method of examining the esophagus, stomach and duodenum using a flexible fiber optic gastroscope. If additional devices are available, targeted biopsy can be performed, as well as photographing and filming of the gastric mucosa.

EGD is widespread and practically safe for patients.

Diagnostic value of the method:

EGD allows assessing the lumen and condition of the esophageal mucosa (cicatricial narrowing and strictures in burns and neoplasms, erosion, linear ruptures in Mallory-Weiss syndrome, varicose veins of the lower third of the esophagus in portal hypertension, reflux), the condition of the gastric mucosa and duodenum - color , the presence of erosions, ulcers, neoplasms.

FGDS gives an idea of \u200b\u200bthe state of blood vessels, the presence of hemorrhages, the nature of mucus separation.

Using this method, you can study the relief in detail, i.e. the nature, height, width of the folds of the gastric mucosa.

If necessary, a targeted biopsy can be performed for morphological examination of the mucosa, especially if a malignant neoplasm is suspected.

With the help of additional methods, it is possible to determine the acidity of gastric juice, as well as the presence of Helicobacter pilory, which plays a significant role in the development of gastric ulcer and duodenal ulcer.

EGD is used for medicinal purposes: performing polypectomy, stopping bleeding, local application of drugs.

inform the patient about the upcoming study and obtain his consent;

to provide high-quality preparation of the patient for the study and timely receipt of results.

examination of the stomach and duodenum;

diseases of the stomach of the duodenum.

narrowing of the esophagus or cardia as a result of a tumor;

pathological processes in the mediastinum that shift the esophagus (aortic aneurysm, enlarged left atrium);

perforation of the esophagus (extremely rare);

perforation of the stomach (extremely rare);

anaphylactic shock or allergic reactions to lidocaine;

getting the endoscope into the trachea;

organ wall injuries;

wrapping the endoscope in the lumen of the organ;

increased gag reflex;

negative attitude of the patient towards the upcoming manipulation;

fear of interference.

emergency kit for anaphylactic shock;

inpatient card or referral for research (on an outpatient basis).

Explain to the patient (relative) the purpose and the course of the upcoming study and obtain his consent to the study.

The patient's right to information, informed participation of the patient in research is ensured

Explain to the patient (relative) the purpose and course of the forthcoming preparation for the study

The possibility of obtaining a reliable research result is provided.

3. Inform the patient:

From 7 pm on the eve of the study, do not eat, drink, or smoke.

The study is carried out in the morning on an empty stomach.

To reduce painful sensations during the introduction of the endoscope, the patient will be irrigated with an anesthetic (lidocaine) of the pharyngeal mucosa. Clarify the patient's tolerance to lidocaine.

During the study, he will be deprived of the opportunity to speak, to swallow saliva.

After EGD, the patient will temporarily have difficulty speaking and swallowing (ask the patient not to eat for two hours after the study).

The most important conditions for a high-quality examination of the mucous membrane of the examined organs.

Possibility of an allergic reaction

The act of swallowing is impaired due to the introduction of an endoscope and anesthesia.

Anesthetic effect of lidocaine.

The risk of aspiration by food or liquid is eliminated.

4. Warn the patient:

On the place and time of the study.

The need to remove dentures before examination.

The need to have a towel (absorbent) napkin with you.

Timely procedure

The risk of damaging the oral mucosa with prostheses is eliminated.

Discomfort associated with salivation is excluded.

5. Ask the patient to repeat the course of preparation (if necessary, give written instructions).

Make sure the information is understood.

6. Escort (transport) the patient to the endoscopy room.

Ensure timely research.

7. Monitor the patient's condition after EGD.

8. Accompany the patient to the ward after examination.

The risk of bleeding is eliminated.

Note: If the patient is planned to undergo EGD with targeted biopsy, food and liquid during the day (after the study) should be cool.

After any examination, you are required to issue his conclusion. This conclusion must indicate the results of the survey.

The survey results are divided into those that correspond to the norm and those that deviate from them.

Norm

As a result conclusions of gastroscopy (esophagogastroscopy), which corresponds to normal indicators, they usually write that no abnormalities were found during the examination. Or they can write: no pathology has been identified.

Pathology

When pathology is detected in the results of gastroscopy (esophagogastroscopy) usually they write what kind of pathology was identified.
For example, it can be written that it was revealed:

• ulcerative or duodenal lesions of the stomach;
• signs of inflammatory processes in any of the examined organs or simultaneously in several organs. If it is in the stomach, then it is gastritis, if it is in the esophagus, then it is esophagitis, if inflammation is detected in the small intestine, then it can be either enteritis or duodenitis.
• abnormal (different from normal) holes in the hollow organ. It may be bleeding, swelling, ulceration, or perforation;
• varicose veins of the submucosal layer of the studied organs;
• hiatal hernia, this is a hernia of the esophageal opening of the diaphragm;
• narrowing (stricture) or pathological expansion (dilation) of the organs under study;
• Foreign (foreign) body in the examined organs.

The conclusion issued after the FGDS in writing confirms the state of the digestive organs examined during this procedure. You need to understand that the validity of any analysis may be limited. So do not delay and start collecting forms as soon as possible. It is important to correctly interpret it so as not to be misled about your own health. Best of all, this can be done by the attending gastroenterologist in order to take further measures to treat the existing pathologies.

Many patients, due to common fear, do not dare to go to the examination for a long time. However, you need to understand how great the information content of this FGS procedure is, and that it lets you know everything about the state of the stomach, esophagus, and also the duodenum, if it needs to be examined.

On the regularity, duration of the conclusion

The easiest way to get used to it is when you are a child. And if you need to regularly monitor the state of the examined organs, then there is nothing terrible in this. In addition, people who are predisposed by heredity, as well as after identifying any diseases earlier, need to remember that FGDS has a limited shelf life, therefore the FGDS protocol can operate and it is recommended to repeat manipulation 1-2 times a year.

Whoever has been assigned an examination before the operation can provide a sample of his research, because the validity of the FGDS analysis is within a calendar month. This is important, because during the intervention with an ulcer, its exacerbation can occur, which is fraught with large blood loss.

What should be in the document according to the norm?

Often, during the examination, a FGDS conclusion is issued, the norm for all parameters. This is especially pleasant after such a procedure. So, after a lengthy description of all the features, starting from the entrance to the esophagus, with all the sphincters and the state of the walls, the document contains the conclusion of the FGDS. Ideally, it will be indicated that pathologically altered phenomena in the stomach are not detected or not detected, as in 12PK (duodenum).

As an introduction, you can give an example of how the FGDS protocol looks like a sample with good indicators:

Esophagus

The entrance to the esophagus is normal in shape, then it is indicated how many cm from the incisors. The upper esophageal sphincter is toned. The patency of the esophagus is free, the shape of the lumen, the caliber are normal, the state of mucus, walls (in N - elastic, pale pink, smooth, shiny). The shape of the lower esophageal sphincter is normal, the tone is preserved. The distance from the incisors to the toothed line is 35 cm.

Stomach

The distance to the entrance is 36 cm, in the area of \u200b\u200bthe hiatal constriction. Further, the gaps with narrowings are indicated, the norm should be normal, caliber. The elasticity of the stomach walls. The color in the area of \u200b\u200bthe lumen, as an option, is straw, as well as the presence of mucus, during the procedure on an empty stomach, the amount is small. The mucous membrane can be with folds, the height of which is average. They can expand when air is supplied. On the body of this digestive organ, the color is pink, with a smooth, shiny, dull vascular pattern. The shape of the antrum is usual. The condition of the walls is elastic with the preservation of peristalsis. The color of the mucosa is normal, without an enhanced vascular pattern. The shape of the gatekeeper is round, the state is closed.

Duodenum

Normally, during this examination, the shape of the lumen is common in a 12-pc bulb, with a normal caliber. The condition of the walls is elastic, with preserved peristalsis. Filling the lumen with a small amount of bile is allowed. The color of the mucosa can be pale pink, the structure is granular, the vascular pattern is slightly visible. Peculiarities of postbulbar divisions are ideally not revealed.

This is how the main parameters may look after fgds in the conclusion. Of course, for various diseases, including gastritis, slightly different parameters will be indicated.

You can study another sample for comparison:

Or another option:

According to FGDS, the expiration date is decent, so that you can have time to go through all types of services, without wasting time. And while the truly cherished conclusion, you can continue to be examined for complex treatment or the prescribed operation. And it may be related not only to the gastrointestinal tract, but also in terms of gynecology and other other body systems.

Fibrogastroduodenoscopy, or simply FGS - the "gold" standard in the diagnosis of diseases of the gastrointestinal tract. This technique allows you to identify pathological changes in the mucous membrane of the gastrointestinal tract (stomach and duodenum 12), as well as conduct additional research methods, such as biopsy. What does EGD of the stomach show? With the help of this examination, the attending physician is able to visually inspect the inner lining of the organ, examine its suspicious places, as well as perform a biopsy and a number of simple surgical procedures (resection of a polyp, stopping bleeding, etc.). Patients are referred to FGDS only if they have signs of a possible stomach disease (pain in the epigastric region, nausea, etc.) and with the obligatory observance of indications and contraindications to the procedure.

The doctor hones the skills of conducting FGS on the simulator

Examination of the organs of the gastrointestinal tract should be carried out subject to the indications and contraindications, as well as only by a highly qualified specialist.

Method information

EGD of the stomach is a type of endoscopic examination that can be used in various groups of patients, including those with concomitant diseases of the gastrointestinal tract, such as hiatus hernia, cardiac insufficiency, etc. This gives the attending physician the opportunity to examine the mucous membrane of the gastrointestinal tract, for which shows the changes characteristic of various diseases.

Endoscopy is performed using a special fiberscope - a small tube with a light bulb and a video camera at its end. In addition, a device for biopsy or microsurgical operations can be additionally introduced through the fiberscope.

Indications and contraindications for examination

EGD of the stomach is carried out for those patients who have symptoms of damage to this organ or suspicions of another pathology:

• Pain syndrome in the upper part of the abdomen, associated with food intake or, conversely, arising from hunger, which is typical for gastritis and gastric ulcer and 12 duodenal ulcer.
• Feeling of discomfort or burning behind the breastbone, which may be a manifestation of cardia insufficiency and gastroesophageal reflux disease.

• Suspected growth of benign or malignant tumors in the stomach wall.
• Violations of the motor activity of the esophagus and stomach.
• Frequent bouts of nausea or vomiting.
• The study of the duodenum is indicated for indirect signs of pancreatitis, most often associated with impaired assimilation of fatty foods and pain in the left abdomen.

Thanks to EGD, the doctor can look at the display screen and see all changes in the gastric mucosa directly at the time of examination, which significantly increases the accuracy of diagnosis.

In all these cases, endoscopic examination of the upper digestive tract allows you to see pathological changes in the organs. However, there are a number of contraindications for which EGD is not done:

• violations of the patency of the esophagus due to its stenosis or functional disorders;
• severe somatic diseases with damage to the respiratory or cardiovascular system.

If a person has contraindications to endoscopy, then the procedure is not performed, but other methods of examination are chosen, for example, ultrasound.

Preparation for FGDS

EGD is done strictly on an empty stomach

The main task of the doctor before the examination is to properly prepare the patient for it. It is very important to conduct certain conversations with a person, explain to him the need for the upcoming examination, the course of its conduct, and also familiarize him with all the risks inherent in this diagnostic method. All patients are advised to undergo a general blood and urine test, which can help in the detection of concomitant diseases of internal organs.

In addition, the patient should refuse to eat food 8-10 hours before endoscopy, especially if he has cardia insufficiency. During this period, you can drink a small amount of plain water. Such measures are necessary to prevent the development of nausea and vomiting, as well as the possible reflux of stomach contents into the esophagus and respiratory tract.

Before the procedure, it is very important to exclude drug allergies in humans, since local anesthetics can be used during EGD.

Gastric endoscopy

By means of EGD of the stomach, various diseases of this organ are detected. However, the high information content of the procedure can be achieved only if the rules for its implementation are observed.

EGD of the stomach should always be performed only under appropriate conditions and by trained doctors.

Gastroscope

All studies are carried out in a special endoscopic room. The patient is placed on a couch, most often on the left side. Using a local anesthetic in the form of a spray, anesthesia of the oral mucosa is achieved. Why is this needed? This allows you to get rid of the gag reflex, which develops when the fiberscope is inserted. After the anesthesia has worked, the endoscope is inserted through the patient's mouth. Gradually advancing the device deep into the esophagus, the doctor begins to examine the mucous membranes and can detect pathology even at the first stages of the examination.

After examining the gastric mucosa, the duodenum can be examined, which is indicated if there are suspicions of concomitant diseases of this localization (neoplasms, ulcerative defects, etc.). After completing the procedure, the doctor carefully removes the endoscope. If the study was carried out using only local anesthesia, then the patient remains in the hospital for 20-30 minutes. If general anesthesia was used, then the patient is prescribed a ward mode in a hospital for one day.

Potential consequences and complications

High safety of EGD of the stomach is determined by the correct preparation of the patient and adherence to the research technique. However, like any medical method, endoscopy can lead to certain consequences:

• An increase in gastric acidity with the possible development of minor erosions and reflux esophagitis, which is especially often observed in patients with cardiac insufficiency and hiatal hernia.
• Violations of the integrity of the mucous membrane or the entire wall, which can lead to the development of inflammation in the mediastinum or abdominal cavity.
• Mechanical damage to the junction of the esophagus into the stomach, which can cause cardia insufficiency with the subsequent development of gastroesophageal reflux disease.

Normal and reflux disease

• As a result of vascular damage, intragastric bleeding of varying severity may develop.
• When using drugs for local or general anesthesia, there is always a risk of allergy to drugs in the form of skin rashes, itching, Quincke's edema, etc.

If the patient has these complications, then the procedure must be stopped and immediately started to treat them.

EGD is an indispensable method for diagnosing diseases of the stomach and duodenum, which gives the doctor the opportunity to visually examine the mucous membrane of the gastrointestinal tract and directly identify their diseases. This feature of the procedure also determines its widespread use in a large number of diseases of the upper digestive tract. Following the indications and contraindications to the procedure allows you to increase the information content of EGD and reduce the risk of developing unwanted complications.

Fibrogastroduodenoscopy (FGDS) is an endoscopic examination method in which a special probe is inserted through the mouth into the upper parts of the digestive system (esophagus, stomach, duodenum) to visually assess the state of the internal mucous membrane.

Gastroscopy is a routine examination that shows what is going through the esophagus. It is prescribed for suspected inflammatory, degenerative and oncological diseases. The undoubted advantage of FGDS is that a specialist has the ability to measure acidity, conduct an express test for the presence of Helicobacter pylori infection and biopsy of altered tissues.

After the end of the examination, the patient is given a conclusion with the results. It usually describes the detected changes in the mucous membrane. Given these statements, the attending physician makes a final diagnosis or poisons the patient for additional research.

What does the protocol look like normal?

Normally, the mucous membrane in the upper parts of the digestive system should be pink in color, its surface is covered with a moderate amount of mucus.

In the esophagus, when swallowing, reflex movements are noted. The wall is not widened, the mucous membrane contains several longitudinal folds. There are no leftovers of food or drinks in the norm. The lower esophageal sphincter is completely closed when viewed. The lower esophageal veins are not visualized.

In the stomach, the mucous membrane forms numerous folds, which are easily straightened when air is supplied through a tube. There are no white fibrin deposits or blood clots on the walls. Vessels are not visualized. There are also no defects in the inner wall. Periodic perilstaltic movements are clearly visible. The gastric juice in a healthy patient is clear. In the place of transition to the duodenum there is a pylorus (smooth muscle sphincter), which periodically opens.

The mucous membrane of the duodenum is pink, with Kerkring's transverse folds. In the lumen, yellow-green bile impurities are often found. Large bulb of regular shape, no deformation.

A rapid test for the presence of H. pylori infection in a healthy patient is negative.

The normative indicators of acidity are presented in the following table:

What diseases can be detected during the examination of the stomach?

With fibrogastroduodenoscopy, you can find changes characteristic of the following pathologies:

1. Gastritis (inflammation of the gastric mucosa, sometimes superficial and deeper):
   • catarrhal (wall hyperemia);
   • erosive (mucosal defects with minor hemorrhages);
   • atrophic (thinning of the membrane with a decrease in the number of mucous glands);
2. Diseases of Menetrie (hypertrophic gastritis).
3. Peptic ulcer disease (in the photo, a stomach ulcer looks like a local defect in the mucous membrane with swelling of adjacent tissues).
4. Duodenogastric reflux.
5. Esophagitis.
6. Barrett's esophagus (instead of a flat epithelium in the lower sections, a cylindrical one appears).
7. Crohn's disease is a specific inflammatory process that can affect all parts of the digestive system.
8. Good or malignant neoplasms of the esophagus, stomach, duodenum, or metastases of tumors from other localizations.
9. Chemical or radiation injury.
10. Candidiasis (mainly in immunosuppressed patients, as a complication of HIV infection or chemotherapy).
11. Portal hypertension in chronic liver failure (swelling and enlargement of the lower esophageal veins).
12. Congenital malformations of the digestive system.
13. Hernia of the esophageal opening of the diaphragm.
14. CREST syndrome in systemic scleroderma (an autoimmune disease with damage to connective tissue).
15. Congenital Peutz-Jeghers syndrome (mucosal pigmentation with polyposis).
16. Celiac disease (an autoimmune intolerance to foods containing gluten protein).
17. Whipple's disease (an infectious lesion of the intestine, which is accompanied by the deposition of lipids in its wall).
18. Insufficiency of the cardia (not enough closure of the lower esophageal sphincter).
19. Stomach tone (hypotension).

How is esophageal gastroscopy performed?

At the beginning of the study, the probe gradually passes through the esophagus. The image from his camera is fed to a special screen, where the inner wall of the digestive system is carefully examined by an endoscopist.

Also information is displayed from the sensor, which determines the acidity.

Passing through the esophagus and stomach, the probe enters the duodenum. Here the doctor turns his attention to the condition of the mucous membrane and its integrity. Especially scrutinized the area of \u200b\u200bthe large nipple - this is where ulcers or erosion are most often found. On the posterior wall, there is a risk of finding hidden small hemorrhages.

Then the study goes to the stomach. Pay attention to the functioning of the gatekeeper. In healthy patients, it should close tightly and not let the contents of the duodenum pass back. Otherwise, duodenogastric reflux is diagnosed.

In the antrum of the stomach, mucus is taken to detect Helicobacter pylori infection, which most often colonizes this particular part of the digestive system.

When examining the gastric mucosa, take into account the severity of the haustra - its folds. If active bleeding is detected, it is necessary to evaluate its activity and the approximate blood loss (in ml), as well as the risk of relapse.

Then the probe again enters the lumen of the esophagus. In its lower third, attention is paid to the presence of protrusion of veins, and their size is also measured.

If an ulcer or neoplasm is found, a biopsy of the altered tissue is mandatory. With the help of a manipulator, several small tissue samples are taken, which are then poisoned for cytological examination. Its results usually come in a few days. They indicate the type of tissue in the sample, the degree of differentiation and malignancy.

The results are usually handed out to the patient a few minutes after the end of the examination, or sent to the specified email address. The conclusions of a cytological study (when conducting a biopsy) come in approximately 10 days.

Deciphering the results for common pathologies

The most common diagnoses and their signs with fibrogastroduodenoscopy are shown in the following table:

Disease	Signs with FGDS
Achalasia	The passage of the probe through the esophagus is difficult. Food remains are found in its lumen. Slightly above the transition to the stomach is the expansion of the esophageal cavity.
Barrett's esophagus	An area is observed in the lower esophagus persistent redness of the mucous membranewhich extends 3 cm above the edge of the diaphragm.
Bleeding	In the active phase, the endoscopist sees active bleeding into the organ cavity. Inactive - blood clots, blood clots, large deposits of fibrin, or vessels with an eroded wall.
Catarrhal (simple) gastritis, esophagitis, or duodenitis	Hyperemia (redness) of the mucous membrane, an increase in the amount of mucus.
Atrophic gastritis	On examination the mucous membrane is thinned, pale, folds are poorly expressed, the amount of mucus is reduced, acidity lowered... Most often localized in the antrum of the stomach.
Erosive gastritis	On the surface of the mucous membrane, numerous defects (erosion)... Their surface cuts through with blood, which over time forms crusts.
Hypertrophic gastritis (Menetrie's disease)	They reveal enlarged folds of the gastric mucosa (width often exceeds 10 mm) of a bright red color, which fit tightly one to one. Visually, they resemble a cobblestone pavement or cerebral convolutions. Mucus accumulates between the folds.
Enlargement of the lower esophageal veins	Before the passage of the esophagus into the stomach, there are enlarged blue-violet vessels, which protrude into the lumen of the organ from under the mucous membrane and partially narrow it.
Peptic ulcer	Discovered a defect in the mucous membrane of an irregular round or oval shape... There is a zone of tissue edema around. May be covered with blood or fibrin (white protein). The results indicate the location and size of the defect.
Malignant neoplasm	Often flat or semicircular formation without clear boundaries... May be patchy, with cauliflower-shaped growths or indentations. Around education there is always a zone of reactive mucosal inflammation. In the later stages happens also tissue death and frequent hemorrhage... The localization and size of the tumor must be indicated, a biopsy of the tissue sample is performed.
Benign education (adenoma, polyp, cyst)	A clear boundary is found between the altered and normal tissue. Inflammation around a tumor is uncommon. It often looks like a small mucosal growth (polyp) or a circular formation (cyst).
Celiac disease	Severe atrophy (until complete disappearance) of the folds of the duodenum is observed. The mucous membrane is smooth, covered with a large amount of mucus.
Duodenogastric reflux	With FGDS in the lumen of the stomach there is yellow-green bile, the way to treat pathology is affected by a low acidity level.
Crohn's disease	A limited lesion of the mucous membrane with severe hyperemia and the formation of erosions of a small (1-2 mm) size is observed.

The most dangerous disease that can be detected during EGD is stomach cancer. You can read more about this.

When to retest?

For a young patient necessity preventive endoscopic examination of the stomach low... Modern recommendations for the treatment of Helicobacter pylori infection generally advise avoiding EGD if there is a possibility of a repeated fecal test for antigen to the pathogen.

It is rational to conduct a new study only if antibiotic therapy did not give the expected results, and the symptoms of pain and discomfort in the abdomen persist.

When areas of precancerous degeneration are found mucous membrane (polyps, Barrett's esophagus) and refusal of surgical intervention is recommended to repeat EGD annually.

After the performed surgical interventions re-examination is underway not earlier than six months later... It is indicated for patients who have persistent pain in the upper abdomen and symptoms of dyspepsia, despite adequate drug therapy.

Tips from will help to transfer the procedure easier.

How long is the result valid?

Validity of results FGDS for the doctor - 3 months... However, this term can be shortened. The action depends on the patient's condition, for example, if signs of gastrointestinal bleeding occur, the study should be carried out as soon as possible.