Description of the problem:
I've always had a bad stomach, often accompanied by a feeling of heartburn, and I'd like to have a gastroscopy, but I've heard that it's very painful, and I don't know if there's any other equipment out there that is as thorough and clear as the gastroscope? I don't know if there is any other equipment that can do a thorough and clear examination as well as gastroscopy.
Ans:
In addition to direct visual observation of the surface of the gastric mucosa, gastroscopy can also be used for gastric mucosal pathology biopsy, which confirms the correctness of the disease seen. Gastroscopy is uniquely effective in determining the degree of chronic gastritis and the presence or absence of intestinal epithelial hyperplasia, identifying the benign and malignant nature of ulcerative lesions, determining the etiology of upper gastrointestinal hemorrhage, and detecting gastric cancer at an early stage. Some cases of upper gastrointestinal bleeding and gastric polyps can also be treated under gastroscopy.
The advantage of gastroscopy is that it can be repeated many times, regardless of gender, age, severity, bleeding or not. However, it is contraindicated for people with severe heart and lung failure and those who are confused because they cannot cooperate well with the examination.
In order to avoid the occurrence of hepatitis virus cross-infection, the hepatitis B virus surface antigen test should be done before the examination, and those who are positive should use a special gastroscope.
Prescription
1. Gastroscopy is an important method of diagnosing gastric and duodenal diseases. If the physician thinks it is necessary to check, the patient should actively cooperate.
2. Fiberoptic gastroscopy technology has been very mature, safe and reliable, without much pain, the patient does not need to be nervous.
3. Fasting for 8 to 10 hours before the examination. Remove the dentures during the examination, relax the belt, take off the shoes on the bed, take the left side of the lying position; the anesthetic sprayed can be swallowed.
4. Check with the nasal cavity for smooth breathing, do not hold your breath. When inserting the gastroscope, you should try to cooperate with the doctor and swallow the gastroscope.
5. After the examination, you can eat a warm liquid or semi-liquid diet every 1 to 2 hours, and then return to normal diet the next day.
6. The pain in the throat caused by the examination and the small amount of bleeding after taking the gastric mucous membrane specimen can mostly be cured by themselves, so there is no need to worry. If black feces appear after the examination, you should go to the emergency room.
(Prof. Zhang Shan-shen, Shanghai Medical University)
Clinical value of gastroscopy Knowledge of gastrointestinal diseases In addition to clinical diagnosis and treatment, I have been doing gastroscopy since 1982 and have examined tens of thousands of patients. Many people are afraid of gastroscopy, hearsay, that gastroscopy is very painful, and do not dare to carry out the examination, some patients in the early stages of upper gastrointestinal tract tumors are not examined, to the late stage, and then check the diagnosis of cancer, has been incorrigible, it is really heartbreaking.
In fact, now the new electronic gastroscope body thin, soft, good compliance, coupled with the doctor's proper operation techniques, 3-10 minutes to complete the examination, only some nausea, and not much pain. Below, I introduce the knowledge of gastroscopy:
Clinical value of gastroscopy
1. Provides a diagnostic basis for clinical treatment. Confirmation of the diagnosis is conducive to the selection of treatment methods, so that the treatment is targeted. For example: benign, active gastric, duodenal ulcer internal medicine treatment, need to anti-ulcer treatment 4-8 weeks, after which, then half the amount of anti-ulcer drug treatment 6-18 months; HP infection, with two, three or four anti-HP drugs uninterruptedly for a course of treatment, and the heaviest plus a course of treatment; if diagnosed as a tumor, it should be taken as soon as possible If the diagnosis is a tumor, it is necessary to take surgical radical surgery as soon as possible and cooperate with radiotherapy and chemotherapy, and so on.
2. Provides a reference for the development trend and prognosis of the lesion. For example: chronic superficial gastritis, most of them have good prognosis; active peptic ulcer, further development, may be accompanied by pyloric obstruction, perforation, hemorrhage and other comorbidities, which need to be closely observed to prevent accidents; more than moderate atrophic gastritis, gastric polyps, recurrent peptic ulcers, which belong to the pre-cancerous diseases of stomach; gastric epithelial hyperplasia, intestinal epithelial hyperplasia, atypical hyperplasia, or gastric epithelial hyperplasia, in the sense of pathology, in esophageal mucosa, or gastric mucosal epithelial hyperplasia. or gastric mucosal intestinal epithelialization and atypical hyperplasia are precancerous lesions. Pre-cancerous diseases and pre-cancerous lesions need active treatment, close observation and regular review to prevent the development of lesions, and even if cancerous lesions occur, they can be detected and cured at an early stage.
3. Gastroscopy provides doctors with evidence of the disease. Gastroscopy not only provides a scientific diagnosis for patients and a basis for treatment for doctors, but also provides scientific evidence to protect the interests of doctors and prevent medical disputes. The images and textual information examined in our endoscopy room are stored in the computer hard disk, which can be called by the patient and the doctor concerned.
4. It can relieve the patient's psychological burden. Some patients are hypochondriacs, suspecting that they have digestive tract tumors. The best prescription for treating this kind of gastrointestinal tumor suspicion is a gastroscopy certificate that excludes gastrointestinal tumors.
5. Hard indicators for objective examination of scientific research topics. Such as: the treatment of upper gastrointestinal mucosal lesions drug research clinical observation as well as the control group, are required before and after taking medication for gastroscopy. Gastroscopy is the main objective indicator to reflect the efficacy.
Indications for gastroscopy
1. Anyone with suspected esophageal, gastric, or duodenal disease. Gastric and duodenal diseases that have not been diagnosed after a thorough examination (including X-ray).
2. Retrosternal pain, burning sensation and dysphagia. Burning sensation and dysphagia, suspected esophageal disease.
3. Esophageal. Gastric and duodenal ulcers can be detected by gastroscopy, and their healing should be followed up to identify their benign or malignant nature.
4. In patients with suspected esophageal and gastric cancer, gastroscopy can improve diagnostic accuracy, detect early history, and provide treatment.
5. Gastroscopy can diagnose upper gastrointestinal polyps and elevated lesions and treat them.
6. Gastroscopy can identify the cause of upper gastrointestinal hemorrhage in emergency cases and provide treatment.
7. Chronic inflammation of the upper gastrointestinal tract can be diagnosed with the help of gastroscopy; chronic atrophic gastritis with intestinal epithelial hyperplasia or atypical hyperplasia can be diagnosed and followed up by gastroscopy.
8. After gastric surgery, gastroscopy can be used to detect symptoms and follow up.
9. Gastroscopy can also detect other rare diseases, some of which can be treated with gastroscopy.
Contraindications to gastroscopy
1. Absolute contraindications
1. Severe coronary artery disease and myocardial injury with severe cardiac insufficiency.
2. Esophageal stenosis or cardia obstruction.
3. Aortic aneurysm.
4. Hemorrhagic shock.
5. Acute pharyngitis and tonsillitis.
6. pneumonia or other infection with high fever.
7. Asthmatic dyspnea.
8. Severe pulmonary dysfunction.
9. extreme physical weakness.
10. uncooperative or mentally ill patients.
II. Relative contraindications
Acute disease or acute attack of chronic disease, can be recovered after treatment, such as acute tonsillitis, pharyngitis, esophagitis, bronchial asthma attack period.
Precautions before and after gastroscopy
I. Precautions before and after gastroscopy
1. Explain to the patient the purpose of the examination and the general process: relieve the patient's concern and fear, and obtain the patient's cooperation.
2. Fasting before the examination: the patient should be fasted from six hours before the operation, no food, no water, no smoking for one day, in order to reduce the secretion of gastric juice, so as to facilitate the observation.
3. Gastric retention: gastric lavage before the examination, in order to carry out the examination.
4. Understand the medical history: please bring along the patient's medical history and X-ray film, so that the doctor can understand the condition and the general situation of the upper gastrointestinal tract.
II. Post-examination precautions
1. 1-2 days after the examination: the patient may have a transient pain in the throat, at the same time the posterior wall of the pharynx due to local anesthesia, there may be a foreign body sensation, and there is often a reflex to cough up secretions. The patient should be advised not to cough up secretions, so as not to cause mucosal damage, at the same time, some disinfectant gargle or tablets can be used to alleviate the symptoms and facilitate recovery.
2. Post-examination diet: after the examination, you can drink warm and cool semi-liquid or soft food for a day, so as to avoid the rough food on the gastric mucosa wound friction, resulting in bleeding.