Video esophagogastroduodenoscopy (VEGDS, video gastroscopy, esophagogastroduodenoscopy, EGDS, gastroscopy) is a procedure for examining the stomach, esophagus and duodenum, which is performed using a video endoscope.
An endoscope is a thin flexible tube at the end of which there is a camera that transmits an image to a monitor, a light, and forceps used to take a biopsy or remove polyps. The video endoscope is inserted through the mouth and often causes discomfort to the patient. We will tell you how to deal with them in this article.
Indications for gastroscopy examination
- Anemia (lack of hemoglobin in the body).
- Pain in the upper abdomen.
- Signs of gastrointestinal bleeding.
- Heartburn.
- Nausea and vomiting.
- Rapid weight loss (if the patient did not follow a diet).
- Constant bad breath.
- Screening for possible cancer in people over 45 years of age or those predisposed to cancer.
- Taking a biopsy.
- Tumors.
- Assessment of the gastrointestinal mucosa before surgery.
- Removal of polyps in the stomach and duodenum.
Decoding concepts
Both methods are carried out with a medical device - a gastroscope, which displays the condition of the mucous membrane through the lens. During the examination, the doctor may remove a small piece of tissue for microscopic examination.
Fibergastroscope
To understand the differences between each method, let’s decipher their names:
- FGS is fibrogastroscopy. Translated from Greek: “gaster - stomach”, “skopeo - look”. That is, this research method only involves studying the gastric mucosa and assessing its condition to make a diagnosis. The prefix “fibro-” translates as “fiber” and symbolizes the long gastroscope probe that penetrates the esophagus.
- FGDS stands for fibrogastroduodenoscopy. Here in the middle of the word we see “gaster - stomach” and “duodenum - duodenum”. That is, during the examination, the gastroscope probe first assesses the condition of the stomach, and then penetrates further along the digestive tract into the initial section of the small intestine - the duodenum.
In terms of technique FGDS is a more complex method ; it is prescribed when a comprehensive assessment of the initial third of the digestive tract is necessary.
Preparation for video esophagogastroduodenoscopy
Since videogastroscopy is an intervention in the human body, before it you need to take tests for blood clotting, the presence of antibodies to syphilis, hepatitis, HIV and an ECG.
6 hours before video gastroscopy, you are not allowed to eat and 3 hours before you are prohibited from drinking. Therefore, gastroscopy is most often done in the morning, on an empty stomach. It is recommended not to overeat in the evening.
There are no other food restrictions before the examination.
You should not smoke or chew gum before a gastroscopy.
You should definitely consult a specialist about taking medications that you take daily.
Alternative Methods
Sometimes situations arise in which the use of a gastroscope is impossible - due to intolerance to discomfort, the presence of contraindications and other reasons.
In such cases, additional methods may be prescribed. Let's display them in table form and compare them with gastroscopy - note the pros and cons.
| Research method | Advantage | Flaw |
| Ultrasound | Painless examination, minimal contraindications | The mucous membrane is displayed worse than with gastroscopy |
| MRI | Painless examination, minimal contraindications | It is impossible to conduct a study if you have claustrophobia, pacemakers or metal implants |
| CT with contrast | The procedure is faster, less discomfort | The study is accompanied by radiation |
| Using the video capsule | Painless examination, minimal contraindications | The quality of the images depends on intestinal motility; there is no possibility of directed examination. |
safety for the patient’s health and information content are primarily taken into account . Sometimes it is better to endure discomfort for the sake of an accurate diagnosis than to treat complications later.
Advantages of video gastroscopy in our clinic
The main advantage of our medical center is that we perform the gastroscopy procedure under light anesthesia.
Often patients feel discomfort from the introduction of a video endoscope and ask doctors to prescribe an ultrasound instead of video gastroscopy. But, unfortunately, ultrasound cannot make a biopsy or record a study. We meet patients halfway and offer to undergo the study under medicinal sleep.
It differs from conventional anesthesia in that it lasts no more than half an hour. Sleep completely relieves discomfort during video esophagogastroduodenoscopy. The procedure itself lasts no more than 10 minutes.
The clinic also offers the opportunity to undergo video gastroscopy under local anesthesia. It is performed by injecting lidocaine into the throat and mouth. This method will help relieve discomfort and pain.
At the Elena Malysheva Clinic of Digestion and Gastroenterology, you can undergo a complete examination of the gastrointestinal tract using both instrumental and laboratory methods. Experienced specialists will do everything for your comfort during gastroscopy and colonoscopy. Sign up!
How is it carried out?
The main task of the doctor during gastroscopy is to penetrate the problem areas of the digestive system with a probe, obtain images and take material for biopsy (if necessary). The procedure itself is unpleasant for the patient and is accompanied by discomfort during swallowing of the probe and its movement.
- You can read how to minimize discomfort here.
- Learn about breathing techniques during the procedure here.
- You can also always use sedation or anesthesia.
- Or alternative diagnostic methods.
For the patient, there is no noticeable difference between FGS and FGDS; the differences lie in the depth of penetration of the gastroscope and the time during which the study is carried out.
The procedure consists of the following steps:
- Pain relief - the throat is irrigated with lidocaine solution. This allows you to reduce gagging and discomfort during the passage of the probe.
- The patient lies on his left side - this position facilitates the passage of the tip. The stomach has a left-sided bend; in this position, nothing interferes with the probe. For convenience, a cushion is placed under the waist, and a container for saliva is placed near the mouth.
- Insertion of the probe - the patient swallows the tip, then the doctor slowly moves it along the esophagus and into the stomach. The specialist takes pictures, takes scrapings or material for research. If an FGDS is performed, the doctor then penetrates the duodenum and repeats similar manipulations.
Carrying out FGS
The gastroscope tube is designed in such a way that the doctor can change the direction of the tip. This allows you to move easily and unhindered through the gastric tract without injuring the mucous membrane . On the working part there is a flashlight for illumination, special nozzles that pump water or air to inflate the cavities and clean the lens. The probe is removed in the reverse order, slowly and carefully.
Help During the procedures, it is strictly forbidden to try to talk, make movements, cough, or clench your jaws - this can damage the mucous membrane! Experts recommend trying to relax, breathing slowly and deeply.
Endoscopy of the stomach under anesthesia (gastroscopy, colonoscopy) on an outpatient basis
Our Clinic offers the possibility of performing endoscopic procedures under general anesthesia on an outpatient basis:
- VXS of the intestines (colonoscopy) under anesthesia.
- IGDS (gastroscopy) under anesthesia.
For this purpose, modern pharmacological drugs are used, which create the possibility of safe anesthesia. In addition, taking care of patient safety, the clinic has developed and carries out a number of diagnostic measures that allow us to assess the risk of adverse events during anesthesia. They are preceded by a consultation with a therapist, who determines the presence and degree of compensation for concomitant pathology, and refers them to studies that will help identify hidden threats to the occurrence of adverse events during anesthesia.
Only the anesthesiologist makes a decision about the possibility of anesthesia. During the consultation, he analyzes all the data received, determines the degree of risk for each individual patient and the possibility of giving him anesthesia on an outpatient basis. In some cases, when the risk of complications during anesthesia is high, the anesthesiologist will suggest performing an endoscopic procedure in a hospital setting, where they will first prepare for anesthesia and then observe for a longer period of time, which will help, if necessary, provide timely medical assistance.
Videocolonoscopy (VCS, colonoscopy) under general anesthesia on an outpatient basis.
This is an instrumental examination, often called simply colonoscopy, that allows you to examine all parts of the colon and the distal ileum. The procedure can be painful in patients who have had surgery on the pelvic organs in the past, adhesions, uterine fibroids, or prostate adenoma. For such patients, it is recommended that a VCS (colonoscopy) be performed under anesthesia, which can be done on an outpatient basis in our clinic if there are no contraindications. Preparation for the study is carried out by the patient at home. It must be thorough, since the quality of the research depends on it.
Currently, the endoscopic department uses only the latest generation digital video technology, which allows obtaining a good image with high magnification and applying additional research methods, such as NBI (narrow light spectrum examination), which improves the detection of polyps, benign and malignant tumors, even very small ones size (from 1 mm), and ZOOM (increase) technology - this makes it possible to study tumors in more detail. and thereby determine the tactics of their treatment even before receiving the results of histological examination. This also includes chromoscopy - the use of vital dyes, which are not harmful to the body, but improve the quality of visualization of pathological changes in the intestinal mucosa.
All the additional research methods described above significantly increase the quality of diagnosis, but at the same time lengthen the time of an already unpleasant procedure. Carrying out an examination under anesthesia will significantly improve the information content of the examination and make it more comfortable to endure.
Contraindications
Before conducting a study, it is important to take into account the limitations - ignoring contraindications is dangerous for the health, and sometimes even for the life of the patient.
We list when gastroscopy cannot be done:
- problems with blood pressure are noted;
- history of stroke or heart attack;
- there is a risk of bleeding ;
- the patient has bronchial asthma ;
- mental disorders are noted.
What can gastroscopy of the stomach do?
During the procedures, it is possible not only to identify various pathologies of the digestive system, but also to carry out therapeutic manipulations. Modern gastroscopes are equipped with useful functions and allow you to do without surgery in some cases.
With gastroscopy you can:
Taking a biopsy during FGDS or FGS
- Removing polyps is a potential cancer threat. If the doctor discovers these tumors during the procedures, they are cauterized using a gastroscope.
- To carry out bougienage is an expansion of the narrowed esophagus. The device moves deformed shells apart and restores patency.
- Spray the medicine - a gastroscope is capable of spraying medicines over a specific area of the mucosa. This option is widely used to eliminate hidden bleeding.
- Take a biopsy to determine the bacteria Helicobacter pylori or to check for tumors.
- Take a stomach acid test.
