Additional methods for examining the gastrointestinal tract. Gastrointestinal Tests - Digestion

Or are at risk, very often they ask themselves the question: how to check the stomach and intestines? Exists a large number of diagnostic methods that are characterized high efficiency and allow you to determine the disease as accurately as possible.

Doctors often prescribe colonoscopy.

If the patient has pathological changes in the intestines or stomach, then he needs to mandatory undergo an instrumental examination. Doctors in most cases recommend:

1. Magnetic resonance imaging;
2. PET scan;
3. Computed tomography;
4. Capsule endocopy;

With the help of these methods, it is possible to examine the gastrointestinal tract, as well as to determine the presence of diseases. Some research methods require the use of anesthesia, since the person will not be able to tolerate the intervention. The choice of a particular research method directly depends on the characteristics of the development of the disease and the preliminary diagnosis.

Features of PET scan and computed tomography

PET scan - as an effective diagnosis.

Computed tomography and PET scans are very often used to examine the large and small intestines.

With the help of these research methods, visualization of the affected organs is carried out.

During the diagnosis, the doctor receives an image on an X-ray or a computer monitor.

The equipment used for diagnostics visualizes the condition internal organs through the use of methods such as magnetic field, ultraviolet waves, X-rays.

Thanks to the use of a computer, it is possible to obtain several multilayer images of the stomach and intestines, which greatly simplifies the process of studying the state of these organs for a doctor.

With the help of this research method, an assessment is given not only to the inner, but also to the outer contour. Before scanning, the patient receives a contrast agent. Also, intravenous administration of the drug can be carried out during the period of computed tomography.

During the period of diagnostics, pictures are taken in a special camera. That is why it is not recommended to conduct research if the patient is claustrophobic. Also, the diagnosis is not carried out with excessive obesity of the patient. Virtual colonoscopy refers to one of the types of computed tomography.

During the period of using this method, it is possible to obtain images that have a three-dimensional image. This diagnosis is quite informative in the presence of growths on the intestinal walls, the size of which is more than one centimeter.

PET diagnostics consists in the use of radioactive sugar, with the help of which images of a thick and small intestine... It is given intravenously to the patient prior to the study.

For diagnostics, positron emission equipment is used, which is equipped with a special table for positioning the patient. The duration of the study is on average half an hour.

If the doctor has previously diagnosed the patient with early oncology, then to confirm the diagnosis this method not used. But, with its help, the level of anomalies of the inflamed intestinal wall, which was previously revealed by a tomogram, is checked.

With bowel cancer, this research method is used to check for the presence of metastases lymphatic system and nearby bodies. Thanks to the possibility of the simultaneous use of computed tomography and a PET scanner, the doctor can compare the images and establish the diagnosis as accurately as possible.

To get a more complete picture, the doctor often prescribes delivery.

What is capsule endoscopy, the video will tell:

Ultrasound and MRI

Ultrasound is one of the diagnostic methods.

In order to check the intestines and stomach for the development of cancer, ultrasound is used.

It is used for large enough tumors. If the patient has early or polyps in the organs gastrointestinal tract, then this method is not used for diagnostics.

In some cases, ultrasound is used to identify metastases of bowel cancer to other organs.

If a patient is previously diagnosed with rectal cancer, then endorectal ultrasound is used to confirm this diagnosis. For this purpose, a special device is used, which is introduced to the patient through the rectum.

Endorectal ultrasound makes it possible to determine the prevalence of pathological foci and the presence of pathological processes in the rectum and adjacent organs.
Magnetic resonance imaging can be used to diagnose diseases of the stomach and intestines.

When it is carried out, images are obtained on the computer screen that display sections of the patient's body. This research method uses radio waves and strong magnets. During the examination, the human body absorbs energy, which is displayed by the image. Thanks to the presence special program in the tomograph, the template is converted into a picture.

Before conducting a study, a person is administered medicine, which contains gadolinium. The spread of the substance through the patient's body is carried out in different ways, depending on the location of the disease.

This makes it possible to distinguish between healthy and diseased tissues of the stomach and intestines. Compared with computed tomography Magnetic resonance imaging transmits clearer images. If the patient has renal failure this diagnostic method is not applicable. Capsular endoscopy is most often used to determine.

This research method is based on the use of a capsule, which has a built-in wireless camera of the smallest possible size. Thanks to this device, it is possible to obtain photographs of the stomach and intestines. The video tablet makes it possible to examine hard-to-reach areas. Unlike endoscopy, this method examines the small intestine.

Ultrasonography, magnetic resonance imaging and capsule endoscopy are highly effective diagnostic methods that are characterized by a minimum number of contraindications.

Features of laparoscopy and endoscopy

A laparoscope is an instrument for performing laparoscopy.

If the diagnostic case is unclear, then laparoscopy is used.

With the help of this research method, the depth of the gastric lesion is determined. This method can be used to carry out not only diagnostics, but also surgical interventions. With the help of laparoscopy, stomach cancer is determined, as well as the degree of spread to neighboring organs.

During the study period, a special instrument is used - a laparoscope. Initially, the patient is given anesthesia. After that, an incision is made, the dimensions of which reach from 0.5 to 1 centimeter.

Through it, a device is introduced, with the help of which carbon dioxide is pumped into the stomach. Thanks to this, the organ is enlarged, which allows you to get the most detailed picture. Next, a laparoscope is introduced into the resulting space.

Standard laparoscopy does not make it possible to determine the presence of metastases in. For this purpose, laparoscopic ultrasonography is used, which makes it possible to examine organs abdominal cavity... For this purpose, special laparoscopic sensors are used. With their help, the study of hard-to-reach areas is carried out.

Laparoscopy is practically the only diagnostic method by which the definition of metastases is carried out before surgical intervention... Endoscopy is performed using a special device - an endoscope.

It has a small camera that connects to the computer screen. Using this method, the upper sections are examined. digestive tract... The endoscope tube must be swallowed by the patient during the study period.

Before this, the throat is irrigated with anesthetics. This provides a simplified coping process. With the help of the camera, during the period of the study, the walls of the stomach are examined. The doctor examines the captured pictures with a camera in the endocop's eye.

This research method allows you to take a biopsy. In some cases, with the help of an endoscope, a catheter is inserted and all ducts are filled with radiopaque contrast. This makes it possible to conduct an X-ray of the gastrointestinal tract.

A variety of research methods can be used to determine the condition of the stomach and intestines. They should only be selected by a doctor in accordance with the indications and individual characteristics the patient.

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Diseases of the gastrointestinal tract are one of the most common problems of a modern person, who most of the time lives on constant snacks, business lunches and late dinners. According to statistics, almost every second modern man suffers from diseases of the gastrointestinal tract, however, most of these ailments remain unidentified due to a simple reluctance to visit a specialist. Today, there are many opportunities for diagnosing gastrointestinal diseases, which make it possible to identify the problem with high accuracy and in a short time and determine ways to solve it.

Physical examination methods

Of course, the first step towards a diagnosis is consultation with a specialist. It is necessary to answer in detail all the questions of a gastroenterologist or therapist, who, according to your complaints, will be able to draw up a general picture of the disease. Next, the specialist proceeds to a more detailed examination, which includes methods such as palpation, auscultation, and percussion. Below we will look at some of these survey methods in more detail:

Palpation is a special technique of palpating the patient's abdomen, performed with the doctor's fingers without using additional tools... Scientists have long identified features characteristic of gastrointestinal diseases that can be detected by palpation. So, for example, with the help of palpation, a specialist can determine the foci of localization of pain, the degree of tension abdominal wall and other changes in the gastrointestinal tract. Palpation is performed in a warm room, while the patient can be both upright and horizontal position... It is most convenient to carry out this diagnostic method when the patient is in the supine position and the abdominal muscles are relaxed. For this, the couch should be soft, and a small pillow should lie under the head of the person being examined. It is important that the room is warm, the hands of a specialist should also be warmed up beforehand. If it is necessary to diagnose diseases of the gastrointestinal tract located in the lateral parts of the abdominal cavity, then it is better to palpate in a standing position. Auscultation is a diagnostic method in which a specialist listens to sounds emanating from the digestive tract using a stethophonendoscope. In some cases, auscultation can also be performed by placing the ear on the patient's abdomen. In the room where the auscultation is performed, silence must be observed, and listening is carried out on symmetrical parts of the body for subsequent comparison of the results. In this case, pressing on the patient's abdomen should be avoided. Percussion is a method for examining the organs of the gastrointestinal tract, which is carried out in order to determine the boundaries of their location. As a rule, percussion is performed simultaneously with palpation for the most accurate diagnosis... Percussion is used primarily for examining the liver and spleen.

More often, these methods for diagnosing diseases of the gastrointestinal tract are of a primary nature and allow only an approximate determination of the state of a person. For a more accurate diagnosis, the specialist prescribes a number of clinical and laboratory tests. It is necessary to pass a general and biochemical blood test, as well as general analysis urine.

Other technologies for diagnosing diseases of the digestive system: probing

As a rule, the above diagnostic methods can only reveal an approximate picture of the disease. If the specialist wants to get more accurate information for the diagnosis, then he will refer you to additional examinations, which are carried out using special tools and equipment. The simplest and most common method for examining the gastrointestinal tract is intubation. The main purpose of probing is to access gastric juice, which reflects all the necessary indicators of the state of the gastrointestinal tract. Content violation of hydrochloric acid in gastric juice causes disruptions in digestion and becomes the cause of certain diseases. Probing is the only way to examine the balance of acidity in the stomach. In addition, it can be relevant in situations where it is necessary to diagnose certain diseases of the duodenum and even flush the stomach in case of poisoning.

Endotracheal and nasogastric intubation

The probing procedure consists in the introduction of a special probe through the esophagus to the stomach. In preparation for this method of examining the gastrointestinal tract, the patient should avoid consuming vegetables, fruits, carbonated drinks, milk and black bread in his diet for two to three days. During this period, it is recommended to take Activated carbon in order to reduce gassing. The procedure itself is carried out ten to twelve hours after the last meal, on an empty stomach. Probing lasts on average no more than two hours and does not entail any consequences for the gastrointestinal tract.

Endoscopy and features of its conduct

Endoscopy is another method of examining the gastrointestinal tract, which consists in the introduction optical instruments into the lumen of the gastrointestinal tract. As a rule, endoscopy is the most effective technique for diagnosing diseases of the small or large intestine. During endoscopy, a special tube with a camera is inserted into the intestinal lumen, which allows you to get a picture of the state of the intestine from the inside. Endoscopy also allows you to extract material (biopsy) for further research and even do some treatment. For the first time, this method for diagnosing diseases of the gastrointestinal tract began to be used back in the 19th century, and with the advent of a flexible gastroscope with optical system it began to be used more actively. Indications for endoscopy include suspicion of cancerous tumors, colitis and some other diseases. Endoscopy allows you to see polyps and monitor the condition of the graft during a bowel transplant. Endoscopy should not be performed if there is an allergic reaction to anesthesia drugs, blood clotting disorders in order to avoid dangerous consequences... In preparation for an endoscopy, only liquid within 24 hours and laxatives should be consumed. This method of studying the gastrointestinal tract practically does not cause complications, however, it requires only professional approach and neatness.

Fast and effective: sigmoidoscopy

The range of methods for diagnosing diseases of the gastrointestinal tract is constantly updated with new technologies, one of which is sigmoidoscopy. This method allows you to examine the rectal mucosa using a special optical instrument. A sigmoidoscope, which is inserted through the anus, is a rigid metal tube with a small chamber at the end. With the help of a rectoscope, a specialist can assess the condition of the intestines at a distance of 20-25 cm from the anus.

Sigmoidoscopy is performed within a few minutes and does not require the use of anesthesia. In the case of professional execution, such a diagnosis does not cause the patient painful sensations however, if young children are examined, anesthetics may be used. Sigmoidoscopy is used in cases when the patient experiences pain in the rectum, with purulent and mucous discharge and bleeding. These conditions can act as symptoms of diseases such as hemorrhoids, polyps, malignant tumors, so timely diagnosis in such cases is of particular importance. There are practically no complications after this research method; preparation for the procedure is limited to brief recommendations. On the eve of sigmoidoscopy, it is necessary to cleanse the intestines with an enema and avoid heavy foods in the diet.

Rectosigmocolonoscopy and ERCP

Additional methods for diagnosing diseases of the digestive system are also rectosigmocolonoscopy and. The first procedure is used when a more thorough examination of the intestine is required, when conventional endoscopy and sigmoidoscopy are not enough. It is performed using a flexible tube with a camera that photographs the condition of the intestinal mucosa and takes material for analysis. The procedure is absolutely painless, however, before carrying out it, the patient must observe special diet for several days and thoroughly cleanse the intestines the day before.

Endoscopic retrograde cholangiopancreatography

ERCP, in turn, is aimed at examining the bile ducts and includes both endoscopic and X-ray methods... Using an endoscope in bile ducts contrast liquid is injected, which allows you to subsequently see and assess their condition in the picture. The patient should not eat food prior to having ERCP to obtain a high-quality x-ray. Among the rare complications of ERCP, only pancreatitis can be called, however, the professional execution of this procedure excludes the possibility of such a complication.

One way or another, today there is a wide variety of methods for diagnosing diseases of the digestive system, which allow you to accurately determine the problem and prescribe effective treatment. Modern technologies make these techniques painless for the patient and indispensable for a specialist.

It's no secret that a person's well-being largely depends on the state of the gastrointestinal tract. If digestion is disturbed, all body systems are affected. Therefore, it is not surprising that people who have a history of gastrointestinal pathology or are at risk often ask themselves how to check the stomach quickly and painlessly. Modern medicine has many diagnostic methods, allowing you to reliably establish the cause of the ailment.

With discomfort in the stomach, timely and competent diagnosis is necessary

Research methods

If a patient has complaints about a violation of the gastrointestinal tract, then he needs to go through a complete medical examination... There are several methods of medical diagnosis:

1. Physical method. Based on a visual examination of the patient and taking anamnesis.
2. Laboratory research. They include the delivery of tests prescribed to confirm the preliminary diagnosis.
3. Hardware methods. Provide the opportunity to examine the gastrointestinal tract and identify the presence of pathologies.

Pick up the best option diagnostics or prescribe complex inspection only a doctor can. The choice will depend on the nature of the patient's complaints, the history and the preliminary diagnosis. We're going to talk about hardware research options.

Gastroscopy and sounding

Gastroscopy refers to the methods of endoscopic examination. Gives comprehensive information O inner surface 12 duodenal ulcer and stomach. The manipulation is based on the oral introduction into the organ cavity of a probe with a videoscope and a lamp at the end.

Gastroscopy - effective, but unpleasant method research

The study is unpleasant, but the most informative of all diagnostic measures that exist today. During the examination, the doctor may remove single, small polyps or take a tissue sample for biopsy. The procedure is prescribed when chronic forms gastritis and ulcerative pathology to confirm the diagnosis and select a treatment regimen.

In the same way as FGS, a probe study is carried out. With the help of manipulation, the specialist obtains information about gastric secretion, but does not see the mucous membrane.

Oral tube insertion is extremely unpleasant sensations for the patient, so many are afraid of the procedure. How can you check the stomach without swallowing the intestine? Are there other research options?

Alternative diagnostic methods

Any medical checkup begins with the collection of anamnesis during a personal conversation with the patient. The physician then proceeds to a visual examination of the patient. By palpation, the specialist finds out the localization pain, the tension of the walls of the organ and the presence of dense structures.

The next stage of the examination will be the study of the stomach by the apparatus method. Modern medicine can offer several diagnostic options that can, to one degree or another, replace FGS:

• capsule gastroscopy;
• Sali desmoid test;
• radiography;
• ultrasonography;
• MRI (magnetic resonance imaging).

Advice. Before heading out for a stomach checkup, you should seek the advice of a specialist. For example, if a patient has a possible gastritis at the initial examination, an ultrasound scan in this case will be useless.

Below we will analyze in more detail each diagnostic method.

Capsule gastroscopy

This research method is based on replacing the probe with a special capsule equipped with a video camera. The device allows you to conduct a thorough examination of the gastric mucosa and identify the disease in the early stages of development.

Capsule gastroscopy does not cause discomfort and discomfort

To make a diagnosis, the patient must swallow the capsule. For the inspection to be successful, you should prepare for it:

1. For 2 days before the procedure, the patient must adhere to a diet. It is recommended to exclude fatty, heavy foods, alcohol and meals from the diet, flatulent... Food should be well chopped and steamed or boiled.
2. The study is carried out in the morning, on an empty stomach. It is allowed to drink a capsule with ½ glass of plain liquid.

The process does not take much time and does not cause any discomfort to the person. During the examination, the patient can return to ordinary life limiting physical exercise... After 7–8 hours, the patient again visits the doctor's office, where the doctor transfers the indicators recorded by the capsule to the computer and makes a diagnosis.

Across certain time the device leaves the body naturally... The advantages of such a procedure are obvious, but I could not find a way. wide application due to the rather high price of the device. It also doesn't biopsy, remove polyps, or stop bleeding.

How the stomach is examined by the capsule method, you can watch the video:

Desmoid test

Often to determine the degree of activity gastric juice gastroenterologists use a desmoid test. During the study, the patient swallows a bag filled with methylene blue powder and tied with catgut thread.

Using methylene blue, check the acidity of gastric juice

After the filament dissolves, the dye is gradually absorbed into the bloodstream and excreted from the body no later than 18–20 hours later. The study is based on an assessment of the intensity of urine staining. If the first portion of urine acquires a bright blue-green color, it means that the acidity of the stomach is increased.

Radiation research methods

You can check the gastrointestinal tract in an adult both with the help of invasive manipulations and by radiation diagnostics... Such examination methods allow obtaining information about the configuration of the stomach and the presence of neoplasms, but do not provide an opportunity to assess the state of the mucous membrane.

From ray methods the most widely used x-ray. There is inspection equipment in almost every medical institution, therefore, research is available to all segments of the population.

MRI and ultrasound are more modern ways research and pose less threat to patient health.

You can find out about the difference between these procedures from the video:

X-ray

With the help of radiography, a stomach ulcer is detected, its configuration is checked and its size is estimated. R-graphing is performed using a contrast agent - barium suspension. It is prescribed for the patient's complaints of rapid weight loss, the appearance of blood in the feces, frequent and exhausting diarrhea, constant pain in the gastrointestinal tract.

X-ray of the gastrointestinal tract is informative and does not take much time, but it has contraindications

The procedure is completely painless and not very complicated, but it requires adherence to some rules:

1. Within 2-3 days before the examination, alcohol, thick, fatty and solid foods should be excluded from the diet.
2. On the eve of the check-up, it is necessary to cleanse the intestines with an enema or special means with a laxative effect.
3. Before the procedure, the patient is prohibited from eating or drinking colored drinks.

X-ray of the stomach takes 30-40 minutes. All this time, the doctor asks the patient to take certain positions and takes six pictures of the gastrointestinal tract in different projections.

The procedure has its own advantages and disadvantages. The advantages include the ability to obtain information that is not available when using a fibrogastroscope. For example, with the help of FGS, narrowing of the intestinal lumen or stenosis of the gastric pylorus cannot be detected.

Attention. Contraindication to the X-ray is the first trimester of pregnancy and internal bleeding... In addition, x-rays are undesirable in case of allergy to iodine preparations.

Ultrasonography

Today, ultrasound is performed if there is a suspicion of bleeding and the presence of cancerous growths in the organ cavity. It is quite popular, but not very informative method diagnostics.

Ultrasound is an uninformative method of checking the stomach

The procedure helps to identify only the main violations in the gastrointestinal tract. For a more accurate diagnosis, the patient will have to use other diagnostic methods. Therefore, ultrasound is most often prescribed not to detect an ailment, but to confirm an existing diagnosis.

Advice. Ultrasound examination is completely safe, therefore it can be recommended for women at any stage of pregnancy.

Magnetic resonance imaging

An MRI stomach scan is completely safe and does not require swallowing a tube or administering barium solution. In this case, the procedure is quite informative and allows you to assess the structure of the organ, the thickness and condition of its walls, the presence of neoplasms.

MRI is a modern method for diagnosing stomach diseases

During the examination, a volumetric image of the stomach is displayed on the monitor, allowing you to see polyps and other lumps. To get a better picture, you need to properly prepare for the procedure:

• For several days before the MRI, it is recommended to follow a diet, taking only boiled, liquid and chopped food that does not cause flatulence.
• Before the event, you need to cleanse the intestines with the Esmarch mug or laxatives.
• The last meal should take place no later than 19-20 hours on the eve of the examination.

Computed tomography is most often prescribed for patients who already have a diagnosis and have undergone specific treatment, as well as people who have crossed the 50-year mark. For effective visualization of cavities, a contrast agent or air is used. At the request of the patient, it is possible to carry out the procedure under slight anesthesia.

, gastroenterologist

After 30 years, the aging process is already starting in the body - the metabolism slows down, the body does not so easily tolerate strict diets or, conversely, overeating.

In our youth, we are often quite frivolous about our health and go to the doctor only when the disease has already made itself felt. It is not right. And the older you get, the more important it is to change this approach to your health. It is necessary to closely monitor all body systems, including the gastrointestinal tract. Elena Igorevna Pozharitskaya, gastroenterologist of the Semeynaya network of clinics, spoke about how to properly examine the gastrointestinal tract after 30 years.

After 30 years, the aging process is already starting in the body - the metabolism slows down, the body does not so easily tolerate strict diets or, conversely, overeating. Risk gastric diseases increases. And, as you know, the disease is easier to prevent than to cure. Therefore, after 30, it is important to undergo regular examinations of the gastrointestinal tract - in order to timely identify the risks of certain pathologies.

Gastrointestinal examinations

Here are 4 gastrointestinal examinations that should be done after age 30:

1. ultrasound- the simplest, non-invasive, but still informative examination. With the help of ultrasound, you can assess the condition of the spleen, pancreas, gallbladder and liver. Ultrasound will help to identify diseases such as cirrhosis of the liver, cholecystitis, the presence of stones in the gallbladder, cysts, neoplasms, anomalies in the structure of organs, internal injuries of the abdominal organs, as well as a number of some chronic disorders.

The presence of gas in the stomach can interfere with an ultrasound study, therefore, 1 day before the procedure, it is important to exclude from the use of foods that increase gas formation and cause bloating (legumes, bread, flour, sweet, raw vegetables and fruits containing fiber, sauerkraut, milk, carbonated drinks, alcohol). The last meal should be taken no later than 5-6 hours before the study. An ultrasound scan can be done as often as necessary for health reasons. For a routine inspection, it is enough to do it once a year.

2. Esophagogastroduodenoscopy- examination of the mucous membrane of the esophagus, stomach and duodenum using a gastroscope (it is inserted through the mouth), which is used if erosion or ulcer is suspected, and also often helps to clarify the presence of diseases of neighboring organs - the pancreas and gallbladder. The examination, like others, is carried out on an empty stomach; to facilitate the insertion of the gastroscope, local anesthesia is used - irrigation of the mucous membrane with anesthetics.

- a method that allows you to measure acidity directly in the esophagus, stomach and duodenum, to diagnose the reflux of stomach contents into the esophagus (gastroesophageal reflux), as well as reflux from the duodenum into the stomach. If these conditions are prolonged, then this can lead to the development of inflammation of the esophagus, gastroesophageal reflux disease, and the reflux of bile into the stomach can lead to the appearance of erosions and even ulcers.

4. Colonoscopy- examination of the rectum and colon using an endoscope. This procedure is invasive and is prescribed by a doctor when other diagnostic methods have been exhausted. During this study, the doctor can not only "live" see the state of the colon mucosa, but also take a piece of tissue to confirm the diagnosis. It is enough to pass every 5 years after 50 years in the absence of risk factors. Colonoscopy after 30 years for healthy patients is recommended if there are clear indications, such as: oncological diseases colon in first-line relatives under the age of 40, hereditary colon polyposis. Inflammatory diseases colon, such as Crohn's disease and Ulcerative colitis have a characteristic clinical picture and if the doctor suspects this pathology, to confirm the diagnosis, they initially use non-invasive diagnostic methods that are prescribed by the doctor, when positive results of these methods, a colonoscopy is performed to determine the volume of the lesion, morphological examination. 72 hours before the procedure, it is necessary to exclude from the diet fatty foods, legumes, sweets, coffee, foods rich in fiber (fruits, vegetables), milk, cereals. It is better to give preference to liquid food and drink a lot. A light snack is possible 1.5 hours before the study.

Watch your health!

Appointment to a gastroenterologist

Be sure to go through the consultation qualified specialist in the field of gastrointestinal diseases in the clinic "Family".

The appointment of examinations of the gastrointestinal tract is based on the symptoms presented by the patient, and in order to control and prevent diagnosed chronic diseases Gastrointestinal tract. Indications for diagnostic procedures can be: difficult and painful digestion (dyspepsia), regular nausea, vomiting, heartburn, stomach pain, suspicion of oncopathology.

Today, the most accurate examination of the gastrointestinal tract is fibrogastroduodenoscopy. During FGDS, the gastroenterologist has the opportunity to assess in detail the condition of the mucous membrane of the stomach and duodenum, and to make the only correct diagnosis. The difficulty of the examination is the inability of some patients to swallow the flexible hose equipped with a video camera.

Many people ignore the procedure precisely because of the uncomfortable sensations. Therefore, it will be useful to find out how to check the stomach without gastroscopy in order to diagnose this or that pathology in a timely manner. In addition to autonomic bias towards EGD, there are a number of contraindications to its conduct: a history of hemostasis (blood clotting) disorders, bronchial asthma, gagging hyperreflex.

In such cases, other methods of examination of the stomach are prescribed. Diagnostics of diseases and abnormalities in the work of the stomach is carried out in three main areas: physical complex of measures, laboratory examination of patient analyzes, examination by means of medical diagnostic equipment, alternative endoscopy.

Simple diagnostics

Simple methods diagnostics are mandatory for use when a patient complains about sharp stomach, nausea and other symptoms of stomach ailments.

Physical examination

Physical activities are carried out at a doctor's appointment, the results depend on the qualifications of the medical specialist. The complex includes:

• study of the anamnesis, assessment of symptoms according to the patient's words;
• visual examination of mucous membranes;
• feeling painful areas of the body (palpation);
• palpation in a specific position of the body (percussion).

Based on the results obtained during such an examination, it is extremely difficult to diagnose the disease. The doctor may suspect the presence of pathology, but deeper research methods are needed to confirm it.

Microscopic laboratory diagnostics

Laboratory methods consist in taking analyzes from the patient for further study and evaluation of the results. Most often, the following physical and chemical studies are assigned:

• general urine analysis;
• coprogram (feces analysis);
• clinical blood test. The number of all types of blood cells (erythrocytes, leukocytes, platelets) is counted, the level of hemoglobin is determined;
• gastropanel. This blood test is aimed at studying the condition of the gastric mucosa. According to its results, it is established: the presence of antibodies to Helicobacter pylori bacteria, the level of pepsinogen proteins produced, the level of the polypeptide hormone - gastrin, which regulates the acidic environment in the stomach;
• blood biochemistry. The quantitative indicators of bilirubin, liver enzymes, cholesterol and other blood cells are established.

Blood sampling for clinical analysis hold out of the finger

Analyzes help to identify inflammatory processes and other disorders of the organs and systems. If the results differ significantly from the standard indicators, the patient is prescribed an instrumental or hardware examination.

Applying hardware techniques

Examination of the stomach without gastroscopy is carried out with the participation of special medical devices. They record the state of the mucous membrane, density, size and other parameters of the organ, and transmit information that is subject to subsequent decoding by a specialist.

• X-ray examination(using contrast);
• CT and MRI (computed and magnetic resonance imaging);
• EGG (electrogastrography) and EGEG (electrogastroenterography);
• Ultrasound (ultrasound examination).

At gastric examination by hardware, all manipulations are performed without direct intervention in the body, without damaging the external tissues of the body (non-invasively). The procedures do not cause painful sensations in the patient.

The significant disadvantages of the method include low information content in the initial period of the disease, exposure to X-rays, which is unsafe for health, side effects from taking barium solution.

X-ray with contrast

The method is based on the use of X-rays. To improve visualization of the stomach, the patient drinks a barium solution before the examination. This substance plays the role of contrast, under the influence of which soft tissue acquire the ability to absorb X-rays. Barium darkens the organs of the digestive system in the picture, which makes it possible to detect possible pathologies.

X-rays help in determining following changes:

• incorrect arrangement of organs (displacement);
• the state of the lumen of the esophagus and stomach (enlargement or narrowing);
• non-compliance of bodies with regulatory sizes;
• hypo- or hypertonicity of the muscles of the organs;
• a niche in the filling defect (most often, this is a symptom of a peptic ulcer).

CT scan

In fact, this is the same X-ray, only modified, with advanced diagnostic capabilities. The examination is carried out after pre-filling the stomach with liquid for a clearer view.

In addition, an iodine-based contrast agent is injected intravenously to excrete blood vessels on the tomogram. CT, as a rule, is used when there is a suspicion of tumor processes of oncological etiology. The method allows you to find out not only whether a patient has stomach cancer and its stage, but also the degree of involvement of adjacent organs in the oncological process.

The imperfection of diagnosis consists in irradiating the patient with X-rays, possible allergic reactions on contrast, as well as the inability of CT to complete and detailed study of the digestive tract, since its hollow tissues are difficult to diagnose with CT. The procedure is not performed for women in perinatal period.

MRI tomography

The prerogative aspects of MRI are the use of magnetic waves that are safe for the patient, the ability to determine the initial stage of gastric cancer. In addition, this diagnosis is prescribed for suspected ulcers, intestinal obstruction and gastritis, to assess the adjacent lymphatic system, to detect foreign objects in the gastrointestinal tract. The disadvantages include contraindications:

• body weight 130+;
• the presence of metal objects in the body medical purpose(vascular clips, pacemaker, Ilizarov apparatus, implant prostheses inner ear);
• rather high cost and inaccessibility for peripheral hospitals.

Examination of the gastrointestinal tract on a magnetic resonance imager is more often performed with contrast

EGG and EGEG

Using these methods, the stomach and intestines are assessed during the period of peristaltic contractions. Special device reads the pulses of electrical signals that come from the organs when they contract during the digestion of food. It is practically not used as an independent research. Applied only as an auxiliary diagnosis. The disadvantages are the long time period of the procedure (about three hours) and the inability of the electrical device to establish other diseases of the gastrointestinal tract.

Ultrasound

Diagnostics of the stomach by ultrasound, most often, is carried out in the composition comprehensive survey organs of the abdominal cavity. However, unlike the indicators of other organs (liver, pancreas, gallbladder, kidneys), it is not possible to fully examine the stomach. There is no full picture of the organ.

In this regard, the list of diagnosed diseases is limited:

• abnormal change in the size of the organ, edema of the walls;
• purulent inflammation and the presence of fluid in the stomach;
• limited accumulation of blood in case of organ damage with rupture of blood vessels (hematoma);
• narrowing (stenosis) of the lumen;
• tumor formations;
• bulging of the walls (diverticulosis) of the esophagus;
• intestinal obstruction.

Ultrasound examination of the abdominal organs is desirable to be carried out annually

The main disadvantage of all hardware diagnostic procedures is that medical specialist examines only external changes in the stomach and adjacent organs. At the same time, it is impossible to determine the acidity of the stomach, to take tissue for further laboratory analysis(biopsy).

Supplement to hardware diagnostics

Additional method is Acidotest (taking a combined medical product to establish the approximate indicators of the pH of the gastric environment). The first dose of medication is taken after emptying. Bladder... After 60 minutes, the patient takes a urinalysis and takes a second dose. An hour and a half later, urine is taken again.

Do not eat for eight hours before testing. According to the analysis of urine, the presence of a dye in it is revealed. This allows you to roughly determine the acidity of the stomach without gastroscopy. The acidotest does not give 100% effectiveness, but only indirectly indicates a low (increased) level of acidity.

Alternative endoscopy

Capsular endoscopy is the closest to EGD in terms of information content. The examination is carried out without swallowing the probe, and at the same time reveals a number of pathologies that are inaccessible to hardware procedures:

• chronic ulcerative and erosive lesions;
• gastritis, gastroduodenitis, reflux;
• neoplasms of any etiology;
• helminthic invasions;
• inflammatory processes in the small intestine (enteritis);
• the cause of systematic indigestion;
• Crohn's disease.

The diagnostic method is carried out by introducing a capsule with a scanty video camera into the patient's body. There is no need for an instrumental introduction. The weight of the micro-device does not exceed six grams, the shell is made of polymer. This makes it easy to swallow the capsule with plenty of water. These video cameras are transmitted to a device installed on the patient's waist, the readings from which the doctor removes in 8-10 hours. At the same time, the rhythm of a person's usual life does not change.

Gastric endoscopic capsule

Removal of the capsule occurs naturally during bowel movement. The significant disadvantages of the technique include: the inability to conduct a biopsy, the extremely high cost of the examination. All methods of diagnostics of the gastrointestinal tract provide for the preliminary preparation of the body. First of all, it concerns nutrition correction.

The diet should be lightened a few days before the examination. Hardware procedures are possible only on an empty stomach. The stomach can be checked using any method that is convenient and not contraindicated for the patient. However, the palm tree in terms of information content, and therefore the maximum accuracy of the diagnosis, remains with EGD.