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What is an upper endoscopy / gastroscopy | Diseases and conditions: Medical tests.

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Upper endoscopy or gastroscopy

The high digestive endoscopy, also known as gastroscopy, is a medical test used to diagnose and treat diseases of the upper digestive tract, i.e. of the esophagus, stomach, and duodenum.
This is done through an Endoscope, which is a device that consists of a hose of about one centimeter in diameter and slightly more than 100 cm in length. The endoscope is inserted through the mouth and is advanced by all of the upper intestine. Lets you view the inside of the bowel, because it has a video camera on its end, whose image is seen through a monitor.
In addition, endoscope tube has several channels inside where you can enter various instruments, and allow diagnostic testing such as the taking of biopsies, or even perform treatments such as Cauterization of bleeding vessels or the removal of polyps.

When an upper endoscopy is done

The most common reasons for which you can request the realization of an upper endoscopy or gastroscopy are as follows:
To study problems of the esophagus as esophagitis, narrowing of the esophagus or tumors.
Studying problems of the stomach gastritis, gastric ulcers and tumors.
To study problems of the duodenum as duodenal ulcer.
Diagnose a hiatal hernia or gastroesophageal reflux.
Find the cause of the vomiting up blood (hematemesis).
Before anemias ferropenicas (due to lack of iron), when it is suspected that they are due to chronic blood loss by the upper digestive tract.
The presence of black stools (Melena) that are due to the mixture of feces with digested blood caused by a hemorrhage of the upper intestine.
Find the cause of symptoms such as upper abdominal pain, difficulty swallowing (dysphagia), vomiting, or unexplained weight loss.
In patients with liver cirrhosis, because this disease produces a thickening of veins of the esophagus and stomach. These thickenings are called varices. They have the risk of rupture and bleed, so it can be controlled through the upper endoscopy.
Samples taken to diagnose diseases such as celiac, infection by Helicobacter pylori (a closely related gastroduodenal ulcer bacterium), or digestive tumors.
Provides access to the output of the bile into the duodenum. There a contrast may be injected to draw via biliary and pancreatic and diagnose diseases at this level. This test is called endoscopic retrograde cholangiography.

Therapeutic uses of the gastroscopy

In addition to diagnose digestive diseases, the procedure can be used for therapeutic as in the following cases:
Remove foreign bodies that may have been swallowed and nestled in the upper intestine.
Dilating the esophagus in cases of esophageal narrowing, as that occurs in a disease called achalasia achalasia.
Remove the upper intestine polyps.
Treat digestive bleeding through the Cauterization of the bleeding vessel or ligand varicose veins varices that may bleed.
Unlike colonoscopy, endoscopy in digestive high not is required a special preparation of the digestive tract.

Preparation for an upper endoscopy

These are the issues that you must consider when you undergo an upper endoscopy or gastroscopy:
Duration: test is performed in about 15-30 minutes, although it may take longer depending on the findings, which is, or if it carries out any therapeutic procedure or take biopsies.
Entry: the test can be done on an outpatient basis.
Is necessary to be accompanied?: is usually given a sedative to relax during the test, so it is recommended that someone accompany you to take you home then.
Drugs: is not required any special medication.
Food: is necessary to remain without ingesting water or food for 6-8 hours before the test. This facilitates the exploration of the intestine. In addition, it reduces the possibility of vomiting with the consequent risk of vomiting to enter through the airway and give serious lung problems. It should become an urgent (mainly in cases of major bleeding) endoscopy is usually attach a tube through the nose into the stomach (a nasogastric tube), which will empty the stomach of food scraps.
Clothing: you can wear any clothes you want to but it should be easy to remove, as they will remove it part of the clothing and will facilitate you a hospital gown.
Documents: should be informed consent, which is a role where they explain you what is the test and its potential risks. You should read it carefully and take it signed. You must take the wheel of the test request.
Contraindications: You should not do a gastroscopy in the following cases:
  • Intestinal diseases that may worsen with the completion of the test as a perforation of the upper intestine, recent intestinal surgery, etc.
  • Serious or "unstable" patients with significant hypotension, respiratory failure, serious arrhythmias, etc.
  • Pregnancy is a relative contraindication.
  • Diseases that limit the mobility of the neck and preclude the introduction of the endoscope as severe cervical scoliosis
  • Serious blood clotting problems.
Pregnancy and lactation: in general carry out this test, should be avoided though sometimes can be given that the benefits outweigh the risks. In this case, it must be without sedation or with the minimum possible sedation. Breastfeeding in general is not a contraindication the test. Sedatives administered to the test in general do not pose a risk for the infant, unless you have severe breathing problems.

Other considerations on gastroscopy

You should tell the doctor if you have allergies to medications, particularly to anaesthetics.
If you are taking aspirin, NSAIDs, or iron supplements may indicate you to stop taking them the 7-14 days prior to the test. This must be that aspirin and anti-inflammatory drugs would facilitate the bleeding where necessary take a biopsy or remove a polyp, and iron sticks on the wall of the intestine and hinders their exploration. The doctor will instruct you when to resume this medication.
If you are taking anticoagulants, it is very important to warn the doctor, then it will be necessary to temporarily stop them. The doctor will give you instructions in this sense depending on the anticoagulant that take.
You should also be alert if you've had a test with contrast of the upper intestine in two days prior to the test. Barium used as contrast can remain in the intestine and make it difficult to scan.
You must not take the day of the test, antacid or sucralfate because they interfere with the correct visualization of the upper intestine.

How the high digestive endoscopy

Endoscopy digestive signup or gastroscopy is usually done a medical specialist in digestive system, along with an Assistant who may be nursing staff. Initially, they will tell you to undress from the waist up and put on a hospital gown. It will pick up a vein in the arm. There you can pass a drug that will make you to be relaxed and drowsy during the test. It is possible to then not remember much about the procedure.
You will have a device in the mouth to prevent it closing it and damage to the teeth with the endoscope. It is usually given an anesthetic spray in the mouth and throat to lessen the discomfort and facilitate the introduction of the endoscope. They defeated him on a stretcher on the left side and then the doctor will proceed to introduce the endoscope previously lubricated by the mouth. It will ask you to swallow to facilitate its passage through the pharynx and will to progress to the duodenum. We must try not to swallow during the procedure unless directed him to do so. The saliva that can form in the mouth will be sucked by the wizard using a small vacuum cleaner tube. On an attached screen the doctor can see the entire surface of the upper intestine with clarity. During the test, you may be asked to change position to facilitate the movement of the endoscope.
The doctor has tools such as microtweezers, capsula, etc., that you can get the channels that has the endoscope, and allow you to perform some diagnostic or therapeutic procedures. For example, can suck secretions, take a biopsy, removing a polyp coagulate bleeding, remove a body odd, etc.
After all this, the endoscope carefully take and leave him 1-2 hours under observation in an enclosed room until it recovers the sedative effect. As an anesthetic throat have applied you, it is necessary not to eat or drink until you pass the effect of anesthesia. Otherwise it could happen that food was by the respiratory route. It is recommended that you do not drive or operate dangerous machinery during the 12 hours following the test. Your doctor will instruct you when you can eat normally and restart normal activities. This depends on the procedure that have yet done you and medication which provided him.

Complications of the upper endoscopy

The upper endoscopy or gastroscopy is a very safe test. It is also rare to have side effects from medications that can be given as sedatives. The anesthetic spray that will have in the throat knows something bitter and makes you feel tingling and swelling in the throat and tongue.
Some people notice shortness of breath following the introduction of the endoscope through the mouth, but due to the anesthesia of the throat. Don't worry, as there is sufficient space around the endoscope as to which you breathe normally. It is important to stay calm and make slow, deep breaths. One can notice some discomfort such as nausea, abdominal cramps or gas while the procedure is done. If you notice any significant discomfort can be noted the doctor giving him a small hit in the arm or with any previously agreed signal.
After the procedure you will feel drowsy for a few hours, and is likely to not remember much of what happened. You may also notice abdominal bloating and gas, which will go out little by little. You may notice some discomfort in the throat for a few days. If you've had a biopsy or have had your a polyp removed, you can see that the stool is black for a few days to be mixed with traces of blood.
It is very rare that there is a serious complication for an upper endoscopy. In rare cases the procedure can cause cardiac arrhythmias. Sometimes, the endoscope can damage the surface of the mucosa and cause bleeding. If vomiting occurs during the test, there is a risk that part of it will be by the respiratory route and originate a pneumonia. This event requires treatment with antibiotics. Some cases of punctures of the intestine with the endoscope, have been which is a completely exceptional circumstance. This complication requires to be repaired by surgical treatment.
If after the test Note chest pain, shortness of breath, fever, severe dizziness, or any other symptom that worries you, should immediately contact their doctor. It must also consult urgently if you vomit blood, whether it is fresh red blood - which indicates that it is a hemorrhage recently-, as blood-like "coffee grounds", which indicates that it is blood that it takes a while in the intestine.

The high digestive endoscopy results

During upper endoscopy or gastroscopy surface of the intestine, is seen with what your doctor can diagnose many diseases directly. It is possible that later you any results the day of the test. The specialist will make a written report that will give you a few days of the test, possibly along with some photos of possible pathological as ulcers or polyps findings.
When biopsies have been taken, the samples will be studied under a microscope by a pathologist and a report will be made separately with this result. You can also that you have caught samples for microbiological study of possible intestinal infections. This will result in a third report by a specialist in microbiology. All these results may take several weeks to be available.
The report of the result of the high digestive endoscopy will include data on the quality of the preparation of the bowel, where has been reached with the endoscope, medication that has been given him, and possible eventualities that have occurred during the test. Describe the appearance of the bowel and possible pathologies such as polyps, diverticula, tumors, ulcers, bleeding, inflammation, etc. Specify possible diagnostic or therapeutic procedures that have been made, like biopsies or removal of polyps, and to which lab extracted samples have been sent. The report will be completed in a few weeks with the results of these samples.
It is advisable to go to pick up the result and not assume everything is normal because the results you are not delivered in a few weeks. The doctor has asked the test will give you the results and will instruct you to need to make other complementary examinations or treatment.
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