Gastrointestinal endoscopy = through the stomach?
This gastrointestinal endoscopy cheats are not thankful
Come and see your stomach and intestines
01.
Why do I have a gastrointestinal endoscopy?
China is a country with a high incidence of gastrointestinal tumors, stomach cancer, esophageal cancer, colorectal cancer accounted for the 3rd, 5th and 6th tumor incidence in China, and more than 600,000 patients die of malignant tumors of the digestive tract every year. Most patients with gastrointestinal malignancies are diagnosed in the progressive phase, while early and advanced tumors have very different prognosis. Taking gastric cancer as an example, the 5-year survival rate of advanced patients is less than 30%, while the 5-year survival rate of early patients is more than 90%, which reminds us that we need to pay attention to the early screening of gastrointestinal tumors.
02.
Who should have a gastrointestinal endoscopy?
Indications for gastroscopy are as follows:
People with gastrointestinal discomfort, such as dysphagia, nausea, vomiting, belching, acid reflux, melaena, abdominal pain, bloating, etc.;
Those who have been diagnosed with upper gastrointestinal lesions such as Helicobacter pylori infection, polypsectomy, gastric esophageal varices, etc. that require regular review, patients with dynamic change therapy, and patients with suspected or confirmed upper gastrointestinal foreign bodies;
Have bad lifestyle habits, such as smoking, drinking, eating irregularly or overeating or overeating or big fish and meat, liking pickled foods and barbecues, working under pressure, staying up late often, etc.;
People with a family history of esophageal cancer, stomach cancer, etc., and physical examination found that the tumor index of the digestive tract is elevated, and patients with unexplained anemia and weight loss are found;
General populations over the age of 40, both men and women, are advised to have a routine medical examination.
Indications for colonoscopy are as follows:
Patients with gastrointestinal symptoms such as lower abdominal pain, changes in stool habits and traits (once a day becomes multiple times), constipation, loose stools, blood in the stool, black stools, nasal mucus blood;
Unexplained lower gastrointestinal bleeding, intestinal obstruction, abdominal mass can not exclude intestinal diseases and unexplained wasting, anemia patients;
Normal physical examination found that the tumor markers of the digestive tract such as carcinoembryonic antigen (CEA) are elevated;
People with a family history of bowel cancer, patients who require regular follow-up;
Patients who have been diagnosed with intestinal lesions such as inflammatory bowel disease, colon polyps, early stage cancer and colon cancer after surgery require endoscopic treatment and regular follow-up;
03.
Who is not suitable for gastrointestinal endoscopy?
Contraindications to gastroscopy are as follows:
Patients who refuse to be examined or who are mentally abnormal or mentally impaired;
Severe heart and lung dysfunction;
Patients with lesions of the throat;
Patients with acute myocardial infarction;
Other severe visceral diseases cannot tolerate examination.
Contraindications to colonoscopy are as follows:
Absolute contraindications (definitely not colonoscopy):
Severe cardiopulmonary insufficiency, shock, abdominal aortic aneurysm, acute peritonitis, intestinal perforation, etc.
Relative contraindications (need to inform the doctor in advance of the condition, as appropriate to arrange colonoscopy):
Pregnancy, extensive adhesions in the abdominal cavity and various causes leading to intestinal stenosis, chronic pelvic inflammatory disease, cirrhosis of the liver, ascites, mesenteric inflammation, highly abnormal flexion of the intestinal tube and advanced cancer with extensive metastasis in the abdominal cavity, etc.;
Patients with severe ulcerative colitis, multiple colonic diverticulum;
Those who have had abdominal, especially pelvic surgery, have suffered from peritonitis, and have a history of abdominal radiotherapy;
Frail, elderly and those with severe cardiovascular and cerebrovascular diseases who cannot tolerate examination;
There are severe purulent inflammation or painful lesions in the anus and rectum, such as perianal abscesses and fissures;
Children and people with mental illness or inability to cooperate;
Menstrual period in women;
04.
Can blood draws, ultrasound, and CT be used in lieu of gastrointestinal endoscopy?
Routine physical examinations, including blood routines, liver and kidney work, electrocardiogram, abdominal ultrasound, CT, etc., do not involve common gastrointestinal tumors, so there are too many "fish that slip through the net" for gastrointestinal tumors. In addition, the lack of specificity of tumor markers, many reasons will cause tumor markers to rise, blindly believe that tumor marker changes, may lead to delay in the condition, not to mention can not replace gastrointestinal endoscopy. As the saying goes, a physical examination without gastrointestinal endoscopy is a "hooligan", so choosing a gastrointestinal endoscopy is the only choice for physical examination.
05.
How do I prepare?
Prepare before gastroscopy as follows:
Generally fasting for more than 6h before the examination, do not abstain from drinking (it is not recommended to drink a lot of water before ordinary gastroscopy, you can drink a small amount of water in batches, you can not drink water 2h before painless gastroscopy), wear loose, round neck or low-necked clothes, remove masks, dentures and glasses during the examination, loosen the tie and buttons. If you have high blood pressure and coronary heart disease, it is still recommended to eat a small amount of water in the morning. After the examination, it is generally best to eat after 2h, and it is better to eat soft food or warm and cold food. If the endoscopy is painless, someone needs to be accompanied and I cannot drive, ride or do high-risk work on the day.
Preparations before colonoscopy are as follows:
Do not eat red or seeded foods such as watermelon, tomatoes, kiwi fruit, etc. for 2 to 3 days before colonoscopy, so as not to affect colonoscopic observation. The three meals before the examination are mainly low-fiber, semi-liquid diets, such as porridge and noodles, and do not eat vegetables, fruits and other dregs of food and dairy products. Prepare a small amount of snacks and chocolates for use at the end of the colonoscopy.
If you have long-term constipation, please explain to your doctor that you can take power drugs such as mosabili or lactulose or a small dose of magnesium sulfate solution 3 days before the examination to ensure that you have a bowel movement at least once a day. Bowel lavage is performed at least 4 to 6 hours before the examination. In the morning of the same day, colonoscopy begins oral lavage at 3 to 5 a.m.; if colonoscopy is examined in the afternoon, a small amount of diet can be eaten in the evening of the previous day, fasted at breakfast on the same day, oral intestinal lavage at 8 to 10 a.m., fasted at noon, and patients without diabetes can take sugar water to prevent hypoglycemia.
06.
Will choosing a painless gastrointestinal endoscopy affect my memory?
First of all, there is no scientific basis for the claim that painless gastrointestinal endoscopy, that is, general anesthesia, leads to memory loss and people becoming stupid. The intravenous anesthetics used in painless gastrointestinal endoscopy are metabolized quickly, and will be completely decomposed and metabolized within 6 hours, which will not bring any sequelae to the human nervous system, although a small number of people will have "transient cognitive impairment", but it will disappear in a short time. So don't worry about the side effects of "taking it for granted" such as memory loss and senile dementia.
Is that painless gastrointestinal endoscopy that anyone can do? Of course not, because anesthesia tests are also contraindicated. If you are too old, cardiorespiratory insufficiency, recent colds and coughs, anesthesia allergies, etc., you should not do painless examination. There is also a painless examination on the day, it is best to be accompanied by someone, not to drive, ride.
07.
What should I do if I am afraid of gastrointestinal endoscopy?
If you choose a regular gastrointestinal endoscopy, there will definitely be some discomfort. Gastroscopy is mainly manifested as nausea, especially when passing through the throat, some patients will have obvious nausea and vomiting symptoms; colonoscopy is mainly manifested as colonoscopic inflation, abdominal distension and even abdominal pain when pulling the intestine, each person's tolerance is not the same, some patients will have mild nausea, limb numbness, burning and other discomfort. But in general, the vast majority of people can successfully complete the examination. Of course, now painless gastrointestinal endoscopy, that is, gastrointestinal endoscopy under anesthesia, can make the patient sleep to complete the examination.
08.
I want to do a gastroscope and a colonoscope together, can I?
Yes, but you need to inform your doctor before the examination, complete the ECG for anesthesia assessment, and be accompanied by a family member.
09.
Do gastrointestinal endoscopies need to be done annually?
Gastrointestinal endoscopy is not required every year. However, patients who meet the above indications for gastrointestinal endoscopy need to be promptly performed. But if the above indications are not met, that is, there is no discomfort or disease, is there no need for gastrointestinal endoscopy? The answer is "NO"!
It is currently recommended to complete a gastrointestinal endoscopy before the age of 40, and if there is a family history of tumors, that is, family members with gastrointestinal tumors, it is necessary to advance the time to 30 years old. Gastrointestinal diseases require systematic treatment, and timely review is required after treatment. For patients with intestinal polyps, it is currently recommended to repeat colonoscopy every 2 to 3 years to avoid recurrence or cancerousness of polyps.
Source: Department of Gastroenterology, Affiliated Hospital of Southwest Medical University
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