Gastroenterološki pregled

Customer question:

How is a gastroenterological examination performed? Anonymous customer's question

Pharmacist's answer:

There are several types of gastroenterology examinations, depending on the symptoms and the suspected diseases. Before the examination, patients often consult with their doctor about the procedure, preparations, and possible risks. Before the procedure, the doctor may also request special diets or food and fluid restrictions.

Some standard gastroenterology examinations are as follows:

Endoscopy

• Gastroscopy (esophagogastroduodenoscopy - EGD): a procedure in which a flexible tube instrument (gastroscope) is used, which is inserted through the mouth and throat into the esophagus, stomach, and the first part of the small intestine (duodenum).

• Colonoscopy: a procedure that uses a long, flexible endoscope (colonoscope) to be inserted through the rectum into the large intestine to examine the inner wall of the intestine.

Capsule endoscopy

The patient swallows a small capsule containing a camera, which then passes through the digestive system and takes pictures of the inner walls of the intestine. It is mainly used to examine the small intestine.

Ultrasound of the digestive system

Used to examine abdominal organs, including the liver, gallbladder, pancreas, and stomach.

X-ray examinations

• Abdominal X-ray: helps to examine structures in the abdomen.

• Colonography with double contrast: X-ray examination of the colon after administration of a contrast medium.

Laboratory tests

These may include tests of the liver, pancreas, and other parameters that help assess the function of the digestive system.

Biopsy

During an endoscopy or other procedure, the doctor may take a small tissue sample (biopsy) for further laboratory analysis.

Is a gastroenterology examination painful?

Gastroenterological examinations are usually not painful, as they are performed under appropriate anesthetic or sedation control. However, it is essential to note that the experience of certain sensations may vary between individuals, and some may feel discomfort or anxiety before the procedure itself. Here are some of the different types of gastroenterology exams and information about what patients may experience:

• Gastroscopy (EGD): during a gastroscopy, a thin, flexible endoscope is inserted through the mouth and throat and advanced through the esophagus into the stomach and duodenum. A local anesthetic is usually used to numb the throat to reduce discomfort. Patients may feel a slight pressure or feeling of fullness, but the pain is minimal. Many patients are under sedation during the procedure itself and may not feel it at all.

• Colonoscopy: During a colonoscopy, a long, flexible endoscope is used and inserted through the rectum into the colon. Sedation is usually used before the procedure so patients do not feel pain in most cases. However, they may feel slight discomfort due to the air injected into the intestine to expand the space in the intestine for a better examination.

• Ultrasound of the digestive system: ultrasound is a non-invasive procedure that does not cause pain. The gel is applied to the skin, and the ultrasound probe is moved over the abdominal skin to view the internal organs.

• Capsule endoscopy: patients swallow a small capsule with a camera that travels through the digestive system. This procedure is usually not painful, as the capsule passes naturally through the body.

Although most patients are satisfied with the comfort level after these procedures, it is essential to consult with your doctor about possible sedatives or anesthetics and procedures to manage discomfort before the procedure. The doctor will also provide detailed instructions on preparing for the examination and what to expect during the procedure.

How long does a gastroenterological examination take?

The duration of a gastroenterology examination depends on the type of examination, the procedure, and any additional interventions that need to be performed. A gastroscopy usually takes about 10 to 20 minutes. The execution time may vary depending on the complexity of the procedure and possible additional interventions, such as taking tissue samples (biopsy). A colonoscopy usually takes 30 to 60 minutes. Testing time may vary depending on various factors, such as removing polyps or taking tissue samples for biopsy.

Ultrasonic examination usually takes about 30 minutes. Time may vary depending on the complexity of the review and the need for additional assessments. In capsule endoscopy, patients swallow a capsule with a camera that passes through the digestive system. The examination lasts about 8 hours, during which the camera records image material. The patient then returns the data carrier they wore during the examination.

The duration of the review is only part of the entire process. Additional steps may be required before and after the examination itself, such as preparation for the examination, recovery from anesthesia or sedation, and, if necessary, additional assessments or medical interventions. It is essential to consult your doctor before the examination about all questions regarding the procedure, including the duration, preparations, and possible restrictions after the examination.

Which diseases can a gastroenterological examination detect?

Gastroenterological examinations aim to detect various diseases and conditions of the digestive system. Some of the diseases that can be detected or evaluated by gastroenterology examinations include the following possible conditions:

• Reflux disease: gastroscopy can help evaluate damage to the esophagus from acid reflux.

• Ulcers: gastroscopy can detect ulcers in the stomach or duodenum.

• Polyps: colonoscopy is used to examine the colon and detect polyps that may potentially develop cancer.

• Cancer of the digestive system: endoscopic examinations, such as gastroscopy and colonoscopy, allow the visualization of the mucous membrane of the digestive tract and the detection of possible malignant changes.

• Celiac disease: a small intestine biopsy during a gastroscopy can help confirm the diagnosis of celiac disease.

• Inflammatory bowel disease: Colonoscopy and gastroscopy may be used to evaluate conditions associated with inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.

• Liver disease: Ultrasound, endoscopy, or other examination methods can help evaluate liver disease, including cirrhosis and liver cancer.

• Diseases of the pancreas: endoscopy or ultrasound can help evaluate the condition of the pancreas and detect diseases such as pancreatitis.

• Gallbladder diseases: ultrasound or other examination methods can be used to assess the condition of the gallbladder and detect gallstones.

• Diverticulosis: Colonoscopy can be used to detect diverticula in the colon.

Which examination should I undergo to detect celiac disease?

Diagnosing celiac disease involves several steps, including a clinical assessment of symptoms, blood tests, and, if necessary, a small intestine biopsy. If you have symptoms that could indicate celiac disease, talk to your doctor. Avoiding gluten before starting the test is essential, as it can affect the test results.

The most commonly used tests to diagnose celiac disease include:

• Serological tests measure specific antibodies in the blood that often appear in people with celiac disease. The most commonly used tests are for antibodies to tissue transglutaminase (tTG) and antibodies to endomysium (EMA). A positive serological test may indicate the presence of celiac disease but does not guarantee a definitive diagnosis.

• The deaminated gliadin peptide antibody test is another serological test that can help identify celiac disease.

• Genetic testing: Celiac disease is associated with specific genetic characteristics, particularly the HLA-DQ2 and HLA-DQ8 alleles. Testing for genetic characteristics is usually used to rule out celiac disease in people who do not have these genetic characteristics. Still, the presence of these genes is not enough to make a diagnosis, as many people who do not develop celiac disease also have them.

• Small bowel biopsy: if serological tests are positive and celiac disease is suspected, a small bowel biopsy may be performed. During a gastroscopy, a small tissue sample is taken from the small intestine and then assessed under a microscope for damage or inflammation characterized by celiac disease. Biopsy remains the gold standard for confirming the diagnosis of celiac disease.

Who performs gastroenterology examinations?

Gastroenterological examinations are performed by doctors specializing in the field of gastroenterology. Gastroenterologists specialize in the digestive system, including the stomach, intestines, liver, bile ducts, and pancreas. These doctors specialize in diagnosing, treating, and monitoring various digestive diseases and conditions.

In some cases, gastroenterological examinations or procedures such as polyp removal or other surgical procedures can be performed under the supervision of gastroenterological surgeons. These are surgeons specializing in the digestive system. Some simple endoscopy procedures may also be performed under the supervision of specially trained medical technicians known as endoscopy technicians or medical assistants.

It is essential to consult your general practitioner, who will assess your symptoms and, if necessary, refer you to a gastroenterologist or other specialist for further evaluation and diagnosis. Depending on the type of test or procedure you may need, your doctor may refer you to different specialists within the gastroenterology team.

Does a gastroenterological examination detect liver diseases?

Yes, gastroenterology tests can help detect liver disease. Gastroenterologists specialize in the digestive system, which includes the liver, and have a variety of diagnostic methods available to assess the condition of the liver. Based on the test results, gastroenterologists can diagnose and monitor the progression of liver disease and advise on further treatment. The liver is a crucial organ in the digestive system, and early detection and treatment of liver diseases can significantly improve health and prevent more severe complications.

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