Home Prevention Instrumental diagnostics of the gastrointestinal tract. Procedure for examining patients with diseases of the digestive system

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Instrumental diagnostics of the gastrointestinal tract. Procedure for examining patients with diseases of the digestive system

In gastroenterological practice, there are a considerable number of different diseases, some of which can be very dangerous and lead to the development severe complications. According to statistics, every second person on earth suffers from one or another pathology of the digestive system. That is why it is extremely important to conduct a timely examination of the gastrointestinal tract (GIT), which will allow the specialist to develop effective treatment tactics.

Today there are quite a few modern diagnostic methods, allowing for a comprehensive study of all organs and parts of the gastrointestinal tract, to identify the disease in the shortest possible time and with maximum reliability, to clarify its stage, degree of prevalence and other features. Research methods used in gastroenterology can be divided into three groups:

physical;
laboratory;
instrumental.

Instrumental methods, in turn, can be divided into secretion studies, endoscopic and radiation studies. The appropriateness of prescribing a particular examination will be determined by the doctor while working with the patient.

Physical studies

The first stage of a gastroenterological examination is a consultation with a gastroenterologist or therapist, who must collect a history of the patient’s complaints and draw up a general clinical picture. The doctor conducts a more detailed examination using special methods: palpation, percussion, auscultation.

Palpation is a procedure in which the patient’s abdomen is felt without the use of any additional instruments. This method makes it possible to detect certain signs characteristic of certain diseases of the gastrointestinal tract, in particular, to identify the degree of tension in the peritoneal wall and painful areas. Palpation can be performed while the patient is standing or lying on the couch. In a standing position, palpation is performed in cases where it is necessary to examine organs located on the sides abdominal cavity.

Usually, simultaneously with palpation, percussion is performed - a study that allows one to determine the boundaries of the location of the organs of the gastrointestinal tract by tapping. In gastroenterological practice, this technique is used mainly for studying the spleen and liver.

Diagnosis using auscultation involves listening to the sounds made by the organs of the gastrointestinal tract. To do this, the doctor uses a special instrument - a stethoscope. During the procedure, symmetrical areas of the body are listened to, and the results obtained are then compared.

The above diagnostic studies are only primary and do not allow a specialist to accurately diagnose a particular gastrointestinal disease. So, for example, practical physical methods do not allow a specialist to identify organic pathologies of the gastrointestinal tract when their mucous membrane is predominantly affected. This requires a more complete examination, the plan of which is drawn up individually for each patient and may include a number of different clinical, laboratory and instrumental methods.

Lab tests

In identifying many diseases of the gastrointestinal tract vital role plays laboratory diagnostics. At the discretion of the doctor, the patient may be prescribed blood tests to determine the following substances and enzymes:

bilirubin is a special substance formed after the breakdown of hemoglobin in red blood cells and is part of bile. The detection of direct bilirubin in the blood may indicate a number of gastrointestinal pathologies associated with impaired bile outflow, for example, obstructive or parenchymal jaundice;

transaminases: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) - these enzymes function in almost all organs human body, especially in the liver and muscle tissues. Increased concentrations of AST and ALT are observed in various liver diseases, including chronic ones;

Gamma-glutamyl transpeptidase (gamma-GT) is another enzyme increased level which indicates inflammation bile ducts, hepatitis or obstructive jaundice;

amylase - this enzyme is produced by the pancreas, and as part of its juice, amylase enters the intestines, where it promotes accelerated digestion of carbohydrates. If amylase levels in the blood are elevated, the patient most likely has some kind of pancreatic disease;

lipase is another enzyme produced by the pancreas, the level of which increases with pancreatitis and other pathologies digestive system.

In addition, it is necessary to assign general analysis stool, which will allow a specialist to summarize the functioning of the digestive system, detect signs of disorders and inflammation various departments intestines. In addition, when examining stool, microorganisms that cause infectious diseases can be detected.

A more detailed examination of stool is called a coprogram. With its help, the digestive and enzymatic activity of the stomach is assessed, signs of inflammation are identified, microbial activity is also analyzed, and fungal mycelium can be detected.

If necessary, it can be prescribed bacteriological examination, that is, determination of microbial composition. This will detect intestinal dysbiosis and infections. There are also special tests for identifying antigens of microbial pathogens, which make it possible to identify viral infectious diseases.

Another common laboratory test widely used in gastroenterology is the occult bleeding test. This analysis is based on the detection of hidden hemoglobin in stool.

If the patient is taking iron supplements or other medications, the attending physician must be informed about this, since medications can significantly distort test results. Before donating blood, you must adhere to a special diet for several days, eliminating fatty foods, meat, green vegetables and tomatoes.

If necessary, laboratory diagnostics of the gastrointestinal tract can be supplemented with studies such as enzyme-linked immunosorbent assay (ELISA) of feces and blood plasma.

Instrumental techniques

The most important section of a comprehensive examination of patients with gastrointestinal pathologies is instrumental diagnostics. It includes endoscopic, x-ray, ultrasound, electrometric and other diagnostic techniques.

The appointment of a particular study in order to obtain the most common information occurs at the discretion of the attending physician, depending on the available clinical picture. Each of the instrumental methods makes it possible to assess the structural and morphological features of the organ under study, as well as its function. Most of these tests require the patient special training, since their information content and reliability will depend on it.

Assessment of gastric acid secretion

Since most inflammatory diseases of the digestive system are characterized by changes in stomach acidity. That is why during diagnostic examination Secretion assessment may be indicated Gastric acid necessary for adequate digestion of food, using a special technique called pH measurement. Indications for its implementation are peptic ulcer of the duodenum and stomach, chronic duodenitis, gastritis and other pathologies of the gastrointestinal tract.

In gastroenterology, there are several types of pH measurements: short-term (intragastric), long-term (daily), endoscopic. Each of these methods involves inserting a pH probe through the mouth or nasal opening into the corresponding part of the digestive system for a certain period of time. The acidity level is measured at a specific point using built-in electrodes. With endoscopic pH-metry, the probe is inserted through a special instrumental channel of the endoscope.

Any type of pH measurement requires certain preparation. First, the patient should not smoke or eat food for at least twelve hours before the procedure. Secondly, several hours before the study, drinking any liquids is prohibited in order to avoid vomiting and aspiration. Additionally, you should consult your doctor about the medications you are taking.

Another common procedure used in gastroenterological practice for suspected gastritis, peptic ulcer and many other pathologies is duodenal intubation of the stomach. When conducting research secretory function stomach in this way, all contents are first pumped out of the stomach, and then the basal secretion. After this, the patient is stimulated with secretion using special drugs or given a trial breakfast in the form of broth; after half an hour, a fifteen-minute secretion is collected, which is then studied in the laboratory. The procedure is performed under local anesthesia on an empty stomach.

Probing of the stomach is a procedure that has a number of contraindications. It cannot be performed in case of severe pathologies of cardio-vascular system, stomach bleeding, and also during pregnancy.

If the patient has contraindications to duodenal intubation of the stomach, secretion assessment is performed using a probeless method using the drug "Acidotest". The test is also carried out in the morning on an empty stomach. Analysis of the secretory function of the stomach is carried out by examining portions of urine after taking the drug.

Endoscopic techniques

Endoscopic examination of the gastrointestinal tract involves the introduction of special optical instruments into its lumen. Today, this is the most technologically advanced procedure that allows you to get a complete picture of the condition and functioning of the colon and small intestine, as well as perform a biopsy - obtain a sample of material for further histological examination.

Endoscopic methods for examining the gastrointestinal tract include the following diagnostic procedures:

As a rule, endoscopic methods for examining the gastrointestinal tract are not used if the patient is allergic to anesthetic drugs, as well as pathologies associated with blood clotting disorders. In addition, they all require special training, which the attending physician will discuss in detail.

Radiation techniques

As the name suggests, radiation methods for studying the gastrointestinal tract usually include those that involve the use of radiation. The following methods are most widely used in gastroenterology:

Fluoroscopy or radiography is the study of the abdominal organs by taking x-rays. Usually, before the procedure, the patient needs to consume barium porridge, which is opaque to X-ray radiation and makes it possible to clearly visualize almost all pathological changes; abdominal ultrasound examination of the gastrointestinal tract using ultrasound radiation. A type of ultrasound is the so-called Doppler ultrasound, which allows one to evaluate the speed of blood flow and movement of organ walls; scintigraphy is the study of the activity of the gastrointestinal tract using radioactive isotopes that the patient consumes with food. The process of its advancement is recorded using special equipment; computed tomography and magnetic resonance imaging, these studies are prescribed only if absolutely necessary, if tumor neoplasms, cholelithiasis and other pathological conditions are suspected.

Opportunities of modern gastroenterology

Today many modern clinics offer their patients such a service as comprehensive examination Gastrointestinal tract, which can be passed both if you suspect a disease of any organ of the digestive system, and for preventive purposes. Comprehensive diagnostics involves the use of a combination of various techniques, allowing you to assess the condition of the gastrointestinal tract and get the most complete picture of existing disorders.

Such an extended diagnosis may be necessary for those patients who suffer from a complex disease of unknown etiology, accompanied by metabolic disorders and other serious symptoms. The capabilities of modern gastroenterological clinics make it possible to conduct a comprehensive examination of patients using medical equipment latest generation, with which you can obtain the most accurate research results in a short time. The list of tests and studies performed may vary depending on the specific diagnostic program.

The presence of symptoms such as:

smell from the mouth
stomach ache
heartburn
diarrhea
constipation
nausea, vomiting
belching
increased gas formation (flatulence)

If you have at least 2 of these symptoms, then this indicates a developing

gastritis or ulcer.

These diseases are dangerous due to the development of serious complications (penetration, gastric bleeding, etc.), many of which can lead to

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It is quite difficult to determine the disease in any patient without the use of modern technologies. There are diseases that cause the same symptoms, so in most cases, for patients complaining of gastrointestinal (gastrointestinal) problems, doctors prescribe instrumental, laboratory or x-ray examinations. These research methods accurately identify the diseased organ, find out the cause and help make recommendations for the treatment of the gastrointestinal tract.

Basic diagnostic methods

Instrumental examination of the gastrointestinal tract

Methods for studying diseases of the gastrointestinal tract are divided into several categories:

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Physical examination. The simplest examination methods: palpation, percussion.
Instrumental methods. Capsule endoscopy, fibroesophagogastroduodenoscopy, colonoscopy.
Magnetic resonance imaging (MRI).
X-ray methods. X-ray, computed tomography (CRT), irrigoscopy.
Ultrasonography.
Method for identifying the bacterium Helicobacter pylori.
Other technologies (sensing).

Physical studies

Until recently, a physical examination was the only way a doctor could determine the disease. Nowadays this technique is used less and less, especially in developed countries.

Palpation

Palpation is used to examine the gastrointestinal tract

Manual examination of the patient. To identify diseases of the gastrointestinal tract, there are certain palpation techniques that are gradually disappearing from the medical arsenal.

Percussion

Tapping of some organs. The doctor determines the presence of pathology by sound.

Instrumental research methods

As the name suggests, special tools and devices are used for diagnosis.

Fibroesophagogastroduodenoscopy

Examination of the gastrointestinal tract with an endoscope, the tip of which is equipped with a small television camera. The esophagus, duodenum, and stomach are examined. It is carried out both in emergency cases and when chronic diseases Gastrointestinal tract.

Diagnosis with an endoscope is contraindicated for burns of the esophagus, respiratory failure and heart problems.

Colonoscopy

Examination of the colon mucosa with a fibrocolonoscope - a special probe with a television camera.

Sigmoidoscopy

Examination of the colon to a depth of 25 centimeters using a rectoscope - a lighting device capable of supplying air. It is carried out quickly and efficiently. During the examination sigmoid colon A rectosigmocolonoscopy is prescribed, during which doctors usually also perform a biopsy - sampling of suspicious tissue for analysis.

Video capsule endoscopy

The patient swallows small capsules, and as they pass through the gastrointestinal system, they take pictures, from which the gastroenterologist can determine which of the gastrointestinal diseases the patient has.

X-ray examinations

X-ray of the gastrointestinal tract

Even today, X-ray images remain one of the important methods for diagnosing various diseases. With their help, doctors can examine changes occurring in organs.

X-ray

Conducted for examination different organs by removing X-ray images after filling the organs with barium suspension.

CRT or computed tomography

This is a virtual diagnosis, which is carried out by a tomograph to determine changes in the condition of the colon, liver, gallbladder, pancreas, appendix, spleen, intestines, and detect polyps and tumors in them.

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Ultrasonography

Ultrasound of the gastrointestinal tract is used to detect diseases associated with pathological changes in the contour of organs and the accumulation of fluids.

Ultrasound methods for studying diseases of the gastrointestinal system are not as effective as others, and therefore are usually used in conjunction with additional methods.

Magnetic resonance imaging

Computed tomography is used to examine the gastrointestinal tract.

Magnetic resonance imaging (MRI) in many cases helps doctors make a diagnosis. The examination is carried out without radiation hazardous to health, without the use of chemical additives for contrast images. Gives clear images of the gastrointestinal tract.

Methods for identifying bacteria Helicobacter pylori

These methods are effective for identifying gastric and duodenal ulcers. According to the latest data from scientists, this problem occurs in most cases due to damage to the gastrointestinal tract by bacteria. To determine the source of diseases, diagnosis involves histological studies, determination of antigens in stool and blood, and breath tests with urea.

Other methods

Methods for examining the gastrointestinal tract

There are other methods for detecting diseases of the digestive system, such as gastric probing. A piece of the organ's contents is sucked out using a probe and sent for analysis to the laboratory.

Possible consequences

To examine the gastrointestinal tract, such methods are simply necessary, but the patient should know that in some cases they can lead to some complications. True, this happens extremely rarely, not always due to the negligence of doctors; the result largely depends on the patient himself and his mood.

Research risks:

at instrumental methods possible bleeding, damage to the walls of the gastrointestinal tract, psychological trauma, development of aspiration pneumonia and serum hepatitis;
X-ray examinations are dangerous because they expose the patient to radiation and cannot be performed frequently.
safer methods may not show an accurate picture of the pathology and lead to erroneous data.

About the diagnosis of the digestive tract:

Diagnosis of diseases in Israel

Israel is considered one of the leading countries where medicine has reached the highest level. Diagnosis of the gastrointestinal tract is carried out using modern technologies and qualified doctors.

Before going for diagnostics, you need to consult a doctor; the study sometimes requires a one-day diet and adherence to a special diet.

After examining the gastrointestinal tract, the doctor determines treatment methods. In Israel, all conditions have been created for patients so that they can quickly recover, feel calm and be sure that they will definitely get help.

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How to check your intestines? This question often worries many people. Problems with intestinal dysfunction are very relevant today, since the intestines are a complex system, which reacts sharply to any changes in diet. The intestine is a large functional system, which is prone to the accumulation of waste, toxins and feces, which clog the lumen and interfere with the normal functioning of all departments. Disturbances in the gastrointestinal tract cause the development of various pathologies.

When the first symptoms of intestinal dysfunction appear, every person has a question: “How to check the gastrointestinal tract?”, “Which methods are the safest?”, “Is it possible to check the intestines non-invasively?” All these questions arise, and without finding a solution, a person simply ignores his problem, which from discomfort turns into a serious pathology of a chronic nature. As a rule, to prescribe adequate and effective treatment, a specialist needs to examine the condition of the small and large intestines. For this purpose they are used different methods. The issue of intestinal diagnostics is especially acute for parents. For children, highly effective methods of examining the gastrointestinal tract are used, which allow assessing its condition quickly and painlessly.

If your stomach or intestines hurt, and the pain is constant, then checking with modern examination methods is simply necessary. As a rule, the doctor himself explains what diagnostic methods exist before the examination. He also prescribes a specific verification method. Before signing up for an intestinal examination, make sure there are no contraindications and consult a specialist.

When is a bowel examination necessary?

Any examinations are prescribed by a doctor if there are appropriate indications. As a rule, the intestines immediately after the appearance of disturbances let you know about this, and characteristic symptoms. Symptoms of gastrointestinal dysfunction can be chronic and periodic. The first complaints about disturbances in the functioning of the gastrointestinal tract should be accompanied by a trip to the doctor, because in the future even minor symptoms can develop into serious illness. If you begin to notice alarming symptoms, then it’s time to get tested. Symptoms of gastrointestinal dysfunction include:

abdominal pain;
bloating and flatulence;
defecation disorders and indigestion;
spasms of the intestinal walls;
hemorrhoids and exacerbation of its course;
irritable bowel syndrome;
impurities of blood, mucus and pus in the stool;
burning and pain during bowel movements.

Sigmoidoscopy allows you to diagnose the rectum and identify cracks and bleeding

The presence of the above symptoms indicates serious disorders of the intestines and requires mandatory treatment. Symptoms may disappear or be constant, but even if they occur rarely, it is necessary to identify the cause of their occurrence. Examination of the colon, in particular the rectum, is a delicate issue. As a rule, many people are afraid of going to the doctor, and they postpone the examination until the symptoms worsen. Before checking your intestines, you need to familiarize yourself with all available diagnostic methods. You can undergo an examination of the gastrointestinal tract only if prescribed by a doctor and under his supervision, since in order to obtain sufficient information about the state of the gastrointestinal tract, it is necessary to properly prepare.

About Enterosgel for children

Bowel Check Methods

Modern medicine offers many methods for examining the intestines. To trust the intestines, you do not need to undergo painful manipulations. Modern diagnostic methods are simple and painless, so they can also be used to test children. The choice of gastrointestinal examination method depends on the patient’s symptoms and complaints, on the basis of which the doctor determines the most appropriate examination for the intestines.

Before checking the intestines in the laboratory, the doctor conducts a preliminary examination by palpation. After palpation, more informative examination methods are prescribed, which allow a better assessment of the condition of the lower and upper intestines.

The most common methods modern diagnostics gastrointestinal tract:

sigmoidoscopy (rectoscopy);
anoscopy;
sphincterometry;
colonoscopy;
radiography;
endoscopy;
CT scan;
capsule examination.

Ultrasound can detect diseases of the entire gastrointestinal tract

Diagnostic methods are prescribed on an individual basis depending on the departments required for examination. These examination methods not only allow you to assess the condition of the intestines, but also identify existing diseases.

Sigmoidoscopy (rectoscopy).
Sigmoidoscopy (rectoscopy) is a method for diagnosing the large intestine, which allows you to assess the condition of the rectum to the sigmoid colon. The procedure is carried out using a special device - a retroscope. The device has a built-in camera and a light source, which allows you to study the condition of the mucous membrane. This device allows you to diagnose diseases of the rectum and identify cracks and bleeding. During the examination, there is a feeling of distension of the rectum, similar to the desire to empty the bowel movement. This is a very informative examination of the small intestine.
The procedure itself is painless and is often used to examine children. The patient takes a knee-elbow position, and a retroscope is inserted into the anus. In this position, the doctor can assess the condition of the mucous membrane, blood vessels and identify diseases of the lumen of the rectum and anal canal.
Anoscopy.
Anoscopy is the simplest method for diagnosing the anus and its canal. Unlike other examination methods, anoscopy allows you to assess the condition of the anus and rectum by no more than 12 cm. The procedure is prescribed for preventive examination children, as well as for the treatment of hemorrhoids in adults. The procedure is very unpleasant, but an anesthetic is used to examine children. This procedure is also indicated for removing foreign objects from the rectum.
Sphycterometry.
Sphycterometry is a procedure to assess the muscle tone of the anus. This method used to examine children and evaluate sphincter contractility and ability to retain feces. Using spicterometry, a cellular study is performed and biopsy samples are taken. Using this diagnostic method, it is possible to detect diseases of the rectum, as well as abnormalities in cell development, polyps and the initial development of cancer.
Ultrasound.
Ultrasound examination is an informative method that can be used to assess the condition of all parts of the intestine. This is a simple way to check the small intestine, stomach and assess the condition of the large intestine. The diagnostic method is non-invasive, so it is often used to study the state of the gastrointestinal tract in children. Ultrasound allows you to identify diseases of the entire gastrointestinal tract, therefore it is one of the safest examination methods.
Colonoscopy.
Colonoscopy is modern way diagnostics, which is carried out using a colonoscope - a device equipped with a video and photo camera. The end of the colonoscope is inserted into the rectum. It can be used to examine the entire colon and take samples for biopsy. The procedure requires special preparation, since it covers a large volume of the intestinal cavity. Colonoscopy is considered the most reliable way to examine the rectum.
Radiography.
X-ray diagnostics is a research method that uses contrast. The contrast agent fills the lumen and increases the information content of the study. Using X-rays, you can identify any diseases of the abdominal cavity, in particular tumors, abnormalities of structure and function, as well as inflammatory processes. X-rays or irrigoscopy are used to examine both adults and children.
Endoscopy.
Endoscopy is one of the most unpleasant research methods. This procedure involves inserting a special device into the esophagus - an endoscope, which is equipped with a camera. Endoscopy is used to evaluate the condition of the esophagus and stomach. Endoscopy plays a big role in recognizing oncological diseases at an early stage.
Computed tomography (CT).
CT – modern method diagnostics, which is used for layer-by-layer research. This method is effective for diagnosing diseases of the small and large intestines. During the examination, a three-dimensional image of the part of the gastrointestinal tract being examined is created, which makes it possible to obtain reliable results about the condition of the intestine. This is a non-invasive and safe method that can be used to examine children even of primary school age. Using CT, you can assess the condition of all organs of the abdominal cavity.
Capsule examination.
Capsule examination is newest method gastrointestinal tract diagnostics. With its help, you can assess the condition of all parts of the intestine. The essence of the method is to swallow a small capsule with a built-in video camera. The capsule slowly moves through the gastrointestinal tract, transmitting information about the condition of the mucous membrane, the presence of pathological processes and tumors.

Before starting self-medication and checking the intestines, it is better to consult a doctor and undergo a comprehensive examination of the state of the gastrointestinal tract. Minor symptoms may hide dangerous pathologies, and their timely identification will speed up recovery.

Contrast studies of the gastrointestinal tract

The gastrointestinal tract (GIT) is often the object of contrast-enhanced X-ray examination. X-ray examination stomach, esophagus and small intestine is performed on an empty stomach, the patient is prohibited from drinking and smoking on the day of the study. In the case of severe flatulence (gas in the intestines), which interferes with the study in patients with colitis and constipation, more thorough preparation is necessary (see page 19).

The main contrast agent for examining the gastrointestinal tract is aqueous suspension of barium sulfate. Barium sulfate is used in two main forms. The first form is a powder mixed with water before use. The second form is a ready-to-use suspension for special x-ray studies. In clinical practice, two levels of barium concentration are used: one for conventional contrast, the second for double contrast.

For routine examination of the gastrointestinal tract, an aqueous suspension of barium sulfate is used. It has the consistency of semi-thick sour cream and can be stored in a glass container in a cool place for 3-4 days.

To conduct a double contrast study, it is necessary that the contrast agent has a high degree of dispersion and concentration of barium sulfate particles with a low suspension viscosity, as well as good adhesion to the gastrointestinal mucosa. To do this, various stabilizing additives are added to the barium suspension: gelatin, carboxymethylcellulose, flax seed mucilage, starch, marshmallow root extract, polyvinyl alcohol, etc. Ready-to-use, finely dispersed barium suspension of high concentration is produced in the form of finished preparations with various stabilizers, astringents, flavorings additives: barotrast, baroloid, barospers, micropack, mixobar, microtrust, novobarium, oratrast, skiabarium, sulfobar, telebrix, hexabrix, hitrast and others.

NB! Barium preparations are contraindicated in cases of suspected perforation of the gastrointestinal tract, since their entry into the abdominal cavity leads to severe peritonitis. In this case, water-soluble contrast agents are used.

A classic X-ray examination necessarily includes three stages:

Study of the relief of the mucous membrane;

Study of the shape and contours of organs;

Assessment of tone and peristalsis, elasticity of the walls.

Now contrasting only with barium suspension is gradually giving way to double contrasting with barium suspension and air. Double contrast is in most cases much more effective and is considered as standard method X-ray examination of the gastrointestinal tract. Inflating the examined part of the gastrointestinal tract with air helps to identify wall rigidity and uniform distribution of a small amount of barium suspension, which coats the mucous membrane with a thin layer. Contrasting only with barium is justified in elderly and debilitated patients, in the postoperative period and for special purposes - for example, when studying the motility of the gastrointestinal tract.

NB! With double contrast, as a rule, drugs are used to relax the muscles of the gastrointestinal tract (atropine, aeron; glucagon and buscopan, which paralyze motility). They are contraindicated for patients suffering from glaucoma and prostate adenoma with urination problems.

X-ray symptoms of various pathologies of the digestive tract can be grouped into ten main syndromes.

1. Narrowing of the lumen (deformation) of the esophagus, stomach or intestines occurs in a large group of pathological processes. This syndrome can be caused by both pathological processes emanating from the wall of the esophagus, stomach or intestines, and diseases of adjacent organs, as well as some developmental anomalies (malformations). Narrowing of the lumen often occurs after surgical interventions on the esophagus, stomach and intestines. The cause of narrowing of the lumen (spasm) of any part of the digestive canal can also be cortico-visceral and visceral-visceral disorders.

2. Expansion of the lumen(deformation) esophagus, stomach or intestines may be limited to a part of the organ (local) or involve the entire organ (diffuse) and reach varying degrees expressiveness. The expansion of the lumen of the organ is often combined with a significant accumulation of contents, usually gas and liquid.

3. Filling defect can occur in any part of the digestive tract and can be caused by various diseases of the organs or the presence of contents in their lumen.

4. Barium depot(niche) often occurs in pathological processes accompanied by organ destruction (ulcer, tumor, actinomycosis, syphilis, tuberculosis, erosive gastritis, ulcerative colitis), local bulging of the wall (diverticulum) or its deformation (related process, scar changes, consequences of injury or surgical interventions).

5. Changes in the relief of the mucous membrane- a syndrome, the timely detection of which contributes to the early recognition of many diseases of the esophagus, stomach and intestines. A change in the relief of the mucous membrane can be manifested by thickening or thinning of folds, excessive tortuosity or straightening, immobility (rigidity), the appearance of additional growths on the folds, destruction (breakage), convergence (convergence) or divergence (divergence), as well as complete absence(“bare plateau”) folds. The most informative image of the relief of the mucous membrane is obtained on images under double contrast conditions (barium and gas).

6. Impaired wall elasticity and peristalsis usually caused by inflammatory or tumor infiltration of the organ wall, a nearby process or other reasons. It is often combined with a decrease in the lumen of the organ in the affected area or its diffuse expansion (atony, paresis), the presence of pathological relief of the mucous membrane, a filling defect or barium depot (niche).

7. Violation of position- displacement (pushing, pulling, tugging) of the esophagus, stomach or intestines can occur as a result of damage to the organ itself (scarring ulcer, fibroplastic form of cancer, gastritis, colitis) or be a consequence of pathology in adjacent organs (heart defects, tumors and cysts of the mediastinum, abdominal cavity and retroperitoneal space, aneurysm of the thoracic or abdominal aorta). Violation of the position of the esophagus, stomach or intestines can be observed with certain anomalies and malformations, as well as after surgical interventions on the organs of the thoracic and abdominal cavities.

8. Accumulation of gas and fluid in the intestines accompanied by the formation of single or multiple horizontal levels with gas bubbles above them - Kloiber bowls. This syndrome is detected mainly when mechanical intestinal obstruction, developing as a result of narrowing of the intestinal lumen due to tumors, cicatricial changes in the intestinal wall, volvulus, intussusception and other reasons, as well as dynamic obstruction intestines, which occurs reflexively during various pathological processes in the abdominal cavity and retroperitoneal space (appendicitis, pancreatitis, peritonitis).

9. Free gas and/or fluid (blood) in the abdominal cavity or retroperitoneum found in certain diseases (gastric or duodenal ulcers, ulcerative colitis, acute appendicitis) and injuries ( closed injury abdomen, penetrating wound, foreign body), accompanied by a violation of the integrity of the wall of a hollow organ. Free gas in the abdominal cavity can be detected after blowing out the fallopian tubes and surgical interventions (laparotomy).

10. Gas in the wall of a hollow organ can accumulate in the lymphatic crevices of the submucous and serous membranes of the stomach, small or large intestine in the form of small thin-walled cysts (pneumatosis cystoides), which are visible through the serous membrane.

Esophageal examination

The essence of the method: the method is simple, painless, but its information content and diagnostic value are several times inferior fibrogastroscopy - endoscopic examination esophagus and stomach. The most common indication for using the method is the patient’s fear and active reluctance to undergo fibrogastroscopy if there are certain complaints. Then an X-ray contrast study is performed, but if there is the slightest doubt or suspicion of pathology, endoscopy is performed.

Indications for the study: The main indication for the study is swallowing disorders (dysphagia), detection of hilar lymphadenopathy, tumors and mediastinal cysts. Besides:

Anomalies of the aortic arch and its branches,

Chest pain of unknown origin,

Foreign body in the pharynx and esophagus,

Mediastinal compression syndrome,

Bleeding from the upper alimentary canal,

Determination of the degree of heart enlargement, especially with mitral defects,

Suspicion of cardia failure or esophageal achalasia,

Suspected hernia hiatus diaphragm.

Conducting research: The examination is carried out with the patient standing. The patient is asked to drink

barium suspension, and then stand next to the X-ray machine; the doctor adjusts the position of the device depending on the patient’s height. Next, the patient is asked not to move for a few minutes and told when the study is completed.

There are no contraindications to the study. There are no complications.

Preparing for the study: not required.

It must be carried out by a qualified radiologist, the final conclusion based on all data on the patient’s condition is made by the clinician who referred the patient for the study - a gastroenterologist, surgeon, oncologist, cardiologist.

Examination of the stomach and duodenum

The essence of the method: X-ray of the stomach allows you to clarify the position, size, contours, relief of the walls, mobility, functional state of the stomach, identify signs of various pathologies in the stomach and its localization ( foreign bodies, ulcer, cancer, polyps, etc.).

Indications for the study:

Abdominal abscess;

Kidney amyloidosis;

Aspiration pneumonia;

Stomach ache;

Gastrinoma;

Gastritis is chronic;

Gastroesophageal reflux disease;

Hernia of the white line of the abdomen;

Hiatal hernia;

Dumping syndrome;

Benign stomach tumors;

Difficulty swallowing;

Foreign body of the stomach;

Ovarian cystoma;

Nephroptosis;

Liver tumors;

Acute gastritis;

Belching, nausea, vomiting;

Stomach polyps;

Portal hypertension;

Postoperative hernia;

Umbilical hernia;

Stomach cancer;

Ovarian cancer;

“Small signs” syndrome;

Zollinger-Ellison syndrome;

Decreased blood hemoglobin level (anemia);

Stomach ulcer.

Conducting research: the patient drinks a barium suspension, after which fluoroscopy, survey and targeted radiography are performed with different positions patient. The evacuation function of the stomach is assessed by dynamic radiography during the day. X-ray of the stomach with double contrast- a technique for contrast X-ray examination of the condition of the stomach against the background of its filling with barium and gas. To perform a double-contrast x-ray, the patient drinks a barium sulfate slurry through a tube with perforated walls, which allows air to enter the stomach. After massaging the anterior abdominal wall barium is evenly distributed throughout the mucous membrane, and the air straightens the folds of the stomach, allowing a more detailed examination of their relief.

Contraindications, consequences and complications: absolute contraindications There is no X-ray of the stomach. Relative contraindications include pregnancy, ongoing gastric (esophageal) bleeding; as well as such changes in the lumbosacral spine that will not allow the patient to spend the necessary time lying on his back on a hard surface.

Preparing for the study: , i.e., exclude or limit dairy products, sweets, baked goods, carbonated water, cabbage, etc. The diet should contain lean meat, eggs, fish, and a small amount of water-based cereals. For constipation and flatulence, a cleansing enema is given in the morning on the day of the study, and if necessary, the stomach is washed.

Decoding the research results

Duodenal examination

The essence of the method: relaxation duodenography - contrast radiography duodenum in its relaxed state, artificially induced by drugs. The technique is informative for diagnosing various pathological changes intestines, head of the pancreas, final parts of the bile duct.

Indications for the study:

Gastrinoma;

Duodenitis;

Small intestine cancer;

Zollinger-Ellison syndrome;

Bile duct strictures;

Duodenal ulcer.

Conducting research: in order to reduce intestinal tone, an injection of an anticholinergic agent is performed, then a portion of warm barium suspension and air is introduced through an intranasal probe installed into the lumen of the duodenum. Radiographs are performed under single and double contrast conditions in direct and oblique projections.

Preparing for the study: patients whose stomach and intestinal functions are not impaired do not require any special preparation. The only condition that must be met is not to eat 6–8 hours before the procedure. Patients suffering from any pathology of the stomach and intestines, and elderly people are recommended to begin to adhere to Diet to reduce gas, i.e., exclude or limit dairy products, sweets, baked goods, carbonated water, cabbage, etc. The diet may contain lean meat, eggs, fish, and a small amount of water-based cereals. For constipation and flatulence, a cleansing enema is given in the morning on the day of the study, and if necessary, the stomach is washed.

Decoding the research results should be carried out by a qualified radiologist, the final conclusion based on all data on the patient’s condition is made by the clinician who referred the patient for the study - a gastroenterologist, surgeon, oncologist.

Small intestine examination

The essence of the method: X-ray recording of the progress of contrast through the small intestine. By radiography of the passage of barium through the small intestine

Diverticula, strictures, obstructions, tumors, enteritis, ulcerations, disturbances of absorption and motility of the small intestine are detected.

Indications for the study:

Kidney amyloidosis;

Femoral hernia;

Crohn's disease;

Hernia of the white line of the abdomen;

Dumping syndrome;

Benign tumors of the small intestine;

Malabsorption;

Interintestinal abscess;

Inguinal hernia;

Postoperative hernia;

Umbilical hernia;

Small intestine cancer;

Celiac disease;

Enteritis;

Enterocolitis.

Conducting research: X-ray contrast examination of the small intestine is carried out after ingestion of a barium suspension solution. As the contrast moves through the small intestine, targeted radiographs are taken at intervals of 30–60 minutes. Radiography of the passage of barium through the small intestine is completed after contrasting all its sections and entering the barium into the cecum.

Preparing for the study: patients whose stomach and intestinal functions are not impaired do not require any special preparation. The only condition that must be met is not to eat 6-8 hours before the procedure. Patients suffering from any pathology of the stomach and intestines, and older people, already 2-3 days before the procedure, it is recommended to start following a diet that reduces gas formation, i.e. exclude or limit dairy products, sweets, baked goods, sparkling water, cabbage, etc. etc. The diet may include lean meat, eggs, fish, and a small amount of water-based cereals. For constipation and flatulence, a cleansing enema is given in the morning on the day of the study, and if necessary, the stomach is washed.

Colon examination

X-ray examination of the large intestine is performed by two (or one might say three) methods: X-ray of the passage (passage) of barium through the large intestine And irrigoscopy(regular and double contrast).

X-ray of barium passage through the large intestine The essence of the method: a radiocontrast study technique performed to assess the evacuation function of the large intestine and the anatomical relationships of its parts with neighboring organs. Radiography of the passage of barium through the large intestine is indicated for prolonged constipation, chronic colitis, diaphragmatic hernias(to determine whether the colon is interested in them).

Indications for the study:

Appendicitis;

Hirschsprung's disease;

Crohn's disease;

Hernia of the white line of the abdomen;

Diarrhea (diarrhea);

Intestinal obstruction;

Megacolon;

Interintestinal abscess;

Nonspecific ulcerative colitis;

Perianal dermatitis;

Postoperative hernia;

Colon cancer;

Seronegative spondyloarthritis;

Irritable bowel syndrome;

Chronic appendicitis.

Conducting research: the day before the upcoming test, the patient drinks a glass of barium sulfate suspension; An x-ray examination of the large intestine is performed 24 hours after barium ingestion.

Preparing for the study: no special preparation is required.

Irrigoscopy

The essence of the method: Unlike the passage of barium in the natural direction of movement of masses in the intestine, irrigoscopy is performed by filling the large intestine with a contrast agent using an enema - in a retrograde direction. Irrigoscopy is performed to diagnose developmental anomalies, cicatricial narrowings, tumors of the large intestine, chronic colitis, fistulas, etc. After tightly filling the large intestine with a barium suspension, the shape, location, length, distensibility, and elasticity of the intestine are studied using an enema. After bowel movement from the contrast suspension, organic and functional changes in the wall of the colon are examined.

Modern medicine uses irrigoscopy with simple contrast of the colon(using barium sulfate solution) and irrigoscopy with double contrast(using a suspension of barium and air). Tight single contrast allows you to obtain an x-ray image of the contours of the colon; irrigoscopy with double contrast reveals intraluminal tumors, ulcerative defects, inflammatory changes in the mucosa.

Indications for the study:

Abdominal abscess;

Anal itching;

Anococcygeus pain syndrome ( coccydynia);

Appendicitis;

Femoral hernia;

Hirschsprung's disease;

Rectal prolapse;

Haemorrhoids;

Hernia of the white line of the abdomen;

Diarrhea (diarrhea);

Benign tumors of the small intestine;

Benign ovarian tumors;

Gastrointestinal bleeding;

Ovarian cystoma;

Intestinal obstruction;

Megacolon;

Interintestinal abscess;

Lightning acne;

Nephroptosis;

Liver tumors;

Inguinal hernia;

Perianal dermatitis;

Rectal polyps;

Postoperative hernia;

Pseudomucinous ovarian cystoma;

Anal cancer;

Liver cancer;

Cancer of the uterus;

Colon cancer;

Small intestine cancer;

Cervical cancer;

Ovarian cancer;

Birth injury;

Uterine sarcoma;

Vaginal fistulas;

Rectal fistulas;

Seronegative spondyloarthritis;

Irritable bowel syndrome (IBS);

Chronic appendicitis.

Conducting research: The patient is placed on an inclined table and plain radiography abdominal cavity. Then the intestines are filled with a barium solution (an aqueous suspension of barium sulfate heated to 33–35 °C). In this case, the patient is warned about the possibility of a feeling of fullness, pressure, spastic pain or the urge to defecate and is asked to breathe slowly and deeply through the mouth. To better fill the intestine, during irrigoscopy the tilt of the table and the position of the patient are changed, and pressure on the abdomen is made.

As the intestine straightens, targeted radiographs are taken; after complete tight filling of the lumen of the colon - a survey radiography of the abdominal cavity. The patient is then escorted to the toilet to have a bowel movement. naturally. After removal of the barium suspension, a survey X-ray is again performed to assess the relief of the mucosa and the evacuation function of the colon.

Double contrast barium enema can be performed immediately after simple barium enema. In this case, the intestine is dosed with air.

Contraindications, consequences and complications: irrigoscopy is not performed during pregnancy, general severe somatic status, tachycardia, rapidly developing ulcerative colitis, suspected perforation of the intestinal wall. Extra Caution when performing irrigoscopy is required in case of intestinal obstruction, diverticulitis, ulcerative colitis, loose stool with an admixture of blood, cystic pneumatosis intestinalis.

NB! factors that can distort the results of irrigoscopy may be:

Poor bowel preparation

The presence of barium residues in the intestines after previous studies (radiography of the small intestine, stomach, esophagus),

The patient's inability to retain barium in the intestines.

Preparing for the study: Before irrigoscopy, a thorough bowel preparation is carried out, including a slag-free diet, cleansing enemas in the evening and in the morning until the waters are clear. Dinner on the eve of irrigoscopy is not allowed.

NB! In case of bleeding from the gastrointestinal tract or ulcerative colitis, administering enemas and taking laxatives before irrigoscopy are not allowed.

Examination of the liver (gallbladder and bile ducts), pancreas

Cholegraphy and cholecystography

The essence of the method: Holegraph?I- X-ray examination of the biliary tract by intravenous administration hepatotropic radiopaque agents secreted by the liver with bile. Cholecystography- a technique for X-ray contrast examination of the condition of the gallbladder, performed to determine the position, size, shape, contours, structure and functional state of the gallbladder. Cholecystography is informative for identifying deformities, stones, inflammation, cholesterol polyps, gall bladder tumors, etc.

Indications for the study:

Biliary dyskinesia;

Cholelithiasis;

Calculous cholecystitis;

Gallbladder cancer;

Chronic cholecystitis;

Chronic acalculous cholecystitis.

Conducting research: cholegraphy performed on an empty stomach. Beforehand, the patient is recommended to drink 2–3 glasses of warm water or tea, which reduces the reaction to the procedure, and 1–2 ml of a radiopaque substance is administered intravenously ( allergy test), if there is no reaction after 4–5 minutes, pour in the remaining amount very slowly. Typically, a 50% solution of bilignost (20 ml) warmed to body temperature, or similar products, is used. For children, the drugs are administered at a dose of 0.1–0.3 g per 1 kg of body weight. Radiographs are taken 15–20, 30–40 and 50–60 minutes after injection with the patient in a horizontal position. To study the function of the gallbladder, targeted images are taken in vertical position subject. If the images do not show the bile ducts 20 minutes after the administration of the radiocontrast agent, 0.5 ml of a 1% solution of pilocarpine hydrochloride is injected under the skin to cause contraction of the sphincter of the common bile duct.

Before cholecystography produce a survey X-ray right half of the abdominal cavity. After x-raying, several photographs of the gallbladder are taken in different projections with the subject being examined in vertical and horizontal positions. Then the patient is given the so-called “ choleretic breakfast"(2 raw egg yolks or 20 grams of sorbitol in 100–150 ml of water), after which after 30–45 minutes (preferably serially, every 15 minutes), repeat images are taken and determined contractility gallbladder.

Contraindications, consequences and complications: cholegraphy and cholecystography are contraindicated in case of serious dysfunction of the liver, kidneys, cardiovascular system and hypersensitivity to iodine compounds. Side effects when using bilitrast, they are observed infrequently and are of a very moderate nature. They can be expressed in the form of a feeling of heat in the head, a metallic taste in the mouth, dizziness, nausea, and sometimes slight pain in the abdomen.

Preparing for the study: 12–15 hours before cholecystography, the patient takes bilitrust(organic iodine compound) or other contrast agent ( cholevid, yopagnost, telepac, bilimin etc.) in a dose of 1 g per 20 kg of body weight, washed down with water, fruit juice or sweet tea. Contrast agents ( organic compounds iodine) can be taken by the patient not only orally, but also administered intravenously, less often through a tube into the duodenum. The night before and 2 hours before the examination, the patient cleanses the intestines with an enema.

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To identify gastrointestinal pathologies in modern medicine different research methods are used. The latest equipment helps to obtain valuable information about human health; in many cases, diagnosis does not cause discomfort. An anomaly can be detected even in situations where there are no complaints or external signs of illness.

Indications for examination of the gastrointestinal tract

Examination of the gastrointestinal tract is the most important step in making a correct diagnosis, since pathologies are common in people of all ages and can lead to serious consequences. Indications for intestinal examination are:

A stomach check is prescribed in the following cases:

internal bleeding;
gastritis (acute or chronic);
pancreatitis;
malignant formations;
gallstones;
stomach or duodenal ulcers;
pain of unknown etiology;
nausea, dry or bitter mouth;
belching and heartburn;
pronounced narrowing of the upper part of the stomach or its underdevelopment.

Often the entire gastrointestinal tract is examined. This allows you to determine the coherence of the organs or deviations in functioning.

Methods for diagnosing diseases of the gastrointestinal tract

Thanks to modern techniques, defect detection is now possible with minimal error. Standard studies are offered in any clinic, but many consider the procedures difficult to access, which is why they seek help when the pathology is at risk. late stage development. Often one diagnostic method is sufficient; in complex cases they are combined. How to examine internal organs?

Physical approach

External non-invasive procedures are called physical techniques. These include palpation, percussion, visual inspection and auscultation. When examining a person, the doctor notes the following factors:

dullness and roughness of the skin;
pallor of the integument and deterioration of its elasticity;
smoothness of the tongue or the presence of a white/brown coating on it.

If a person does not have problems with the gastrointestinal tract, these symptoms are unusual for him. The examination allows you to make a preliminary diagnosis. If one of the signs is detected, the doctor performs superficial or deep palpation. The specialist presses on the stomach, moving upward from the groin area. In a healthy person, the muscles do not tense too much and there is no pain. Deep palpation is carried out in the area of discomfort.

A rectal examination is necessary to examine the anus and determine its functionality. The procedure is performed by a proctologist, assessing the presence of fissures, hemorrhoids, and polyps.

Analyzes and laboratory tests

Diagnostics in the laboratory is a necessary measure for all diseases. To check the stomach and intestines, a specialist prescribes tests:

general blood test (performed in the morning, on an empty stomach);
examination of stool for the presence of protozoa;
examination of stool for worm eggs;
microflora analysis (for dysbacteriosis);
coprogram (comprehensive check of stool for changes in color, smell, shape, presence of various inclusions).

Instrumental methods

To examine the stomach and intestines, various instruments are often used that can show part of the organ or completely visualize parts of the gastrointestinal tract. How can you check your stomach and intestines? The following methods are relevant for the examination:

Radiation diagnostics

Patients may be offered non-invasive radiation examinations to help make a diagnosis. These include the following methods:

Possible complications after procedures

Most examinations are completely harmless, but some are quite unpleasant and painful, such as endoscopy and colonoscopy. For this reason, rectal tube insertion is performed under local anesthesia or sedation. The risk of complications is small, but it is there.

The consequences of different types of diagnostics are presented in the table.

Type of examination	Complications
Colonoscopy	The probability of problems occurring is 0.35%. Perforation, bleeding, infection, and reaction to the anesthetic are possible.
Swallowing the capsule	In the presence of gastrointestinal hemorrhage, the device will provoke its intensification; electromagnetic radiation can damage the pacemaker.
Endoscopy	A safe procedure, but possible allergies to the anesthetic, injury to the walls with perforation and bleeding, aspiration pneumonia, and infectious diseases.
Laparoscopy	Damage to the vessels of the anterior abdominal wall.
Radioisotope survey	Allergy to “illuminating” drugs.
Irrigoscopy	Perforation of the intestine and release of contrast into the peritoneal cavity (extremely rare).
CT	Dizziness and nausea during the procedure, in people with hypersensitivity– itching at the site of skin puncture when contrast is administered.

To identify gastrointestinal pathologies in modern medicine, various research methods are used. The latest equipment helps to obtain valuable information about human health; in many cases, diagnosis does not cause discomfort. An anomaly can be detected even in situations where there are no complaints or external signs of illness.

Indications for examination of the gastrointestinal tract

A stomach check is prescribed in the following cases:

internal bleeding;
gastritis (acute or chronic);
pancreatitis;
malignant formations;
gallstones;
stomach or duodenal ulcers;
pain of unknown etiology;
nausea, dry or bitter mouth;
belching and heartburn;
pronounced narrowing of the upper part of the stomach or its underdevelopment.

Often the entire gastrointestinal tract is examined. This allows you to determine the coherence of the organs or deviations in functioning.

Methods for diagnosing diseases of the gastrointestinal tract

Thanks to modern techniques, defect detection is now possible with minimal error. Standard tests are offered in any clinic, but many consider the procedures difficult to access, which is why they seek help when the pathology is at a late stage of development. Often one diagnostic method is sufficient; in complex cases they are combined. How to examine internal organs?