Examination of the gastrointestinal tract is carried out for diagnosis. Examination of the gastrointestinal tract (gastrointestinal tract)

Diseases of the stomach and intestines - the organs that make up the gastrointestinal tract - occupy the 1st place among all diseases that occur in people of different ages. These pathologies bring patients many unpleasant minutes - from an uncomfortable state to excruciating pain. But the most dangerous thing is that it is the diseases of the gastrointestinal tract that give a huge number of complications - perforated ulcers, severe inflammation and cancerous tumors, leading to disability and even death. That is why ultrasound of the gastrointestinal tract is recommended to be periodically performed by every person, even if he still does not have any pain.

And your digestive tract is healthy: stomach health is a matter of time

Let's look at medical statistics on diseases of the stomach and intestines. Alas, it is scary, even without taking into account hidden patients who have not been examined and residents of the poorest countries where there is no access to medical services.

According to statistics:

Almost 90% of the population of developed countries suffer from gastritis of varying degrees of neglect.
60% of the world's inhabitants are infected with Helicobacter pylori - a bacterium that causes inflammation of the mucous membrane of the stomach and intestines, and is the cause of gastric ulcer gastritis.
In Western countries, up to 81% of citizens, according to statistics, periodically experience heartburn, which is a symptom of gastroesophageal reflux disease - a disease of the esophagus that leads to disruption of the digestive tract.
About 14% of people have stomach ulcers.

At the age of over 60, the quality and duration of life depends on the state of the stomach and intestines, but it is possible to get rid of the existing pathology only in the initial stages of the disease. That is why it is so important to be attentive to your health and not bring the problem to a chronic stage.

How to check the stomach and intestines quickly, cheaply and informatively?

There are several types of examination of the intestines and stomach, but only has a full range of advantages that doctors consider invaluable and very effective in making a diagnosis.

Ultrasound can be done urgently in any condition of the patient. The examination will take a maximum of 15-30 minutes.
Ultrasound diagnostics is painless, without causing psychological discomfort. Unfortunately, other methods of examining the gastrointestinal tract require very unpleasant procedures - swallowing tubes, inserting sharp instruments into the anus, sometimes to a decent depth, taking fluids that cause vomiting, etc.
Ultrasound is completely safe. The method is based on echolocation and does not require the involvement of X-ray and MRI equipment.
This is one of the cheapest surveys. Examination of the gastrointestinal tract, together with the rest of the abdominal organs, will cost around 1 thousand rubles.

With all this, this technique is sometimes even more informative than other methods of examining the stomach and intestines. For example, unlike the endoscopic diagnostic method (using probes that are inserted inside), ultrasound detects intestinal inflammation, thickening and protrusion of the walls, stenosis (expansion of the lumen), abscesses, fistulas, congenital anomalies (Crohn's disease), neoplasms in the early stages of development diseases.

The specifics of the study of the gastrointestinal tract: why the stomach and intestines need to be examined in detail

Despite the close relationship between the stomach and intestines, the doctor examines both organs in detail, since they have not only similar diseases. For example, ulcers can be localized in any part of the gastrointestinal tract or form immediately in all departments. The same applies to oncological tumors, inflammation and other processes.

Depending on the patient's complaints, the specialist examines the intestines and stomach separately. Having received data indicating dangerous processes, the doctor directs the patient for additional diagnostics.

Together with ultrasound, it is recommended to take a breath test for Helicobacter pylori at the same time. This analysis is also not traumatic - the patient will only need to exhale the air several times. The ultrasound plus complex will literally in 15-20 minutes reveal the cause of heartburn, pain and cramps in the abdomen, diarrhea or constipation, bloating and other symptoms, establish the extent of the processes and prescribe treatment without resorting to unpleasant diagnostic methods.

How the intestines are examined: ultrasound plus additional techniques

The intestine has three sections: the large intestine, small intestine and rectum, and the study of each of them has its own characteristics and nuances.

Colon ultrasoundhelps to detect cancer at an early stage. To finally make sure, the patient is prescribed a contrast x-ray and colonoscopy. Also, irrigoscopy will be very effective - an X-ray examination using a contrast fluid. The method allows you to "see" areas that are invisible for colonoscopy and difficult to see for ultrasound, for example, areas of bends or accumulations of mucus.
Ultrasound of the small intestinemakes it difficult to twist and deep, as well as the accumulation of gases that distort the image on the monitor. A special curved sensor and the latest high-precision equipment help to explore the small intestine. Ultrasound evaluates wall thickness, visualization of layers, patency, wall expansion, peristalsis.
Ultrasound of the duodenumcarried out together with the study of the stomach. Allows you to 100% diagnose stomach ulcers, cancer, gastroduodenitis.

Depending on the department under investigation, the doctor uses a sensor with certain characteristics.

Ultrasound apparatus for examining the intestines

The intestine is examined using two types of sensors: transabdominal (through the abdominal wall) and endorectal. To study the colon, a 2D apparatus is sufficient, which produces a flat two-dimensional image. Such an examination already provides reliable information about the patient's health status. The endorectal method is more informative, because the sensor is inserted into the anus and examines the organ from the inside.

The doctor decides which sensor to choose depending on the patient's complaints. In special cases, both methods are used.

The transabdominal sensor in 15% of cases "does not see" the rectum, as well as the area of the anal canal. The endorectal method is not possible with stenosis of the terminal gastrointestinal tract (abnormal narrowing).
An endorectal sensor is usually used to examine the distal parts of the rectum. For a rectal examination, you need to be trained.

Preparation and performance of ultrasound of the intestine

Preparation for the procedure begins 3 days in advance, the patient refuses food that causes constipation or flatulence (legumes, sweets, flour products, smoked and spicy foods).

On the eve of 18.00, the patient completely refuses any food, having previously taken a laxative (Guttalax, Regulax, Duphalac, Bisacodyl). If there are problems with peristalsis, the patient is given an enema, and in special cases, a special cleansing enema is performed using the Bobrov apparatus (a glass vessel for injecting a large amount of liquid inside).

In the morning, the patient goes to the ultrasound examination until 11.00 am. This is due to the fact that the procedure is carried out only on a well-cleansed intestine and an absolutely empty stomach, while large breaks in eating are contraindicated.

In the ultrasound diagnostic room, the patient lies on the couch on his side with his back to the apparatus, having previously removed his clothes below the waist and lowered his underwear. The legs are tucked into the chest. Ultrasound begins in the direction from the lower sections to the higher ones. In parallel with this, the doctor drives the sensor in such a way as to examine the intestine in the transverse, longitudinal and oblique planes. When the echogenic picture is not entirely clear, the doctor asks the patient to change his position (lean on his knees and elbows, stand up).

It is carried out using a transabdominal probe. Previously, a contrast liquid (solution of barium sulfate) is introduced into the empty intestine. Thanks to this, a clear picture is obtained on the monitor screen.

To examine the rectum, 3.5-5 MHz sensors are used. Ultrasound of a given length passes through the soft tissues of the intestine, reflecting back. The built-in receiving sensor picks up the signal and transmits it in processed form to the monitor screen. Various compactions, neoplasms and erosion are expressed as white, black or mixed areas of varying echogenicity. An experienced doctor does not make a diagnosis immediately, but correlates the data obtained with the results of analyzes and other studies.

Interpretation of the results of ultrasound of the intestine

A healthy intestine has two layers. The outer one is a muscle tissue with low echogenicity, the inner mucous membrane is in contact with the gas, therefore it is visualized as a hyperechoic layer.

During the ultrasound examination, the following parameters are evaluated:

Dimensions and shape. The wall thickness is 3-5 mm. The picture is distorted in the case of the formation of gases that deform ultrasound, and insufficient filling of the intestine with liquid.
Intestine locationrelative to other organs.
Wall structure (echogenicity). The outer layer is hypoechoic, the inner wall is hyperechoic. The contours are even, the intestinal lumen should not have expansions or narrowings. Noticeable peristalsis.
The length and shape of the various departments.The thermal section is 5 cm, the middle section is 6-10 cm, and the middle ampulla is 11-15 cm.
Lymph nodes.Should not be rendered.

Deviations from the norm indicate various pathologies:

Enteritis (inflammation of the small intestine): intestinal expansion, increased peristalsis, accumulation of contents of various echogenicity;
Hirschsprung's disease (congenital pathology of an increase in individual intestinal sizes): a significant expansion of the lumen, uneven contours, heterogeneous wall thickness, noticeable places of thinning, lack of peristalsis;
If it is impossible to determine the layers of the intestine, we can talk about acute mesenteric thrombosis - a consequence of myocardial infarction, expressed in thrombosis of the mesenteric artery;
Uneven internal contours (which is the cause of ulcerative lesions of the mucous surface), weak echogenicity, thickening of the wall - all this indicates ulcerative colitis;
Chronic spastic colitis: areas of high echogenicity against the background of a hypoechoic surface, thickening of the walls;
Ischemic colitis: inability to visualize layers, uneven thickening, reduced echogenicity;
Acute appendicitis: the appendix 7 mm in diameter is visible on the monitor screen, the layers of the appendix do not differ from each other, the walls of the appendix are asymmetrically thickened, free fluid is visualized, increased echogenicity indicates an abscess;
Diverticulitis (protrusion of the intestinal walls): at the site of the diverticulum, ultrasound “sees” wall thickening by more than 5 mm above normal, echogenicity indicates an abscess, the contours are uneven;
Mechanical damage to the intestines: in addition to strong tension in the abdominal muscles, the echogenicity of the patient at the site of the hematoma is reduced, the walls at the site of damage are thickened;
Oncology (cancerous or precancerous tumor): the outer contours are uneven, the lumen is narrowed, peristalsis is disturbed at the site of the neoplasm, lymph nodes of reduced echogenicity are visualized.

What are the advantages and disadvantages of ultrasound of the intestinal tract

Ultrasound diagnostics of the intestine is used for primary examination in cases of suspected pathology, as well as in cases where the endoscopic method is contraindicated due to health conditionspatient (perforation (damage) of the intestine, inflammation).

Ultrasound examination of the intestine has several advantages:

The patient does not experience psychological discomfort.
The doctor receives information about the size of the organ, its structure, thickness, number of layers, without penetrating inside the organs.
Ultrasound allows you to examine the inflamed intestine and clearly sees the upper gastrointestinal tract.
Peristalsis is visualized in real time, it determines intestinal obstruction.
On an ultrasound of the intestine, a specialist will see even small seals or changes in the echostructure of tissues.
Ultrasound allows you to do screening (endorectal method), fully confirm or refute oncology.

Despite the large number of advantages, the diagnosis of this organ by ultrasound has some disadvantages, the main of which is the impossibility of making an accurate diagnosis without additional examination.

Also, the disadvantages of the method include the following:

Only functional disorders in the work of the organ are revealed.
Structural changes are determined without defining the parameters of the changes.
It is not possible to assess the state of the internal mucosal surface; if structural changes are detected, a colonoscopy is prescribed - an endoscopic method

Analyzes and studies that complement intestinal ultrasound

As mentioned above, intestinal ultrasound is not a 100% confirmation of a particular diagnosis, although in many ways the method is informative and accurate. Depending on the preliminary diagnosis, in addition to ultrasound, the patient is prescribed:

Capsule examination. The patient swallows a capsule with a sensor inside, which conducts video surveillance and transmits the image to the monitor screen. The method allows you to see areas inaccessible to the endoscope. Significant advantages also include the absence of trauma (the walls of the intestine are not scratched) and radiation (unlike X-rays).

The disadvantages of the capsule technique include the low prevalence of capsule examination, because the method was first tested in the United States in 2001, and today it is still not widespread. Its cost is very high, and this limits the circle of customers. Among other disadvantages is the inability to conduct a capsule study with intestinal obstruction, infections, peritonitis. The method has age restrictions associated with the peculiarity of peristalsis.

Colonoscopy. This is an endoscopic method that allows you to examine the internal mucosa for polyps, colitis, tumors, Crohn's disease, inflammation and other pathologies. The disadvantage of the method is the risk of injury to the intestine, perforation (punctures of the walls). Colonoscopy also does not see tumors between the walls of the intestine.
Irrigoscopy. This is a special method aimed at identifying hidden tumors located between the inner and outer lining of the intestine. In addition, the method, unlike colonoscopy, sees areas on the folds of the intestine and its remote areas.

Irrigoscopy involves the introduction of a liquid solution of barium sulfate through the anus, which allows, upon contact with air, to obtain a clear contrast picture. The advantages of irrigoscopy are the ability to examine structural changes in tissues (scars, diverticula, fistulas). The method is carried out with diarrhea or constipation, mucus in the intestines, pain in the anus.

Ultrasound of the stomach is an important part of the examination of the gastrointestinal tract on ultrasound

For a long time, ultrasound diagnostics was not used in the study of the stomach. This is due to the fact that the stomach is a hollow organ, and the air does not allow the full use of a conventional ultrasound sensor - special sensors are needed to study the back walls. In addition, accumulated gases distort the displayed results. However, medicine does not stand still, and modern techniques already allow you to get enough information to make an accurate diagnosis.

Sensors for studying the stomach appeared relatively recently, in the late 2000s. However, the speed and safety of scanning makes ultrasound of the stomach more and more popular.

During an ultrasound examination, the doctor makes an assessment of the organ according to the main indicators:

The volume of the stomach.It is a hollow muscular organ resembling a pouch. The volume of an empty stomach is 0.5 liters, and in a full form it stretches to 2.5 liters. In height, the stomach reaches 18-20 cm, width - 7-8 cm. When filled, the stomach stretches up to 26 cm in length and up to 12 cm in width.
Structure.Near the heart is the cardiac region, in which the esophagus passes into the stomach. On the left, you can see the bottom of the organ, where the air that comes with food accumulates. The body of the stomach is the largest part, rich in glands that produce hydrochloric acid. The pyloric zone is the transition of the stomach to the intestines. There is a partial absorption of substances received with food.
Structure.The walls of the stomach have a muscular membrane responsible for the contraction and promotion of the food coma. The serous membrane is intermediate between the muscular and mucous layers. It contains lymph nodes and blood vessels. The mucous layer is covered with the finest villi that secrete gastric juice produced by the glands.
Blood supply.The circulatory system covers the entire organ. The organ is supplied with venous blood by three main vessels: the left, hepatic and splenic. The venous network runs parallel to the arterial network. Various bleeding occurs when the gastric mucosa is damaged (ulcers, tumors).

How is an ultrasound of the stomach performed?

Preparation for an ultrasound of the intestine is similar: the patient adheres to a strict diet for 3 days, and does not eat any food the night before from 18.00. If there is a tendency to gas formation, the patient drinks 2 capsules of Espumizan before going to bed. In the morning, half an hour before the procedure, you should drink a liter of water so that the walls of the stomach straighten.

There is also a method of ultrasound with contrast. Water is an excellent conductor of ultrasound, and without it, scanning an organ is somewhat difficult.

The procedure is carried out on an empty stomach. The doctor evaluates the condition and thickness of the walls on an empty stomach, looks for the presence of free fluid. Then he asks the patient to drink 0.5-1 liter of liquid, and evaluates changes on the expanded stomach on an ultrasound machine. The third ultrasound scan is performed 20 minutes later, when the stomach begins to empty. The doctor evaluates the motility of the organ, the rate of fluid outflow. Normally, a glass of water (250 ml) leaves the stomach in 3 minutes.

The patient lies on the couch on his side, the specialist applies a gel to the peritoneal area and drives the sensor over the surface. Periodically, he tells the patient to change position or slightly change posture. The doctor pays attention to the following indicators:

stomach position and size
whether the mucous surface of the stomach has straightened
is there any thickening or thinning of the walls
what is the state of the circulatory system of the stomach
contractility of the stomach
whether there are inflammations and neoplasms

The entire study takes a maximum of 30 minutes, does not cause discomfort and pain. Ultrasound, unlike FGDS, is much easier to tolerate by children and the elderly.

Advantages and disadvantages of ultrasound of the stomach, when examining the gastrointestinal tract

The doctor prescribes an ultrasound examination of the stomach to the patient as a primary auxiliary diagnostic method.

The advantages of ultrasound are as follows:

the output department, the most susceptible to diseases, is examined;
ultrasound "sees" any foreign bodies in the cavity;
Ultrasound accurately assesses the thickness of the walls of the organ;
thanks to the method, venous blood flow is clearly visible;
with the help of diagnostics, benign and malignant tumors of minimal size are detected;
gastric ulcer is well evaluated;
the degree of inflammation of the gastric mucosa varies;
the method allows you to see reflux disease - throwing the contents of the lower sections back into the stomach;
the organ is examined from different points and in different sections, which is impossible with x-rays;
Ultrasound sees what is happening in the thickness of the stomach wall;
thanks to the echostructure, ultrasound can easily distinguish a polyp from an oncological neoplasm;
in addition to diagnosing the stomach, ultrasound diagnostics reveals concomitant pathologies of other organs (usually with gastritis, diseases of the biliary tract and pancreas develop);
Ultrasound is done for newborns and young children who cannot do EGD or x-rays.

The main advantage of ultrasound over FGDS is the ability to detect forms of cancer developing in the thickness of the organ wall (infiltration forms), which cannot be detected using fibrogastroscopy.

Despite all the advantages, ultrasound has some drawbacks that do not allow the method to be widely used as an independent study of the stomach.

The disadvantages include the following:

unlike endoscopic examination, ultrasound does not allow tissue samples to be taken for further study (for example, gastric juice;
scraping of the mucous membrane, tissue biopsy);
on ultrasound it is impossible to assess the degree of changes in the mucous membrane;
limitation of the studied areas (it is possible to examine only the exit zone of the stomach).

What does ultrasound of the stomach reveal when examining the gastrointestinal tract

The ultrasound method is not the most popular in the study of the gastrointestinal tract, but it makes it possible to obtain very important information.

The stomach is an extension of the alimentary canal in the form of a bag. This is a hollow organ, the walls of which have an external muscular and internal mucous layer. The mucous membrane is rich in glands that produce gastric juice and hydrochloric acid, as well as enzymes. With their help, the incoming food is softened, processed with a natural antiseptic. The stomach is separated from the esophagus by the sphincter, and from the duodenum by the pylorus.

The organ is examined on ultrasound in two ways:

Transabdominal (through the walls of the peritoneum). It is carried out by different sensors, but the results always require additional confirmation.
Probe (sees the stomach from the inside). Used extremely rarely.

When conducting a study using a sensor, the specialist pays attention to the following:

thickness, folding, structure of the mucous membrane (are there neoplasms, bulges, irregularities on it);
the thickness of the muscle layer (expansion or thinning indicates pathology);
the integrity of the gastric wall (whether there are perforations, ulcers or neoplasms on it);
amount of free fluid (indicates inflammation);
peristalsis, motility and contractility of the stomach;
transitional sections of the stomach (sphincter and pylorus, features of their
functioning).

It is worth noting that ultrasound of the stomach and duodenum with its informative value is significantly inferior to the more popular method known as FGDS. But in some cases, other research methods for the patient are unacceptable due to the state of health or fear of a traumatic procedure.

Transabdominal examination identifies three layers of the stomach wall: a hyperechoic mucosal layer (1.5 mm), a hypoechoic submucosal layer (3 mm), and a hyperechoic muscular layer (1 mm). With the probe method of research, 5 layers up to 20 mm thick are determined.

Ultrasound diagnosis of the stomach allows you to identify the following pathologies

Symptoms	Possible disease
Swelling of the antrum mucosa	Acute pancreatitis, nephrotic syndrome (kidney damage)
Thickening of the stomach wall, uneven round neoplasm, rich in blood vessels, no boundaries between layers, no peristalsis	Carcinoma (malignant tumor) with distant metastases
Lack of boundaries between layers, narrowing of the pylorus lumen	Pyloric stenosis (narrowing of the pylorus due to scarring left by an ulcer)
Changes in the echostructure of the walls of the stomach, the walls are expanded, the contours are uneven	Neurinoma (a tumor that develops from the tissues of the peripheral nervous system), leiomyoma (a benign tumor of the smooth muscles of the stomach), adenomatous polyp
Expansion of the abdominal region (compared to the norm) after filling the stomach with water, splitting of the echo signal, the presence of hypoechoic inclusions, fluid stagnation in the cardiac region	Gastroesophageal reflux (reflux of intestinal contents back into the esophagus)
Small amount of fluid, rapid exodus of fluid from the stomach, changes in the contour of the stomach	Diaphragmatic hernia
Dense hyperechoic formations with a clear structure, the boundaries between the layers are clearly visible, the echogenicity of the mucous and muscle layers is not changed	Cystic formations
Indeterminate changes recorded by the ultrasound machine	Syndrome of the affected hollow organ. This diagnosis requires mandatory confirmation by other types of research (CT, MRI, FGDS, X-ray).
Anechoic crater-like areas on the inner wall of the stomach	stomach ulcer

Ultrasound scanning of different parts of the stomach

Thanks to ultrasound, the doctor assesses the condition of the following areas of the body:

Bulbar or bulb of the duodenum. This part of the organ is located in the area of the exit of their stomach, and controls the flow of the contents processed by gastric juice into the intestinal lumen. With bowel diseases, ulcers and inflammation sites form on the bulb. The main prerequisites for a duodenal ulcer are increased acidity and the bacterium Helicobacter pylori, which begins to multiply actively under such conditions.

The study is carried out in real time with a linear or convex probe with a frequency of 3.5-5 MHz. To detail the state of the walls, sensors with a frequency of 7.5 MHz are used, but they are ineffective for obese patients with developed subcutaneous fat.

If the patient is diagnosed with a stomach ulcer and 12 duodenal ulcer, then in most cases the walls of the bulb are affected. On ultrasound, this is reflected by anechoic areas, because, unlike healthy walls, the ulcer does not reflect ultrasound.

The diagnosis of gastric and duodenal ulcer, if anechoic zones are established on ultrasound, is conditionally made. Additionally, the condition of the walls of the bulb is assessed (they have a mucous structure with longitudinal folds). The thickness should normally be no more than 5 mm, and in the antrum (the transition of the stomach into the duodenum 12) - up to 8 mm. With thickening, we are not talking about an ulcer, but about an oncological neoplasm. The patient will need an additional study: endoscopic with the collection of material for a biopsy.

Due to the fact that ultrasound is not able to establish an accurate diagnosis, the patient is given a preliminary diagnosis of "anechoic areas", and then he is sent for fibrogastroduodenoscopy. It is this method that makes it possible to take the tissue of the bulb wall to determine the nature of the pathology. FGDS also allows you to assess the state of the vessels of the body.

Pyloric canal or pylorus of the stomach.This is a slight narrowing at the junction of the bulb in the duodenum 12. It consists of smooth muscle walls 1-2 cm long, located both in the annular and in the transverse direction. Normally, there is some curvature of the canal. Ultrasound can detect diseases such as polyps, stenosis (narrowing), ulcers, pyloric spasm.

Sphincter (cardia)is the border between the peritoneum and the esophagus. Normally, the sphincter opens only after eating, and the rest of the time it is in a closed state. Due to its functional significance, the sphincter has a stronger muscle layer than that of the stomach, which allows it to open and close like a valve. When eating, the sphincter closes the exit from the stomach, allowing food to be digested. But as a result of increased acidity and other pathologies, the organ ceases to function normally, and the contents of the stomach enter the esophagus.

Pathology detected: is it necessary to double-check?

Ultrasound of the stomach and intestines is very informative, but only on the basis of the data obtained it is impossible to make a diagnosis. If problems are found, the patient undergoes an additional examination. The most popular methods for examining the gastrointestinal tract include:

FGDS. This is an endoscopic method that allows you to see bleeding, neoplasms in the stomach and intestines.
Sounding. It consists in taking the contents of the stomach for further laboratory research.
Gastropanel. This is an innovative method, according to which the patient is taken blood from a vein, and certain markers reveal a possible ulcer, atrophy, cancer.
CT scan. They take pictures of sections in different projections, reveal the location of tumors, hematomas, hemangiomas, etc.
MRI. This is the most expensive and effective research method. It allows you to visualize not only the organ itself, but also nearby lymph nodes and blood vessels.
Endoscopy. It is used for sampling material for biopsy.
X-ray. It reveals the incorrect location of the stomach and intestines relative to other organs, the pathology of the form, various neoplasms.
Parietography. It shines through the walls of the stomach and intestines due to the injected gas.
Laboratory tests (blood, urine, feces).

After passing additional diagnostics, the doctor decides on treatment methods. It is important to understand that the treatment of the gastrointestinal tract also cannot be in the "mono" mode - it is always a set of measures associated with restoring health and preventing relapses and complications. You can also track the quality of treatment on ultrasound, comparing the previous results of the examination of the gastrointestinal tract with the new ones.

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

To date, the most accurate examination of the gastrointestinal tract is fibrogastroduodenoscopy. During FGDS, the gastroenterologist has the opportunity to assess in detail the condition of the gastric mucosa and duodenum, and make the only correct diagnosis. The complexity of the examination lies in the inability of some patients to swallow a flexible hose equipped with a video camera.

Many people ignore the procedure precisely because of the discomfort. Therefore, it would be useful to find out how to check the stomach without gastroscopy in order to timely diagnose one or another pathology. In addition to the vegetative prejudice to EGD, there are a number of contraindications to its implementation: a history of hemostasis (blood clotting) disorders, bronchial asthma, emetic hyperreflex.

In such cases, other methods of examining the stomach are prescribed. Diagnosis of diseases and abnormalities in the work of the stomach is carried out in three main areas: a physical set of measures, a laboratory study of the patient's tests, an examination using medical diagnostic equipment, and alternative endoscopy.

Easy Diagnosis

Simple diagnostic methods are mandatory for use when a patient complains of an acute abdomen, nausea, and other symptoms of gastric diseases.

Physical examination

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

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

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

Microscopic laboratory diagnostics

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

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

Blood sampling for clinical analysis is carried out from a finger

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

Application of hardware techniques

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

x-ray examination (with the use of contrast);
CT and MRI (computed and magnetic resonance imaging);
EGG (electrogastrography) and EGEG (electrogastroenterography);
Ultrasound (ultrasound examination).

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

Significant disadvantages of the method include low information content in the initial period of the disease, X-ray irradiation unsafe for health, side effects from taking a barium solution.

X-ray with contrast

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

X-ray helps in determining the following changes:

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

CT scan

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

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

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

MR imaging

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

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

Examination of the gastrointestinal tract on magnetic resonance imaging is often performed with contrast

EGG and EGEG

Using these methods, the stomach and intestines are evaluated during the period of peristaltic contractions. A special device reads the impulses of electrical signals that come from the organs during their contraction during the digestion of food. As an independent study, it is practically not used. They are used only as an auxiliary diagnostics. The disadvantages are the long time period of the procedure (about three hours) and the inability of the appliance to establish other diseases of the gastrointestinal tract.

ultrasound

Diagnosis of the stomach by ultrasound, most often, is carried out as part of a comprehensive examination of the abdominal organs. However, unlike the indicators of other organs (liver, pancreas, gallbladder, kidneys), it is not possible to examine the stomach completely. There is no complete picture of the organ.

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

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

Ultrasound examination of the abdominal organs is preferably carried out annually

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

Addition to hardware diagnostics

An additional method is Acidotest (taking a combined medical preparation to establish approximate indicators of the pH of the gastric environment). The first dose of medication is taken after emptying the bladder. After 60 minutes, the patient gives a urine test and takes a second dose. After an hour and a half, urine is taken again.

Before testing, it is forbidden to eat food for eight hours. Urine analysis reveals the presence of a dye in it. This allows you to roughly determine the acidity of the stomach without gastroscopy. Acidotest does not give 100% effectiveness, but only indirectly indicates a reduced (increased) level of acidity.

Alternative Endoscopy

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

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

The diagnostic method is carried out by introducing a capsule with a tiny video camera into the patient's body. There is no need for an instrumental introduction. The weight of the microdevice does not exceed six grams, the shell is made of polymer. This makes it easy to swallow the capsule with a sufficient amount of water. The video camera data is transmitted to the device installed on the patient's waist, the indications from which are taken by the doctor after 8-10 hours. At the same time, the rhythm of a person's habitual life does not change.

Capsule for endoscopic examination of the stomach

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

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

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

Physical examination methods

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

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

More often, these methods of diagnosing diseases of the gastrointestinal tract are of a primary nature and allow only approximately determining the condition of a person. For a more accurate diagnosis, the specialist prescribes a series of clinical and laboratory tests. It is necessary to pass a general and biochemical blood test, as well as a general urine test.

Other technologies for diagnosing diseases of the digestive system: probing

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

Endotracheal and nasogastric sounding

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

Endoscopy and features of its implementation

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

Fast and efficient: sigmoidoscopy

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

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

Rectosigmocolonoscopy and ERCP

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

Endoscopic retrograde cholangiopancreatography

ERCP, in turn, is aimed at examining the bile ducts and includes both endoscopic and radiological methods. With the help of an endoscope, a contrast fluid is injected into the bile ducts, which allows you to subsequently see and evaluate their condition in the picture. Before the ERCP, the patient should not eat to get a good x-ray. Among the rare complications of ERCP, only pancreatitis can be called, however, the professional performance of this procedure excludes the possibility of such a complication.

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

Subjective examination of the patient

Subjective examination patients with diseases of the digestive system includes such traditional sections as:

passport part,

The patient's complaints

History (anamnesis) of present illness,

History (anamnesis) of the patient's life.

Patient's complaints

Complaints of patients with diseases of the gastrointestinal tract (GIT) are very diverse and depend on which part of the digestive tract is involved in the pathological process.

Complaints characteristic of diseases of the esophagus include dysphagia, pain along the esophagus (odynophagia), heartburn, esophageal vomiting, and esophageal bleeding.

Dysphagi I Difficulty or inability to swallow food completely. Distinguish oropharyngeal (oropharyngeal) and esophageal (esophageal) dysphagia.

Oropharyngeal dysphagia occurs at the very first swallowing movements and is often combined with food entering the nasal cavity, larynx. In this case, the patient develops a cough. It happens with certain diseases of the oral cavity, larynx, or more often with damage to the nervous system.

Esophageal dysphagia occurs, as a rule, after several swallowing acts and is accompanied by unpleasant sensations along the esophagus. This type of dysphagia occurs in cancer of the esophagus, scarring after burns of the esophagus with alkalis or acids, and ulcers of the esophagus. In addition, dysphagia can also be observed when the esophagus is compressed by an aortic aneurysm or a mediastinal tumor. Unlike dysphagia caused by organic diseases, functional dysphagia is also isolated due to spasm of the esophagus, esophageal dyskinesia, achalasia of the cardia (impaired relaxation of the cardiac sphincter). These two forms can be distinguished from each other on the basis of a thorough questioning of the patient and instrumental research methods.

At organic dysphagia difficulty swallowing food through the esophagus is usually permanent. With the progression of the disease that caused the phenomena of dysphagia, there is a gradual increase in it up to the complete delay of not only solid, but also liquid food.

For functional dysphagia characteristic is the difficulty in swallowing liquid food, water, while solid food passes freely. Often functional dysphagia is intermittent, appears in any stressful situations. However, it should be remembered that the diagnosis of functional dysphagia is competent only after a thorough instrumental examination and the exclusion of all organic causes of the disease.

Dysphagia may be associated with pain along the esophagus(odynophagy ). This happens with burns of the mucous membrane of the esophagus, inflammation of the esophagus (esophagitis), tumors of the esophagus and mediastinum.

With a sharp narrowing of the esophagus, usually appears esophageal vomiting . It differs from gastric vomit in that the vomit is alkaline and contains unaltered pieces of food. In addition, vomiting is not preceded by nausea and the patient necessarily has dysphagia.

An admixture of blood to the vomit is observed during the decay of the tumor, an ulcer of the esophagus. Profuse bleeding may occur due to rupture of varicose veins of the esophagus. This happens with cirrhosis of the liver.

Heartburn (pyrosis). Heartburn is a burning sensation in the esophagus that the patient feels behind the sternum. The main cause of heartburn should be considered the reflux of stomach contents into the esophagus ( gastroesophageal reflux ). Somewhat more often, heartburn occurs with increased acidity of gastric juice, but it can also be with reduced acidity. It is also caused by insufficiency of the cardiac sphincter. As a result of this, the gastric contents, when the torso is tilted and in the horizontal position of the patient, enters the esophagus. The acid contained in the gastric juice irritates the esophageal mucosa and causes a burning sensation.

For diseases of the stomach the main complaints are pain in the epigastric region, burning sensation in the epigastrium, nausea, vomiting, and loss of appetite.

In the presence of pain it is necessary to clarify its exact localization, irradiation, to find out the nature and conditions under which it occurs (to find a connection with the time of eating, the nature of the food). According to the time of onset of pain, they are conditionally divided into “early pains” - occurring immediately after eating or 10-30 minutes after eating, and late pains - 1-2 hours after eating. In addition, there may be "hungry pains" - pain on an empty stomach. It is also important to establish, after which the pain passes. So, for example, in diseases of the stomach, accompanied by increased acidity of gastric contents, the pain calms down after eating, artificially induced vomiting, taking a solution of soda.

Belching – it is a sudden ingestion of stomach contents into the mouth. Belching is air ( eructatio ) or food ( regurgitation ). Belching with air can be in people with habitual swallowing of air ( aerophagia ). It should be noted that swallowing air while eating and drinking is a normal physiological process. This air is expelled during periodic relaxation of the lower esophageal sphincter. Therefore, belching can be considered a disorder when it begins to cause concern to the patient. Such excessive belching can occur with gastroesophageal reflux disease. In addition, sometimes belching with air can also be with increased fermentation processes in the stomach with the formation of gases.

Rumination Syndrome is a condition characterized by repetitive, spontaneous regurgitation of recently eaten food into the oral cavity, followed by repeated chewing and swallowing or spitting. It is important to note that regurgitation is not caused by nausea, the regurgitation contents contain discernible food with a pleasant taste. The process stops when the regurgitation content becomes acidic.

Nausea (nausea). It often precedes vomiting, but may be without it. This is a reflex act associated with irritation of the vagus nerve. The mechanism of nausea is not fully understood. Nausea is manifested by a peculiar, difficult-to-define unpleasant feeling of pressure in the epigastric region, an unpleasant feeling of an impending need for vomiting. It can be combined with general weakness, dizziness, strong salivation (salivation). It occurs frequently and without any connection with the disease of the stomach. For example, nausea occurs with toxicosis of pregnant women, renal failure, cerebrovascular accident.

Vomit (vomitus) is a common complaint. It can occur in various diseases of the stomach (acute and chronic gastritis, peptic ulcer of the stomach and duodenum, pyloric stenosis, stomach cancer). However, it can also occur with other diseases that are not related to the disease of the stomach itself. Distinguish:

1) Vomiting of nervous (central) origin

(brain tumors, meningitis, traumatic brain injury, increased intracranial pressure, etc.).

2) Vomiting of visceral origin (peripheral, reflex). It is observed in gastric ulcer and duodenal ulcer, acute cholecystitis, cholelithiasis.

3) Hematogenous-toxic vomiting. It is observed with uremia, various intoxications and poisonings.

In many cases, various causes are involved in the mechanism of vomiting. When vomiting in a patient, it is necessary to clarify the nature of the vomit, whether vomiting brings relief or not.

When questioning, attention should be paid to the state appetite at the patient. With a reduced acid-forming function of the stomach, appetite is often reduced, while in diseases of the stomach, accompanied by an increase in the acidity of gastric juice, it is usually increased. Complete lack of appetite (anorexia ) and especially aversion to meat products is characteristic of gastric cancer. Simultaneously with loss of appetite, these patients complain of weight loss.

Currently, the term is very widely used in foreign gastroenterological practice. gastric dyspepsia .

Under gastric dyspepsia syndrome understand the symptom complex, which includes pain in the epigastric region, epigastric burning, a feeling of fullness in the epigastric region after eating, rapid satiety. In the old domestic literature, a slightly different meaning was put into this concept. During a clinical examination of a patient, a doctor can already conditionally distinguish two fundamentally different types of gastric dyspepsia:

- organic - it is based on diseases such as gastric ulcer, chronic gastritis, stomach cancer, etc.;

- functional dyspepsia - symptoms related to the gastroduodenal region, in the absence of any organic, systemic or metabolic diseases that could explain these manifestations (Rome III Consensus, 2005).

Currently, the following types are distinguished functional dyspepsia:

1.Dyspeptic symptoms caused by eating (postprandial dyspeptic symptoms), which include rapid satiety and a feeling of fullness in the epigastrium after eating. These symptoms should occur at least several times a week.

2. epigastric pain syndrome . This is pain or burning, localized in the epigastrium, of at least moderate intensity with a frequency of at least once a week. It is important to note that there is no generalized pain or pain localized in other parts of the abdomen or chest. No improvement after stool or flatulence. Pain usually appears or, conversely, decreases after eating, but can also occur on an empty stomach.

For bowel diseases the main complaints are pain along the intestines, bloating (flatulence ), diarrhea, constipation, and sometimes intestinal bleeding.

Pain in the intestines can be caused by a sharp spasm of the intestinal muscles, for example, in acute inflammatory processes in the small and large intestines. They can also be caused by a sharp distension of the intestine as a result of intestinal obstruction or the presence of a large amount of gas in it.

It is important to find out the localization of pain. Their occurrence in the left iliac region occurs in diseases of the sigmoid colon, in the right - in diseases of the caecum, appendicitis. Pain in the middle of the abdomen is characteristic of diseases of the small intestines. Pain during the act of defecation is observed with a disease of the rectum (hemorrhoids, anal fissures, cancer of the rectum or sigmoid colon) and is accompanied by the release of scarlet blood. If intestinal bleeding occurs from the upper intestine, which is more common with duodenal ulcer, the stool becomes dark, tarry ( mel a ena ).

Constipation characterized by a low frequency of defecation (three or less times a week), its low productivity, the presence of compacted non-plastic stools, the need for additional efforts to empty the intestines.

Diarrhea (diarrhea) is characterized by an increased frequency of stools per day (more than two times), the presence of unformed or loose stools. (See below for more on stool disorders.)

History of present illness

When collecting an anamnesis in patients with diseases of the digestive system, it is necessary to ask them about how the disease began and what symptoms it manifested. Next, find out in detail whether the patient applied for medical help, what examination and treatment was carried out, his well-being after treatment. It is necessary to find out the nature of the course of the disease, the presence of exacerbations in its course, outpatient or inpatient treatment. It is necessary to find out in great detail the time, nature (symptoms) of the last deterioration in the patient's condition.

The history of the patient's life

Of great importance in the development of a number of diseases of the stomach and intestines are irregular meals, the systematic intake of spicy, very hot food, frequent drinking and smoking. It is important to identify occupational hazards (frequent stress, contact with toxic substances at work, for example, ingestion of metal dust). For example, frequent stress, smoking can serve as factors contributing to the formation of peptic ulcer with a hereditary predisposition to this disease. Therefore, the analysis of the heredity of the patient is very important, because. It is well known that many diseases of the gastrointestinal tract have a genetic predisposition. However, the above unfavorable environmental factors play a certain role in the implementation of this genetic defect.

It should also be noted that long-term use of certain drugs can cause not only indigestion, but also contribute to the development of a number of gastrointestinal diseases. We are talking about non-steroidal anti-inflammatory drugs, antibiotics and other drugs.

In the materials of this resource, you will learn everything about diseases of the internal organs of a person, their occurrence, mechanisms of development, common symptoms that may bother you, and from this section - which complexes of analyzes of the gastrointestinal tract, respiratory and endocrine system are prescribed by the doctor.

You will also get acquainted with the main directions and approaches in the treatment of diseases of internal organs.

According to localization, diseases of internal organs are usually divided:

Respiratory diseases (ARVI, bronchitis, pneumonia, obstructive pulmonary disease, bronchial asthma, etc.)
Diseases of the digestive tract (dyspepsia, gastritis, stomach and duodenal ulcers, enteritis, enterocolitis, etc.)
Diseases of the urinary system (pyelonephritis, glomerulonephritis, urolithiasis, cystitis, etc.)
Diseases of the pancreas (hepatitis, cholelithiasis, pancreatitis)
Diseases of the heart and blood vessels (endocarditis, myocarditis, congenital and acquired heart defects, atherosclerosis)
Autoimmune diseases (rheumatism, Crohn's disease, etc.)

The causes of diseases of the internal organs of the gastrointestinal tract are diverse - it is like an infectious lesion (bacterial, viral, protozoan), a violation of the diet and image (provoking factors for the occurrence and analysis of the gastrointestinal tract).

Separately, a congenital pathology of the internal organs is distinguished, which can form, either due to infection, the influence of toxins, pathology during pregnancy, or a violation of the individual development of the fetus caused by genetic disorders in the DNA of the fetus.

You will learn more about the mechanisms that determine the course of the disease:

inflammatory process, with the formation of purulent discharge
Allergic inflammatory process, with specific manifestations
Mechanisms of compensation and tissue regeneration

Get acquainted with the main symptoms that occur when a particular system of internal organs is damaged:

With damage to the organs of the gastrointestinal tract - pain in different parts of the abdomen, nausea, vomiting, unstable stools (diarrhea, which can be replaced by constipation), belching.
In case of damage to the organs of the urinary tract - a violation of urination (pain, changes in the amount of urine, its color and smell)

Diagnosis of diseases of the internal organs is based on a survey of the patient, clarification of all the circumstances of the disease, the moment of their occurrence.

After examining the auscultation (listening to the chest or abdomen with a stethophonendoscope), percussion (tapping to determine the sound above the surface of the human body) and (determining the size and consistency of organs by probing), the doctor makes a preliminary diagnosis.

In addition to general clinical tests - blood, urine and biochemical blood tests, for example, for the organs of the gastrointestinal tract, special diagnostic studies are carried out, such as:

Radiography of the abdominal organs.
Ultrasound of the abdominal cavity and retroperitoneal space.
Fibrogastroesophagoduodenoscopy (FEGDS) to detect mucosal pathology and taking a blood test from the gastrointestinal tract if a source of bleeding is detected.
Analysis of feces for the detection of eggs of worms, enterobiasis, occult blood of pancreatic enzymes
Fecal analysis to detect H. pylori, a pathogen that provokes the occurrence of gastritis and stomach and duodenal ulcers.

For the organs of the urinary system, the following diagnostic procedures are carried out:

Urinalysis according to Nechiporenko and Zimnitsky
Excretory urography of the kidneys
Ultrasound of the kidneys and renal pelvis, bladder
Cystoureteroscopy
Kidney biopsy to determine the type of glomerulonephritis

The features of each pathology are also clearly presented in the rubric articles. In short, the treatment of pathologies of the internal organs, after the analysis of the gastrointestinal tract, the urinary system, depends on the identified pathology, its severity and form of manifestation.

In gastroenterology, there are a large number of diseases that can lead to severe complications and be very dangerous. Today, according to statistics, every second person on the planet suffers from various pathologies of the digestive system.