Is it painful to take a biopsy of the stomach. Questions

Through a biopsy of gastric tissues, a layer-by-layer study of their structure at the cellular level is performed in order to prove or refute the presence of pathological formations, their type and characteristics. Endoscopic biopsy of the stomach, which detects cancer, is considered a highly informative and safe diagnostic method.

Description

A biopsy or gastrobiopsy of the stomach is a technique for conducting a study of the cellular structure and composition of altered tissues in an organ. With the help of the technique, an accurate diagnosis is made. During the biopsy, a biopsy is taken, that is, a small fragment of the epithelial mucosa of the organ for further histological and microscopic tests. There are two types of stomach biopsy:

• Search or blind method. During the biopsy procedure, a special biopsy probe is used. During the execution of work, visual control is not carried out.
• Aiming method. The procedure is performed using a gastroscope. The device is equipped with high-quality lighting equipment and an optical system called an endoscope. At the end of a long flexible tube there is a special tool for taking materials for analysis from the affected areas of the mucosa. These can be tongs, a knife, loops or retractors with a special electromagnet.

The second method allows for targeted sampling from specific areas of the gastric walls. The analyzed sample gives a conclusion about the benign or malignant neoplasm detected. With the help of additional tests, the doctor receives a complete picture of the pathology, which allows him to prescribe the appropriate treatment. The procedure is done by means of or the classical method of fibrogastroscopy. The reliability of the results obtained with a biopsy is 97%. With method:

• existence of atrophic destructions is confirmed;
• the malignant nature of tumors in the stomach is differentiated from benign;
• it is determined whether the stomach ulcer has turned into cancer or not.

Why is the procedure needed?

Scheme of the procedure.

Biopsy of the stomach using endoscopy is used when other methods of diagnosing the stomach, such as endoscopy, radiography, are of little information. Often, a biopsy is used as a differential method for determining the disease among similar pathologies in terms of symptoms and examination results. The method allows you to determine the type of cancer. The method is indicated for use in the presence of suspicions:

• on tumors of stomach tissues, precancerous conditions;
• gastritis in acute and chronic manifestation;
• oncological transformation of lesions in gastric ulcer;
• development of dyspepsia;
• infection with Helicobacter pylori.

A biopsy of the stomach is necessary to determine the degree of damage to the mucosa in order to choose the tactics of surgical treatment, to assess the postoperative state of the gastric tissues.

Contraindications

A biopsy is prohibited when there are:

• severe state of shock;
• severe pathologies of the heart - from high blood pressure to a heart attack;
• CNS disorders;
• serious inflammation of the larynx and other ENT organs;
• erosive or;
• acute infections;
• unpreparedness of the upper respiratory tract, in particular, nasal congestion, which provokes breathing through the mouth;
• severe general condition;
• intestinal obstruction;
• destruction of the gastric epithelium;
• physiologically sharp narrowing of the esophagus;
• burns of the gastrointestinal tract with caustic chemicals;
• severe mental disorders.

Biopsy technique

Biopsy of the stomach with an endoscope.

The biopsy does not require general anesthesia. The duration of the procedure is a maximum of 45 minutes. The method is applied on an empty stomach and after complete fasting for the last 14 hours. Immediately before the biopsy, you can not drink any liquid, make a toilet of the oral cavity, chew chewing gum. The patient practically does not feel pain, only slight discomfort.

Visual examination is carried out using a gastroscope. The device is equipped with special forceps for material sampling, optical and lighting equipment, which allows visualizing the process and assessing the condition of the mucosa. The execution technique is as follows:

1. Immediately before the start is carried out.
2. The patient is taking a sedative.
3. The patient is placed on the left side with a straight back.
4. Local anesthesia is done. To do this, the throat and larynx are treated with lidocaine or other means that can reduce pain and discomfort.
5. The endoscope is inserted into the stomach. To facilitate the insertion process, the patient takes a sip.
6. During the procedure, deep breathing is recommended to reduce pain and discomfort.
7. A biopsy is taken.
8. The endoscope is removed.

Sampling is carried out from several sites, in particular, if the zones have surfaces different from healthy tissues. A biopsy sample should be taken especially carefully from the site at the junction of healthy and damaged tissue. The doctor who performs the biopsy is reported to inform the patient about the detected abnormalities in the examined stomach. After the material is taken, it is sent for analysis. The extracted tissue is degreased, treated with paraffin to give elasticity and cut into thin layers for examination on a glass slide under an electron microscope.

According to the results of histological analysis, the histomorphologist gives parameters for the cellular composition of the selected sample. With a biopsy, small injuries are formed on the internal tissues, which do not give complications and heal quickly. Due to the specificity of the biopsy instruments, the muscle tissue is not disturbed, so there is no pain after the procedure.

With a slight inflammation, slight bleeding is possible. The condition is self-recovering without the help of doctors. The patient is sent home immediately after the procedure is completed. The sensitivity of the oral cavity and the swallowing reflex gradually return. How long do you need to fast after the procedure?

You can not eat the next 2 hours and drink alcohol - 24 hours.

Complications

With a biopsy, the risk of complications is minimal. However, it does happen:

• damage to the esophagus, stomach, which in especially severe cases require reconstructive correction by surgery;
• tissue infection;
• the development of bleeding in case of damage to the vessel, which stops on its own;
• the occurrence of aspiration pneumonia when vomiting occurs during the procedure, due to which the vomit partially enters the lungs (corrected by antibiotic treatment).

Some time after the biopsy, chest or throat pain, dizziness, respiratory dysfunction, chills with fever, dark and thick vomiting are possible. If any of these symptoms appear, you should immediately consult a doctor.

Among the methods of early diagnosis of gastric cancer in recent years, cytological is increasingly mentioned. Our observations certainly confirm the statement of N. A. Kraevsky that "... in some cases, this safe method, which allows you to quickly obtain a tissue substrate and process it just as quickly, can provide an invaluable service to the clinic." A fundamentally new step in the cytological diagnosis of stomach diseases in recent years has been the widespread use of endoscopic instruments made of fiber optics and the method of targeted acquisition of material for this study.

Until now, there is no single classification of the cytological picture found in the pathology of various organs, including the stomach. The most widely used classification was Papanicolau and Cooper (1947), who, depending on the degree of cell changes, divided them into five classes. They assigned normal cells to class I without signs of atypia, to class II - cells with unsharp changes without signs of malignancy, to class III - cells with more distinct changes, already resembling malignant, but without convincing data, to class IV - cells characterized by clear signs of malignancy during a small number of pathological elements in the smear, to class V - definitely malignant cells. However, one of the significant drawbacks of this classification is the lack of a clear morphological characteristic of each class, which allows one to quite freely interpret the detected changes in cells.

Having accumulated some experience in the field of cytological studies of the stomach, based on the results of comparing the nature of cell changes with the data of a cytological examination of the gastric mucosa, determining the DNA content in the nuclei of epithelial cells and karyometry data, we decided to fill the gap in this classification.

The experience of the work carried out showed that it is sometimes difficult to distribute the various changes in cells that were found in the study of preparations. Therefore, we believe that it is advisable to introduce a division into classes I-II, II-III, III-IV, implying the presence of cells belonging to both one and the other class. The first figure reflects the predominance of cells of this class in preparations. In the presence of class III-IV cells, one should speak of a suspicion of cancer.

As experience shows, the success of the cytological diagnosis of gastric cancer depends on two main reasons: obtaining a sufficient number and good preservation of mucosal epithelial cells from the site of injury and the correct classification into "malignant" and "benign". In most cases, the diagnosis of gastric cancer can be confidently made on the basis of cytological criteria for malignancy developed by practice. In some cases, either a false-negative response is possible or cancer is suspected. Based on personal experience, we can conclude that the reasons, as a result of which an incorrect (false-negative) diagnosis is made, are diverse and often combined. In particular, these are technical difficulties for the targeted obtaining of material for the purpose of its cytological study (tumors of the pyloric, cardiac, subcardial sections of the stomach). The histological structure of the tumor and the stage of the disease did not turn out to be factors determining the success of the cytological diagnosis of cancer when the material was targeted.

Is it possible to improve the results of diagnostics, to minimize the number of false negative answers. Yes, you can. For this purpose, a dynamic cytological study is shown during treatment or in diagnostically unclear cases and obtaining material from various areas of the mucosal lesion. So, according to our observations, out of 57 patients with gastric cancer who underwent multiple biopsy, in 48 cancer cells were found only in individual preparations, and only in 7 patients were detected in all preparations. Therefore, in most cases, an accurate cytological diagnosis was determined by multiple biopsy of altered areas of the gastric mucosa. Of course, in the targeted obtaining of material from the gastric mucosa, the qualifications of a gastroscopist and the experience of a laboratory assistant preparing cytological preparations from biopsy specimens are important.

Of great practical and theoretical interest are patients in whom, during a cytological examination of material obtained from the stomach, only a suspicion of cancer can be expressed. When analyzing our own observations, we came to the conclusion that in these cases, other causes come to the fore compared to the group of patients with a negative result of a cytological study. The localization of the malignant process and its size, the stage of the disease, the macroscopic structure of the carcinoma are not essential. It turned out that uncertain conclusions are associated with the following reasons: insufficient amount of material for evaluation, its poor quality - many destroyed cells, in a small number of cases cell changes were underestimated, and in almost 1/3 there were significant difficulties in determining the nature of cell changes. Thus, the difficulties in determining the nature of cell changes are not only associated with purely technical reasons, but also depend on the difficulties in classifying cells into benign and malignant. The study of cytological preparations prepared from scrapings from the edge of the tumor in unmixed forms of the most common gastric cancer helped to understand the latter circumstance.

With adenocarcinoma the cytological picture looks motley, polymorphic. Cells are located in layers with poorly distinguishable intercellular boundaries; they lie separately in the form of complexes. Cells and nuclei in most cases are enlarged in size; in cells with well-preserved cytoplasm, an irregular, bizarre shape can be noted, sometimes resembling a cylindrical epithelium. In some cases, due to the pronounced vacuolization of the cytoplasm, the cells acquired the shape of a cricoid. Rarely, binuclear or phagocytic cells are encountered. The nuclei are most often round-oval in shape with uneven contours, often without cytoplasm ("naked"). Chromatin is punctate, reticulate, clumpy. In some nuclei, large and small nucleoli (1-3, rarely more), vacuoles, very rarely mitoses, and karyorrhexis are determined. In some cases, there are cells that, despite the signs of atypia, cannot be attributed with full confidence to cancer.

For solid cancer enlarged cells are located in the form of clusters, complexes, lie separately, can be represented by "naked" nuclei. The intercellular boundaries are usually not defined, the cells lying separately sometimes resemble a cylindrical epithelium. Anisocytosis and anisokaryosis are clearly defined. The nuclei, most often enlarged, are predominantly round-oval in shape, contain finely punctate, reticulate, or clumpy chromatin. Nucleoli of different sizes are determined in the nuclei (1-4).

In cases of mucosal cancer the phenomena of cellular and nuclear atypia are somewhat less pronounced than in the previous two cases. In preparations, large cells with large nuclei, occupying almost the entire cytoplasm, or "cricoid" cells are quite rare. At the same time, layers of little-modified cells can be seen.

For undifferentiated cancer the cytological picture differs in considerable variegation. Cells of various sizes and shapes, mostly enlarged, are located in layers, complexes, lie separately. Cytoplasmic vacuolization, phagocytosis phenomena are noted. Well visible nuclear polymorphism, nucleoli, increased in number and size. In all of the listed histological forms of cancer, there are cells that can only be classified as suspicious.

Significant polymorphism of the cytological picture within one histological form of cancer, when morphologically unchanged cells, cells with mild signs of atypia and completely undifferentiated, are found in the preparation, it is difficult to explain by one reason. The answer should, apparently, be sought in the staging of cell development during carcinogenesis, the lack of stability in the structure of cancer, and the different functional state of cells in different parts of the tumor. The question whether there are ways to overcome these diagnostic difficulties can be answered positively. In particular, at present, with the help of mathematical methods, it is possible in almost 100% of cases to distinguish between benign and malignant processes according to cytological data. A great future, obviously, belongs to the use for diagnostic purposes of quantitative determination of the DNA content in the nuclei of epithelial cells of the gastric mucosa.

All of the above allows us to draw a practical conclusion that obtaining sufficient quantity and good quality of material from the site of injury, as well as the use of special research methods in some cases, makes it possible to increase the number of correct answers to almost 95-98%, while at present it is about 80-85%.

Of particular importance is the cytological study in the diagnosis of early forms of gastric cancer. Cytodiagnosis of the early stages of cancer is based on the well-known fact that during the development of a malignant tumor, first of all, changes in cells appear, and then in the structure of the tissue. In the cytological diagnosis of the initial gastric cancer, we relied on the generally accepted criteria for malignancy of the cell. The results achieved at the same time indicate that in cases of "early" cancer, including cancer in situ, there are already quite morphologically formed cancer cells, and the generally accepted signs of cell malignancy are quite reliable for their recognition. It must be remembered that the mandatory accounting of clinical data and a comprehensive laboratory and instrumental examination of the patient significantly improve the quality of diagnosis. We present the following observation.

Patient A., 63 years old, was admitted to the clinic with complaints of recurrent pain in the epigastric region, occurring for no apparent reason, belching with air. For the first time, a stomach ulcer in the pyloric region was discovered 27 years ago, when a patient went to the doctor about abdominal pain. After the treatment, good health persisted until last year, when pain in the epigastric region reappeared. Didn't go to doctors. Periods of improvement were replaced by deterioration in well-being. An x-ray examination in February of this year revealed an ulcer of the pyloric canal.

Upon admission, the condition is satisfactory. Nutrition is reduced. Palpation of the abdomen is painless, the liver and spleen are not palpable. Blood test unchanged. X-ray of the stomach revealed an ulcer of the pyloric canal measuring 0.3x0.3 cm. During gastroscopy, there are somewhat thickened folds in the body of the stomach, the mucous membrane is edematous, hyperemic. The antral section is wide, in the prepyloric section along the anterior wall there is a longitudinal ulcer 1.2x0.4 cm in size. Its bottom is covered with yellow hemorrhagic plaques. The edges are uneven, bumpy, flattened. The opening of the pyloric canal is deformed. The mucous membrane in this area is sharply edematous. Conclusion: chronic ulcer of the prepyloric stomach in the acute stage.

Cytological examination: predominantly large "naked" hypochromic nuclei of irregular shape with large bizarre nucleoli were found. Reticulate chromatin. Conclusion: cancer.

Histological examination: focal atrophic gastritis and superficial gastritis in the pyloric region. No signs of malignant growth were found in the studied material. However, despite the data of the cytological study, taking into account the negative results of other studies, the doctors did not have sufficient confidence in the correctness of the diagnosis. After a course of conservative treatment, the patient was examined again.

X-ray of the stomach: on an empty stomach contains fluid, the amount of which increases significantly towards the end of the study. There is a pronounced deformation of the prepnloric and pyloric sections of the stomach, which are pulled up and fixed. The pilar canal is narrowed with rigid contours. In the area of ​​narrowing, a flat ulcerative "niche" with a diameter of 0.8 cm is visible. There is a violation of evacuation from the stomach. After 24 hours, about half of the accepted barium suspension is determined in the stomach. Conclusion: a pyloric ulcer with a pronounced deformation and narrowing of it; violation of the evacuation of the contents of the stomach. It is not possible to exclude a tumor lesion or malignancy of the stomach in the pyloric canal.

When gastroscopy in the pyloric section is visible area of ​​edematous, erosive and tuberous mucosa, rigid biopsy. Peristalsis in this section is not traced, the pylorus is sharply edematous, deformed, narrowed. Conclusion: a picture of carcinoma of the prepyloric stomach. Cytological examination: a picture of stomach cancer. Gastrsbiopsy - mucous cancer of the stomach.

The patient was transferred to a surgical clinic, where a resection of the stomach was performed. Histological examination of the resected stomach revealed a mucoid cancer in the edge of the ulcer, extending to the muscular layer of the stomach.

Diagnosis of gastric cancer is closely related to issues of postoperative prognosis. Until recently, there was clarity in this respect only in cases of advanced development of cancer. As for other stages of cancer, there were no controversial points for the prognosis. However, the works of recent years allow us to hope that with the help of modern diagnostic methods it is possible to predict the outcome of treatment even before surgery. Thus, comparing the DNA content in tumor cells depending on the depth of tumor spread in the stomach wall, it can be assumed that the study of the DNA content in cytological preparations reflects to some extent the depth of tumor growth in the stomach wall. This is especially important when determining the stage of tumor development.

Diseases of the upper gastrointestinal tract require a thorough diagnostic study. One of the parameters of an accurate diagnosis is the correct interpretation of the stomach biopsy. To do this, you need not only to know the principles of conducting this diagnostic study, but also its norms in order to adequately interpret the results of the analysis.

How to interpret the results of a stomach biopsy

To be able to take a parietal biopsy from the wall of the stomach, a preliminary fibroesophagogastroduodenal study is performed. This technique belongs to minimally invasive endoscopic research methods with a high degree of informativeness of the results obtained.

The biopsy material taken during FEGDS is sent to the laboratory, where, under a microscope, after special treatment with chemical reagents, a detailed study of the composition of the tissues of the organ wall is carried out.

Basic values

A detailed microscopic examination of the gastric mucosa makes it possible to morphologically confirm a specific gastric disease and, together with clinical data, establish a final diagnosis.

As a rule, the results of a histological examination of a biopsy material contain the following data:

• Data on the structure and shape of the studied tissue - normally, the wall of the stomach is represented by a mucous, submucosal base, together with glandular epithelial tissue and a muscular component.
• The nature of the cell wall component. The quantitative ratio of one or another cellular tissue component can provide the necessary information about the presence or absence of a neoplastic process in the organ wall.
• The degree of differentiation of tissue and individual cells. This parameter is especially important in the presence of neoplasms with localization in the stomach. The degree of tissue differentiation allows you to determine the type of tumor, its benignity or malignancy, as well as the risk of further malignancy, i.e. malignancy.
• The presence or absence of association with Helicobacter pylori plays an important role in shaping further treatment for peptic ulcer, since in 80% of cases it is associated with this bacterium.

Each of the parameters allows the specialist to understand how pronounced the degree of a particular pathology observed in the patient being examined. And histology and the study of the pathogenesis of the disease at the cellular level makes it possible to form an idea not only about a specific pathological condition, but also about the severity of the disease.

Norm indicators

Depending on which part of the stomach the biopsy will be taken from, different indicators will be considered the norm. You can decipher and interpret the result in accordance with the norm. Below is a table of results in adults.

The analysis is deciphered both by a histologist and directly by a gastroenterologist.

What can affect the result

An important role in the result of the study is played by the preparation of the patient directly for fibrogastroscopy, because it is possible to conduct a full-fledged study with a pinch biopsy only on an empty stomach, since the upper sections of the digestive tract must be completely emptied of the contents when its mucosa is ready for a detailed examination.

It follows from the above table that the result is directly dependent on the zone from which the tissue section is taken for histological examination. The endoscopist tries to capture the area with the most pronounced zone of epithelial transformation, since it is in this place that the pathological focus is located.

Another important role in the result of the study is played by the age of the patient being examined, since an adult, as a rule, has a less favorable result of the study, in comparison with young people.

Important! Only an experienced gastroenterologist should decipher the result of a histological examination, since the whole principle of further treatment of the patient will be built on the basis of the results of the histological examination.

What result can be obtained

The histology of the biopsy material and the correct interpretation make it possible to confirm with high accuracy almost any disease of the stomach. The most common of these include:

• Erosive and ulcerative-necrotic changes in the mucosa and directly the wall of the organ under study with a history of long-term gastritis or gastric ulcer.
• Atrophic changes in the stomach wall - a decrease in the amount of glandular tissue, which leads to a decrease in the protective properties of the mucous membrane of the organ.
• Complete or incomplete metaplasia of the gastric epithelium is a precancerous condition. In this case, the normal glandular tissue is replaced by the epithelium that contains the intestines, i.e. accumulation of the epithelium of the intestinal type is observed.
• Benign neoplasms, polyps of the stomach - while the cellular elements of the tumor have a high degree of organization, tissue and cellular differentiation.
• Malignant neoplasms or cancer of the stomach - most often, adenocarcinoma is confirmed by histological examination.

Today, biopsy is the gold standard for confirming the clinical diagnosis of most diseases of the upper gastrointestinal tract.

A biopsy is the taking of a small piece of material from the gastric mucosa for subsequent analysis in a laboratory.

The procedure is usually carried out.

The technique reliably confirms the existence of atrophic changes, allows you to relatively confidently judge the benign or malignant nature of neoplasms in the stomach. When detected, its sensitivity and specificity is at least 90% (1).

Technology of the procedure: how and why is a biopsy done with EGD?

The study of gastrobiopsy became a routine diagnostic technique only in the middle of the twentieth century.

It was then that the first special probes began to be widely used. Initially, the sampling of a tiny piece of tissue was carried out not aiming without visual control.

Modern endoscopes are equipped with sufficiently advanced optical equipment.

They are good because they allow you to combine sampling and visual examination of the stomach.

Now in use are not only devices that mechanically cut the material, but also electromagnetic retractors of a fairly perfect level. The patient does not have to worry that a medical specialist will blindly damage his mucosa.

A targeted biopsy is indicated when it comes to:

• confirmation of Helicobacter pylori infection;
• identifying individual;
• supposed .

The standard process of fibrogastroscopy is not too lengthy due to sampling - in total, the case takes 7-10 minutes.

The number of specimens and the site from which they are obtained is determined taking into account the admitted diagnosis. In the case when infection with Helicobacter bacteria is assumed, material is studied at least from the antrum, and ideally from the antrum and body of the stomach.

Having found a picture characteristic of a polyposis, they examine directly a piece of the polyp.

Suspecting YABZH, take 5-6 fragments from the edges and bottom of the ulcer: it is important to capture the possible focus of rebirth. A laboratory study of these gastrobiopsy specimens makes it possible to exclude (and sometimes, alas, detect) cancer.

If there are already signs indicating oncological changes, 6-8 samples are taken, and sometimes in two steps. As noted in the Clinical Guidelines for the Diagnosis and Treatment of Patients with Gastric Cancer (2),

With submucosal infiltrative tumor growth, a false-negative result is possible, which requires a repeated deep biopsy.

Radiography helps to make final conclusions about the presence or absence of a diffuse-infiltrative malignant process in the stomach, but it is not carried out in the early stages of the development of such cancer due to low information content.

Preparing for the biopsy procedure follows.

Is it harmful to the body?

The question is legitimate. It is unpleasant to imagine that something will be cut off from the gastric mucosa.

Professionals say that the risk is almost zero. The tools are tiny.

The muscle wall is not affected, the tissue is taken strictly from the mucous membrane. Subsequent pain, and even more so full-fledged bleeding, should not occur. Standing up almost immediately after taking a tissue sample is usually not dangerous. The patient will be able to safely go home.

Then, of course, you will again have to consult a doctor - he will explain what the answer means. A “bad” biopsy is a serious cause for concern.

In the case of receiving alarming laboratory data, the patient may well be referred for surgery.

Contraindications for biopsy

1. alleged or phlegmonous gastritis;
2. physiologically determined probability of a sharp narrowing of the esophagus;
3. unpreparedness of the upper respiratory tract (roughly speaking, stuffy nose, which forces you to breathe through your mouth);
4. the presence of an additional ailment that is of an infectious nature;
5. a number of cardiovascular pathologies (from high blood pressure to a heart attack).

In addition, it is impossible to insert a gastroscope tube into neurasthenics, patients with severe mental disorders. They may respond inappropriately to the sore throat that accompanies the introduction of a foreign body.

Literature:

1. L. D. Firsova, A. A. Masharova, D. S. Bordin, O. B. Yanova, "Diseases of the stomach and duodenum", Moscow, "Planida", 2011
2. "Clinical guidelines for the diagnosis and treatment of patients with stomach cancer", a project of the All-Russian Union of Public Associations "Association of Oncologists of Russia", Moscow, 2014

In the diagnosis of gastric pathologies, gastrobiopsy, due to the highest information content, is of great diagnostic value.

The procedure is carried out in various ways, but all of them involve obtaining a bio-sample from the gastric mucosa for the purpose of its further study through histological and analysis.

Indications

The need to study the gastric biopsy arises in the following cases:

• If other diagnostic studies (MRI, ultrasound, etc.) did not clarify the picture of the pathology and did not show accurate results;
• In chronic or acute type of gastritis, to clarify the stage of the pathological process, assess the risk of degeneration into peptic ulcer, determine the degree of damage to gastric tissues;
• With an ulcerative or tumor process, to determine the nature of the tumor (this or);
• To clarify the etiology of gastritis, the detection of Helicobacter pylori on the mucous tissues of the stomach, because it is this bacterium that often causes the development of inflammatory gastric processes;
• In the presence of a peptic ulcer, to determine the extent of the pathology, because an ulcer is a precancerous condition that requires treatment. If peptic ulcer is running, then it manifests itself similarly to cancer. It is precisely the study of a tissue sample that will help to accurately determine the pathology;
• In the presence of damage to the gastric mucosa, the doctor examines the tissues during the biopsy and produces;
• After surgery or removal of a polyp in order to assess the rate of recovery of the gastric walls, as well as to prevent the development of complications in a timely manner.

Contraindications

I interfere with the conduct of a gastric biopsy of a condition like:

1. Cardiovascular pathologies;
2. Shock conditions, when the patient is unable to control himself and be immobile during the procedure;
3. In acute pathologies of infectious origin;
4. Diathesis of hemorrhagic type;
5. Gastric perforations, which are characterized by a violation of the integrity of the walls of the organ;
6. With inflammatory lesions of the upper respiratory tract, larynx and pharynx;
7. Narrowing of the esophageal lumen;
8. With a general serious condition of the patient;
9. With mental disorders;
10. For gastric burns with chemicals.

Varieties

Obtaining a biopsy can be carried out by endoscopic (aiming) method, probing and open way.

• Targeted biopsy is a classic fibrogastroscopy. Forceps with a micro-camera are inserted through the endoscope, so the doctor controls his actions on the monitor screen. Forceps carefully pinch off the bio-sample.
• sounding, blind or exploratory gastrobiopsy is performed using a special biopsy probe blindly without video control.
• Open biopsy carried out during surgery on the stomach.

The most common and frequently used method of research is endoscopic gastrobiopsy.

Training

The study is carried out in a clinic or hospital. The patient undergoes a preliminary examination for the presence of contraindications.

Approximately 10-13 hours before the study, the patient should not drink or eat, since a gastric biopsy can only be performed on an empty stomach. In addition, before the procedure, you can not drink water, brush your teeth and chew gum.

First, the patient undergoes an x-ray of the gastric region. If the patient is very excited, nervous and worried, he is given a sedative.

How is a stomach biopsy taken?

The procedure for obtaining a biopsy is quite simple and fast.

1. The patient is placed on the couch, placing him on his left side.
2. The larynx, throat, and upper esophagus are treated with a local anesthetic.
3. Then the patient is given a special device in his mouth - a mouthpiece, through which the endoscope will be inserted, equipped with special tweezers to separate the tissue sample.
4. The tube of the gastroscope is inserted into the throat and asked to make several swallowing movements to push the device into the stomach. Usually this moment does not cause difficulties, since the tube of the device is very thin.
5. The image of what is happening in front of the hysteroscope is displayed on a special monitor. The gastrobiopsy is performed by an endoscopist. He takes the material from the desired area of ​​​​the stomach and brings the hysteroscope back.

Sometimes biopsy sampling is carried out in several stages, for example, when tissue samples need to be obtained from several gastric regions. Patients usually do not experience pain during the procedure.

Such a procedure lasts no more than a quarter of an hour, does not cause difficulties and very rarely can cause undesirable consequences.

The results of the study are usually ready 3-5 days after the procedure, but sometimes you need to wait longer.

Interpreting the results of a stomach biopsy

Gastrobiopsy is the best procedure to confirm or rule out cancer.

Deciphering the results of a biopsy of the stomach contains information about the structure and shape of the tumor, as well as its cellular structures. In general, the results are either benign or malignant. In each case, the doctor indicates the specific type and origin of the tumor.

If there are still doubts about the nature of the tumor or the results are incomplete due to insufficient biomaterial, then a second gastrobiopsy may be necessary.

Possible Complications

Experts assure that the risk of developing any complications after a gastrobiopsy is almost zero.

Sometimes bleeding may occur, therefore, for their prevention after gastrobiopsy, the patient is given hemostatic or coagulant drugs that improve blood clotting and exclude internal bleeding.

If minor bleeding occurs, then for a couple of days the patient will have to spend in bed, first starving, and then following a sparing diet.

In rare cases, complications are theoretically possible, such as:

• infectious infection;
• Damage to the integrity of the stomach or esophagus;
• If a vessel was damaged in the process of obtaining a biosample, then bleeding is possible, which resolves on its own;
• aspiration pneumonia. The cause of this complication is vomiting that appeared during the procedure, in which the vomit partially got into the lung structures. This complication is treated with antibiotic therapy.

But this is extremely rare, usually after a gastric biopsy, patients feel great and do not notice any deterioration in the state of limbo.

If, after the procedure, the state of health is steadily deteriorating, there is an increase in temperature, and the patient is tormented by hematemesis, then it is necessary to visit a doctor without delay.

Care after the procedure

After the study, a few more hours will require abstinence from food, and in the first days it is necessary to refuse to eat hot, salty and overly spicy foods.

Minor damage to the mucosa during the biopsy is not capable of causing complications, therefore, food restrictions are sufficient for their healing.

The instrumentation used during the procedure is so tiny that it cannot affect the muscle tissue, therefore, there is no pain during and after the study.

Alcohol should not be consumed for at least a day after the gastrobiopsy.