Currently, medicine is developing non-stop, such as the development of diagnostic technology in gastrointestinal tract diseases, which can diagnose diseases that occur in the abdominal region thoroughly, erasing the old concept that “External wounds can be checked but abdominal diseases cannot be seen,” because now we can use endoscopy to check the gastrointestinal tract system in order to look for abnormalities in the esophagus, stomach, and duodenum, and check the sigmoid colon, proximal colon, dismal colon, ileum, bile duct, and pancreas. Gastroscopy can be divided into 3 types, which are:
• Gastroscopy and Esophagogastroduodenoscopy (EGD)
• Endoscopic Retrograde Cholangio Pancreatography (ERCP)
Gastroscopy and Esophagogastroduodenoscopy (EGD)
It is the technology that involves inserting an endoscope into the mouth, passing through the esophagus, and into the stomach and duodenum. In the diagnosis, an endoscope is used, which has a 1-centimeter small duct that can be bent with the lens to magnify the picture at the end of the endoscope. Then it will send the picture to the monitor, which allows the doctor to clearly see the inside of the organ. Endoscopy will be used when there is inflammation, wound, tumor, or constriction. It can also be used in those who have pain in the upper abdomen and the pain does not get better after receiving treatment, together with difficulty swallowing and vomiting blood. Moreover, it can be used in a biopsy, collecting fluid or gastric enzyme for diagnosis, cutting polyps, cauterizing tumor in the upper gastrointestinal tract, and inserting equipment or tool via the endoscope, such as esophagus expansion tool and tool for injection or fastening enlarged blood vessel in the esophagus.
With endoscopy, the patient will not feel pain. This method is quite safe and the diagnosis takes about 10-15 minutes. If polyp or tumor is found, the doctor can perform the treatment immediately. In case of suspecting cancer, a biopsy can be performed and submitted to the histopathology at the same time. For the procedures of gastroscopy and
esophagogastroduodenoscopy, the patient must abstain from water and food for 6-8 hours. If the patient wears removable dentures, they must be taken out. The doctor will give an injection through the muscle to relax the intestines at least 10-15 minutes before performing the endoscopy. Then, the patient will be asked to lie down on the left side. The doctor will insert the endoscope into the mouth and ask the patient to swallow, which will make it easier for the endoscope to be inserted.
This method can be done to check the sigmoid colon, proximal colon, and dismal colon and the duodenum, allowing accurate and precise diagnosis of colon diseases. The colonoscopy involves the insertion of endoscope into the anus. The patient will not feel pain and it is safe. The diagnosis takes about 20-30 minutes, depending on the length of the patient’s colon. Polyps in the colon can also be removed without having to perform surgery and can be sent to the histopathology immediately. A colonoscopy is performed on patients who have excretion disorder, such as regular constipation or diarrhea, constipation with diarrhea, or black stool. While excreting, there will be polyps that come out from the anus with blood. The patient will feel discomfort in the stomach with flatulence and have a stomachache with lump in the stomach. They will lose weight and feel weak. Those with the family members who have cancer in the gastrointestinal tract, those who have anemia with unknown cause, and those who have physical check-up at the age of 50 and above should receive an endoscopy according to the doctor’s suggestion.
For the preparation before and after the diagnosis, the patient should abstain from water and food at least 8 hours and take the laxative before the diagnosis. The doctor will give you the medicine to make you sleep while performing the operation. Therefore, during the colonoscopy, the patient will not feel pain. After the diagnosis, recuperation is needed for observation.
Endoscopic Retrograde Cholangio Pancreatography (ERCP)
The treatment can be done by inserting the endoscope into the mouth and passing through the esophagus, stomach, and duodenum until reaching the valve for bile in the small intestine. The doctor will inject the contrast media and perform x-ray to detect any abnormality of the bile duct and pancreas. This method can be done to clear a blockage in the bile duct or pancreas duct. ERCP will be done when the doctor needs to treat jaundice in the bile duct, blockage of bile duct, blockage of pancreas duct, tumor in the bile duct, or pancreatitis from gallstones in the bile duct.
Preparation before and after the diagnosis
• Abstain from water and food at least 6 hours before the diagnosis.
• Abstain from thrombolytic drugs for at least 7 hours. Some people might need antibiotics before receiving the treatment.
Paolo Hospital Phaholyothin Tel : 0-2271-7000