Medical audition: taking you to a painless gastrointestinal endoscopy

This is the 4723rd article of Da Yi Xiao Hu

It's the end of the year again. Don't forget to write a small summary of your body while writing the year-end summary. Dr. Zhou, who is about to enter his 40s, finally made up his mind to experience a "gastrointestinal endoscopy". Considering that the ordinary gastroscopy in the past two years was painful and painful, I firmly chose the "painless gastrointestinal endoscopy" this time. I can get two items done with one anesthesia, which is very cost-effective.

Because anesthesia requires family members to accompany, I called my husband. He didn't understand at all - he was so young and didn't feel uncomfortable, why did he "run to suffer"? It seems that as a doctor who often popularizes intestinal health and prevents colorectal cancer, my family's popular science is not enough. In fact, it is really important to do a gastrointestinal endoscopy: you should know that digestive tract tumors such as gastric cancer and colorectal cancer are the most common malignant tumors today. According to the latest cancer statistics in my country, the number of new cases of colorectal cancer and gastric cancer ranks second and third, the number of deaths from gastric cancer ranks third, and colorectal cancer ranks fifth, and the onset is characterized by younger age and high malignancy. Hundreds of thousands of new cases in China each year have caused heavy burdens and huge losses to countless patients and families, and we need to take it seriously! People often don't "feel" early gastrointestinal tumors. When symptoms such as vomiting blood, black stools, abdominal pain, lumps, changes in stool shape, and blood in the stool appear, it is often "too late to regret." Gastrointestinal endoscopy can intuitively and accurately detect gastrointestinal lesions, strangle tumors in the budding stage, and the cure rate of some early cancers can reach more than 90%. We generally recommend that healthy people after the age of 40, regardless of whether they have gastrointestinal symptoms or diseases, can find an opportunity to undergo a gastrointestinal endoscopy screening, because after the age of 40 enters the high incidence period of polyps or tumors, so early detection, early diagnosis, and early treatment become particularly important.

Preparation before the examination

1. Assessment Preparation

Before making an appointment for painless gastroscopy, I first completed physical examinations such as blood tests, electrocardiograms, lung CT scans, and basic examinations to prepare for the doctor's pre-examination evaluation. In addition, when the anesthesiologist asks about basic data such as weight, you must answer truthfully. God knows how many people have "falsely reported military intelligence" and caused the anesthesiologist to underestimate the dosage of anesthetics, resulting in "shocking moments" when the patient wakes up halfway through the operation or examination.

2 Bowel preparation

Two days before the gastroscopy, I started to control my diet. I chose to eat noodles, porridge, fish, meat, eggs and other foods with less residue and low fiber. I did not eat or ate less high-fiber whole grains, vegetables and fruits, and tried to avoid gas-producing foods such as milk, soy milk and sweets.

Preparation for cleaning the intestines starts the night before the gastrointestinal endoscopy. Many people who have undergone colonoscopy complained to Dr. Zhou that the most uncomfortable step is to drink laxatives, which has even become the main reason for them to avoid colonoscopy. Two hours after dinner, around 8 o'clock, soak the laxative polyethylene glycol electrolyte powder in 1L warm water in proportion and drink it. The main function of this medicine is to help clean the intestines. There are 3 packets in total. Drink 1 packet the night before the examination and 2 packets 4 hours before the examination. Each packet is diluted with 1L of water and controlled to be drunk within 1 hour. I was a little inexperienced when I drank the first packet. I drank a lot of liquid in less than half an hour, and I felt a little bloated. If you usually have the habit of drinking a lot of water, you should be able to adapt; but some people will experience bloating, nausea, and vomiting because they drink too fast and too urgently. In fact, the taste of polyethylene glycol electrolyte powder is a bit sweet and salty, and electrolytes are added to it. My packet is still pineapple-flavored, and I personally feel it tastes good. Some people also use Pulse directly as a solution to brew polyethylene glycol. It tastes good and provides a better experience. In addition, polyethylene glycol electrolytes dispersed in the body will replenish the sodium and potassium ion elements needed by the body while draining, so even if only water is left, there will not be the feeling of weakness after eating a bad stomach or diarrhea. Instead, it will give people a refreshing feeling of "eliminating toxins and feeling relaxed".

The reaction after taking the laxative varies from person to person. Some people feel the urge to defecate half an hour later, while some people have a stronger reaction and may have to go to the toilet several times a night. I don’t know whether it is fortunate or unfortunate that I didn’t feel anything at all and slept until 5 am.

At 5 o'clock the next morning, I got up on an empty stomach and drank the polyethylene glycol electrolyte solution again. This time, the amount was 2 packets for 2L. I was a little scared of such a large amount of water. So I made a two-hour water drinking plan, put a small cup next to the large cup of solution, set an alarm every 10 minutes, and when the time came, I poured the solution into the small cup and drank a cup slowly, then went to do housework, watch TV, run and jump, and wait for the next alarm. Try not to force yourself to swallow so much water in a short period of time, it will definitely be uncomfortable. Not long after drinking water this time, the urge to defecate finally came, and I had to go to the toilet from time to time between drinking water until the intestines were full of transparent water. After the laxative, you should also take a small cup of dimethicone, which is a defoaming agent used to reduce bubbles in the intestines so that the operating doctor can observe the health of the intestines more clearly. After that, continue to fast and abstain from water until the examination.

Painless examination

Around 10 am, I came to the endoscopy room and put on professional colonoscopy pants in the dressing room. This is a very cleverly designed short skirt + pants, which can protect privacy and only expose key parts for the doctor's operation. I like the inventor. I lay on the examination bed in the left side decubitus position, and the doctor began to prepare for the gastrointestinal endoscopy. The anesthesiologist also arrived with a smile and injected the anesthetic into the body through the vein. To be honest, this process was a bit painful, but before I had time to say it hurt, I fell asleep in a daze.

During the time when I was dreaming, the doctor very gently and quickly inserted the endoscope for examination, first the stomach and then the intestines. Let me explain here that the so-called "gastrointestinal endoscopy" is not a mirror that goes from beginning to end. The gastroscope is to enter the stomach from the mouth through the esophagus for examination; and the enteroscope we usually call is the colonoscope, which observes the entire large intestine to the ileocecal part. The general gastrointestinal endoscopy does not do the small intestine in the middle, unless there are some special indications that require a small intestinal endoscopy with longer anesthesia time and higher difficulty of operation, which is "another story". For doctors who are skilled in the operation, the process of inserting the endoscope only takes a few minutes, and the key is to withdraw the endoscope, which is an important part of identifying gastrointestinal lesions. If polyps or suspected lesions are found, they can be directly removed or biopsied with the help of an endoscope. The time to withdraw the endoscope is sometimes slower than that of inserting the endoscope, depending on the specific situation.

Recovery after inspection

I was woken up by a colleague in a daze. My head was a little fuzzy, but I didn't feel any discomfort in my gastrointestinal tract. Some patients even thought that the examination "had not started" when they woke up because they slept too well and the examination went too smoothly. After the examination, when I was no longer dizzy, I started to walk slowly, rubbed my stomach clockwise, and squatted in the toilet to pass gas. After 2 hours, I can drink a small amount of warm water, and after 6 hours, I can eat some mild and easily digestible food. To be honest, I was really hungry during these hours, so I simply took advantage of the daze to sleep a little longer, and I didn't feel anything when I fell asleep.

In fact, gastrointestinal endoscopy is not as scary and uncomfortable as you might imagine. In many cases, when you make up your mind to do the examination, 80% of the whole process has been completed. The rest is to follow the steps, which may help you find polyps and tumors in the gastrointestinal tract early, greatly reduce the risk of cancer, and let you have a "long-term bowel health" for the next 5 to 10 years.

TIPS

Whether ordinary gastroenteroscopy is uncomfortable or not is related to the operator's technical proficiency, the patient's own conditions (height, weight, age), sensitivity to pain, tolerance to pharyngeal reflex, history of abdominal surgery, gastrointestinal cleanliness, etc. If you are afraid of pain and pass the anesthesia assessment, you can choose a more comfortable painless gastroenteroscopy. When the doctor is operating, it is not easy to be affected and disturbed by the patient, and the diagnosis and treatment are smoother and more meticulous.

Author: Huadong Sanatorium

Zhou Lu