1 What is an ultrasound examination?

Before talking about when the ultrasound of the gastrointestinal tract or individual organs is shown, it is worth mentioning a few words about the very method of ultrasound( or sonography) for a better understanding of what it is. The collection of information on the state of the objects under investigation is made here due to the fact that a high-frequency sound wave( ultrasound) has the ability to propagate in various media. On the boundary of these media at their different density, the ultrasound is reflected, captured by the sensor and displayed on the monitor as a picture that the experienced diagnostic physician shows the presence or absence of any changes in the organ under investigation. Currently, large clinics have equipment with 3D or 4D-visualization, which gives a clear color image and greatly simplifies the process of examination and diagnosis.

The examined patient at this time is on the couch, usually in a lying or half-sitting position. The only inconvenience that this kind of examination can cause is unpleasant sensations from applying a cold gel, which serves to enhance the contact between the sensor and the patient's body surface.

Because this survey method is completely safe due to the lack of active electromagnetic radiation, it can be carried to pregnant and young children. For children it is also safe due to the fact that it does not cause inconveniences and unpleasant sensations - even an experienced doctor will put a gel so that the child does not feel discomfort.

2 Indications for prescribing

Often, when directed to a test, ultrasound of the esophagus and stomach is prescribed to conduct a diagnosis of both organs if the diagnosis is unclear on the basis of the patient's complaints or when the patient due to age can not voice these complaints. It is clear that in the latter case we are talking about the youngest patients. This is especially true for infants, who not only can not say what and where it hurts, but also indicate. Indications for ultrasound of the gastrointestinal tract directly here can be, for example, plentiful regurgitation after feeding, if the child has already been examined by other specialists and they did not reveal the causes of the problem. In this case, gastroendoscopy in children is not performed, so ultrasound to identify diseases and malformations of internal organs remains the most reliable method.

For adults, the ultrasound is made on the basis of the direction of the attending physician and with a sufficient number of indications. The ultrasound of the gastrointestinal tract reveals a number of diseases from various organs. So, from the side of the esophagus with ultrasound, the following diseases are diagnosed: hernia of the esophagus of the diaphragm, esophagitis - inflammatory processes in the esophageal mucosa, developmental defects of the esophagus, diverticula( hernial-like sacs) of the esophagus.

On the part of the stomach, ultrasound is diagnosed with the following diseases: peptic ulcer, gastritis, cancer, pyroduodenal stenosis( constriction of the pyloric lumen), intestinal obstruction, abnormal structure of the stomach. And, finally, examination of the intestines with the help of ultrasound can diagnose: acute appendicitis, suspicions of its complications;inflammatory diseases: gastritis, colitis, erosion, ulcers;Crohn's disease;mesenteric lymphadenitis;primary or metastatic tumor-like intestinal lesions;hemorrhage, ascites;stool stones;cancerous growths;ulcerative colitis;congenital or acquired disorders in the sigmoid colon;irritable bowel syndrome, chronic constipation, fecal incontinence.

3 How to prepare for the procedure?

When examining all organs with an ultrasound examination, preparation for this procedure is required. On the part of the organs of the gastrointestinal tract, these requirements are simple, but they must be strictly enforced, otherwise the results obtained as a result may differ greatly from the real state of affairs.

So, the preparation for ultrasound includes the following stages.

At least two days before the examination, the patient is transferred to a special diet, which eliminates products that cause flatulence and increased gas production. Such products include beans( peas, beans), black bread, white cabbage, broccoli and kohlrabi, carbonated drinks, fresh vegetables and fruits, alcohol is completely excluded.

On the eve of the procedure it is recommended not to eat in the evening. Various sources on this issue indicate even the exact time - from 19 or 20 pm, but it must be remembered that there is also the time of appointment of the procedure itself, which can occur both at 8 am and at 1 pm. Therefore, it will be more correct to adhere to the rule that at least 12-14 hours must pass from the last meal to the examination itself. In children this period is shorter, the infant can undergo diagnostics even after feeding.

Returning to adult patients, it is necessary to recall that their examination is carried out on an empty stomach, moreover, in addition to eating and drinking, even a morning cigarette for those who smoke is excluded.

An exception is made for patients with severe pain on the background of fasting - they are allowed half a cup of warm, weak tea without sugar and a small dry biscuit.

When ultrasound of the gastrointestinal tract, when the examination of the small or large intestine is carried out, the preparation also includes the cleansing of the intestine.

In any case, before the examination, the doctor should consult the patient in detail about how to prepare properly for the procedure.

During the ultrasound of the stomach, the patient is required to drink a certain amount of fluid. Do this, firstly, in order to stretch the walls of the stomach for better visualization of the image, and secondly, the rate of passage of the fluid indicates the presence or absence of pathological changes in the examined organs.

To obtain a more reliable picture, it is sometimes necessary to introduce a contrast fluid that is given to the patient along with the drink.

The patient's position in the ultrasound of the esophagus and stomach usually lying on his back, if necessary, to perform separate manipulations to better visualize the individual parts of the body, this position can be changed to another - lying on his side.

By time the procedure takes from 10-15 minutes to half an hour.

4 Survey of children

It has already been said that the preparation for ultrasound of the stomach in children differs in time - from the last meal to the actual examination in children, it is much less than that of adults. In addition, the ultrasound procedure itself, fortunately, is completely painless, unlike, for example, the procedure of blood sampling from the finger.

For children it is generally a unique method of examination - after all, the kid does not understand what is being done to him, and it is impossible for a child, especially a small child, to explain that it is necessary to undergo one or another medical manipulation, most of which are usually associated with pain or discomfort. Ultrasound diagnosis and in this regard is advantageous - even the gel, which is used to slide the sensor of the device, contains absolutely harmless substances.

But, nevertheless, a number of rules should still be observed. First, we must adhere to the same recommendations for limiting nutrition as for adults, but taking into account the time that is calculated for children: infants can be brought to the examination and after feeding, but it is better to do this if the time is already coming,those.in 3-3,5 hours after the next meal. Older children can already be persuaded not to eat for a while, but definitely better if the procedure takes place in the morning. Yes, the recommended break in eating is 4-5 hours, but the results will be much more reliable if this break is longer.

Secondly, and this is important, it is necessary to prepare the child for the forthcoming procedure psychologically. It is clear that we are talking about those children who are able to understand what is happening around. Why is it important? Because the psyche of the child and the adult is very different. If you do not explain to the child all the procedure and the manipulations that the doctor will produce, no one can guarantee that at the most inopportune moment, suddenly, tears and requests will not start to go home, negating all the results of the diagnosis.

5 Features of the

method Until recently, it was believed that the ultrasound diagnostic method is not as reliable as gastroendoscopy, but modern equipment suggests that this is not the case.

Moreover, if a comprehensive examination of the organs located in the abdominal region is carried out, it is also recommended that a scan of the stomach is carried out - this is the most convenient, safe and fast method of examination, during which pathological changes are clearly identified and then sufficiently confirmed or disproved by other types of research.

In many cases, ultrasound of the stomach is indicated in case of exacerbation of the disease, directly, apparently, with the digestive organs not related - for example, bronchitis. In this case, gastroscopy will be unequivocally a premature appointment, but ultrasound will help to understand the actual clinical picture.

Moreover, it has recently been established that it is ultrasound that can show changes in the stomach of an oncological nature.

How is this revealed? First, according to the state of the lymph nodes of the retroperitoneum. If they are enlarged, this is a compelling reason for further research - this increase is sometimes an indirect sign of oncology.

Secondly, for cancer, the stomach is characterized by deformation, narrowing of its cavity, and also a change in normal peristalsis, which is also possible to evaluate with ultrasound diagnosis.

Thirdly, with ultrasound diagnosis, the stomach is examined in various projections, in the study of which the physician draws attention to the increased or decreased echogenicity( the degree of tissue density) uncharacteristic for the individual parts of the organ under investigation.

If the ultrasound shows one of the listed signs, in this case the gastroscopy has already been shown with the obligatory sampling of the biomaterial for histological examination. Moreover, often patients themselves perceive signs of cancer as manifestations of very different diseases, which is confirmed by the history of the disease, which often indicates such diseases as pancreatitis, cholecystitis, diabetes mellitus.