Did you know that upper gastrointestinal bleeding can be quite serious?

This condition can present symptoms such as vomiting blood, dark stools, and intense abdominal pain, and needs to be treated as quickly as possible to avoid complications.

In this article from EndoBlog, we will cover the main symptoms of upper gastrointestinal bleeding and the treatments available for this condition.

Follow along to better understand this subject and know when to seek a specialist.

Upper gastrointestinal bleeding (UGB): what is it?

Upper gastrointestinal bleeding (UGB) manifests as bleeding in the regions responsible for digestion, such as the esophagus, stomach, and duodenum.

Considered an emergency, UGB can be identified when there is vomiting of blood or the presence of very dark stools.

It is important to emphasize that, with the appearance of symptoms, it is necessary to seek medical attention immediately, and hospitalization is usually required.

Pay attention to the signs of your body and do not hesitate to seek help if you notice any symptoms or signs.

Main symptoms

When it comes to upper gastrointestinal bleeding, it is important to be aware of the main symptoms that may indicate the presence of this condition:

• Vomiting blood;
• Dark stools with a very foul odor;
• Heartburn;
• Abdominal pains;
• Syncope;
• Weakness;
• Tiredness.

Causes of upper gastrointestinal bleeding

Upper gastrointestinal bleeding is due to a rupture in the mucous membranes of the digestive system, resulting in bleeding in the organs that act in digestion.

This condition can be caused by a variety of factors, including peptic ulcer or by abuse of medications, such as anti-inflammatories. In addition to medical conditions such as ICU admission, abdominal surgeries, and especially hepatic cirrhosis when there are esophageal varices.

Gastrointestinal bleeding: treatment and diagnosis

Diagnosis

To diagnose upper gastrointestinal bleeding, it is important to perform an upper digestive endoscopy (UDE), preferably within the first 24 hours after the onset of symptoms.

This examination is considered the most important for the detection and localization of the bleeding, enabling early treatment.

However, before the examination, it is also important to perform a complete blood count, coagulation tests, renal function, liver function, and electrolytes. All these procedures help to obtain an accurate and timely diagnosis for the appropriate treatment to be started as soon as possible.

Treatment

The therapeutic approach can vary according to the cause of the bleeding, the amount of blood lost, and the clinical conditions of the patient.

Initially, the patient will be stabilized, with supportive care: hydration, cardiorespiratory monitoring, and blood transfusion if necessary. Then, it is essential to identify the source of the bleeding, through examinations such as upper digestive endoscopy and rarely arteriography.

The specific treatment may require the use of medications to reduce stomach acidity, antibiotics to treat possible infections, endoscopic procedures, such as cauterization or elastic ligatures, to stop the bleeding. In severe cases, surgery may be necessary.

Medical follow-up is fundamental to promote the effectiveness of the treatment and prevent recurrences. In addition, it is important to adopt healthy habits, with a balanced diet and abstinence from alcohol and tobacco, to prevent the onset of new episodes of upper gastrointestinal bleeding.

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If you are looking for detailed information about portal hypertension or want to know how this condition affects health, follow this article from EndoBlog.

Portal Hypertension: What is it?

Portal hypertension is a syndrome characterized by increased blood pressure in the portal system region, which is responsible for transporting blood from the gastrointestinal tract to the liver.

This condition is closely linked to liver dysfunctions and changes in the blood vessels that make up the portal system.

We can understand portal hypertension through an analogy with the principles of Ohm’s law, relating pressure, blood flow, and resistance.

In this context, the main factors that determine the pressure in the portal system are blood flow and the resistance found in the vessels that make up this system.

Causes

Portal hypertension is a complex condition that can arise from various causes, with liver cirrhosis being the most common in Western countries.

Liver cirrhosis, in turn, can originate from viral hepatitis B and C, chronic alcohol consumption over a lifetime, and hepatic steatosis (accumulation of fat in the liver). Cirrhosis creates an increase in resistance to blood flow in the liver, contributing to portal hypertension.

Besides cirrhosis, there are other causes for portal hypertension, such as:

• Polycystic liver disease, which involves the abnormal growth of cysts in the liver;
• Schistosomiasis;
• Congenital hepatic fibrosis, a condition of abnormal liver formation from birth;
• Right heart failure;
• Budd-Chiari syndrome, a disease that involves obstruction of the hepatic veins;
• Thrombosis in the liver and spleen veins.

Symptoms

The symptoms of portal hypertension can vary and, in many cases, they may not be immediately apparent. However, individuals with a liver condition that increases the risk of cirrhosis are more susceptible to developing portal hypertension.

When it manifests with visible symptoms, it can cause:

• Ascites (accumulation of fluid in the abdomen);
• Lower limb edema (swelling in the legs and feet);
• Hematemesis (vomiting of blood);
• Melena, which are dark stools due to gastrointestinal bleeding;
• Esophageal varices, which are dilated veins in the esophagus.

It is important to be aware of these symptoms and seek medical attention if you or someone you know shows signs of portal hypertension.

How is the diagnosis made?

The diagnosis of portal hypertension involves several approaches, starting with a detailed medical evaluation. The doctor will examine the patient’s history, paying attention to any pre-existing liver disease, and will also observe physical signs, such as abdominal swelling and dilated veins.

Upper gastrointestinal endoscopy should always be performed to investigate esophageal or stomach varices.

Laboratory tests play an essential role in the diagnosis, and they may include a complete blood count, coagulation profile, creatinine analysis, bilirubins, electrolytes, as well as liver enzymes AST and ALT.

For patients with advanced liver cirrhosis, hepatic elastography is a useful tool to identify the presence of clinically significant portal hypertension, and the results are interpreted together with the blood platelet count.

In addition, imaging tests, such as magnetic resonance imaging, Doppler ultrasonography, and computed tomography, may be requested to examine the presence of various indicators, such as spleen enlargement (splenomegaly), collateral circulation, changes in liver morphology, fluid accumulation in the abdomen (ascites), and modifications in blood flow in the portal system.

Possible treatments

The treatment of portal hypertension is focused on preventing additional damage to the liver and managing complications, such as bleeding from ruptured blood vessels.

The doctor may prescribe medications to prevent the rupture of blood vessels, although it is important to note that they can cause various side effects and not all people tolerate their use.

When bleeding from vessels occurs, elastic ligation of the varices in the esophagus through endoscopy is often the treatment of choice to stop the bleeding and prevent future episodes. This procedure is also used as a preventive measure to avoid vascular ruptures and hemorrhages.

In situations where the bleeding is not related to esophageal varices but rather in the stomach, endoscopic treatment may involve the injection of a biological glue directly into the affected vessels in the stomach.

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Discover everything you need to know about ulcerative colitis (UC), a chronic inflammatory condition that affects the large intestine and rectum.

If you’re looking for detailed information about this disease, its symptoms, and available treatment options, EndoBlog is the right place!

In this article, understand the main aspects of ulcerative colitis. Happy reading!

What is ulcerative colitis

Ulcerative colitis, also known as colitis ulcerosa, is a chronic disease that is part of the group of Inflammatory Bowel Diseases (IBD), mainly affecting the large intestine, resulting in inflammation and ulcers in the intestinal mucosa.

Although it is more common in adolescents and young adults, it manifests in people of different age groups.

Ulcerative colitis is distinct from Crohn’s disease, another form of IBD.

While UC specifically affects the large intestine, sparing the small intestine, Crohn’s disease can affect any region of the gastrointestinal tract, both the small and large intestines, and presents with alternating areas of inflammation and healthy tissue.

Ulcerative colitis: symptoms

Ulcerative colitis presents characteristic symptoms, and one of the main ones is diarrhea, with the presence of blood in the stool.

This diarrheal condition occurs due to inflammation of the intestinal wall, which interferes with the proper absorption of water by the body. The ulcerations in the intestine trigger bleeding, resulting in the release of blood in the stool.

In addition to bloody diarrhea, other common symptoms of ulcerative colitis are abdominal pain, cramps, and an urgent need to evacuate. Abdominal pain is felt at different intensities and locations, often accompanied by cramps.

The bleeding resulting from ulcerative colitis can cause anemia, due to continuous blood loss. Anemia, in turn, contributes to the development of additional symptoms, such as fatigue and tiredness.

Ulcerative colitis: treatments

Although there is no definitive cure for ulcerative colitis, proper treatment helps control symptoms and maintain a good quality of life.

The goal of treatment is to reduce inflammation and keep the disease in remission. With medical follow-up and a personalized therapeutic plan, including dietary re-education and medication, symptoms are minimized, and the achievement of well-being is undeniable.

Even though it is possible to manage the disease, flare-ups occur throughout the patient’s life. The treatment aims to control symptoms, reduce inflammation, and prolong periods of remission.

How the diagnosis is made

To diagnose ulcerative colitis, the doctor will consider the possibility of other diseases with similar symptoms and will perform a series of tests to rule out these other possible causes, such as infections.

The tests frequently used in the diagnosis of ulcerative colitis are:

• Stool test: to rule out infections and check for blood in the stool;
• Blood test: to reveal signs of inflammation in the body and identify antibodies related to ulcerative colitis;
• Sigmoidoscopy: allows visualization of the rectum and the lower portion of the colon.
• Colonoscopy: a more comprehensive examination, which allows the visualization of the entire colon and the end of the small intestine.

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A colonoscopy is one of the main exams for the confirmation of the diagnosis of ulcerative colitis. With it, the doctor will assess the degree of inflammation, the extent of the disease, and rule out other similar conditions.

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Have you heard about rectosigmoidoscopy? If you’re looking for detailed information about this examination, you’ve come to the right place!

In this article from EndoBlog, understand all aspects of rectosigmoidoscopy: its purpose, how it is performed, and how to prepare for the procedure.

Rectosigmoidoscopy is a medical examination that reveals valuable information about your intestine and the health of your colon. By understanding what this exam involves, why it is performed, and the steps in preparation, you will equip yourself with the necessary knowledge to face the procedure with confidence.

Happy reading.

What is rectosigmoidoscopy and what is it for

Rectosigmoidoscopy is a medical procedure that involves the use of a flexible, illuminated tube, known as a sigmoidoscope, to examine the lower portion of the intestine, also called the large intestine.

This tube is inserted through the rectum and gradually advances until it reaches the sigmoid colon region. Thus, the doctor can view the final part of the colon.

What it’s for

This exam is essential for the early detection of colon or rectal cancer, especially useful for screening this condition in individuals who do not show symptoms but have risk factors for developing this type of cancer.

In addition, rectosigmoidoscopy also helps in the diagnosis of symptoms such as diarrhea, bleeding, pain, or inflammation in the rectum.

When is the exam necessary?

The rectosigmoidoscopy exam is recommended by the coloproctologist or gastroenterologist in the following situations:

• Evaluation of specific conditions, such as hemorrhoids, fissures, and anal fistulas;
• Searching for the underlying cause of fulminant colitis, a severe inflammation of the colon;
• Identification of diverticula and polyps;
• Investigation of possible masses or tumors in the rectal region;
• Locating the source of intestinal bleeding;
• Monitoring of inflammatory diseases that affect the rectum;
• Colorectal cancer screening.

The doctor may also recommend rectosigmoidoscopy to observe possible changes associated with alterations in bowel habits.

In each of these circumstances, rectosigmoidoscopy serves as a valuable tool in diagnosis, follow-up, and clinical decision-making, with the aim of preserving digestive health and the well-being of the patient.

How is it done?

By inserting an instrument (rigid or flexible sigmoidoscope) through the anus, it is possible to get a detailed visualization of the intestinal regions: the rectum and the sigmoid colon.

How to prepare for rectosigmoidoscopy

Before rectosigmoidoscopy, fasting is not mandatory or a specific diet is not required. However, it is advisable to have light meals on the day of the procedure, in order to minimize any stomach discomfort.

For proper preparation, it is recommended to perform a cleaning of the final portion of the large intestine, with the introduction of a glycerin suppository or by an enema, approximately four hours before the exam.

It is important to repeat this process again, two hours before the scheduled time for the rectosigmoidoscopy, according to the instructions provided by the doctor.

These preparation steps are essential for clear visualization during the exam and to obtain accurate results.

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If you suffer from hemorrhoids, you know how uncomfortable this condition can be and how it can affect your quality of life.

At EndoBlog, we have prepared this article for those who have questions about how hemorrhoids are diagnosed and the treatment options available. Follow along.

What are hemorrhoids and how do they develop

Hemorrhoids are a common condition that affects many people at some point in their lives. They manifest when the veins around the anus or rectum become dilated, causing pain and bleeding.

There are two types of hemorrhoids: internal and external:

• Internal hemorrhoids are found above the anal sphincter and are more difficult to identify;
• External hemorrhoids are visible at the edge of the anus and resemble varicose veins or blood vessel clumps.

Causes

Some of the main causes are:

• Genetic predisposition. In this case, it is important to note that a person can develop hemorrhoids even if there are no cases in the family;
• Diet low in fiber and insufficient water intake;
• During pregnancy, when the fetus exerts pressure on the veins in the lower abdomen;
• Obesity, which, like pregnancy, causes pressure on the abdominal veins;
• Constipation;
• Sedentary lifestyle, which impairs food digestion and blood flow to the anus.

Grades of hemorrhoids

Internal hemorrhoids are classified into four grades according to the severity of the case:

Grade I hemorrhoids: do not prolapse outside the anus;

Grade II hemorrhoids: prolapse outside the anus during bowel movements but return spontaneously inside;

Grade III hemorrhoids: prolapse from the anus and need to be manually relocated inside;

Grade IV hemorrhoids: permanently prolapsed outside the anus and cannot be relocated inside.

Symptoms

Symptoms that indicate the presence of hemorrhoids:

• Presence of a noticeable lump in the anus;
• Bleeding after bowel movements, resulting from the rupture of anal veins;
• Unrelenting itching, caused by increased tension on nerve endings;
• Burning during or after bowel movements.

How is the diagnosis of hemorrhoids made?

To diagnose hemorrhoids, a physical examination is usually sufficient in the case of external hemorrhoids.

For internal ones, a rectal examination and anoscopy are necessary, performed during the proctological exam.

It is important to emphasize that, in elderly patients with rectal bleeding, even if hemorrhoids are identified, a colonoscopy is recommended to rule out other possible causes.

Hemorrhoids: all possible treatments

The treatment for hemorrhoids begins with diet, but in many cases, it is necessary to take medications and/or apply ointments to the area. Understand.

Eat more fiber and drink more water

One of the main recommendations for treating hemorrhoids is to maintain a diet rich in fiber and drink plenty of water.

Consuming whole foods, leafy vegetables, and fruits with skin at every meal helps to soften stools and facilitate evacuation, relieving discomfort.

In addition, it is important to drink at least 2 liters of water daily, aiming for better fiber absorption and proper intestinal function.

Use hemorrhoid cream

Hemorrhoid creams are a treatment option available to relieve symptoms of pain and discomfort caused by inflammation and/or dilation of the veins around the anus/rectum.

However, it is important to highlight that these creams should only be used under medical supervision.

Add pain medications

There are different types of medications to treat hemorrhoids: analgesics and medications to reduce swelling and bleeding.

Band ligation for hemorrhoids

During the proctological exam, band ligation can be performed for the hemorrhoids to sclerose, and other sessions may be necessary to resolve the problem.

Surgery for hemorrhoids

Surgery for hemorrhoids is a treatment generally reserved for more severe cases, such as when the hemorrhoid undergoes thrombosis or ruptures.

We emphasize that, after surgery, it is important to continue following a diet rich in fiber and avoid straining during bowel movements, to prevent the appearance of new hemorrhoids.

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Endoscopy is a very common, simple, and quick examination, but uncomfortable for most people.

Therefore, sedation is necessary to perform the examination.

Learn in this article from EndoBlog about the types of sedation for endoscopy, the administered medication, why it is necessary, and what happens to the patient after the procedure.

Sedation for endoscopy: what type is used?

The chosen sedation for endoscopy is deep sedation. This means that the substance acts directly on the patient’s consciousness and sleep state.

To be more efficient, the medication is applied intravenously and acts immediately in the body in two ways:

• Amnesia: the patient usually does not remember many details of the examination.
• Deep sleep: the patient falls into a deep sleep, and the examination can be carried out calmly by the doctor.

Medication used

The medication chosen for endoscopy varies depending on the location of the examination but is usually Propofol or a Benzodiazepine (such as Midazolam).

An Opioid (Fentanyl or Meperidine) is also occasionally used. The medication needs to be prescribed by the doctor, according to the patient’s peculiarities (age, presence of comorbidities, risk factors, etc.).

Furthermore, the dosage of sedation for endoscopy is calculated by the doctor to last only as long as the examination requires. Thus, the patient can regain consciousness and go home after the procedure. Remember that it is not allowed to drive after sedation.

The drugs used for endoscopy sedation are controlled and provide a pleasant sensation to the patient; therefore, there is nothing to worry about.

Why is sedation for endoscopy necessary?

Sedation is very important for the examination. Endoscopy involves inserting the endoscope through the throat, causing nausea, a sensation of vomiting, and a lot of discomfort.

Therefore, sedation is extremely necessary so that the patient can relax, sleep, and not feel gagging and discomfort.

Who administers anesthesia for endoscopy?

In summary, the endoscopist doctor can perform venous sedation, but it is not allowed for the professional to perform the examination and anesthesia simultaneously, according to the guidelines of the Federal Council of Medicine (CFM).

Therefore, the sedation that precedes the endoscopy examination is usually done by an anesthesiologist, a professional trained in Medicine with a medical residency in the area of anesthesia, in order to keep the patient adequately sedated, according to all the specifics of the case.

What happens after the sedation procedure?

The sedation procedure and the examination, in the case of diagnostic endoscopy, tend to be quick, between 10 and 15 minutes. In the case of therapeutic endoscopy, performed for treatment purposes (such as removal of tumors or polyps), the duration will depend on the type of lesion.

In any case, the complexity is considered by the anesthesiologist when administering the medication, and, after the end of the procedure, it is recommended that the patient rest for up to 30 minutes to recover from the main effects of sedation.

To aid recovery, the patient may consume some light food, such as fruit, and it is essential to have a companion to take them home, as driving is not permitted.

If the person feels any discomfort, such as abdominal pain, fever, or vomiting, it is necessary to seek medical attention to take care of the case.

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Many doubts arise regarding the term duodenal ulcer, after all, little is said about the subject.

Understand the condition, its main symptoms, how the diagnosis and treatment are done, as well as tips to take care of yourself if you are feeling pain.

What is a duodenal ulcer?

A duodenal ulcer is nothing more than a sore that forms on the mucosa (inner lining) of the duodenum, which can be superficial or deep. In more severe cases, it can cause perforation of the organ.

The duodenum is located right after the stomach, at the beginning of the intestine, and an ulcer in this region is called a “duodenal ulcer”.

The condition tends to develop more in men between 40 and 50 years old.

Main symptoms

Among the symptoms of a duodenal ulcer, it is possible to mention:

• Constant pain in the abdomen, mainly with a burning sensation;
• Nausea and vomiting;
• Weight loss;
• Constant feeling of a full or bloated stomach.

There may be a worsening of the symptoms mentioned above after heavier meals, when the stomach needs to increase the synthesis of gastric acid. The same occurs when the patient goes a long time without eating, and the gastric acid ends up affecting the mucous membranes of the digestive system.

How does the sore develop?

In most cases, the natural protection of the duodenum decreases due to some factor, such as stress, excessive alcohol use, or as a result of the use of anti-inflammatory medications. As a consequence, the small sore originates from the direct contact of gastric acid with the mucosa of the organ.

But the main cause of duodenal ulcer is infection by Helicobacter Pylori, and treatment of this bacterium is mandatory in these cases.

How is the diagnosis and treatment?

Diagnosis

The diagnosis of a duodenal ulcer is made through an upper digestive endoscopy, and there may be a need to perform a biopsy (removal of a small part of tissue for laboratory tests).

Treatment

The treatment, in turn, depends on the size and causes of the duodenal ulcer.

The protocol depends entirely on the doctor’s diagnosis, but usually combines medication to protect the gastric mucosa and antacid medication, aiding in the healing of the sore.

If the biopsy identifies the presence of the H. Pylori bacterium, it will be necessary to use antibiotic medication.

Regarding diet, it is essential to adopt a series of changes aimed at dietary re-education, including reducing the consumption of fatty foods, heavy meals, processed products, and carbonated drinks, which tend to intensify symptoms.

How can you take care of yourself?

If you have a duodenal ulcer, there are some important steps to follow to take care of yourself, such as:

• Resting well;
• Following the treatment prescribed by the doctor and continuing with the follow-up as long as necessary;
• Having a balanced diet, preferably with the guidance of a nutritionist;
• Avoiding alcoholic beverages, tobacco, citrus drinks, spicy foods, caffeine, and sodas;
• If possible, avoiding anti-inflammatory medications that irritate the stomach, such as diclofenac, aspirin, and naproxen;
• Exercising as recommended by the doctor;
• Seeking therapy to deal with emotions and stress.

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Esophageal varices are a condition in which blood vessels in the esophagus become very dilated, causing a series of unpleasant symptoms and even bleeding from the mouth.

Understand what these varices are, the potential causes, what the main side effects are, and how diagnosis and treatment are carried out.

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Esophageal Varices: What Are They?

Basically, esophageal varices can be understood as swollen veins located in the walls of the esophagus – the tube responsible for connecting the throat to the stomach.

Such veins are called varices precisely because they are larger than what is considered normal, caused by increased local pressure.

Due to this increase in pressure, the walls may rupture, causing sudden bleeding. Because of the risk of intense and serious bleeding, esophageal varices require immediate treatment when they rupture.

Main Causes

The main causes of esophageal varices involve conditions that lead to obstruction of blood flow in the liver, increasing pressure in the veins of the area – a condition known as portal hypertension.

The increase in pressure causes the veins in the walls of the esophagus to dilate, accumulate blood, and in severe cases, intense bleeding.

The main causes of portal hypertension that can lead to the appearance of esophageal varices are:

• Liver cirrhosis of any origin (alcoholic, viral, steatohepatitis, etc.);
• Thrombosis of the hepatic veins or arteries.

Symptoms of Esophageal Varices

Esophageal varices do not have specific symptoms, but when they rupture, they can lead to hemorrhage and some symptoms, such as:

• Abdominal swelling;
• Darker stools with a very strong odor;
• Weakness;
• Pallor or more yellowish skin;
• Presence of blood in vomit;
• Labored breathing;
• Feeling of malaise;
• Dizziness.

It is important to note that the presence of bleeding is a serious symptom of esophageal varices. It is necessary to seek hospital assistance to avoid considerable blood loss and resulting problems.

How Diagnosis and Treatment Are Performed

Upper digestive endoscopy is the main examination for the diagnosis of esophageal varices. It is through endoscopy that the doctor will be able to observe the presence of varices and possible bleeding points.

Regarding treatment, there are some options. One of the main ones is through medications that relieve pressure inside the veins, reducing or preventing bleeding.

For the treatment of bleeding, the doctor, through endoscopy, may choose to use elastic bands around the varices to contain detected bleedings.

In more severe cases, if really necessary, there is the option of vascular surgical intervention.

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Endoscopy with biopsy is a commonly requested examination by gastroenterologists as it is a safe way to assist in the diagnosis of diseases and conditions that may affect the upper digestive tract, such as:

• esophageal ulcers;
• esophageal cancer;
• infections caused by fungi;
• gastritis;
• stomach cancer;
• celiac disease;
• duodenal cancer;
• duodenal ulcer, etc.

What is endoscopy with biopsy?

Upper gastrointestinal endoscopy with biopsy, also called cytology in the research of Helicobacter pylori, can be performed on the upper structures of the digestive system, such as the esophagus, stomach, and duodenum.

It was originally developed to remove small samples of stomach tissue to diagnose the presence of Helicobacter pylori – or H. pylori, as it is also known.

What is the purpose of endoscopy with biopsy?

Today, digestive endoscopy with biopsy, or cytology, is used in medicine to diagnose a series of diseases and conditions that affect the digestive system, such as ulcers, gastritis, reflux, and types of cancer.

In the case of ulcers and gastritis, the main goal of the examination is to find traces of H. pylori, since this bacterium can colonize the stomach and cause various symptoms, in addition to being a cofactor in the development of stomach cancer.

The doctor usually requests the performance of endoscopy with biopsy for complaints such as stomach pain, abdominal pain, burning, heartburn, and reflux.

How is endoscopy with biopsy performed?

The examination can be performed in hospitals, clinics, and offices. The patient needs to be fasting and bring a companion to assist them after the endoscopy, as an intravenous sedative is applied.

The doctor administers the sedative intravenously and uses a type of anesthetic spray in the throat. The patient is placed on their side on a stretcher, and the professionals ensure that the position is comfortable.

A flexible tube, called an endoscope, is inserted through the patient’s mouth and travels down the esophagus to the stomach and duodenum, allowing for the capture of a tissue sample.

In addition to tissue collection, images are captured and transmitted to a high-definition monitor, so that the doctor can perform a clinical analysis of the case.

The need for biopsy

A biopsy is necessary when it is necessary to remove a small sample of tissue for analysis. In upper gastrointestinal endoscopy, the biopsy is done using a very fine forceps present in the endoscope.

The collected tissue sample goes to a specialized pathology laboratory for histological investigation. Subsequently, the result is sent back to the doctor, usually after 15 days.

Although endoscopic biopsies are performed after the suspicion of the presence of the bacterium H. pylori, the examination also serves to study the mucosa of the esophagus and stomach in order to diagnose any changes and, even, the differentiation of benign and malignant lesions.

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Endoscopy is a widely used imaging test by doctors to obtain information about the digestive system. But when is it really necessary to undergo an endoscopy?

In addition to aiding in the diagnosis of diseases and conditions, endoscopy can also be used to perform treatments.

That is, the examination helps in the investigation of symptoms, assists in the performance of certain procedures, and allows the collection of tissues for biopsy.

Understand when it is necessary to undergo an endoscopy, how the procedure works, and what is required to prepare for it.

Types of digestive tract endoscopy

There are different types of endoscopy that can be performed with the aim of examining the digestive system. The main ones are:

• Upper gastrointestinal endoscopy: an examination that aims to analyze the esophagus, stomach, and upper part of the intestine (duodenum);
• Colonoscopy: a type of examination that evaluates the large intestine;
• Endoscopic ultrasound: the goal is to obtain images of the layers of the digestive tube wall and nearby structures;
• Capsule endoscopy: an electronic device ingested by the patient that emits images via wireless to a receiver. Generally, doctors opt for this examination to evaluate the small intestine.

When is it necessary to undergo an endoscopy?

Given certain symptoms, the doctor may request the performance of endoscopy:

• Anorexia or unexplained weight loss;
• Heartburn or pyrosis (burning sensation in the stomach);
• Pain in the upper abdomen;
• Dark stools;
• Frequent nausea and vomiting;
• Reflux;
• Vomiting accompanied by blood.

An endoscopy may be necessary when the doctor wants to identify tumors, both in the stomach and esophagus.

Depending on risk factors, such as family medical history or Barrett’s esophagus, the doctor may request the examination during check-ups.

What is the preparation for an endoscopy?

Preparation for the endoscopy examination involves fasting for 12 hours and consuming only mushy and light foods the day before, such as soups, broths, and juices.

The patient also needs to be accompanied by a person over the age of 18, as it is not possible to undergo the examination alone.

In addition, the patient should receive anesthesia to remain calm and stable throughout the procedure.

How is endoscopy performed?

After administering anesthesia, the doctor responsible for the examination introduces a flexible tube with a camera attached to the tip (endoscope) through the patient’s throat. The equipment transmits the images in real-time on a monitor.

The doctor guides the endoscope through the digestive tract, analyzes the condition of the tissues, takes pictures, and can remove material for biopsy if something needs to be investigated more closely.

The procedure lasts a few minutes, and the patient is monitored from start to finish, heartbeats are followed, and a source of oxygen remains close by.

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