"Beiping Theory" opener
The spleen and stomach are the source of acquired nature and the source of qi and blood, so internal damage to the spleen and stomach, and all diseases are born. The spleen and stomach play an important role in maintaining physical health.
Chief physician Zhang Beiping of the Department of Spleen and Stomach Diseases of Guangdong Provincial Hospital of Traditional Chinese Medicine and the integrated prevention and treatment team of premature gastrointestinal cancer will regularly push the health care and prevention and treatment knowledge of digestive diseases through this column to protect your digestive health! Welcome to continue to pay attention.
Today is the day when Mr. Li undergoes painless gastroscopy. Mr. Li keeps in mind the advice of the doctor and nurse. He never ate or drank water after getting up in the morning. He came to the digestive endoscopy center early to wait for the examination. As time passed by minute by minute, the patients around him were called to the clinic one by one for examination, and Uncle Li couldn't help but become nervous. Mr. Li, who had no food and water after getting up in the morning, felt more and more dry mouth and thirsty, and muttered to himself: The doctor told me not to eat on the day of the examination, but if I don’t replenish it in time, it would be difficult for me to deal with the subsequent anesthesia and examination? A few sips of water shouldn’t be a big problem! So, Uncle Li picked up the kettle and secretly took a few mouthfuls. His dry mouth and thirst were resolved, and his nervousness eased a lot.
Not long after, it was Mr. Li's turn to check it out. Before the examination, the doctor asked Mr. Li when he had the last time he ate and drank water. Mr. Li thought that he had just drunk some water and was not discovered, so he lied that he had never eaten or drank water after getting up in the morning. So, Uncle Li lay on the examination bed according to the standard position. A few minutes after the anesthesia began, Uncle Li fell asleep and then began a gastroscopy. But as soon as the gastroscopy entered the esophagus, he saw a lot of refluxed liquid. The endoscopy doctor immediately attracted the refluxed liquid in the esophagus and quickly entered the stomach to absorb the liquid in the stomach cavity. Because the doctor was experienced and skilled in the operation, he avoided the occurrence of aspiration and finally completed the gastroscopy successfully. After the examination of
, the doctor asked Mr. Li about the last time he drank water. Mr. Li stammered and said about drinking water secretly before entering the examination room. The doctor patiently told Mr. Li: Before undergoing painless gastroscopy, you must strictly follow the doctor's instructions to fast and water, otherwise it will increase the risk of anesthesia. Because if there is water and food in the stomach, it is prone to reflux to the esophagus and oropharynx after anesthesia, and enters the airway and even the lungs with breathing, leading to serious complications, such as inhaled pneumonia, airway spasm, respiratory obstruction, and even asphyxiation cardiac arrest. After hearing this, Uncle Li was still scared and said that he would follow the doctor's instructions seriously to prepare before the examination in the future and would never dare to drink water secretly again.
[Peking Say]
1. What is the difference between painless gastroscopy and ordinary gastroscopy?
The difference between ordinary gastroscopy and painless gastroscopy is whether to undergo intravenous anesthesia (commonly known as general anesthesia). Patients without contraindications to anesthesia can choose more comfortable painless gastroscopy, so painless gastroscopy is also the first choice for most patients at present.
"A Talk about Gastroenterology Health" original comic
2. Why should we avoid water and fast before painless gastroscopy?
① Ensure the field of vision under endoscopic.
If the stomach is not completely empty and there is food remaining on the stomach, it will cover the gastric mucosa and affect the field of view under the gastroscopy, causing the endoscopy doctor to be unable to observe the complete and clear gastric mucosa, which directly affects the endoscopy doctor's judgment.
② Prevents aspiration.
In a physiological state, people have the following three physiological reactions to prevent food from entering the airway:
(1) The lower esophageal sphincter at the junction of the esophagus and the stomach plays a gate, which can prevent gastric content from refluxing to the esophagus and the mouth.
(2) Swallowing reflex can ensure that food can enter the esophagus smoothly without entering the trachea when eating and drinking water.
(3) When water or other foreign objects enter the trachea, it will immediately trigger the body's cough reflex and remove these foreign objects.
However, under anesthesia, the above three protective physiological functions are ineffective. The contents of the stomach can reflux to the esophagus and the mouth, and the food in the pharynx can enter the trachea and lungs, and foreign bodies entering the trachea cannot be cleared by coughing, causing foreign bodies to enter the trachea and even the lungs, resulting in serious complications, such as inhaled pneumonia, airway spasm, respiratory obstruction, and even suffocational cardiac arrest.
3. What should I pay attention to before painless gastroscopy?
① Fast and water.
stop eating at least 6 hours before the examination, and water is prohibited 2 hours before! Eat a diet with less residue the day before (such as porridge, soft rice, rotten noodles, minced meat, pureed vegetable, etc.) and avoid eating foods that contain a lot of fiber (such as celery, coarse grains or foods that are too hard).
"A manga about digestive tract health
" original comic
② Drug management.
Physical hypotensive drugs for patients with hypertension can be taken with a small amount of water on the morning of the examination, and then the examination will be performed after taking the medicine for 2 hours.
For a long-term oral administration of aspirin, borvitae, Panax notoginseng and other drugs with antiplatelet and anticoagulant effects, be sure to communicate with the doctor in advance, stop taking the use for one week if the condition allows, and then undergo gastroenteroscopy to avoid bleeding during biopsy or treatment under the microscopy.
Diabetic patients are prohibited from taking antidiabetic drugs on the day of the examination to avoid causing hypoglycemia.
③ Smoking is prohibited. Smoking will aggravate the inflammatory reaction in the throat and increase the secretions of the throat. During examination, it may cause adverse reactions such as choking and throat discomfort.
④ If you have had a barium meal examination within 3 days, gastroscopy should be postponed. Because barium can adhere to the gastrointestinal mucosa, especially the site of ulcer lesions, it affects gastroscopy observation and brings difficulties to gastroscopy diagnosis.
⑤ If the patient develops symptoms such as cold, cough, and allergies on the same day, must inform the doctor and anesthesiologist in time and do not conceal the condition. Because when there is local inflammation in the upper respiratory tract and high airway responsiveness, the probability of laryngeal spasm and bronchospasm is increased. At the same time, the nasal and tracheal endocrine secretions increase after anesthesia, increasing the risk of asphyxiation.
⑥ Complete routine blood, coagulation, and electrocardiogram tests in advance, especially patients with hypertension, coronary heart disease, arrhythmia and over 60 years old. If necessary, heart color ultrasound should be improved.
⑦ Accompany with relatives to explain the condition and sign.
⑧ Before the examination, dentures, glasses and other items should be removed to avoid affecting the examination.
[Expert Profile]
Zhang Beiping
PhD, chief physician, doctoral supervisor. Deputy Director of the Department of Spleen and Gastric Diseases of Guangdong Provincial Hospital of Traditional Chinese Medicine (Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine), Academic Heir of Professor Kira Rakichen, the third batch of national old traditional Chinese medicine experts, trained doctors at the Beiri University Hospital in Japan, the sixth batch of national 100 talented universities training targets, the first batch of outstanding young medical talents in Guangdong Province, the second batch of outstanding traditional Chinese medicine talents in Guangdong Province, selected into the 8th batch of 9th batch of Lingnan Famous Doctors, and the first batch of Hurun Ping An Chinese Good Doctors in 2017. Chairman of the Expert Committee of the Colorectal Early Cancer of the Professional Committee of the Digestive Endoscopy of the Chinese Society of Integrated Traditional Chinese and Western Medicine; Chairman of the Professional Committee of the Gastroenterology Tumor Prevention and Treatment of the Guangdong Society of Traditional Chinese Medicine; Chairman of the Spleen and Stomach Health Branch of the Guangdong Health Association.
is good at: endoscopic diagnosis and treatment of early gastrointestinal and esophageal tumors and precancerous lesions, bile-pancreatic diseases and combined treatment of traditional Chinese and Western medicine; endoscopic treatment of various digestive tract obstructions; combined diagnosis and treatment of inflammatory bowel disease (ulcerative colitis and Crohn's disease).
Introduction to the Department of Spleen and Stomach Diseases of Guangdong Traditional Chinese Medicine
Guangdong Provincial Hospital of Traditional Chinese Medicine is a key specialty in traditional Chinese medicine in the "Eleventh Five-Year Plan" of the State Administration of Traditional Chinese Medicine, a key specialty in the Guangdong Provincial Administration of Traditional Chinese Medicine, a sub-center of the National Colorectal Polyp Management Project, a clinical training base of the National Capsule Endoscopy Research Center, and a Guangzhou Branch of the National Helicobacter pylori Molecular Diagnosis Center.Lead the establishment of the Expert Committee of the Professional Committee of the Digestive Endoscopy of the Chinese Society of Integrated Traditional Chinese and Western Medicine Colonial Early Cancer Expert Committee, the Expert Committee of the Digestive Diseases of the Guangdong Society of Traditional Chinese and Western Medicine, the Professional Committee of the Digestive Endoscopy of the Guangdong Society of Integrated Traditional Chinese and Western Medicine, the Professional Committee of the Digestive Cancer of the Gastrointestinal Tumor Prevention and Treatment of the Guangdong Society of Traditional Chinese and Western Medicine, the Lingnan Traditional Chinese and Western Medicine Medical Alliance and the Academic Alliance of Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Helicobacter Pylore-related Gastric Diseases
Under the guidance of three academic leaders, Yu Shaoyuan, Luo Yunjian and Huang Suiping, the spleen and stomach of the Dade Road General Hospital under the guidance of Zhang Beiping, the deputy director of the major department of the Spleen and Stomach Diseases and Gastroenteroscope Center. Zhang Haiyan, director of the Department of Diseases, Wang Jing, director of the Department of Spleen and Stomach Diseases of Ershadao Hospital, Chen Yan, director of the Department of Spleen and Stomach Diseases of Fangcun Hospital, and Liu Tianwen, director of the Department of Spleen and Stomach Diseases of University Town Hospital, led the team to carry forward the past and promote the future, and always adhere to the integration of one-hand traditional Chinese medicine, the first-hand endoscopy, and the medical and lens. He is committed to using the combination of traditional Chinese and Western medicine to prevent and treat early gastrointestinal cancer and transformed diseases such as chronic atrophic gastritis, colorectal adenoma, inflammatory bowel disease, bile-pancreatic disease, etc. He is especially good at various surgical treatments under digestive endoscopy (ESD, ERCP, EUS) and postoperative traditional Chinese medicine to promote rehabilitation, achieving good clinical efficacy, and is very popular among patients.
END
Submitted by: Department of Spleen and Stomach Diseases of Guangdong Provincial Hospital of Traditional Chinese Medicine Ma Yanyan and Chen Liji
Executive Editor: Liu Wenting
Review and proofreading: Zhuang Yingge
Editor in charge: Song Liping
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