Abdominal Diagnostic Studies
Let’s discuss some common abdominal diagnostic studies!
First and foremost is the Barium Swallow exam. This is an imaging test that uses the metal Barium and X-rays in order to view your upper GI tract, focusing on your esophagus, mouth and throat. The actual “drink” is this milky looking viscous substance. The metal in it coats yours insides so that your GI tract can be properly imaged by the X-ray. You should not consume anything by mouth, for at least 8 hours before the procedure, we want everything inside to have settled down, in fact you shouldn’t even chew gum as that stimulates peristalsis, aka the moving of your intestines. Afterwards, it’s best if you drink as much liquids as possible, increase your fiber, and even administer laxatives if need be. The goal post is to flush all the barium out of you. Not the most pleasant, but helps to rule out a lot of diseases.
Next up is an esophagogastroduodenoscopy, and EGD for short. Much shorter. This is the gold standard when it comes to viewing your stomach and insides, and once again we require patients to have not taken anything, be it food or liquids, 8 hours before the procedure. Also no smoking. After all the consent forms are signed, the IVs are started (so that they can provide you with medications throughout the visit), and you’ve taken some medications, the EGD begins. Side note, the medications they will give include a sedative, probably a good old Xanax, and some topical anesthetics for the back of your throat, to stop you from gagging, but I’m sure you won’t gag ;) The actual EGD is a long tube with a flashlight and a camera attached to it that they thread down your throat and into the stomach or whichever upper GI system they need to get to. They look around for anything out of place, pull the tubing out, wait for your gag reflex to return ;) and then send you home. You can be in and out in less than an hour. Expect a sore throat and some hoarseness afterwards.
Very similar to the EGD is the ERCP, which is short for endoscopic retrograde cholangiopancreatography. The only difference between the two is that the ERCP is used to examine the common bile duct (CBD) and the pancreatic duct. I was very dissapointed to find out that my patient who was going to receive CBD was going to receive this diagnostic test, and that I wasn’t going to get him high af. The medication that is THC and CBD is called Dronabinol/Marinol
Next up is the good old colonoscopy. The thing that most men fear for some reason. So there’s a shit ton of cancers that happen in the colon, pun intended, and the best way to visualize it is with the colonoscopy. It allows for a direct visualization of the large intestines up to the ileocecal valve, this is the valve that separates the small and the large intestines. You know how the previous exams start from the mouth and then go down? Well this one goes the other way. Through your anus and rectum and then throughout your large intestine. The most important thing for a patient to do is to have a clear liquid diet and complete the bowel prep the day before and morning of the test. It’s not a pleasant experience as it involves sitting on a toilet for a few hours drinking a gaudy liquid thing and shitting your guts out, but if you don’t do it then doctor can’t get a proper visualization of your colon (large intestine), and that’s kinda the whole point. They send patients away if you have eaten anything or haven’t completed the bowel prep. And trust me, they know.
Last major one on the list is the sigmoidoscopy. This is very similar to the colonoscopy, in fact it is a type of colonoscopy I guess, since the sigmoid is part of the colon itself, but since it is so close to the rectum and the doctor and his tubing don’t have to go so far, you won’t be required to undergo the whole bowel prep, just a simple enema. Still not pleasant I assume. This can be done at your general doctors office, no hospital visit required.
Some other exams you should know about but I won’t get into much detail: Fecal Analysis exam, or as I call it, a shit kit, this can check anything from nutrition absorption issues (for example the pancreas releases the enzymes that break down fat, so if we see high fat in your shit we might have you undergo an ERCP for followup), possible cancers, and possible infections. A hematest aka Occult Blood Test checks for issues with blood gasses, antigens and infections. Few other tests but I have to get to class now lol.