Additional diagnostics of studies of the digestive tract. How to check the stomach and what tests are needed for this

To detect pathologies of the gastrointestinal tract in modern medicine are used different methods research. The latest equipment helps to obtain valuable information about human health; in many cases, diagnosis does not cause discomfort. An anomaly can be detected even in situations where there are no complaints or external signs illness.

Indications for examination of the gastrointestinal tract

Examination of the gastrointestinal tract is the most important step for setting correct diagnosis, since pathologies are common in people of all ages and can lead to serious consequences. Indications for the study of the intestine are:

Checking the stomach is prescribed in the following cases:

• internal bleeding;
• gastritis (acute or chronic);
• pancreatitis;
• malignant formations;
• stones in the gallbladder;
• stomach ulcers or duodenum;
• pain of unknown etiology;
• nausea, dryness or bitterness in the mouth;
• belching and heartburn;
• pronounced narrowing of the upper part of the stomach or its underdevelopment.

Often, the entire gastrointestinal tract is examined. This allows you to determine the coherence of the work of organs or deviations in functioning.

Methods for diagnosing diseases of the gastrointestinal tract

Thanks to modern techniques today, the detection of defects is possible with a minimum error. Standard studies are offered at any clinic, but many consider the procedures difficult to access, which is why they seek help when the pathology is at a late stage of development. Often one method of diagnosis is enough, in difficult cases they are combined. How to examine internal organs?

Physical Approach

External non-invasive procedures are called physical techniques. These include palpation, percussion, visual inspection and auscultation. When examining a person, the doctor notes the following factors:

• lethargy and roughness of the skin;
• pallor of the integument and deterioration of their elasticity;
• smoothness of the tongue or the presence of a white / brown coating on it.

If a person does not have problems with the gastrointestinal tract, this symptomatology is unusual for him. Inspection allows you to make a preliminary diagnosis. If one of the signs is found, the doctor performs superficial or deep palpation. The specialist presses on the stomach, passing from the inguinal zone upwards. At healthy person muscles do not tense much, there is no pain. Deep palpation is carried out in the area of ​​discomfort.

Rectal examination is necessary to examine the anus and identify its functionality. The procedure is performed by a proctologist, assessing the presence of cracks, hemorrhoids, polyps.

Analyzes and laboratory studies

Diagnostics in the laboratory - necessary measure for all diseases. To check the stomach and intestines, the specialist prescribes tests:

• general blood test (performed in the morning, on an empty stomach);
• examination of feces for the presence of protozoa;
• examination of the stool for eggs of worms;
• analysis of microflora (for dysbacteriosis);
• coprogram ( due diligence feces for a change in color, smell, shape, the presence of various inclusions).

Instrumental Methods

To examine the stomach and intestines, various instruments are often used that can show part of the organ or completely visualize the sections of the gastrointestinal tract. How can you check the stomach and intestines? Methods for examination are relevant:

Radiation diagnostics

Patients may be offered non-invasive beam methods examinations that help in making a diagnosis. These include the following methods:

Possible complications after procedures

Most examinations are completely harmless, but some are quite unpleasant and painful, such as endoscopy and colonoscopy. For this reason, rectal tube insertion is carried out under local anesthesia or with sedation. The risk of complications is small, but it exists.

Consequences from different types diagnostics are presented in the table.

In the materials of this resource, you will learn everything about diseases internal organs human, their origin, mechanisms of development, frequent symptoms that may bother you, and from this section - which complexes of analyzes of the gastrointestinal tract, respiratory and endocrine system the doctor prescribes.

You will also get acquainted with the main directions and approaches in the treatment of diseases of internal organs.

According to localization, diseases of internal organs are usually divided:

• Respiratory diseases (SARS, bronchitis, pneumonia, obstructive pulmonary diseases, bronchial asthma etc.)
• Diseases of the digestive tract (dyspepsia, gastritis, stomach and duodenal ulcers, enteritis, enterocolitis, etc.)
• Diseases of the urinary system (pyelonephritis, glomerulonephritis, urolithiasis disease, cystitis, etc.)
• Diseases of the pancreas (hepatitis, cholelithiasis, pancreatitis)
• Diseases of the heart and blood vessels (endocarditis, myocarditis, congenital and acquired heart defects, atherosclerosis)
• Autoimmune diseases (rheumatism, Crohn's disease, etc.)

The causes of diseases of the internal organs of the gastrointestinal tract are diverse - it is like an infectious lesion (bacterial, viral, protozoan), a violation of the diet and image (provoking factors for the occurrence and analysis of the gastrointestinal tract).

Separately, a congenital pathology of the internal organs is distinguished, which can form, either due to infection, the influence of toxins, pathology during the course of pregnancy, or a violation of the individual development of the fetus caused by genetic disorders in fetal DNA.

You will learn more about the mechanisms that determine the course of the disease:

• inflammatory process, with the formation of purulent discharge
• Allergic inflammatory process, with specific manifestations
• Mechanisms of compensation and tissue regeneration

Get acquainted with the main symptoms that occur when a particular system of internal organs is damaged:

• With damage to the organs of the gastrointestinal tract - pain in different departments stomach, nausea, vomiting, unstable stools (diarrhea, which can be replaced by constipation), belching.
• In case of damage to the organs of the urinary tract - a violation of urination (pain, changes in the amount of urine, its color and smell)

Diagnosis of diseases of the internal organs is based on a survey of the patient, clarification of all the circumstances of the disease, the moment of their occurrence.

After examining the auscultation (listening to chest or abdomen with a stethophonendoscope), percussion (tapping to determine the sound above the surface of the human body) and (determining the size and consistency of organs by probing), the doctor makes a preliminary diagnosis.

In addition to general clinical tests - blood, urine and biochemical blood tests, for example, for the organs of the gastrointestinal tract, special diagnostic tests, such as the:

• X-ray of organs abdominal cavity.
• Ultrasound of the abdominal cavity and retroperitoneal space.
• Fibrogastroesophagogduodenoscopy (FEGDS) to detect mucosal pathology and taking a blood test from the gastrointestinal tract if a source of bleeding is detected.
• Analysis of feces for the detection of eggs of worms, enterobiasis, hidden blood pancreatic enzymes
• Fecal analysis to detect H. pylori, a pathogen that provokes the occurrence of gastritis and stomach and duodenal ulcers.

For the organs of the urinary system, the following diagnostic procedures are carried out:

• Urinalysis according to Nechiporenko and Zimnitsky
• Excretory urography of the kidneys
• Ultrasound of the kidneys and renal pelvis, bladder
• Cystoureteroscopy
• Kidney biopsy to determine the type of glomerulonephritis

The features of each pathology are also clearly presented in the rubric articles. In short, the treatment of pathologies of the internal organs, after the analysis of the gastrointestinal tract, the urinary system, depends on the identified pathology, its severity and form of manifestation.

In gastroenterology there is a large number of diseases that can lead to severe complications and be very dangerous. Today, according to statistics, suffers from different pathologies digestive organs, every second person on the planet.

Hardware examination of the gastrointestinal tract is represented by several types, among which the most commonly used ultrasound procedure(ultrasound) and magnetic resonance imaging (MRI). Examination methods allow you to visually view the organs digestive system and help confirm or refute a suspected diagnosis.

What symptoms require hardware examination gastrointestinal tract?

• abdominal pain different localization and character;
• sensation of pulsation in the abdomen;
• bitter taste in the mouth;
• belching;
• discomfort or feeling of heaviness under the right rib;
• change in the color of the tongue (yellow, white or brown coating);
• nausea, vomiting;
• violation of the stool (constipation, diarrhea, impurities in the feces);
• color change skin(yellowing, the appearance of vascular "asterisks" on the skin);
• the presence of a volumetric formation in the abdomen;
• frequent regurgitation or vomiting with a fountain in children (especially infants);
• during or after the transfer infectious diseases (viral hepatitis, malaria, infectious mononucleosis);
• change in the color of urine (darkening) or stool (discoloration);
• aversion to food, incomprehensibility of any products (cereal, dairy);
• after an abdominal injury.

Ultrasound examination of the gastrointestinal tract. What is it for?

The advantages of ultrasound diagnostics are the ability to examine organs in several projections, as well as the study of peristalsis (muscle contraction) and the work of sphincters (muscle rings at the outlet of the esophagus, stomach or intestines). Sonography (ultrasound) allows you to evaluate the structure of the entire wall of organs, under the control of ultrasound it is easier to conduct a biopsy (collection of a part of the cells) to study for the presence of a neoplasm.

In addition, this type of examination does not penetrate the patient's body, that is, it is non-invasive. Ultrasound is comfortable for the subject, does not cause discomfort during the procedure. Allows you to assess the nature of the blood supply to organs and the work of blood and lymphatic vessels. Ultrasound examination of the gastrointestinal tract reveals:

1. Diseases of the esophagus. Esophagitis (inflammation of the mucous membrane of the esophagus), gastroesophageal reflux disease.
2. Diseases of the stomach. Gastritis (inflammation of the gastric mucosa), changes in the size or curvature of the stomach, outgrowths of the mucous membrane (polyps), tumors, congenital anomalies development, narrowing of the sphincter at the outlet of the stomach (pylorospasm).
3. Intestinal diseases. Dyskinesia (decrease or increase in intestinal tone), enterocolitis (inflammation of the mucous membrane of the small or large intestine), tumors, polyps, narrowing of the intestinal lumen, stenosis (narrowing), congenital anomalies (dolichosigma, etc.).
4. Diseases of the liver and biliary tract. Accumulation of pathological substances in the liver (calcifications), inflammation of the liver cells (hepatitis), cysts (cavities in the thickness of the organ), tumors or metastases in the liver, increased pressure in the portal vein basin, anomalies in the development of the gallbladder, biliary dyskinesia, the presence of calculi (stones ) in the lumen of the gallbladder.
5. Diseases of the pancreas. Pancreatitis (inflammation of the pancreatic tissue), violation of the outflow of pancreatic juice, blockage of the lumen of the pancreatic ducts.

Magnetic resonance imaging (MRI). What are the advantages of the method?

MRI is a type of study that allows you to visualize the structure of an organ, its position in the body, blood supply, communication with neighboring organs and tissues. Visualization takes place in 3D format. This type examination allows to make a diagnosis on the most early stages, even when not yet clinical manifestations(symptoms). This helps to prevent a lot of complications and start treatment in a timely manner.

What can be determined during an MRI?

• congenital anomalies and malformations of the organs of the gastrointestinal tract;
• damage to the abdominal organs after injury;
• foreign bodies in the lumen of the esophagus, stomach or intestines;
• spasms of blood vessels in the liver or pancreas, threatening heart attacks, ischemia;
• inflammatory processes in the organs of the digestive system;
• infiltrates, abscesses (accumulation of pus);
• adhesions, especially after surgery;
• tumor formations in any of the organs of the gastrointestinal tract;
• fatty degeneration of the liver or cirrhosis;
• cavity formations (cysts, hematomas);
• the presence of stones in the gallbladder or bile ducts.

There are a number of contraindications to this type of research. This is the patient's metal prostheses or devices (pacemakers, ectopic coils, dentures). MRI is also not recommended early dates pregnancy, patients with claustrophobia. AT childhood this type of diagnosis is limited, as complete immobility of the patient is required. In extreme cases, if necessary, the examination of the child is administered under anesthesia.

According to medical statistics, 95% of the inhabitants of the Earth need regular monitoring. Of these, more than half (from 53% to 60%) are familiar with chronic and acute forms(inflammatory changes in the gastric mucosa), and about 7-14% suffer.

Symptoms of gastric pathology

The following manifestations may indicate problems in this area:

• pain in the stomach, a feeling of fullness, heaviness after eating;
• pain behind the sternum, in the epigastric region;
• difficulty swallowing food;
• feeling foreign body in the esophagus;
• belching with a sour taste;
• heartburn;
• nausea, vomiting undigested food;
• vomiting with an admixture of blood;
• increased gas formation;
• black feces, bleeding during bowel movements;
• bouts of "wolf" hunger / lack of appetite.

Of course, a serious indication for a gastroenterological examination are previously identified pathologies of the digestive system:

• inflammatory processes;
• oncological diseases etc.

Diagnosis of diseases of the stomach

Diagnosis of diseases of the stomach is a whole range of studies, including physical, instrumental, laboratory methods.

Diagnosis begins with a survey and examination of the patient. Further, based on the collected data, the doctor prescribes the necessary studies.

Instrumental diagnosis of stomach diseases involves the use of such informative methods, as:

• CT scan;

To the complex laboratory methods Diagnosis of diseases of the stomach, as a rule, includes:

• general blood analysis;
• biochemical analysis blood;
• general analysis of urine, feces;
• gastropanel;
• PH-metry;
• analysis for tumor markers;
• breath test for .

General analysis blood . This study is indispensable for assessing the state of health in general. When diagnosing diseases of the gastrointestinal tract by changing indicators (ESR, erythrocytes, leukocytes, lymphocytes, hemoglobin, eosinophils, etc.), one can state the presence inflammatory processes, various infections, bleeding, neoplasms.

Blood chemistry . The study helps to identify violations of the functions of the gastrointestinal tract, to suspect the subject acute infection, bleeding or tumor growth.

General urine analysis . According to such characteristics as color, transparency, specific gravity, acidity, etc., as well as the presence of inclusions (glucose, blood or mucous inclusions, protein, etc.), one can judge the development of an inflammatory or infectious process, neoplasms.

General analysis of feces . The study is indispensable in the diagnosis of bleeding, digestive dysfunction.

tumor markers . To identify malignant tumors gastrointestinal tract use specific markers (REA, CA-19-9, CA-242, CA-72-4, M2-RK).

PH-metry . This method allows you to obtain data on the level of acidity in the stomach using flexible probes equipped with special measuring electrodes that are inserted into the stomach cavity through the nose or mouth.

It is carried out in cases where the doctor needs this indicator to make a diagnosis, to monitor the patient's condition after gastric resection, and also to evaluate the effectiveness of drugs designed to reduce or increase the acidity of gastric juice.

pH-metry is carried out under conditions medical institution under constant medical supervision.

Gastropanel . A special set of blood tests that helps to assess the functional and anatomical state of the gastric mucosa.

The gastroenterological panel includes the most important indicators for the diagnosis of gastric pathologies:

• antibodies to Helicobacter pylori(these antibodies are detected in patients suffering from gastritis, duodenitis, peptic ulcer);
• gastrin 17 (a hormone that affects the regenerative function of the stomach);
• pepsinogens I and II (the level of these proteins indicates the state of the mucous membrane of the body of the stomach and the organ as a whole).

How to prepare for analysis

Urine, stool tests . The biomaterial is collected in a special sterile container (purchased at a pharmacy). On the eve, it is not recommended to drink multivitamins and consume products that can change the color of the biomaterial, as well as laxative and diuretic drugs.

Urine is collected in the morning, after careful hygiene of the external genitalia. It is necessary to drain the first dose of urine into the toilet, and collect the middle portion (100-150 ml) in a container.

Feces are collected in the morning or no later than 8 hours before analysis.

Gastropanel . A week before the study, you should stop taking drugs that can affect the secretion of the stomach. For a day, exclude the use of drugs that neutralize hydrochloric acid. On the morning of the analysis, do not drink, do not eat, do not smoke.

The study consists in donating blood from a vein in two steps: immediately upon arrival at treatment room and 20 minutes later, after taking a special cocktail designed to stimulate the hormone gastrin 17.

Blood tests (general, biochemical) . Blood for research is taken in the morning on an empty stomach. On the eve of the analysis, you should avoid stress, refrain from eating heavy food, alcohol. On the morning of the analysis, you can not eat or smoke. Clean water is allowed.

PH-metry. The probe is installed in the morning on an empty stomach. At least 12 hours must have passed since the last meal, and you can drink water no later than four hours before the procedure. Before the planned study, be sure to inform the doctor about the drugs you are taking. medicines, perhaps, their use will have to be canceled a few hours (and some drugs - several days) before the procedure.

In general, they can be divided into the study of the structure, functions of the gastrointestinal tract, the detection of infections.

Structure Study: Visualization

Standard radiography

Standard abdominal x-ray shows the distribution of gas in the small and large intestines, it is used in diagnosis intestinal obstruction or paralytic ileus, when dilated intestinal loops and (when photographed in a standing position) fluid levels are detected. You can see the contours of parenchymal organs, such as the liver, spleen and kidneys (visualization of calcifications and stones in these organs is possible), the pancreas, blood vessels, and lymph nodes. Abdominal x-rays are not helpful in diagnosing gastrointestinal bleeding. On a chest x-ray, the diaphragm can be seen, and on x-rays taken in the standing position, free gas can be found under the diaphragm when a hollow organ is perforated. It is also possible to accidentally pulmonary pathology eg pleural effusion.

Contrasting Studies

Barium sulfate, used in contrast studies, and nerthen, well envelops the mucous membrane and provides the necessary contrast of structures of interest. However, it may thicken and stop proximal to the obstruction. Water-soluble radiopaque is used to contrast the bowel before abdominal CT and when perforation is suspected, but it absorbs x-rays to a lesser extent and also irritant effect in case of aspiration. Studies with contrast are carried out under fluoroscopic control, which allows you to assess the movement of organs and correct the position of the patient. Double Contrast Technique Using Barium-Coated Inflating Gas inner walls hollow organs, improves visualization of the mucous membrane.

Barium studies are used to detect filling defects. A distinction is made between intraluminal (eg, food or feces), intraparietal (eg, carcinoma), or extraparietal (eg, The lymph nodes) filling defects. Strictures, erosions, ulcers, and organ motility disorders can also be identified.

X-ray studies with contrast in the diagnosis of diseases of the gastrointestinal tract

Ultrasound, computed and magnetic resonance imaging

The use of these methods in the diagnosis of diseases of the abdominal cavity has become widespread. They are non-invasive and provide a detailed image of the contents of the abdominal cavity.

Ultrasound scanning, computed tomography and magnetic resonance imaging in gastroenterology

Endoscopy

Videoendoscopy has replaced endoscopic examination using fiberoptic endoscopes. The image is displayed on a color monitor. Endoscopes are equipped with handpiece controls, and they also have channels for suctioning air and water. Additional instruments are passed through the endoscope to perform diagnostic and therapeutic procedures.

Endoscopy of the upper gastrointestinal tract

Indications

• Dyspepsia in patients over 55 years of age or with warning symptoms
• Atypical chest pain
• Dysphagia
• Vomit
• Weight loss
• Acute or chronic gastrointestinal bleeding
• Suspicious Results of the Barium Breakfast Study
• Biopsy of the duodenal mucosa to identify the causes of malabsorption

Contraindications

• Severe degree of shock
• Recent myocardial infarction unstable angina, cardiac arrhythmia
• Severe respiratory disease
• Atlas subluxation
• Possible perforation of internal organs
• These are relative contraindications: it is possible to perform endoscopic examination an experienced specialist

Complications

• Aspiration pneumonia
• Perforation
• Bleeding
• Infective endocarditis

Endoscopy in the elderly

• Portability: endoscopic procedures generally well tolerated by people even at a very old age Side effects sedation: the elderly are more sensitive to sedation; respiratory depression, hypotension, and prolonged recovery time are more common.
• Bowel preparation for colonoscopy can be difficult in malnourished, immobilized people. Preparations containing sodium phosphate may cause dehydration or hypotension. Antiperistaltic substances: hyoscine butylbromide is contraindicated in glaucoma, it can also cause tachyarrhythmias. If it is necessary to use an antiperistaltic substance, the drug of choice is glucagon.

Fibroesophagogastroduodenoscopy

The study is carried out under intravenous benzodiazepine premedication to a state of mild sedation or using only local anesthetic sprayed on the mucous membrane of the patient's pharynx (the procedure is carried out on an empty stomach for at least 4 hours). When the patient lies on the left side, the entire esophagus, stomach and the first 2 parts of the duodenum can be seen.

Enteroscopy and capsule endoscopy

By using a long endoscope (enteroscope), most of the small intestine. Enteroscopy has special meaning in the assessment of obstruction, recurrent gastrointestinal bleeding. Capsule endoscopes contain a light source and lenses. After swallowing, the endoscope transmits the picture from the small intestine to a data recording device. Then, to localize the detected deviations, the images are processed using software. Capsule endoscopy used for suspected bleeding upper divisions Gastrointestinal tract, tumor or ulcer of the small intestine.

Sigmoidoscopy and colonoscopy

Sigmoidoscopy can be performed on an outpatient basis using a 20 cm rigid plastic sigmoidoscope or in an endoscopy unit using a 60 cm flexible colonoscope after bowel preparation. When combining sigmoidoscopy with rectoscopy, it is possible to identify hemorrhoids, ulcerative colitis and distal colorectal neoplasia. After complete bowel cleansing, it is possible to examine the entire colon and often the terminal area. ileum using a longer colonoscope.

Colonoscopy

Indications

• Suspicion of inflammatory diseases intestines
• chronic diarrhea
• Discomfort in the abdomen
• Rectal bleeding or anemia
• Evaluation of abnormalities identified in the study with a "barium enema"
• Screening for colorectal cancer
• Surveillance for colorectal adenoma
• Therapeutic procedures
• Colonoscopy is unsuitable for establishing causes of constipation

Contraindications

• severe acute ulcerative colitis
• Same as for upper gastrointestinal endoscopy

Complications

• Depression of the heart and respiratory function in connection with sitting
• Perforation
• Bleeding
• Infective endocarditis (in patients with a history of endocarditis or with a prosthetic heart valve, prophylactic prescription antibiotics)

ERCP

ERCP allows you to visualize the ampulla of Vater and get x-rays bile duct and pancreas systems. Diagnostic ERCP has largely been replaced by magnetic resonance cholangiopancreatography (MRCP), which provides comparable images of the bile duct system and pancreas. MRCP complements CT and endoscopic ultrasound in the assessment of obstructive jaundice, identifying the cause of pain in the area gallbladder and suspected pancreatic disease. ERCP is then used to treat a number of biliary tract and pancreatic diseases identified by these non-invasive methods. ERCP involves the removal of common stones bile duct, stenting of bile duct strictures and treatment of pancreatic duct ruptures. Performing therapeutic ERCP is associated with technical difficulties and a significant risk of developing pancreatitis (3-5%), bleeding (4% after sphincterotomy) and perforation (1%).

Histological examination

Biopsy material obtained by endoscopy or percutaneously can provide important information.

Indications for biopsy and cytology

• Suspicion of malignancy
• Evaluation of deviations in the structure of the mucous membrane
• Diagnosis of infections (eg, Candida, H. pylori, Giardia lamblia)
• Determination of enzyme composition (for example, disaccharidases)
• Analysis of genetic mutations (eg, oncogenes, tumor suppressor genes)

Tests for infections

Bacteriological research

Detection of bacterial cultures in feces is essential to determine the causes of diarrhea, especially acute or bloody, and to identify pathogens.

Serological study

The detection of antibodies is of limited value in the diagnosis of gastrointestinal infections caused by microorganisms such as H. pylori, some Salmonella species, and Entamoeba histolytica.

Urease test

non-invasive breath tests for H. pylori infection and suspected small intestinal bacterial overgrowth are discussed below.

Functional Research

Several functional tests are used to investigate various aspects of intestinal activity (digestion, absorption), inflammation and epithelial permeability.

Functional tests in the study of the gastrointestinal tract

If malabsorption is suspected, it is necessary to conduct blood tests [with counting of formed elements, erythrocyte sedimentation rate (ESR), determination of the concentration of folates, vitamin B 12, iron, albumin, calcium and phosphates], determine the condition of the gastrointestinal mucosa in the biopsy material obtained during endoscopy .

Peristalsis of the gastrointestinal tract

There are a number of different X-ray, manometric, and radioisotope tests to study intestinal motility, but most of them have very limited use in clinical practice.

Peristalsis of the esophagus

A study after careful ingestion of barium sulfate suspension may provide information on esophageal motility. In difficult cases, videofluoroscopy may be helpful. Esophageal manometry, usually in combination with a 24-hour pH measurement, is of value in the diagnosis of gastroesophageal reflux, achalasia of the cardia, and non-cardiac chest pain.

Gastric emptying

Delayed emptying of the stomach (gastroparesis) causes persistent nausea, vomiting, bloating, or early satiety. The results of endoscopy and studies with barium sulfate are usually within the normal range. Indicators for the emptying of solids are very variable, but approximately 50% of the contents leave the stomach in 90 minutes (T1 / 2). Calculation of the amount of radioisotope remaining in the stomach after eating food containing solid and liquid labeled components can reveal pathology.

Passage through the small intestine

This parameter is much more difficult to quantify and is rarely required in clinical practice. The study of the passage of barium sulfate can give an approximate idea of ​​the functional state of the intestine when determining the time required to achieve contrast enhancement of the terminal ileum (normally 90 minutes or less). Orocecal transit can be assessed using the lactulose-hydrogen breath test. Lactulose is a disaccharide that normally enters the colon unchanged; here, the breakdown of lactulose by colon bacteria leads to the release of hydrogen. The time of appearance of hydrogen in exhaled air is a measure of orocecal transit.

Peristalsis of the colon and rectum

Direct abdominal radiography, performed on the 5th day after ingestion of inert plastic pills of various shapes, in the first 3 days from the start of the test gives an idea of ​​the duration of complete intestinal transit. The test is used to identify the causes of chronic constipation, since the location of any of the delayed pills can be seen; it helps to differentiate cases of delayed transit from the presence of an obstruction to the movement of feces. The mechanism of defecation and the functional state of the anorectal region can be assessed using anorectal manometry, electrophysiological tests and proctography.

Radioisotope tests

Many different radioisotope tests are used. Some give information about the structure, such as the location of Meckel's diverticulum, or the activity of the inflammatory process in the intestine. In other tests, radioisotopes are used to obtain information about functional status, such as the degree of bowel movement or the ability to reabsorb bile acids. There are tests for infection, they are based on the ability of bacteria to hydrolyze radioactively labeled substances, followed by the determination of the isotope in exhaled air (for example, the respiratory urease test for H. pylori).

Radioisotope tests commonly used in gastroenterology