DIAGNOSTIC TESTS

IN
GASTROENTEROL
OGY
CEM AYGUN, MD.
PROF OF INTERNAL MEDICINE AND GASTROENTEROLOGY
Aims:
Definitions
Diagnostic tests
Diagnostic procedures
◦ Structıral tests
◦ Functional tests
◦ Gastroscopy
◦ Colonoscopy
◦ ERCP
◦ Capsule endoscopy
◦ Biopsy
 INTRODUCTION
-GIS diseases constitute a major cause of morbidity and mortality,
-App 10% of primary care consultations are for symptoms related with GI tract,
-Diarrhea and constipation are very common, esp diarrhea may be a very imp cause of hospitalization and
even death in developing countries,
-GI tract is a very common site for cancer!
-Peptic ulcer disease and H.pylori infection is very common,
-Colorectal cancer frequency is high and seems increasing in many developed countries (due to processed
food comsumption?obesity?),
-GI endoscopy is very useful to diagnose many disorders,
-Therapeutic endoscopy made it possible to replace surgery for many conditions such as bleeding, polyp or
early cancer removal, bilary stone removal, stenting for obstruction, PEG for nutrition.
Definitions
Dysphagia: Difficult swallowing
Odynophagia: Painful swallowing
Aphagia: Inability to swallow
Aerophagia: Swallowing air
Pyrozis: Heartburn
Regurgitation: Spitting up food from stomach to esophagus
Rumination: Spitting up food from stomach to mouth
Hematemesis: Vomiting of blood
Melena: Dark sticky faeces containing digested blood
Hematochezia: Fresh blood from the anus
Diagnostic tests in GI
tract
Esophagus
Stomach
Small intestine
Colon
Liver and biliary tree
Pancreas
Diagnostic procedures
The diagnostic procedures can be divided into several categories

◦ Structural tests
◦ Functional tests
◦ Tests for Helicobacter pylori
◦ Special blood tests
◦ Special stool tests
Structural tests
Radiography
Ultrasonography
Computed tomography
Magnetic resonance imaging
Gastrointestinal endoscopy
Endoscopic ultrasonography
 Plain X ray:
Shows bowel gas, dilated loops or fluid-air levels in erect position,
Air under diaphragm shows perforated viscus.
Imaging studies for GI diseases
Functional tests for GI diseases
Test for motility
- Achalasia

24 hour PH monitoring
- GERD

Tests fo acid output

- Peptic ulcer

Tests for malabsorption

- Celiac disease

Tests for pancreatic function

- Chronic pancreatitis
Gastrointestinal endoscopy
Upper Gastrointestinal endoscopy;
diagnosis and treatment
Upper GI endocopy indications
Upper GI endoscopy
Lower Gastrointestinal endoscopy
Lower GI endoscopy indications
Colonoscopy; lower GI endoscopy
ERCP
ERCP
ERCP
EUS :Endoscopic ultrasonography
Subepithelial mass-tumor in stomach
endoscopic and EUS view
Capsule endoscopy
Capsule endoscopy use?
Diagnostic tests for Helicobacter pylori
Histopathologic diagnosis of H.pylori
Rapid diagnosis during endoscopy
Other diagnostic procedures in GI
disorders
Liver biopsy
Liver biopsy
Thank you!