Biopsy - conducting, processing and interpretation of results

What it is

Esophageal biopsy is a diagnostic procedure during which biological material is taken for subsequent histological examination under a microscope in the laboratory.

Thanks to this examination method, a specialist is able to detect or exclude a cancerous tumor, as well as determine the type of malignant neoplasm.

If, during histological examination, serious pathological processes are revealed that impair the functionality of the organ and increase the risk of cancer, then intensive therapy is selected.

In this case, a biopsy of the esophagus should be performed every six months to monitor the dynamics of the organ’s condition. The procedure is performed during esophagoscopy, during which a special optical endoscope is inserted to examine the esophagus and detect various abnormalities.

When a gastric biopsy is not possible

Endoscopic gastrobiopsy is a short-term manipulation - 10 - 15 minutes, which is completely painless; as a result, the wound heals quickly and leaves no traces.

Thanks to this study, the specialist has the opportunity to confirm or refute the presence of neoplasms of various etiologies. This method also makes it possible to detect other problems of the organ, and by taking the mucous membrane and tissue of the stomach, perform histological and cytological studies.

A gastric biopsy in 100% of cases allows the doctor to determine an accurate diagnosis and prescribe timely treatment. When oncology is detected, the doctor has the time and opportunity to analyze the reason that led to this situation, give a clear assessment of the condition of the organ, the degree of development of the cancerous tumor and, if necessary, set a timely date for surgery.

A gastric biopsy cannot be performed if the patient has the following problems:

• Narrowed esophagus;
• Gastritis of erosive or phlegmonous type;
• With perforation of the walls of an organ of various origins;
• The presence of various types of mental disorders in the patient, for example, neurasthenia;
• Cardiovascular problems – aortic aneurysm, heart attack, high blood pressure;
• Epilepsy;
• Bronchial asthma;
• In case of damage to the walls of the stomach in the form of burns from chemicals;
• Violation of the blood coagulation system;
• ARVI in the subject - nasal congestion - rhinitis, sinusitis and others;
• Intestinal obstruction;
• Diathesis of hemorrhagic type;
• The patient's categorical denial of this procedure.

Kinds

Esophageal biopsy is divided into targeted and non-targeted. The essence of the latter option is to collect particles of tissue structures from various areas of the tube. Moreover, sometimes biological materials are taken from the entire length of the organ.

This happens during the primary diagnostic procedure, examining the condition of the mucous membrane in the presence of precancerous leukoplakia or Barrett's esophagus. During a non-targeted biopsy, the specialist does not need to visually monitor the tissue sample collection.

Targeted manipulation is advisable when a suspicious polyp or tumor-like neoplasm is detected. Therefore, biological material is taken directly from the tissue of the growth.

A biopsy of the esophageal tube is also classified according to the technical method of sampling. Because of this, the manipulation is divided into aspiration, when a needle of the same name is used, pinching using special forceps, and looping. In some cases, several types of biopsy examination are performed at once.

Is it possible to eat after FGDS?

Nowadays, the question of whether it is possible to eat after FGDS, and what kind of procedure it is, is especially relevant.

Fibrogastroduodenoscopy is, of course, not the most pleasant procedure, but in many cases it is simply necessary. Using fibrogastroduodenoscopy, the doctor examines the esophagus, stomach and duodenum, and takes the necessary tests. This is done for the purpose of conducting an examination and identifying diseases of the gastrointestinal tract.

The patient can find out the exact cause of pain, burning, etc. It is recommended to undergo such an examination at least once a year. Before the examination, the patient is usually warned, or he learns on his own, that special preparation will be required. It consists in the fact that you cannot eat or drink in the evening. And on the day of the study, the stomach should be completely empty. But what about after? Nobody talks about this.

Indications

The appropriateness of using the procedure should be determined by the attending physician.

On this topic

• Biopsy

Temperature, bleeding and other consequences of the biopsy

• Natalya Gennadievna Butsyk
• December 4, 2020

Diagnostic manipulation is prescribed in the following situations:

• For long-term ulcers .
• When identifying suspicious polyp growths.
• To detect or exclude benign or malignant neoplasms
• For atrophic pathologies of the esophageal tube.

A biopsy is also done if the patient suffers from Barrett's esophagus or leukoplakia. These two conditions are considered precancerous. If such pathologies have been occurring for a long time, the procedure is repeated in order to begin surgical treatment in a timely manner.

This type of diagnosis is considered extremely effective, since in 95% of cases it allows to detect malignant tumors in the early stages.

Biopsy: description of the method

The term “biopsy” came to medicine from the Greek language.
It is formed from two words: “life” and “appearance”. The method is based on taking a tiny piece of tissue from the patient and carefully examining its cellular composition at high magnification. Biopsy differs in the method of collecting material and in the accuracy class. When they talk about the accuracy class of a procedure, they mean three types of manipulation:

1. A classic biopsy, which has a second name - exploratory. This procedure is performed in the early stages of the disease, when the location of the tumor cannot yet be detected visually.
2. Open biopsy, when material for research is taken during surgery. This may be the entire tumor or any part of it.
3. A targeted biopsy, which can be performed when a tumor is detected, when the doctor can take material directly from the tumor at the border with healthy tissue. A targeted biopsy is performed using an endoscope, under ultrasound supervision, under X-ray control or stereotactic method.

A gastroscope makes it possible to examine the walls of the esophagus, stomach and duodenum. This medical diagnostic equipment takes the form of a flexible tube of considerable length, which houses a light source, an optical system and the actual instrument for taking a piece of tissue. The tool can be forceps, a medical knife, a loop or a retracting electromagnetic device. The use of such equipment allows you to obtain a sample from a specific area of ​​the organ.

Gastroscopy is constantly being improved. The equipment becomes more accurate and controllable. The modern method has a specific name - endoscopic biopsy.

So, the patient is scheduled for a gastric biopsy. How is this procedure done? If the patient is nervous and cannot calm down on his own, he is offered an injection of a sedative. The person should lie on his left side and straighten up. The doctor treats the oral cavity and upper part of the esophagus with an antiseptic and begins to insert the endoscope.

In modern medical centers, gastric biopsies are performed using advanced medical equipment, which means that the tube is thin and the camera and sample collection device are minimal in size. Swallowing this equipment causes virtually no discomfort. The specialist monitors the procedure using a monitor.

Contraindications

A biopsy of the esophagus is temporarily contraindicated in the presence of acute respiratory diseases that impede nasal breathing, therefore, after eliminating ARVI, a tube diagnosis is made. There are the following prohibitions on the procedure:

• Disturbances mental state that interfere with conscious swallowing of the endoscope.
• Severe cardiac and vascular pathologies. Here, manipulation is prescribed after the elimination of acute symptoms and consultation with a cardiologist.
• State of shock.
• Presence of hemorrhagic diathesis.
• Narrowing of the organ for various reasons.
• Damage to the mucous membrane of the esophagus - burns, wounds, disintegration of a malignant node.

It is important to understand that tomography or radiography using a contrast agent does not provide information about the structure of the cells of a suspicious neoplasm, therefore, after such manipulations, an accurate diagnosis is not made and the correct treatment is not prescribed.

Any recommendations after the event?

Gastrobiopsy is a surgical procedure that can lead to certain complications, so the specialist, taking into account the characteristics of the patient’s condition, after taking the biopsy, will familiarize him with the necessary rules of conduct after the intervention. Following these recommendations will enable the patient to quickly recover at home and return to everyday life.

After completing the procedure, the subject continues to be under the supervision of a doctor for another 2 hours, since during this time the active effect of sedatives necessary to create the effect of numbing the root of the tongue and pharynx continues. During this period, the specialist recommends that the patient not take food or liquid until the sensitivity of the tongue is completely restored and the swallowing reflex appears, which will happen in a couple of hours.

The residual cessation of the effect of sedatives will occur after 12 hours and during this time it is not recommended to drive.

Proper preparation

To study the anatomy of the esophageal tube and determine possible limitations for biopsy, an x-ray examination is performed before the procedure.

The manipulation is carried out strictly on an empty stomach, so the patient must stop eating food 8 hours before the event. If necessary, the organ being examined should be washed.

The patient must understand the importance of this diagnostic process, so you need to prepare for minor unpleasant sensations.

To minimize discomfort, the mucous membrane of the oral cavity and pharynx is treated with a local anesthetic. If the patient is very nervous before the biopsy, sedatives are administered to calm him down.

How to prepare for a biopsy

If a gastric biopsy is prescribed, the patient should receive a referral to the hospital. Technically, carrying out the procedure in a clinic is possible, but it is not advisable, since if complications develop, it will be more difficult to provide assistance to the patient.

Before performing the procedure, medical personnel must ensure that there are no contraindications. After this, the patient is prescribed an x-ray of the stomach.

The patient is required to strictly abstain from eating and drinking for 12-15 hours before the procedure. A gastric biopsy is performed only on an empty stomach, since food masses interfere with an internal examination of the gastric mucosa, and insertion of a gastroscope tube can provoke a gag reflex. Abstinence must be so strict that on the day before the procedure, patients are not even allowed to brush their teeth or chew gum.

Progress of the procedure

Diagnostic manipulation is performed during an endoscopic examination (FGDS). The patient swallows a probe with a video camera at the end, through which a special instrument (needle, loop or forceps) is inserted. To prevent damage to the tube, a mouthpiece is inserted into the patient's mouth. It is important to breathe deeply through your nose during the examination to reduce discomfort.

The duration of the event is 30-40 minutes. The discomfort disappears as soon as the hose is removed, although sometimes the patient experiences pain when swallowing for several days.

After the procedure, it is advisable not to eat for three hours. This is especially true for hot food, which should be avoided for the first day after the biopsy.

How is the endoscopic procedure performed?

To carry out such a procedure, additional anesthesia is not needed, and the duration of this examination is about a quarter of an hour.

A prerequisite is that you cannot eat before this diagnosis; it must be done on an empty stomach (you should not eat food 15 hours before the biopsy).

Before the examination it is prohibited:

• brush your teeth;
• drink liquid;
• Chewing gum is also prohibited.

To carry out a visual inspection, a corresponding device called a gastroscope is used. Before performing a biopsy, you need to take an x-ray of the stomach. If there is a need for this, the person is given a special sedative.

To perform this procedure, the patient needs to lie on his left side and keep his back straight. In this case, the throat and larynx must be treated with agents with an analgesic effect. Then the endoscope is inserted and only after the person takes a sip, the device ends up in his stomach.

The analysis is taken in several places at once if the tissue differs from the rest of the surface.

There will be a feeling of discomfort, so to smooth it out, you need to breathe deeply. After deciphering the test results, the doctor must inform the patient about all kinds of abnormalities that were identified during the biopsy.

Possible complications

The collection of material almost always takes place without any consequences. However, sometimes minor bleeding occurs and goes away on its own. If you experience nausea or vomiting blood, you should immediately seek help.

It is extremely rare that a biopsy of the esophageal tube leads to damage to the organ due to the patient’s movements during manipulation, septic shock, or rupture of a blood vessel.

If the patient does not follow medical instructions and does not breathe deeply through the nose, then there is a risk of vomit entering the respiratory tract. Infection occurs and aspiration pneumonia develops.

If the test subject becomes infected due to insufficient cleaning of the instrument, painful sensations occur and body temperature increases. Poor quality actions of a specialist lead to the formation of edema, abrasions and even perforations on the mucous membrane.

Tissue Research Technique

How exactly is tissue testing done? First, it is crushed, then it is degreased before a histological examination.

To make the fabric strong and flexible, it is filled with paraffin and then cut into thin plates. In this form it is placed on a glass slide.

A conclusion based on the results of the analysis can be given by a histomorphologist who conducts histology using an electron microscope, which allows a detailed examination of all elements.

During the procedure, microtraumas of the mucous membrane and esophagus are possible. They are not dangerous and do not lead to complications.

The instruments used during the procedure are very miniature and they cannot affect muscle tissue.

The procedure does not cause severe pain; the patient may experience mild discomfort.

Immediately after the examination, the patient's tongue sensitivity is restored, the swallowing reflex is normalized, and he can go home. After the endoscopy, you are not allowed to eat for another two hours.

Decoding the results

Most often, manipulation is carried out to identify or exclude a cancerous tumor, so the study of the taken biological material allows us to determine the shape and type of tumor, the structure of tissues, cells, and the depth of the crypts.

Thanks to this analysis, a malignant disease is accurately diagnosed and the type of cancer is determined even at an early stage.

A transcript of the results is given to the patient three days after the procedure. If the conclusion is controversial, the sample is taken again.

If a benign neoplasm is detected, then additional diagnostic methods are prescribed to determine the cause of the development of the pathology. When a malignant tumor is detected, the type of disease, size of the pathological formation, and location are indicated.

Nutritional Features

Already half an hour after fibrogastroduodenoscopy, the patient is allowed to eat and drink.

Someone may not want to eat food after FGDS, because unpleasant sensations may arise in the throat: pain, burning, discomfort. Of course, it is advisable to first have a light snack, for example, oatmeal porridge, fruit or low-fat yogurt, kefir. Since the stomach has not received food for a long time, you should not overload it. It is better to leave smoked meats, sausages, canned food and other similar products for later. You can drink almost any liquid except alcohol.

Some people ignore the rules and start eating immediately after the test, without subsequently experiencing any negative consequences. It's all about the individual structural features of each person's body. You can consult with the doctor who performed the fibrogastroduodenoscopy on what to eat and what not.

After the study has been completed, you cannot remain completely hungry. The stomach may begin to get used to doing without food, and this is very bad. It’s not worth worrying and waiting for the moment when you can definitely eat, and constantly delaying this moment. It is better, as already noted, to consult a doctor with a question that is causing concern and get an answer.

Even if the doctor forbids you to eat for the first few hours after the test, he will also tell you that you need to do it in the evening. But in this case there is no need to starve. Among the patients there are those who go hungry and then go back to the clinic for treatment.

After the procedure, an unpleasant sensation occurs in the throat. A burning sensation and discomfort may also appear. Therefore, you should not immediately eat hard foods. It is best to eat something soft after gastroscopy (mashed potatoes, jelly, soup, fermented milk products). The first meal should be no earlier than four hours after the procedure with a biopsy, without it - no earlier than an hour.

After FGDS of the stomach, it is recommended to eat only light, soft foods. It could be:

• kefir;
• yogurt;
• porridge;
• light soup;
• puree.

You can drink any liquids except those containing alcohol.

It is not recommended to drink alcohol after FGS

After the procedure, the doctor determines the period during which it is necessary to follow a diet.

What can you eat after diagnosis? Strict dietary restrictions apply to preparatory measures before the procedure. To cleanse the gastrointestinal tract, eating any food is prohibited for 12 hours. Allowable time is 8 hours before diagnosis. Smoking and alcohol are prohibited.

After FGS, there are also dietary restrictions, but they relate more to the quality of food than to a complete ban:

• Do not consume hot foods and drinks, especially if a biopsy has been performed;
• Fatty foods and adding spices are temporarily prohibited.

You should not eat immediately after the procedure - bloating and other discomfort may occur. If pain relief has been performed, you should not eat until the functionality of the tongue is restored. How long will it take for tissue swelling to go away? This depends on the speed of restoration of oral receptors. Once you can feel your tongue, you can eat.

Why are hot foods prohibited after a biopsy? Because the gastric mucosa is injured, and the intake of hot food can cause indigestion or even an ulcer. If you want to eat the first course, it is better to let it cool to body temperature.

After the procedure, you should adhere to a certain regime. In the first hours after the procedure, you should refrain from eating. Next, it is recommended to eat light and low-fat foods - oatmeal, yogurt, kefir, fruit. The exceptions will be smoked foods, pickles, spicy, hot and cold foods. The intake of canned food and processed meat should also be postponed until a more favorable period. Among drinks, the exception is alcohol, which can only be consumed 24 hours after the biopsy.

Such food restrictions make it possible for the gastric mucosa to heal as quickly as possible. Neglecting these recommendations can lead to undesirable and even dangerous consequences for the patient’s health.

Advantages and disadvantages

The main advantage of esophageal tube biopsy is the effectiveness of this method. The procedure allows in 95% of cases to detect cancer even at the initial stage, making it possible to begin quality treatment on time.

In addition, with the help of manipulation, various pathological conditions of the mucous membrane of the esophagus are detected, as well as precancerous phenomena, which makes it possible to avoid a dangerous disease.

The disadvantages include the presence of unpleasant sensations during the biopsy.

Doctors about the need for a video examination

Is FGDS considered a dangerous and harmful procedure? Examination of the inside of the stomach is necessary to clarify previously performed tests. The procedure is safe for most patients and does not pose a risk to the body. However, to perform a biopsy, it is better to contact a good clinic and highly qualified specialists. In this case, any risk will be minimized.

A biopsy is considered a diagnostic procedure; it is thanks to its completion that the treatment tactics will be correct. It all depends on the test results.

If a biopsy is performed if a tumor is suspected, then using this method it is possible to determine the type of formation and its composition. A positive result will be final. If the conclusion is negative, then the specialist may prescribe the procedure again.

In any case, surgical treatment is carried out only if the atypical cellular composition is confirmed. Thus, the treatment of a particular disease directly depends on the results shown by the biopsy.

Carrying out FGDS with biopsy: indications and contraindications, preparation for the procedure

A biopsy may be prescribed in the following cases:

• studies are prescribed to identify oncopathology or precancerous conditions;
• analysis may be necessary for acute or chronic gastritis;
• to clarify the ulcerative process and exclude suspicions of oncology;
• in case of damage to the gastric mucosa to clarify the extent of organ resection;
• a gastric biopsy can reveal the presence or absence of Helicobacter in case of digestive disorders;
• The study allows you to assess the patient’s condition after surgery or radiation therapy.

However, despite its high efficiency, this diagnostic method cannot be applied to all patients.

When diagnosing any disease, the doctor is obliged to ensure that he does not harm the patient or put his life at risk. Based on this principle, when prescribing any procedure, all possible contraindications are taken into account. In the case of a gastric biopsy, this is:

• state of shock;
• diseases of the heart and vascular system;
• inflammatory or other pathological processes in the pharynx, larynx or respiratory tract;
• diathesis (hemorrhagic form);
• infectious diseases in the acute stage;
• narrowing of the esophagus;
• the presence of perforations of the stomach walls;
• stomach burn from chemicals;
• psychical deviations
• allergic reactions to painkillers (lidocaine and others).

In addition to obvious contraindications, the doctor must take into account the patient’s psychological preparation for the procedure. If there is pronounced fear, then it is better not to conduct the study.

Stomach diseases occur in almost every third person. First of all, these are various types of gastritis and peptic ulcers. However, more serious diseases can also occur, for example, tumor damage to the organ wall with the development of metastases.

The gold standard in diagnosing stomach diseases is fibroesophagogastroscopy, which allows the doctor to visually assess the condition of the mucous membrane of the organ and draw a conclusion about the necessary treatment. But such a procedure cannot always give an accurate answer about damage to the stomach.

Then gastroscopy with biopsy is used - a method of morphological examination of the organ after preliminary staining of the obtained gastric sample.

Fiber gastroscope with biopsy tip

FGDS with biopsy is a combination of two diagnostic methods - fibrogastroduodenoscopy (FGS, FGDS) with fine-needle biopsy and subsequent morphological analysis of the obtained sample of the gastric mucosa.

When performing FGS, a thin flexible probe with a video camera and a light source is inserted through the esophagus into the stomach.

This allows you to visually assess the condition of the mucous membrane of the esophagus and stomach, identifying pathological processes in their wall: inflammation, ulcerative defects, tumor growth, etc.

The main advantages of conducting this survey:

• Thanks to a good video camera, the image has a high degree of detail, which makes it possible to identify even minor changes in the walls of the organ.
• It is possible to detect erosions and small polyps that are invisible during X-ray examination.
• FGDS is the best method for identifying the source of intragastric bleeding with the possibility of stopping it during the procedure.
• A biopsy during FGDS allows you to quickly diagnose tumor diseases due to the possibility of their morphological examination.

A biopsy consists of a minimally invasive procedure involving the collection of a small fragment of the gastric mucosa (sample diameter is several millimeters).

After this, the sample is passed through a series of special stains, which allows individual cells to be visualized and their condition assessed.

Biopsy during FGDS is an indispensable method in the diagnosis of benign and malignant tumors, especially in the initial stages of their growth.

Morphological examination of the mucous membrane allows us to identify pathological processes at the earliest stages of their development.

The doctor monitors the progress of gastroscopy on the monitor

Endoscopic examination of the stomach with biopsy is widely used to diagnose various diseases. There are two methods of performing a biopsy:

• fine-needle, which involves excision of a small fragment of the mucosa;
• aspiration, when organ cells are obtained through special suction.

In each specific case, a certain type of method is selected individually.

There are two types of gastric biopsy: targeted and blind.

In the first case, the attending physician visually monitors the procedure and can select the appropriate area of ​​the organ mucosa for further analysis.

As a rule, the tissue area with the most pronounced pathological changes (erosions, bleeding vessels, etc.) is selected. In the blind method, a fragment of the mucous membrane is taken without visual control.

The patient undergoes FGDS with biopsy

FGDS with biopsy is performed only if the patient has certain indications:

• The need for differential diagnosis of the ulcerative process and tumor growth in the form of an ulcer.
• Early detection of precancerous and tumor changes in the cells of the gastric mucosa.
• Difficult diagnostic situations (Crohn's disease with damage to the stomach, malignancy of the edges of an ulcer, etc.).
• Determination of Helicobacter pylori infection using morphological examination.

The procedure should be carried out only after consultation with the attending physician and a gastroenterologist.

Despite the high information content of the procedure, FGDS and biopsy are contraindicated in the following situations:

• Decompensated state of any diseases of internal organs (respiratory, cardiovascular, urinary system, etc.).
• Blood clotting disorders.
• Conditions and diseases leading to obstruction of the esophagus or intestines.
• Mental disorders in the patient.
• Acute infectious diseases and exacerbations of chronic infections.
• Inflammatory processes in the larynx, nasal cavity and pharynx.

If the patient has no contraindications, then preparations for the study begin.

Your attending physician will tell you about proper preparation for FGS.

Preparation for EGD of the stomach with biopsy does not require special measures, however, there are several recommendations for patients. The attending physician must prepare the patient psychologically for the procedure - explain the risks and possible complications, describe the course of the study and the necessary measures.

Regardless of the duration of the procedure, a number of general tips can be identified:

• A few days before the study, stop drinking alcoholic beverages, spicy and hot foods.
• Do not take food or liquid 3-4 hours before the test.
• The evening before the test, the patient may take sedatives to reduce stress levels.
• Do not take medications that can reduce the effectiveness of hemostasis (Aspirin, etc.).
• If the patient has an increased gag reflex, local anesthetics may be used.

Description of the procedure

Gastroscopy with biopsy examination is performed in an endoscopy room by specially trained doctors. A special flexible endoscope is used, equipped with a light source and a small video camera that allows visual control of the procedure.

It is very important to follow the procedure to minimize the risk of complications.

The probe is carefully inserted into the esophagus through the mouth and carefully advanced into the stomach. As a rule, already at this stage the attending physician carefully monitors the resulting image and evaluates the mucous membrane of the organs.

When it enters the stomach, the probe allows you to examine all its walls, and, if necessary, assess the condition of the duodenum. In this case, the biopsy is performed in a targeted manner, i.e.

a “suspicious” area of ​​the mucous membrane is removed.

A biopsy is performed to clarify the diagnosis or monitor treatment

Upon completion of the study, the probe is removed and the patient can immediately leave the hospital if anesthesia was not used. If anesthesia was used, the patient is left in the hospital for a certain time for observation.

Complications after gastroscopy occur extremely rarely, however, in a number of situations, the following conditions may occur:

• As a result of inflating the stomach with air, nausea, belching, flatulence and bloating in the epigastric region are possible. Such discomfort goes away within a few hours without treatment.
• If sterility conditions have been violated, various bacteria are likely to enter the stomach.
• If the technique of the procedure is violated, the walls of the esophagus and stomach may be injured, resulting in bleeding.

If complications develop, it is necessary to stop the procedure and begin therapeutic measures.

Gastroscopic examination with biopsy is the “gold” standard in the diagnosis of diseases affecting the stomach, in particular, various precancerous and tumor processes.

Proper preparation of the patient and adherence to the procedure allows obtaining informative results while maintaining a low risk of complications.

A gastric biopsy is a fairly traumatic procedure, so it is prescribed only for certain indications. Why do a biopsy?

• Gastritis with unknown type of secretion.
• If your stomach hurts for a long time, but no cause of pain is found during a routine examination.
• Dspeptic phenomena accompanied by unmotivated weight loss.
• Jaundice not associated with liver pathology.
• Suspicion of Barrett's esophagus or intestinal metaplasia of the stomach.
• Polyps of the gastric mucosa.
• Suspicion of malignant gastric ulcer.
• Suspicion of a malignant tumor.

Malignancy of an ulcer is a direct indication for a biopsy.
A biopsy is a secondary diagnostic method when non-invasive methods (ultrasound or x-ray examination) are in doubt. No study can compare with a biopsy in terms of accuracy, since the pathology here is determined at the cellular level.

Contraindications to the procedure relate largely not to the biopsy itself, but to the method of access to the stomach cavity - gastroscopy.

Endoscopic examination is not performed in the following situations:

• Stenosis of the esophageal lumen - adhesions or scars.
• Spasm of the cardiac part of the stomach.
• Acute processes – cardiovascular and pulmonary pathology.
• Blood clotting disorder.
• General inflammatory processes with a rise in body temperature.
• Impaired mental state of the patient.