Name of the Procedure:

Gastric Intubation and Aspiration, Diagnostic
Common names include Gastric Secretory Study, Gastric Stimulation Test.

Summary

Gastric intubation and aspiration with gastric stimulation is a procedure used to collect multiple samples of stomach fluids. This involves the introduction of a tube into the stomach to analyze the secretion of stomach acids and enzymes after administering stimulants like histamine or insulin.

Purpose

The procedure helps to:

• Diagnose conditions related to abnormal stomach acid production.
• Assess the function of stomach cells.
• Determine the cause of unexplained stomach symptoms.

Indications

Indications for this procedure include:

• Unexplained stomach pain or discomfort.
• Suspected peptic ulcers or Helicobacter pylori infection.
• Abnormal levels of stomach acids.
• Preoperative assessment for certain stomach surgeries.

Preparation

Patient Instructions:

• Fasting for at least 8 hours before the procedure.

• Avoidance of certain medications that may affect stomach acid, as advised by the doctor.

  Pre-Procedure Tests:

• Blood tests to check for any underlying conditions.
• Review of the patient’s medical history and medications.

Procedure Description

1. The patient is positioned comfortably.
2. A thin, flexible tube (single or double lumen) is inserted through the nose or mouth and guided to the stomach.
3. Baseline gastric fluid samples are collected.
4. A stimulant (e.g., histamine, insulin, pentagastrin, calcium, or secretin) is administered to the patient to induce stomach acid production.
5. Additional fractional samples of gastric fluids are collected over a period.
6. The tube is removed once the collection is complete.

Tools and Equipment:

• Nasogastric or orogastric tube.
• Syringes for fluid collection.
• Stimulant drugs.

Anesthesia:

• Local anesthesia (to numb the throat).
• Mild sedation may be given to ensure comfort.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

It is usually performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

Healthcare team includes:

• Gastroenterologist or trained medical specialist.
• Nurses.
• Possibly an anesthesiologist if sedation is used.

Risks and Complications

Common risks:

• Discomfort or gagging sensation during tube insertion.
• Nausea or vomiting.

Rare risks:

• Nosebleeds.
• Minor throat or stomach irritation.
• Infection or aspiration pneumonia (very rare).

Benefits

Expected benefits:

• Accurate diagnosis of stomach-related conditions.
• Guidance for appropriate treatment.
• Quick results can usually be expected within a few days.

Recovery

Post-procedure care:

• Observation for any immediate complications.
• Instructions on when to resume normal diet and activities.
• Possible throat soreness which typically resolves within a day.

Expected recovery time:

• Most patients can return to normal activities immediately.
• Any dietary restrictions or follow-up appointments are determined based on the results.

Alternatives

Other diagnostic options:

• Endoscopy.
• Imaging studies (e.g., CT scan, MRI).
• Blood tests for H. pylori.

Pros and cons:

• Endoscopy provides visual inspection but is more invasive.
• Imaging studies are non-invasive but may not provide detailed information about stomach acid production.

Patient Experience

During the procedure:

• The patient may feel discomfort during tube insertion.
• Mild sedatives can ease the process.

After the procedure:

• Temporary throat soreness or mild discomfort.
• Eating and drinking can typically be resumed shortly after the procedure.
• Pain management involves over-the-counter pain relievers or topical solutions for throat discomfort.