Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug administrat
CPT4 code
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
- The patient is positioned comfortably.
- A thin, flexible tube (single or double lumen) is inserted through the nose or mouth and guided to the stomach.
- Baseline gastric fluid samples are collected.
- A stimulant (e.g., histamine, insulin, pentagastrin, calcium, or secretin) is administered to the patient to induce stomach acid production.
- Additional fractional samples of gastric fluids are collected over a period.
- 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.