Examination of the Vomit: The character of the vomit varies with the nature of the food ingested and the absence or presence of bile, blood or intestinal obstruction. In obstruction of the stomach at the distal end, i.e. farthest from the stomach (pyloric stenosis), the vomit is apt to be copious and sour smelling, contains recognisable food eaten many hours before and exhibits froth on the surface. In case of an ulcer in the stomach, if the bleeding is much, the colour of blood in the vomit is red, but if the bleeding is less, then it gets altered to dark brown colour like coffee by contact with gastric juice. If there is obstruction in the intestine, the vomit may smell and look like faecal matter.
Examination of Ascitic Fluid: If the patient has swollen abdomen and physical examination reveals presence of fluid, then this fluid is removed either for diagnostic or for therapeutic purposes, in order to relieve him of the discomfort. The fluid withdrawn is sent for cytological, bacteriological examination and chemical analysis.
Barium Meal: A contrast meal such as barium compound, opaque to X-rays is given to the patient to swallow. This makes the part opaque in contrast to the rest of die structures, so that any abnormality such as a filling defect can be noticed on the X-ray.
Stomach cancer shows on X-ray as a filling defect in the barium-filled organ. The whole examination requires 6 to 24 hours to complete. Patient is asked to take light meal the previous night and not to take anything in the morning till the X-ray examination is over.
Barium Enema: Light food, preferably with least residue is taken for two days before the test. No solid food is taken the night before the test. A laxative is given a day before the test. An enema is done to wash the lower bowel clean.
Barium mixture is run into the bowel by a tube inserted into the rectum above the anus. The barium is seen by the radiologist on the X-ray screen in the dark room and wherever necessary, he takes the X-ray. The barium is then evacuated and further films taken.
By this means, obstruction to the colon in the large intestine by cancer and other abnormalities can be detected.
Gastroscopy: A gastroscope, made up of a bundle of fibre glass, is flexible. It is introduced through the anaesthetized mouth and pharynx into the oesophagus, the stomach and up to the duodenum. With its front and side source of light, it can see all structures that it passes through directly. Also wherever necessary, it can take a punch biopsy which is examined histologically and a diagnosis made of the disease. It can be done in the out-patient department.
This procedure is of great help in differentiating cancer from non-cancer lesions.
Proctoscopy: The anal canal and lower rectum can be readily seen with a proctoscope. The patient cleans his bowels first, if there is urge. He is placed on the bed in a side position with knees bent. The lubricated instrument is passed to its full length. The lower end of the gastro-intestinal tract is seen directly.
Sigmoidoscopy: It is often necessary to examine the rectum and colon more fully than is possible by proctoscopy, and in such cases sigmoidoscope is employed. A lubricated stainless steel tube with small light bulb at the front, is inserted into the anus gendy and the walls of the rectum examined for cancer or at abnormality. It causes only a discomfort but no pain.
Colonoscopy: While a sigmoidoscope is a metallic hard tube, colonoscope is elastic, the inside of which is made up of a bundle of glass fibres which transmit light from the source to its front-most part The colonoscope is introduced through the anus and since it is flexible, it can bend round the curves and go up and visualize the whole of the large colon.
A biopsy can also be taken through the colonoscope of the part of the large bowel suspected of any disease.