Of the direct methods for detecting opisthorchia infection, laboratory stool studies are the simplest, but they can not always be applied with sufficient reliability. It is very likely to find out about the diseases caused by the liver flukes, and also to reveal the eggs of the worms even if their content is insignificant, possibly with duodenal probing. With opisthorchiasis, probing makes it possible to know the state of the biliary tracts from the samples of duodenal contents and isolate the eggs of parasites.
The procedure for probing with opisthorchiasis is to stimulate the ejection of bile from the bladder into the duodenum and its extraction with a probe. In this case, together with the bile, the bubble leaves the opisthores that have settled there and their eggs. To activate the release of bile by the probe, a heated 33% solution of magnesia in the amount of up to 50 ml is introduced into the intestine. The following processes occur:
- The sphincters of the gallbladder and the common bile duct are revealed.
- The gallbladder shrinks.
appoint solutions of sugar, glucose, sorbitol, high concentration xylitol or olive oil. Preparation for duodenal probing with opisthorchiasis takes from two to three days and at this time the following medicines are canceled:
- of cholagogue;
- vasodilator and antispastic;
- laxative substances with choleretic effect such as Karlovy Vary salt, xylitol, magnesium sulphate;
- drugs used to improve digestion or increase the intensity of gastric juice;
- other drugs that affect the increase in bile production. In addition, at this time, it is necessary to stop the intake of medicinal herbs acting on the bile excretory system and with another effect similar to medicines.
A week before probing with the opisthorchiasis, it is not recommended to perform a blind sounding procedure in order to obtain more accurate results. The diet remains familiar, but fatty, fried foods, rich meat and fish broths, and also with a high sugar content, alcoholic drinks and other stimulating cholagogue system, it is desirable to exclude from the menu. Before the day of research, they eat early and easily, and on the day of the examination one can not eat or drink anything.
Two techniques are used in conducting duodenal sounding with opisthorchiasis:
- three-phase traditional;
- fractional.
In the classical method, the contents are taken from the 12-digestive gut, bile ducts, liver and bladder in three phases. A more progressive method is the five-phase fractional method. In the first phase, the probe takes bile, pancreatic, intestinal and partially gastric juice from the bowel for 20 minutes. After the introduction of magnesia, probing with opisthorchiasis takes 4-6 minutes, and this is the second phase. In the third phase, within 3-4 minutes, the contents of the extrarenal biliary tract are secreted. In the fourth bile of dark color is allocated, and in a final phase bile again goes light color.
All samples obtained after duodenal probing of the opisthorchiasis are examined under a microscope and subjected to bacteriological examination. The results of duodenal sounding in opisthorchiasis are determined by changes in the color of bile, each portion of which should normally correspond to its color. Normally, all bile portions should be clear, so turbidity indicates pathology. The violations in the work of the gland, liver is indicated by an increase in the density of bile, the content of bile acids, cholesterol and bilirubin. In addition, eggs are present in the bile of parasites.