Dr. Petyo Kompanski, MD, is the head of the Department of Gastroenterology at the University Hospital in Burgas. He is a specialist in gastroenterology and internal medicine, doctor of medical sciences. He graduated in medicine in 1982 at MU-Sofia. His work experience began as a resident in "Ambulance", where he worked for 4 years. From January 1, 1986, he was assigned to the internal department - gastroenterology sector, where he reached the position of senior doctor, and subsequently became the head of the sector. After the transformation of the sector into a Gastroenterology Department, he heads it until now. In 2003, he defended his dissertation on "Ulcer disease and gastric carcinoma - epidemiological and clinical studies". He has additional qualifications in abdominal ultrasound, Doppler ultrasound, fibrogastroscopy first and second level, fibrocolonoscopy first and second level
Dr. Kompanski, when is fibrogastroscopy required?
- In recent years, fibrogastroscopy is the most used method in the diagnosis of malignant diseases of the digestive tract - mainly the esophagus and stomach. Among those affected are both middle-aged and very young people.
Our department has the latest endoscopy equipment with video surveillance - fibrogastroscope and fibrocolonoscope, for quality examination.
How informative is the method in specifying the diagnosis of stomach cancer?
- Fibrogastroscopy is a state-of-the-art method that has greatly contributed to reducing the risk of developing stomach cancer. Through it, the earliest stages of gastric carcinoma and carcinoma in situ can be detected - the changes that occur in the mucosal relief. They are diagnosed endoscopically and histologically, based on taking histological material with a biopsy clip from the gastric mucosa.
How is the procedure itself conducted?
- In fibrogastroscopy, a thin optical tube is penetrated through the oral cavity, which passes through the esophagus and reaches the stomach and the beginning of the duodenum. Through it, changes in the tissues and mucous membranes are examined in detail.
In which other diseases are endoscopy and fibrogastroscopy so important?
- Endoscopy and fibrogastroscopy also help in the early diagnosis of gastric ulcer. At all costs, it must be diagnosed endoscopically and histologically, because it is a precancerous condition. The test is also indicated for functional dyspepsia of the stomach, in which the presence of the Helicobacter pylori bacterium is often detected in gastric biopsies.
There are different opinions on the relationship of this bacterium. Should Helicobacter pylori be treated? What's your opinion?
- Helicobacter pylori treatment should not be neglected, because the bacterium leads to the development of hyperacid gastritis, duodenal ulcer, stomach ulcer, polypous dysplasia (polyps) and, above all, the development of cancer. Helicobacter pylori is removed by drug treatment and a hygienic-dietary regime.
Self-treatment of Helicobacter pylori infection temporarily masks the ulcer and can have serious consequences - stomach cancer. Since the bacterium has been shown to be a major culprit in a number of stomach ailments, many non-specialist doctors have been prescribing drugs against it. Thus, in recent years, stomach and duodenal ulcers have been diagnosed less and less. Years ago, they were the predominant diagnosis for gastroenterologists. Now leading are tumors of the rectum and colon, of the lower digestive tract - carcinoma of the colon, rectum and sigmoid colon.
Medication alone is not enough for an ulcer, it must be periodically monitored endoscopically. Be it because of self-medication, difficult access to specialists, or low he alth culture, but recently people come to my office with very serious illnesses that could have been avoided.
Which patients fall into the risk group for developing a stomach ulcer?
- Most often people between the ages of 45 and 55 suffer from stomach ulcers. This is due to both age changes and stress, smoking, working with toxic preparations, infection with Helicobacter pylori, and in Burgas, sea influences also play a role. However, gastroscopies are often required for young people aged 18-20.
Are there foods that cause colon cancer?
- Bulgarians don't even know how to eat properly, and some know but don't do it. The risk factors for the stomach are clear: too much alcohol, smoking and poor quality food. Stress also plays a role. Fatty foods, sausages, bacon, eggs, animal fats, fried, spicy, s alty, sour foods should be avoided. There is strong evidence that colon and stomach cancers are associated with consumption of fatty foods, fried, spicy, fatty chicken, nitrate-rich sausages or smoked fish. Instead, we should choose more fresh fruits and vegetables rich in vitamin C and starch.
Bulgarians are quite tolerant of alcohol consumption. It is considered almost normal to drink 50-100 g of concentrate every night, followed by beer and wine. The liver enzyme - alcohol-dehydrogenase, which is responsible for breaking down alcohol, can break down no more than 80 grams of hard alcohol per day. If wine or beer is drunk, the dose is no more than 2 glasses per day.
I don't recommend eating sushi, which is fashionable lately, especially when it's made with raw fish. It is also very s alty. If you do decide to eat it, do it extremely rarely, no more than twice a year.
Men suffer 2 times more often than women
Early stomach cancer has no characteristic symptoms. In the beginning, they are non-specific and occur in many diseases. There may be: fatigue, loss of appetite, lack of energy, heaviness in the upper abdomen. However, there may be no initial complaints. It is possible that the first symptoms appear in other organs, which is a sign of already developed metastases. Loss of appetite and weight loss are observed in 50-70 percent of patients - however, they are often late symptoms of the disease. The progress of this insidious disease is followed by heaviness in the upper middle part of the abdomen, pain, discomfort. About 70 percent of patients with stomach cancer experience such pains. Clinical symptoms are determined by the size of the tumor and the place where it develops. When it has covered the initial part of the stomach, the leading symptom is difficulty swallowing or regurgitation of just swallowed food. Vomiting is more common in cancer that has reached the end of the stomach - the transition from the stomach to the duodenum. Early satiety (soon after the start of a meal) is a characteristic symptom of cancer that surrounds the stomach like a belt. The collection of fluid in the abdominal cavity indicates an advanced process. The disease progresses relatively quickly and usually lasts about 6 months to 1 year after its detection
In younger people, it proceeds even faster and with relatively greater malignancy. In the course of the disease, a number of complications may occur, such as hemorrhages (hematemesis and melena), stenosis of the pylorus, perforation of the stomach wall, etc. The process quickly metastasizes to regional lymph nodes and the liver. With metastases in the liver, it grows, becomes hard and uneven, jaundice appears.