Modern methods of intestinal diagnostics make it possible to see the first changes in the structure of the mucous membranes and reliably establish the cause and consequences clinical manifestations. One of these methods includes endoscopic treatment diagnostic procedure- intestinal colonoscopy.
Colonoscopy is a method of therapeutic diagnostic study intestines along its entire length. The manipulation is carried out using special equipment - a colonoscope. The equipment has several barrels for a probe and surgical instruments.
During the study, you can not only assess the condition of the intestines, but also carry out a number of simple therapeutic procedures:
- Removal of polyps and local pathological foci;
- Stopping bleeding;
- Elimination of adhesions;
- Fence biological material for histological examination.
A modern colonoscope is equipped with an optical device and lighting to improve visualization. The resulting image is transmitted to a computer monitor, which allows the doctor to thoroughly study the condition of pathological foci, the nature of changes in the mucous membranes, and the anatomical features of the intestinal sections.
You can also video record the resulting image online and transfer it to specialized specialists for evaluation:
- proctologist,
- oncologist,
- gastroenterologist.
Why is a colonoscopy done: indications
Colonoscopic examination - promising direction in making a final diagnosis, as it involves the simultaneous implementation of a wide range of manipulations. The main indications for colonoscopy are atypical symptoms and patient complaints.
The objective of the study is to:
- differentiation of various diseases of the lower and upper sections digestive system;
- manifestation of the final diagnosis based on the obtained image data;
- histological and cytological analysis.
The following complaints are indications for the procedure::
- pain during bowel movements;
- the appearance of atypical discharge from the rectal canal (blood, mucous component, serous exudate, pus);
- nagging pain in the lower abdomen without connection with bowel movements;
- suspicion of inflammatory processes in the intestines:
- risks of developing a malignant tumor.
Today, colonoscopy is included in the list of mandatory preventive examinations in patients with a hereditary predisposition to intestinal cancer, as well as at the age of 40-45 years.
Given the high oncological risks, it is necessary to regularly undergo examination of the intestines using endoscopic methods.
What does the research reveal and show?
Using colonoscopic equipment, the doctor is able to discern any atypical changes in the mucous membranes relative to the norm and assess the extent of the lesion in accordance with the patient’s clinical history.
The research has the following capabilities:
- visualization of scars, ulcerative lesions, erosions, polypous neoplasms (types of polyps in the intestine);
- sources of bleeding;
- the nature of hemorrhoids;
- simultaneous elimination of bleeding areas;
- the ability to obtain photographs and video images of the pathological area.
Using colonoscopy, you can easily identify a foreign body and remove it, perform a biopsy of a suspicious fragment of the mucosa and assess the oncological risks.
On a note: often after minimally invasive diagnostic methods, doctors decide to perform a colonoscopy due to the high information content and accuracy of the manipulation.
What does bowel cancer look like?
Cancerous tumors are not particularly diverse endoscopically. This is especially true for cancer tumors localized on the right side colon(this is what is usually diagnosed in the terminal stages).
The main symptoms of bowel cancer are:
- stable bowel movements and frequent alternation of constipation and diarrhea;
- blood (explicit or hidden) in the stool;
- night sweats;
- intestinal stenosis and the appearance of pencil-shaped feces.
Frequently regular confirmation of tests for occult blood and is the only symptom characterizing the appearance of cancer cells in a tumor or, more recently, a benign polyp.
Colonoscopically, the resulting image visualizes a changed area of the mucous epithelium. To confirm oncological risks, a biopsy is taken for further research. Even if there is evidence of the appearance of atypical cells, it is not always possible to make a final diagnosis.
An oncologist surgeon sometimes needs more information than a laboratory technician’s report. The main difficulty is not in diagnosing a typical cancer, but in its differentiation and the ability to see individual features.
Which doctor performs colonoscopy of the intestine?
An appointment for a colonoscopy is issued by a proctologist, surgeon, or gastroenterologist. The procedure itself is performed by an endoscopist. During the manipulation, an anesthesiologist (if anesthesia is necessary) and junior medical personnel may be present in the office.
How is the procedure done?
The colonoscopic examination procedure follows a certain algorithm. After additional examinations, a date for the manipulation is set.
A few days before the procedure, patients switch to a waste-free diet, and the day before the colonoscopy, additional bowel cleansing is performed with a classic enema or by medication. Information about what you can eat before a colonoscopy 3 days in advance.
Given the characteristic discomfort during manipulation, the procedure involves pain relief.
There are several main methods of pain relief during the procedure.:
- Local anesthesia— treatment of the tip of the colonoscope with anesthetic;
- Sedation— light medicated sleep without deep depression of the patient’s consciousness (price of colonoscopy with sedation);
- General anesthesia— absolute depression of consciousness and complete painlessness (cost of colonoscopy under anesthesia).
The advantage for the doctor is local anesthesia, which maintains communication with the patient and control over the progress of the entire procedure. However, in some cases the procedure is only possible using general anesthesia or sedation.
To ensure deep medicated sleep, patients undergo additional examination on the subject allergic reactions so that the doctor has an idea of all the possible risks when administering a particular medication.
How is colonoscopy done?
The examination is carried out with a colonoscope - equipment with several surgical passages, a flexible hose of 1.5 m, a lighting and magnifying device, and a camera. The appearance of the equipment may vary depending on the modification, model and functionality.
Every year, medical engineering allows colonoscopes to be equipped with new capabilities.
Algorithm and technique
The procedure takes place in a specially equipped room. On the day of the examination, the patient may be given an additional enema. The patient enters the room, undresses, changes into a special hospital gown and lies on the couch on his side with his legs bent at the knees.
- Preparation and setup of equipment;
- Antiseptic treatment of the anus;
- Administration of anesthesia (or treatment of the tip of the colonoscope);
- Inserting the tip 3-4 cm into the rectal canal to inject air atmospheres;
- Gradual insertion of the probe along the entire length of the intestine;
- Surgical procedures (if necessary);
- Removing the probe upon completion of the manipulation;
- Removal of excess air;
- Antiseptic treatment of the anus.
Total duration A typical diagnostic study usually does not exceed 15-30 minutes. If surgical correction is necessary, the time can be increased to 60 minutes.
Colonoscopy results
A description of the results of a colonoscopy examination is usually ready within 2-3 days from the date of the procedure. The time frame may be extended if a biopsy is performed at the time of colonoscopy (time to obtain histology results), surgical procedures(time to assess mucosal healing).
If additional data is necessary to reliably assess the condition of the intestines, then final results can be obtained 10 days after the procedure.
The diagnostic criteria are based on the following theses::
- Condition of mucous membranes (shade, deformation, humidity);
- Anatomical structures relative to the norm (location, size, bends of the intestinal sections);
- Size and quantitative composition of tumors, polyps;
- The presence of foci of bleeding, hemorrhoids. How to do a colonoscopy if you have hemorrhoids;
- The presence of inflammatory foci, pus;
- Cleanliness of the folds of the mucous membranes (fecal stones, mucus, excrement);
- The patient’s age and compliance of the intestinal sections with this criterion.
In the conclusion, the additional manipulations performed must be indicated, and a disk with a photo or image of the ongoing process is issued. Patients pass on the information received to a specialized specialist to determine further tactics for patient management.
How dangerous is the procedure - possible complications
Colonoscopy is not a pleasant or painless procedure:
- Firstly, there is obvious discomfort when air is pumped in to straighten the mucous membranes and improve visualization.
- Secondly, moving the probe further than 15 cm can cause a feeling of pain and contraction of smooth muscles.
- Thirdly, involuntary contraction makes it difficult to advance the probe and causes even greater discomfort to the patient.
Complications can arise due to the doctor’s unprofessionalism or the lack of many years of experience in performing such manipulations.
The following are distinguished: possible risks and complications:
- Perforation or perforation of mucous membranes. A rare complication that usually occurs against the background of existing ulcerations and thinning of the mucous membranes associated with erosive damage to the intestinal walls. The pathology requires immediate surgical intervention.
- Bleeding. Intestinal bleeding can occur both during and after manipulation, especially with a complicated coloproctological history. Bleeding of varying intensity can occur after surgical interventions.
- Pain in the lower abdomen. Discomfort with the lungs nagging pain after the procedure is normal. They usually go away on their own after a few days or after taking antispasmodic drugs. If symptoms intensify or persist, it is recommended to consult a specialized specialist.
- Infection. A rare complication that occurs due to insufficient antiseptic treatment of the colonoscope or non-compliance with personal hygiene by the patient after surgical procedures.
- Traumatic damage to the walls. Injury to the intestinal mucosa can occur in the presence of adhesions, as well as during colonoscopy under sedation or general anesthesia. It is for this reason that doctors prefer local anesthesia to keep the patient conscious and control the reaction during the passage of the probe.
Complications are also possible after anesthesia in the form of spontaneous or unexpected allergic reactions such as rash, hives, itching, and partial depression of consciousness.
Attention! If after the procedure there is nausea, general weakness and malaise, or heavy bleeding from the rectal canal, you should immediately contact a specialist or call an ambulance.
Typically, endoscopic colonoscopy is uneventful. Compliance with all medical recommendations during the preparation period and after the manipulation reduces all potential risks to zero.
Types of research
Endoscopic colonoscopy is a collective term for many procedures that examine the condition of the intestinal tract.
The following types of research are distinguished::
- Ultrasound colonoscopy. A new minimally invasive method of examination, involving rectal insertion of a sensor or examination of the intestinal sections through the peritoneum. The main advantage is the ability to diagnose tumors at early stages of development. Contraindications are signs of peritonitis, ulcerative colitis, exacerbation of chronic diseases.
- Capsule colonoscopy. Modern method examination of the colon, which is often combined with examination of the epigastric and stomach organs. The uniqueness lies in the ability to examine in detail the entire length of the intestinal sections, follow all the digestive stages, and examine the condition of the walls of the esophagus, stomach, and intestines. The patient simply swallows a capsule with a built-in video camera and goes about his usual activities. The capsule comes out with the natural process of defecation. The only drawback is the high cost. What's happened capsule colonoscopy.
- Virtual colonoscopy. The virtual research method essentially resembles MRI diagnostics, but it helps to identify only large growths on the mucous membranes. During the manipulation, you can get clear pictures with a three-dimensional image of the colon and even cover a separate part small intestine. What better colonoscopy or virtual colonoscopy.
- Rectosigmoscopy. A research method used when it is necessary to study the rectal lumen at a distance of up to 45-50 from the anus.
- Sigmoidoscopy. The method allows you to estimate only 30-35 cm of the length of the rectum from the anus. Which is better: colonoscopy or sigmoidoscopy?
In all cases, standard preparation is required: diet and maximum bowel cleansing to improve visualization.
Unfortunately, in many cases, minimally invasive methods are a preliminary stage of diagnosis. Often, after the examination, doubts remain, and doctors prescribe a full-fledged colonoscopy.
What parts of the intestine does a colonoscopy check?
Colonoscopy allows you to evaluate the condition of all parts of the large intestine: rectum, colon, cecum and sigmoid colon.
First, the endoscopist examines the area of the lower parts of the gastrointestinal tract, and then assesses the condition of the cecum and sigmoid colon. The cecum borders the department small intestine, so you can also examine part of the small intestine.
How is colonoscopy done for adhesions after surgery?
There are many myths and various unclear questions about colonoscopy. Fear of pain, delicacy and specificity of the manipulation frighten many patients.
The procedure can be performed for the following conditions:
- Colonoscopy and adhesions. Spikes increase painful sensations during the procedure, make the passage of the probe difficult or impossible. During a colonoscopy, surgical removal of the pathology is possible.
- Colonoscopy after intestinal surgery. In the early postoperative period or after ostomy, patients are recommended to turn to minimally invasive diagnostic methods (irrigoscopy, ultrasound, virtual colonoscopy). IN late period It is important to assess the general condition of the patient, the extent of the intervention performed, the degree of healing of the wound surfaces and the feasibility of the procedure.
- Treatment for endometriosis. Intestinal endometriosis is usually diagnosed through colonoscopy. There are no other specific diagnostic methods. The manipulation is carried out on a certain day menstrual cycle, since both processes are closely related.
Whatever the purpose of the diagnostic procedure, you should trust your doctor and undergo an examination.
Contraindications
There may be absolute and relative contraindications for colonoscopy. The only exception is the need for emergency intervention.
The procedure cannot be performed for the following conditions and diseases:
- Cardiovascular diseases;
- Insufficiency of liver and kidney function;
- Diseases of the lungs and respiratory system;
- Instability of blood pressure, arterial hypertension;
- history of diverticulitis;
- Inguinal-scrotal or umbilical hernia;
- Exacerbation of inflammatory diseases;
- Signs of peritonitis;
- Pregnancy;
- Blood diseases.
Carrying out an examination of the intestines requires special preparation, so the need for its appointment is decided by the doctor based on the totality of clinical history data, current state and the patient's age. If it is impossible to perform a traditional colonoscopy, resort to alternative methods research.
How much does a colonoscopy cost?
The average cost of a colonoscopy in Moscow varies from 7,500 to 10,000 rubles.
The final cost is formed from the following criteria:
- clinic level;
- physician experience;
- consultations and preparation for research;
- goals and need for implementation;
- anesthesia;
- hospital stay;
- type of colonoscopy.
The final cost can reach several tens of thousands of rubles.
Watch a virtual video of an intestinal colonoscopy:
Colonoscopy is an informative and accurate method for diagnosing intestinal sections, aimed at identifying and treating many pathological processes. Considering the difficult oncological situation in modern society, endoscopic methods research is constantly gaining popularity.
You can make an appointment with a doctor directly on our website.
Be healthy and happy!
Colonoscopy is a minimally invasive examination procedure that is not as scary as the consequences of untimely detected diseases. Delayed diagnosis can lead to protracted treatment, surgery, or the development of a pathological formation into cancerous tumor. The procedure itself is extremely effective due to the collection of a large amount of information - in just a few minutes it can be used to assess your health status intestinal tract.
What does a colonoscopy do?
Colonoscopy is performed using a modern medical device (colonoscope), consisting of:
- long flexible probe;
- optical device;
- backlight;
- a small video camera for displaying information on a monitor;
- tubes for filling the intestines with air;
- forceps for collecting biological material for histological examination.
During the examination of the cecum, colon and rectum by a colonoproctologist:
- a visual assessment of intestinal patency, color and condition of the mucous membrane is performed;
- it becomes possible to detect neoplasms on the walls of the colon;
- biomaterial is taken to distinguish the benign development of a growth from a malignant one;
- pathological formations of minimal size are eliminated;
- sources of bleeding are identified and stopped by exposure high temperature(thermocoagulation);
- Video and photographic images of the inside of the large intestine are taken for further study.
Colonoscopic examination of the intestine provides a wide range of opportunities for making the correct diagnosis and prescribing treatment, if possible, without surgery.
Preparation for the procedure
To be able to fully examine the intestinal tract, the patient must carefully prepare for the event by cleansing the gastrointestinal system before it. The subject is prescribed to follow a diet for three days and cleanse the intestines the previous day using medications or lavage.
- boiled poultry or beef meat;
- broths made from lean meat or lean fish;
- wheat bread;
- biscuits;
- tea, mineral water without gas.
You can also eat foods that do not cause excessive accumulation of stool and gas. Be sure to exclude from meals:
- fruits;
- greenery;
- nuts and beans;
- carbonated drinks;
- rye bakery products;
- cereals
The final meal is taken at noon 20 hours before the examination. Afterwards you are allowed to drink tea or water.
The gastrointestinal tract is cleansed in the evening and in the morning before direct colonoscopy with an enema or medications. Rinse is done twice with an interval of 1 hour and a volume of water of 1.5 liters per procedure and repeat it in the morning so that pure water without fecal discharge.
The optimal method of cleansing is the use of drugs “Dufalak”, “Flit” or “Fortrans”, intended for bowel movements before examinations and operations. Medicines have a gentle effect on the body, without causing unpleasant or painful sensations to the person. Use medications according to the regimen prescribed in the annotation.
How is a colonoscopy performed?
The patient is exposed to lumbar region, falls on left side, bending your knees and pressing them to your stomach. The doctor slowly and carefully inserts the working part of the colonoscope into the anus and gradually, moving it forward, diagnoses the intestines. To study the inner surface of the colon, the folds are straightened by pumping air. The minimally invasive procedure lasts for 10-15 minutes, during which the entire 2-meter long colon is examined.
Every second patient has an increased threshold of sensitivity, therefore, in order to reduce discomfort, the patient is lubricated with analgesics: dicaine ointment or xylocaingel. Patients who are very afraid of pain are given light anesthesia general action.
At the end of the diagnosis, the air is pumped out with a colonoscope. After the procedure, no discomfort from bloating is felt. Immediately after the endoscopic procedure, you are allowed to start eating without dietary recommendations.
Indications for the study
Every person over 50 years of age should come to a medical facility for an intestinal examination. The reason for this is age-related changes and functional impairment. People of any age with hereditary oncological diseases in the intestinal tract, as well as with sudden symptoms such as:
- intestinal bleeding, mucous and purulent discharge;
- persistent constipation or distress;
- frequent painful sensations in the intestinal area.
In addition, colonoscopy is prescribed when foreign objects enter the intestinal cavity or the presence of previously discovered other research methods pathological formations.
According to statistics, timely prescribed colonoscopic diagnosis reduces the level of fatal outcome due to oncological formations in the intestinal tract by 75-80%.
Contraindications
diseases infectious origin at various stages, contributing to an increase in body temperature and intoxication of the body; There is a list of ailments in which colonoscopy leads to complications in the patient’s body. Among them:
- diseases of bronchial, pulmonary, cardiac and vascular systems;
- hypotension;
- ulcerative colitis;
- peritonitis;
- hernia (umbilical or inguinal);
- decreased blood clotting;
- pregnancy.
If there are contraindications, the colonoscopic method can be replaced with a similar endoscopic examination.
Read about another procedure for identifying gastrointestinal diseases - esophagogastroduodenoscopy. You can familiarize yourself with the diagnostic gastroscopy technique.
Possible complications after the procedure
Examinations should always be carried out in a medical facility under the guidance of a qualified specialist to avoid unforeseen situations. Complications almost never occur after a colonoscopy examination, but a fraction of a percent risk still exists. The patient needs to urgently consult a doctor upon the appearance the following symptoms after research:
- painful sensations V abdominal cavity;
- bleeding in the intestinal area;
- nausea;
- dizziness;
- fainting states;
- increase in body temperature.
Such pathological changes in the body occur in isolated cases, so you should not be afraid of the procedure because of them.
The most common and informative method for diagnosing the colon, recommended by doctors. There are substitute examination methods used by doctors in case of contraindications for the patient.
Sigmoidoscopy is recommended for patients to examine a small area of the rectum of 25-30 cm. Irrigoscopy is used for X-ray examination of changes in the intestinal walls with a contrast agent. Ultrasound colonoscopy (UC) is prescribed for patients diagnosed with colon cancer. This technique can provide full information about the size of the pathological formation, structure, diameter of the lesion.
Capsule endoscopy is used to examine the entire cavity of the gastrointestinal tract. During the eight-hour procedure, the endocapsule takes up to 60 thousand photographs. The doctor can detect its presence in the body at any time and change the settings. After the diagnosis is completed, the capsule comes out naturally. The disadvantage of the ultra-modern technique is the impossibility of collecting biomaterial for further research.
Magnetic resonance imaging (MRI) is used to diagnose pathological changes intestines. During the tomography process, several images of the peritoneum are taken, from which a 3D model of the colon with foci of disease is created and sent to a specialist for study. The disadvantage of MRI is the inability to detect tumors smaller than 1 cm in diameter.
Each method is effective in its own way, but is intended to replace standard colonoscopy. special cases.
Remember that in any case, it is important to strictly follow the doctor’s strict recommendations so that the examination procedure is as informative and useful as possible for subsequent diagnosis and effective treatment. Be healthy!
Colonoscopy is the most modern technique for examining the entire large intestine, which is used for patients with problems in this part of the gastrointestinal tract. The research method allows you to evaluate the intestine over a distance of two meters, as well as visualize it and obtain a digital image for further analysis.
What is the examination method?
Colonoscopy is performed using a special device called a colonoscope. By appearance it resembles a probe with a camera on the tip, as well as a lamp for illumination and a sensor that transmits signals to a monitor. Together with the colonoscope, the patient is given an additional device that pumps air into the intestines as needed, and an instrument for taking a biopsy, that is, a sample of the intestinal mucosa.
The probe is flexible and as atraumatic as possible. He photographs the intestinal cavity and transmits the images to the screen. Colonoscopy can be performed not only for diagnostic purposes; it also allows for operations to remove small tumors and polyps. The method is simple and does not require large financial costs from the patient and the doctor.
What capabilities does the survey have?
Today, this method is one of the most informative in the study of the colon. Using a colonoscope you can perform the following manipulations:
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- detect inflammatory processes in the mucous membrane;
- assess intestinal motility, the condition of the organ wall;
- gently bougie an area of the intestine that has narrowed due to adhesions or other pathology;
- detect minimal changes or defects in the mucous membrane;
- assess the condition of varicose veins and nodes, localize diverticula and ulcers, record their sizes;
- remove benign tumors during the study or take a tissue sample from the affected area;
- influence thermocoagulation on intestinal bleeding, stop blood loss;
- obtain high-quality and detailed images for further analysis at any level.
The procedure is rarely prescribed for prophylactic purposes. But WHO recommendations advise patients after 40 years of age to be examined in this way every five years.
When is a colonoscopy prescribed?
The study is carried out for therapeutic and diagnostic purposes. It is required in following cases:
- mucous or purulent discharge from the rectum;
- regular bleeding from the large intestine;
- problems with regular bowel movements or pain in the intestines;
- suspicion of an oncological process, constant low-grade fever, weight loss;
- possible development of intestinal obstruction;
- presence of a foreign object in the intestine;
- for histological examination during biopsy;
- UC (nonspecific ulcerative colitis) and Crohn's disease.
In some cases, sigmoidoscopy can be used instead of colonoscopy, but the technique is more superficial.
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How to properly prepare for a colonoscopy procedure?
In order for the study not to be in vain and to give maximum results, the patient must prepare independently three days before the procedure. The main points of preparation are a specialized diet and cleansing of the intestines from feces.
Preparation can be done at home one day before the procedure. Enemas are used as an aid. It is recommended to give an enema before the manipulation itself for the second time. The volume of the enema is about 1.5 liters of slightly warm water per administration at intervals of an hour. Over three hours, up to 3 liters of liquid must be injected into the patient until clean water begins to flow into the toilet.
To make the procedure less painful and unpleasant, you can use laxatives. Enemas are also not recommended for people with inflammatory processes of the colon, as well as anal fissures. Can be taken Castor oil, as well as lactulose preparations to obtain a mild laxative effect.
There are special medications that are designed to prepare the patient for tests and help empty the intestines. The most famous remedy is Fortrans. The patient is required to take a dosage based on 1 sachet per 20 kilograms of body weight. One packet is diluted with a liter of hot boiled water and drunk, if possible, in one evening. The solution can be left in the morning.
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Proper preparation for sigmoidoscopy
The drug can be taken gradually to avoid the appearance of a gag reflex. You can take the drug as a snack with lemon. The last sips of the solution must be taken 3-4 hours before the start of the procedure. The drug itself does not enter the bloodstream and is excreted by the body in an identical form.
There is a drug with a similar effect - Lavacol. A sachet of the product can be dissolved in a glass of boiled water. You are required to drink three liters within five hours the evening before the procedure. You can drink one glass every 20 minutes.
Patient's diet before colonoscopy
The procedure requires proper preparation, including the importance of following a diet that allows you to examine the colon. All feces must be removed from the intestines. If this is not done, the probe will not be able to advance along the entire length of the intestine during the study. The diet is followed for two to three days before the procedure.
The diet should not include foods such as:
- vegetables and fruits;
- legumes;
- fatty foods, including meat and sausage;
- black bread;
- sparkling water;
- coffee and milk.
These products contribute to gas formation in the intestines. You can eat lean meat, as well as dry biscuits, fermented milk products and dietary broths. The day before the examination, you can last time eat before 12 noon, then you need to drink enough water.
Problems with the stomach and intestines can torment people for years, eventually developing into serious illnesses. Due to the sensitivity of the problem or the fear of going to the doctor, people try to ignore frequent constipation. And they suffer pain in the lower abdomen, area anus. However, if bloody leaks begin to appear from it, there is no time to delay the visit.
During a professional examination, a specialist may prescribe a detailed examination using intestinal colonoscopy. It is very effective, it helps to deliver accurate diagnosis, and sometimes even eliminate the problem.
Fibercolonoscopy - scientific name diagnostic measures, carried out throughout the large intestine, starting from the anus and ending with the connection with the small intestine. The manipulations are performed using a special apparatus. Simply put, this is a probe on a flexible tube (its diameter is about 1 cm). The length of the device today reaches 160 cm, whereas at the very beginning of the development of this equipment (in the 60s of the twentieth century), only 30 cm of the large intestine could be viewed. Today, its various sections can be viewed by broadcasting to the screen without problems.
On a note! How deep the colonoscope will be inserted is determined by the endoscopist, looking at the monitor. To make the process easier and to avoid injury, the organ is inflated with gas or air. This may cause pain.
Anesthesia is usually given to reduce discomfort. But his methods may be different.
The endoscope transmits a picture to the screen (it is also duplicated in the device window), which both helps during the procedure itself and can become a recording. With this video material, if necessary, you can go to a proctologist, gastroenterologist or oncologist.
Degree of pain and anesthesia
Of course, the question of how painful it will be is not the least of the concerns for people undergoing a colonoscopy.
Depending on the individual state of the organ and sensitivity, a person may feel pain or discomfort. It is caused not so much by the insertion of a thin tube as by the straightening of the intestinal walls with the help of gas. This is done both for a more accurate examination and to avoid accidental injury. Someone may feel not pain, but a burning sensation. But as soon as the examination is over and the supply of the substance stops, the unpleasant sensations will immediately disappear.
Some people are afraid of the possibility of infection during the procedure. However, according to the rules, the device must strictly undergo sanitation, so there is nothing to be afraid of.
Local anesthesia is the most common type of pain relief. To reduce sensitivity, experts use medications with lidocaine as active ingredient:
- gels Xylocaine, Luan, Kategel;
- ointments (for example, Decamine).
Apply medications to the mucous membrane itself, starting from the anus. In addition, they coat them bottom part colonoscope. As a result, sensitivity disappears or decreases, but the person remains conscious. This is the most gentle type of anesthesia for the body, after which you don’t have to “come away” and you can go home straight away.
Attention! Sometimes an anesthetic is given intravenously to locally block the nerve endings.
Sometimes, if a colonoscopy is too painful, the person is unnecessarily afraid and cannot relax the muscles, they are given sedatives such as Propofol, Midazolam. In this case, the person is dozing. Consciousness does not completely turn off, but during this medicinal sleep a person will not feel any discomfort or pain.
The third option (creating additional stress on the body, and therefore used extremely rarely) - general anesthesia, as when conducting surgical interventions. They make it for people with very high sensitivity, children under 12 years of age and people with mental disorders.
So the issue of the painfulness of the procedure is not so pressing. It is enough to choose the optimal anesthesia option, and the procedure will go smoothly.
When is a colonoscopy performed?
This type of video endoscopic examination can be prescribed by a specialist if the patient has:
- traces of bloody fluid on the gusset of underwear or in the stool;
- painful and irregular bowel movements;
- the presence of hemorrhoids - for a more accurate diagnosis;
- formations of unknown nature discovered during a previous X-ray examination or computed tomography of the abdominal organs in an area of the intestine accessible to the colonoscope;
- unclear picture of hemorrhoidal changes or the appearance of polyps;
- purulent discharge from the anus.
Colonoscopy is also part of screening for people with bowel complaints if their relatives were sick cancer diseases or polyposis of this body system.
On a note! Colonoscopy is the most accurate diagnostic method, with the help of which a specialist can personally familiarize himself with the condition of the intestines. Other types of studies - ultrasound, CT, etc. cannot display the pathology in such detail and accurately.
Who does a colonoscopy and where?
The examination is carried out by a separate specialist - a coloproctologist. A nurse is helping him. The diagnostic procedure takes place in a room specially furnished for this purpose.
Only a couple of actions are required from the examinee:
- Remove all clothing worn below the waist.
- Lie on a standard couch on your left side and relax as much as possible to facilitate insertion of the equipment inside. At the same time, the legs are bent at the knees and pulled towards the stomach.
A diagnostic examination with a colonoscope can be combined with additional procedures, if necessary:
- remove found objects of a foreign nature;
- take histological material (biopsy procedure);
- examine very small ulcers, cracks, mini-polyps;
- examine in detail hemorrhoidal cones, diverticula or tumors;
- conduct a detailed examination of the intestinal mucosa and motility, and examine for the appearance of inflammation;
- expansion of a section of the intestine narrowed due to adhesions and tissue scarring;
- remove various tumors urgently, right during the examination;
- carry out thermocoagulation (cauterization of damaged vessels from which blood flows).
Thus, the procedure can become not only diagnostic, but also therapeutic, eliminating problems on the spot. So you shouldn’t give it up out of fear.
Rules for preparing for the procedure
They are not very complicated, but the effectiveness of the procedure depends on their compliance. In a clogged intestine, the doctor simply cannot see anything, so measures are aimed at cleaning it. You will only have to stick to the special diet for 3 days.
In addition, two days before the colonoscopy, you need to temporarily stop taking medications containing iron and bismuth. Do not drink during this period and Activated carbon, and medications that treat arthritis. Medicines that thin the blood (Aspirin, Clexane, etc.) are also prohibited.
It is best to switch exclusively to liquid food on the last day. However, this is at personal discretion.
From the table you can understand how to effectively compose correct menu for these days:
Recommended Products Prohibited Products Various fermented milk dishes Non-heat-treated fruits and vegetables Dishes made from boiled vegetables Rye flour bread Fully boiled eggs Canned and pickled preparations, smoked products Vegetable soups with broths Porridge from pearl barley, wheat, oatmeal Bakery products made from white flour Legume family crops Low fat meat and fish products Roasted sunflower seeds, pumpkin seeds; French fries Compotes and fruit drinks, lightly brewed tea Coffee drinks, milk, chocolate sweets Cheeses, natural butter (cow) Drinks with added carbon Honey Salted foods Buckwheat and rice cereals Alcohol The last meal on the day before the colonoscopy is no later than 8 pm. Additionally, you can cleanse with an enema in the evening.
Medicinal cleansing
If the enema and diet are not to your liking, the doctor may prescribe one of the drugs that cleanse the body the day before. Their mechanism of action is approximately the same, and you will have to run to the toilet. The sensations will also not be the most pleasant - bloating, seething.
The following table shows several popular medications and the nuances of taking them:
Medicine Image Dosage Appointment in preparation for the procedure 1 sachet is designed for 20 kg of weight and is diluted in a liter of purified or boiled cool water Use once, the night before. Or at the same time, but little by little with an interval of 15 minutes. Pour 2 sachets into half a liter of slightly warmed water, stir, add the same amount of chilled water The required amount for administration is 3 liters. Drinks from 5 pm to 10 am 2 bottles, each 45 ml. The bottle is poured into 120 ml of water Take 1 bottle a day before the procedure twice: morning and evening. Drink plenty of water between meals Dissolve 1 sachet in 200 ml of warm water and consume 18-20 hours before the procedure. Drink 3 liters in total The day before, from 2 pm to 7 pm, 200 grams. The interval between doses is a quarter of an hour. So you can choose not only the method of anesthesia, but also the cleaning option.
Who writes a referral for a colonoscopy?
More than one doctor can refer you for the procedure. It all depends on the original type of problem. If you are tormented by difficulties with the digestive system, then you need to go to an appointment with a gastroenterologist.
In cases where pain and discomfort are concentrated in the anal area, it is better to go straight to a proctologist.
Video - Colonoscopy. What is this procedure and who should undergo it?
In this article we will look at how intestinal colonoscopy is performed - under anesthesia or without anesthesia. The lifestyle of modern people affects the nature of the most common diseases. Therefore, due to an unhealthy diet, along with a sedentary lifestyle, doctors are increasingly registering diseases in the lower regions of the digestive system. But if previously doctors could only examine the intestines by palpation, by feeling the patients’ abdomen, modern specialists have a more extensive selection of diagnostic methods.
Many people wonder what is better - a colonoscopy under anesthesia or without it?
Colonoscopy as part of diagnosis
A progressive way to assess the general condition of a person's colon today is a procedure called colonoscopy. It is an examination of the patients' digestive system using a video camera, which is placed at the end of a flexible tube of a special device - an endoscope. During this procedure, the doctor examines the patient's intestines from the inside, centimeter by centimeter, simultaneously collecting samples for analysis, and also removes polyps, which are various changes in the mucous membrane. Such polyps can degenerate into malignant tumor. It is important to know how to prepare for a colonoscopy. More on this below.
When was this procedure first introduced into practice? public clinics, this manipulation was considered painful. Any specialist could cause significant discomfort to the patient during tube insertion. But at the same time, such a procedure did not imply any pain relief. It is for this reason that many people, when they heard about the need to undergo such an examination, tried to find a possible alternative due to fear of pain. Not everyone knows where to get a colonoscopy.
In fact, it is possible to examine the colon using irrigoscopy, which is an X-ray examination in which a contrast agent is injected into the organ cavity through an enema. The disadvantages of these methods include radiation exposure to the patient along with less information content, which today is recognized throughout the world as the gold standard for colon cancer screening.
Let's figure out what is better - colonoscopy under anesthesia or without it?
Colonoscopy and use of anesthesia
The problem associated with the pain of this procedure has already lost its relevance, since modern medical centers offer it under anesthesia. The administration of medications before the procedure involves varying degrees of pain relief:
- Performing a colonoscopy under local anesthesia involves lubricating the tip of the endoscope with a substance that slightly reduces discomfort during insertion of the tube into the rectum. True, the feeling of pain during the procedure, as a rule, can be caused not by direct contact of the device with the mucous membrane, but by the injection of air into the intestines. Unfortunately, local anesthesia does not relieve this discomfort.
- Colonoscopy while you sleep. For this version of the procedure, superficial anesthesia is used, in other words, sedation. The patient is administered a drug that has a hypnotic effect. Under its influence, the unpleasant sensations are significantly dulled, and the examination itself is completely painless. It does not require use. You also do not have to stay in the clinic for a long time after a colonoscopy, since the effects of anesthesia wear off very quickly, and no memories of the procedure remain.
- Colonoscopy using This type of diagnosis is performed in an operating room. Patients under the supervision of an anesthesiologist are immersed in deep dream. This sleep usually lasts a little longer compared to the procedure itself. This option is usually used to examine people with a low threshold for pain sensitivity, as well as against the background of intestinal adhesive disease, when a colonoscopy is performed on a child under the age of twelve. Let's look at the indications for this procedure.
Indications for colonoscopy using anesthesia
People often ask: “Which is better - a colonoscopy with or without anesthesia?” Most often, patients prefer to opt for such a diagnosis using anesthesia in the form of sedation. This method is painless and eliminates probable complications general anesthesia. As a rule, a referral for this examination is issued by the attending physician or specialist who notices deviations in the health status of his patient. So, colonoscopy under anesthesia is prescribed in a number of the following situations:
- low level hemoglobin in general analysis, that is, anemia without any obvious cause;
- presence of bleeding in the intestines or black stools;
- problems associated with bowel movements, which are expressed in chronic constipation, diarrhea, sensation of a foreign body in the rectal area, etc.;
- a regular feeling of intestinal fullness, which is accompanied by increased gas formation along with chronic indigestion;
- unexplained weight loss along with increased fatigue;
- excess level of specific tumor markers as a result of a blood test;
- examination of patients suffering from nonspecific ulcerative colitis or Crohn's disease;
- examination of people at risk of developing tumors in the colon.
Such patients include relatives in whose families cases occurred oncological diseases intestines. Also included in this category are people who have been treated for cancer in the past.
It must be emphasized that screening colonoscopy can be indicated for all people over forty-five years of age. Starting from this age, it is recommended to undergo this procedure annually.
Instructions before a colonoscopy can be obtained from your healthcare provider.
Contraindications to the procedure
Despite the fact that colonoscopy under anesthesia is a common procedure, some people will still be better off avoiding this test. So, the examination is contraindicated in the following cases:
- in the presence of acute infectious diseases;
- peritonitis or suspicion of it;
- severe blood clotting disorders;
- late stages heart failure;
- presence of heart valve stenosis;
- allergies to anesthetic medications;
- neurological and psychiatric illnesses;
- epilepsy;
- during pregnancy.
It should be noted that none of the listed conditions serve a complete contraindication to perform a colonoscopy examination under anesthesia. It is essential to discuss with the endoscopist individual characteristics body so that the specialist can decide on the advisability of diagnosis, taking into account the possible benefits and risks of the procedure. If a study is prescribed, you need to pay attention to preparatory activities. This measure will help make the doctor’s task easier, and will also have a positive effect on the patient’s condition during and after the procedure.
Considering that during the diagnosis the doctor will examine the colon, it is extremely important to first clean the mucous membrane. The desired effect is difficult to achieve with an enema. That is why patients are advised to prepare in advance with diets and medicines, sold in any pharmacy. Proper preparation diagnostic colonoscopy usually includes the following two stages:
- Three days before the procedure, you must stop eating fatty meats. It is prohibited to consume fish along with dairy products, cereals, cereals, and rye bread. It is also important to refuse fresh vegetables and fruits. Alcoholic drinks, carbonated water, hot spices and canned food are prohibited. It is allowed to eat white bread and broths along with lean meat, eggs, pasta, rice, boiled potatoes, and butter. You can drink juice or jelly. Colon cleansing for colonoscopy has important.
- On the eve of the procedure, the patient must take a laxative. As part of bowel preparation for examination, a solution of polyethylene glycol or drugs such as Duphalac and Fortrans is prescribed. In addition, the person will need to drink two liters of fluid the night before the test. Another two liters are drunk on the day of the procedure if it is scheduled for the afternoon. If less than a day is allotted for preparation, the entire volume of the solution is drunk from four to eight o’clock in the evening.
Preparation for anesthesia during colonoscopy is carried out directly on the day of the procedure itself. In this case, you should refuse food and drink in the morning. It is also important to remove contact lenses with dentures before the corresponding manipulation.
Where to get a colonoscopy? The procedure can be performed in any medical institution or diagnostic center.
Under anesthesia
IN treatment room Patients are asked to remove clothing below the waist. The person is placed on his left side on the couch. In this case, the patient should pull his knees to his chest. Next, the anesthesiologist injects an anesthetic drug into a vein, after which the patient falls asleep. In general terms, this usually feels like a normal dream, albeit a very short one. During this period of time, the doctor inserts a tip lubricated with special oil.
The endoscope is inserted through the anus into the rectum. The device then goes into the colon. Using the image displayed on the monitor screen, the specialist examines the mucous membrane. If necessary, the doctor may stop to take a picture, either remove a polyp or take a sample. After completing the examination, the doctor removes the tube from the intestines, and the anesthesiologist wakes the patient and asks about his well-being.
Duration
The total duration of the colonoscopy procedure using anesthesia at the base sedative ranges from fifteen to thirty minutes. Patients usually feel well, noting only mild weakness after waking up. Immediately after completing this procedure, a person can drink or eat food, and half an hour later he is sent home or to work.
What are the possible complications after a colonoscopy?
In the vast majority of situations, colonoscopy is performed without any complications. The patient does not experience discomfort, pain, bloating or severe weakness. But if, immediately or several hours after this procedure, these symptoms are noted, if the patient has a fever and nausea occurs along with bloody discharge from the rectum, you should immediately seek medical help.
Rare but very dangerous complications include damage to the intestinal walls and respiratory arrest during anesthesia, rupture of the spleen and infection of the patient with hepatitis B, as well as others. infectious diseases. For this reason, it is extremely important to responsibly choose a clinic where you plan to undergo a colonoscopy. Preference should be given to a medical institution that has an impeccable reputation and extensive experience in performing this manipulation.
Colonoscopy price
The cost of this procedure with anesthesia in Russian clinics ranges from 4,000 to 20,000 rubles. Such a large gap in price is associated not only with the level and quality of equipment, it depends on the service in a particular medical institution, on different approaches to determining the cost of the presented technique.
As a rule, clinics that offer the lowest price for colonoscopy do not include payment for anesthesia and the work of an anesthesiologist in the price. Diagnostic and therapeutic manipulations required during the procedure may also not be taken into account. For example, we are talking about taking samples of the mucous membrane with their further histological examination, removal of small polyps, and the like. the total cost this method diagnosis turns out to be very impressive and unexpected for patients.
Expensive consultation
In other cases, the attractive cost of colonoscopy under anesthesia can be combined with an expensive consultation with gastroenterologists, without which the procedure is considered impossible according to the clinic’s rules. Therefore, patients should clarify all the conditions for undergoing a colonoscopy in advance, and do not hesitate to ask additional questions. We should also not forget that you should not save on diagnostics, since the quality of the specialist’s work and general standards medical care health directly depends.
And yet, what is better - a colonoscopy under anesthesia or without it, the doctor must decide.
