Colonoscopy – newest method examinations using instruments that are used to diagnose pathological conditions of the rectum and colon. Colonoscopy of the rectum allows you to literally assess the condition of the intestines over an area of about two meters in just a few minutes.
What is a colonoscopy of the rectum?
Colonoscopy of the rectum is performed using a special device called a colonoscope. A colonoscope looks like a long and fairly flexible probe, and at the end it is equipped with a special backlit eye, as well as a miniature video camera. This camera allows you to immediately view the image on a special screen.
The complex with a colonoscope includes a tube for air transmission, forceps, which are intended for biopsy, or collection of histological material.Does it hurt or not?
It is not uncommon for most patients to be concerned about this very question, namely, is rectal colonoscopy a painful procedure, since no one knows what to prepare for.
During the procedure, some discomfort or even pain may indeed occur, this is due to the swelling of the intestine during examination.
You can also feel a certain burning sensation. Bloating can be caused by air being pumped out of the tube. This is done to straighten the intestinal walls, as well as for a more detailed examination.
It is worth noting that colonoscopy of the rectum is mainly performed without anesthesia, since there is a possibility of injury to the colon, and this should be carefully monitored. After the examination is completed, the air supply stops and the pain will immediately disappear.
Many patients are afraid of this procedure, as there is probability of infection, but we hasten to warn you that all equipment must be carefully processed before inspection, please take this fact into account!
Intestinal trauma itself is quite rare, but if it good clinic, should not occur at all. And also, some may simply be embarrassed by this procedure, for this it is worth knowing exactly how it is carried out. You are more ashamed of starting the disease itself, but consulting and having an examination with doctors is not.
How is a rectal colonoscopy performed?
As mentioned above, rectal colonoscopy is an examination of the rectum using a special probe. It is relatively thin, comparable to the little finger.
In the hands of an experienced specialist, this procedure lasts about 10-15 minutes, no more, and is also carried out quite painlessly.
If we go into more detail, the doctor must first insert a colonoscope along the passage of the rectum; if necessary, he can also take a tissue sample (biopsy). If a polyp is identified, it must be immediately eliminated using special devices.
The doctor can also take pictures of the areas where pathologies are found to attach to the protocol. Before the procedure itself, anesthesia must be offered, and the anesthesiologist must tell you in detail about the process itself. You can ask any questions you are interested in, because if you agree to anesthesia, they bring you a document that you must sign. After the colonoscopy is completed, the doctor makes a conclusion and prescribes treatment.
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Advantages and disadvantages
First, it’s worth listing all the advantages of rectal colonoscopy:
- it allows you to immediately assess the condition of the intestines one hundred percent, without additional examinations and tests.
- colonoscopy of the rectum is attributed to patients as a preventive examination, which is one of the most dangerous oncological diseases. It is worth noting here that in Russian Federation About 50 thousand cases of colon cancer are registered annually.
- It is possible to immediately remove any found ulcers during a colonoscopy examination, as well as cauterize the ulcers.
- this procedure allows everything to be thoroughly examined, especially inflammation on the mucous membrane, in contrast to CT scans in which this cannot be detected in principle.
Disadvantages of rectal colonoscopy:
- In the case where the patient agrees and will undergo anesthesia, unintentional damage to the intestine is possible.
- It is also possible to cause an attack of the appendix and dehydration of the body.
- There is a risk of bleeding, as well as a decrease in blood pressure.
- Possible risk of diarrhea, inflammatory process in the intestine itself, as well as infection.
Preparing for a colonoscopy
Colonoscopy of the rectum requires the patient to fully prepare his intestines, which is carried out in a limited diet, as well as cleansing the colon. In turn, the diet is determined by the complete exclusion of vegetables and fruits 2-3 days before the start. And bowel cleansing is done with special laxatives or solutions, which are also taken the day before or on the eve of the test.
Video
Also, do not forget to exclude all alcoholic beverages before the procedure! Quality of preparation everything depends on the patient, since thanks to good preparation it is possible to avoid the patient’s discomfort, as well as provide diagnostic accuracy.
Many people are unaware of diseases in the gastrointestinal tract, suffer for years with constant problems with defecation, pain in the lower abdomen and anorectal area, and also have frequent bloody discharge from anus.
Sick a long period time they refuse diagnosis and therapy. Similar symptoms may be detected during a professional examination.
For staging accurate diagnosis the patient is sent to effective method examinations - intestinal colonoscopy.
What is an intestinal colonoscopy?
Fibercolonoscopy (FCS) – examination of the rectum and colon endoscopic method, through a special optical device (Fibroscope).
The colonoscopy procedure is carried out for a short period of time – just a few minutes. This allows for a visual assessment internal state intestines along its entire length (2 m).
Some people are afraid, embarrassed or distrustful and wary of this diagnostic method. But fibrocolonoscopy of the intestines is the most modern and reliable way identifying disorders in the intestines.
In addition to the general examination, biopsy and polypectomy (removal of polyps) are performed with reliable accuracy. It is also possible to take the material for histological examination directly during the process. The necessary parts of the intestinal walls are collected using special forceps.
Until 1966 (the moment the prototype of a modern colonoscope design was created and tested), examination was carried out only at 30 cm of the length of the colon. Diagnosis was carried out using a rigid rectosigmoidoscope. To see the entire perimeter of the intestine, it was necessary to resort to x-rays, but this did not allow detecting either oncology or polyps.
Now the optical probe is a thin (1 cm), flexible and soft instrument. Such qualities allow you to painlessly bypass any natural intestinal twists. The length of the colonoscope is about 160 cm.
A miniature video camera is placed on the head of the device. The picture capturing the insides is transmitted to the screen in significant magnification. Based on the image, the doctor studies the structure of the pipes.
The chamber is equipped with an internal cold radiation light, which cannot damage the intestinal wall or burn the internal mucous membrane.
Indications for intestinal colonoscopy
This event is carried out according to strictly specified indicators. People over 45 years of age are recommended to undergo an annual examination.
IN mandatory Every year, fibrocolonoscopy is performed for people suffering from Crohn's disease, ulcers and ulcerative colitis. In addition, patients who have had operations related to intestinal diseases should undergo the procedure.
If a person goes to the doctor with certain symptoms, then an examination is prescribed without fail.
Indications for colonoscopy:
- periodic long-term pain in the colon;
- preparation for the elimination of tumors of the uterus or ovary;
- severe constipation and with frequent intervals;
- increased abdominal bloating;
- sudden weight loss;
- identifying the likelihood of diseases;
- unusual blood, mucous or purulent discharge from the anus;
- detection of polyps;
- if there is a suspicion of the possibility of the formation of malignant neoplasms;
- long lasting low-grade fever unknown etiology;
- chronic presence of anemia with a constant decrease in hemoglobin;
- constantly loose stool with a predisposition to delayed bowel movements;
- detection of foreign bodies inside the intestinal tract.
The main need and task of conducting a colonoscopy examination of the intestines is the early detection of various changes and the formation of pathologies.
Thus, you should not self-medicate and resort to eliminating pain with simple painkillers or carminatives. It is better to seek qualified help and determine an accurate diagnosis.
How to do a bowel colonoscopy
After complications have been identified and a referral has been issued, the corresponding question is “Which doctor performs a colonoscopy?”
The examination is carried out with the help of a coloproctologist and a nurse. Such an analysis is done in an office specially equipped for these purposes. The patient needs to get rid of clothes below the waist and move to a prepared couch.
You should take the position: lie on your left side and pull your legs towards your stomach, bending them at the knees.
When examined with a colonoscope, which is revealed and neutralized, if possible, by endoscopy:
- removal of detected foreign objects;
- performing a biopsy (sampling of histological material);
- detection of the smallest cracks, ulcers, identification of polyps, hemorrhoids, tumors or diverticula;
- conducting a visual inspection of not only the walls, but also the mucous membrane, as well as intestinal motility, while identifying inflammatory processes that have appeared;
- in case of adhesions and scars that provoke a narrowing of the lumen, the damaged area is expanded;
- analysis of lumen diameter;
- removal of neoplasms (benign tumors, polyps) at the time of examination;
- factors for the development of bleeding are identified, and exposure to high temperatures is immediately carried out (thermocoagulation).
Thus, colonoscopy and indications for it are a necessary point for curing ailments that have appeared in a person. The sooner you go through it, having done a full examination of the intestinal tract, you can identify diseases on early stages.
Anesthesia
Because colonoscopy is painful, local anesthesia is required. For pain relief, medications are used in which active component is lidocaine: Xylocaine gel, Kategel (gel), Luan gel, Dicamin ointment.
The drugs are applied to the base of the tip of the colonoscope and to the mucous membranes of the anus, thus achieving the effect of loss of sensitivity, that is, colonoscopy is performed without anesthesia, the patient remains conscious.
Local freezing can also be achieved by administering an anesthetic intravenously.
In cases where the intestinal colonoscopy procedure is quite painful for the patient, the patient does not want to feel manipulation or is afraid, he is given sedation. When medications (Propofol, Midazolam) are administered, the person falls into a state of sleep. Consciousness does not turn off, but there is no sensation of any discomfort or pain.
The last option to ensure that the intestinal colonoscopy procedure is performed comfortably is general anesthesia. During the administration of drugs, the patient completely switches off, plunging into deep dream. This method of pain relief is indicated for extremely sensitive people, children under 12 years of age and patients with mental disorders.
Thus, to the question: “Is it painful to do an intestinal colonoscopy?”, we can confidently answer that if you choose the optimal anesthesia, you may not even feel discomfort.
How is a colonoscopy performed?
After the anesthetic is administered, the nurse slowly and carefully inserts the probe into the posterior lumen of the intestine. The doctor examines the walls and internal contents of the intestine on the monitor, as well as how the device passes through the lumen.
The device is advanced by gradually pushing the wire through the nurse. In case of intestinal walls sticking together, the fiber optic cable has the ability to supply air, thereby performing surgical intervention, restoring the normal shape of the pipes.
During colonoscopy of the rectum, auxiliary guidance from the doctor is provided at the turns of the tubes by palpation.
During a colonoscopy, when air is supplied, a feeling of bloating appears in the abdomen. It goes away as the procedure is completed with the help of a doctor who special method releases air accumulated in the cavity.
How long a colonoscopy lasts will be determined only by the doctor who performs the examination. How long it will take depends on the quality of preparation, as well as the presence or absence of inflammation or other indications.
Typically, a colonoscopy procedure takes from 15 to 45 minutes.
Preparation for the procedure
Colonoscopy - what it is, people who have already touched this process at least once know it.
To perform FCS successfully, the patient is recommended to carry out several preparatory measures before the appointment:
- Preliminary preparation.
- Transition to slag-free food.
- Carrying out high-quality intestinal cleaning.
The task of preparation is to remove mucus and blood (pathological masses) from the walls and facilitate the complete release of feces and gas deposits.
- stop taking antidiarrheal medications;
- drink more liquids;
- comply with all doctor's requests.
Preliminary preparation is carried out by introducing castor oil or ricin oil into the body and performing an enema.
To take oil, body weight per 1 gram is calculated. oil – 10 kg, that is, weight 60 kg x 1 g. = 60 gr. – 10 gr. = 50 gr. necessary for admission.
If, after using the recipe, defecation is successful, you need to do a port cleansing. Otherwise, it is necessary to wash the intestines with an enema.
Before conducting a colonoscopy examination of the intestines, exactly one day before your appointment, you should refuse to eat in the evening, and you should also not have breakfast in the morning. The longer there is no formation of slag in the intestines, the better and more accurate the analysis will be.
Diet
To effectively prepare for fibrocolonoscopy and not exhaust yourself by unnecessary abstinence from food, you need to prepare. The diet should be introduced 3 days before the scheduled FCS day.
There are foods that can be left in the diet and foods that are best not consumed until the examination.
What foods you can eat and what you should avoid are presented in the table:
Products |
|
| Authorized for use | Be sure to exclude |
| Fermented milk products | Fresh vegetables and fruits |
| Boiled vegetables | Black bread |
| Hard boiled eggs | Canned food, smoked meats, marinades |
| Kharcho soups | Barley, wheat porridge, oatmeal |
| White bread, crackers | Legumes |
| Lean meat and fish | Chips, seeds, chocolate |
| Compote, weak tea, clear juices | Milk, coffee |
| Cheese, butter | Carbonated drinks |
| Honey | Pickles |
| Buckwheat, rice | Alcohol |
The last meal before fibrocolonoscopy should be no later than 20:00 in the evening.
Medicinal cleansing
If you don’t want to exhaust yourself with diets, you can resort to laxative medications. They are prescribed by the doctor individually for each patient.
The best preparations for removing toxins and complete cleansing are presented in the table:
A drug | Method of application | Necessary reception |
| Fortrans | 1 packet per 20 kg of weight, dilute in 1 liter. boiled cooled water | Drink at once or every 15 minutes in the evening |
| Endofalk | 2 bags per 0.5 l. warm water, stir, add another 0.5 l. cool water. | The required volume before FCS is to drink 3 liters, consume from 17:00 to 22:00 pm |
| Fleet Phospho-soda | 2 bottles (45 ml) dissolved in 120 ml water (each) | Take in the morning: drink 1 bottle per day, morning and evening; Take at lunch: 1 bottle per day in the evening and the next morning; |
| Lavacol | Dilute 1 packet into 1 tbsp. warm water, take 18-20 hours before the procedure, only 3 liters | From 14:00 to 19:00 every 15-20 minutes, 200 g. |
Thus, you can not only choose the method of pain relief, but also decide on the method of colon cleansing. In addition, you can choose the drug for the required amount and not spend a lot of money.
Contraindications to colonoscopy
When FCS is prescribed, you should consult your doctor about contraindications and possible appearance complications after the procedure.
Although the method is considered completely safe, it is necessary to consider whether the process can be carried out if the patient has certain ailments.
Colonoscopy: contraindications for the procedure are shown in the table:
Contraindications |
|
| Absolute – analysis excluded | Relative – possible, but not advisable |
| Peritonitis - severe form, surgery required | Bleeding from the anus |
| Severe degrees of pulmonary and heart failure, with circulatory disorders | The general condition of the patient is bed rest, severe, impossibility of administering anesthesia |
| Myocardial infarction - acute, possibly fatal | Insufficient blood clotting - any mechanical damage can cause bleeding |
| Perforation of the walls - activates severe bleeding | Poor preparation for the procedure – failure to follow recommendations |
| Ischemic or ulcerative colitis– probability of perforation | Recent surgeries on internal organs abdominal cavity |
| Pregnancy - possible premature birth | Hernias (inguinal, umbilical) - after removal surgery |
Also a separate type of contraindication is state of shock patient.
A person should calm down and take medications to neutralize anxiety. Otherwise, muscle spasm occurs and the examination process is not possible.
Colonoscopy results
FCS allows you to accurately determine the condition of the mucous membrane and assess the internal contents of the pipes.
To evaluate the mucous membrane, the following indicators are distinguished:
- color – pale pink or pale yellow tone, pathology changes it;
- shine – reflects the light beam, dullness – deterioration is possible;
- the nature of the surface is smooth, striated, without imperfections, no bulges or bumps;
- the pattern of blood vessels is uniform without associations or absence of capillaries;
- overlays - the appearance of faded lumps, without compactions, waste or pus.
Abdominal findings may include the following:
- Negative result (everything is normal).
- Benign polyps.
- Internal inflammatory processes.
- Cancerous changes.
In the case of polyps, they are immediately eliminated. If inflammation is diagnosed, a referral to a gastroenterologist will be given.
When identified through biopsy and blood test occult blood colorectal cancer, a recommendation to visit a doctor will follow. In 90% of cases, the disease can be successfully cured.
Thus, any deviations indicate a disease. But all ailments can be treated if the problem is detected early. Therefore, fibrocolonoscopy is a very important and necessary diagnostic method.
A proctologist is one of the most disliked doctors by many, whose visit is postponed until the last minute. Yes, and talking about any problems in the intestines is considered quite shameful, and yet colorectal is so confidently gaining momentum and claiming many lives.
And this despite the fact that if you seek help from specialists in time, diagnosing this pathology is not difficult. And the prognosis is favorable, unless the patient arrives at the last stage of cancer. Examination of patients may begin with screening tests to detect hidden bleeding.
They also undergo colonoscopy, irrigoscopy and sigmoidoscopy. Not all patients understand what is meant by these terms, so patients may have the following questions: what is intestinal colonoscopy? How is the procedure done? What does a colonoscopy show? Does it hurt?
general information
The colonoscopy procedure is instrumental study large intestine and its lower segment(rectum), which is used for diagnosis and treatment pathological conditions this part of the digestive tract. It shows in detail the condition of the mucous membrane. Sometimes this diagnosis is called fibrocolonoscopy (). Typically, the intestinal colonoscopy procedure is performed by a diagnostic proctologist, assisted by a nurse.
This diagnostic procedure involves inserting a probe into the anus, equipped at the end with a camera that transmits an image to a large screen. After this, air is pumped into the intestines, which prevents the intestines from sticking together. As the probe advances, various areas of the intestine are examined in detail. In some cases, a colonoscopy is performed not only to visualize problems, but it also allows for the following manipulations:
- take a biopsy sample;
- remove polyps or connective tissue cords;
- remove foreign objects;
- stop bleeding;
- restore intestinal permeability in case of narrowing.
A colonoscope is a soft and easily bendable probe that allows you to delicately move through all anatomical structures intestines, without injuring the tissues and without causing pain to the patient.
For children, colonoscopy is performed under general anesthesia.
Indications for use
An intestinal colonoscopy is performed to confirm preliminary diagnosis. It allows you to accurately determine the location and extent of pathological changes. This is especially appropriate for the following conditions and diseases:
- bleeding from the rectum and colon (thermocoagulation is performed during the procedure);
- neoplasms in the intestines of a benign nature (removal of polyps);
- oncopathology in the large intestine (biopsy specimen collection for histological examination);
- Crohn's disease (granulomatous inflammatory disease);
- nonspecific ulcerative colitis;
- complete disruption of the passage of contents through the intestines;
- stool disorders ( frequent diarrhea or chronic constipation);
- rapid weight loss for unknown reasons;
- low hemoglobin;
- long-lasting low-grade fever.
Colonoscopy of the rectum is indicated for preventive purposes once a year in patients over the age of 50 years. This is especially true for those who have poor heredity (close relatives were diagnosed colorectal cancer).
Preparation
The preparatory process involves the following stages: primary preparation, dietary nutrition, drug cleansing of the intestines. Following these steps accurately will ensure the most reliable results.
Primary preparation
If the patient suffers from constipation for a long time, then only cleansing medications won't be enough. In advance, such patients are prescribed castor oil (castor oil) or classical enemas. Castor oil is taken 2 days in a row at night. The quantity is calculated by weight. If the average patient weighs about 70 kg, then 60 ml of the product is sufficient.
If constipation is persistent and severe, and castor oil does not justify itself, then enemas are recommended. To perform such a manipulation at home, you will need a special tank with tips (Esmarch mug) and 1.5 liters of water at room temperature.
Step-by-step procedure:
- The patient should lie on his left side, and right leg in this case, you need to push it forward and bend at the knee. It is better to place an oilcloth under the body so as not to wet the sofa or bed.
- Esmark's mug is filled with water while the clamp is closed. After this, the air is released and the clamp is closed again.
- The heating pad must be hung 1–1.5 meters above the level of the sofa/bed.
- The nozzle should be generously lubricated with Vaseline and carefully inserted into the anus to a depth of 7 cm.
- The clamp from the Esmarch mug is removed and the entire volume of liquid is allowed into the patient, after which the tip is removed.
- The patient should not immediately run to the toilet, but first move a little, squeezing the sphincter (5-10 minutes). After this you can relieve yourself. This manipulation should be performed 2 evenings in a row.
Doctors do not recommend combining castor oil intake and enemas at the same time. After 2 days of initial preparation, the patient must eat properly and take special cleansing medications.
Diet food
Another way to thoroughly cleanse the lower sections of the digestive tract is to give preference to a slag-free diet 2-3 days before the intended procedure. During this period, you should avoid foods that cause increased gas formation. You can eat lean meats and fish, dairy products, boiled vegetables. The last meal should be no later than 8–12 hours before the scheduled procedure.
Purgation
Drugs such as Fortrans and Endofalk interfere nutrients absorbed into the gastrointestinal tract, so food quickly moves through the intestines and quickly leaves it in liquid form. And another group of drugs (Fleet Phosphosoda and Lavacol) delay the removal of fluid from the intestines, so peristalsis increases, stool softens and intestinal cleansing accelerates.
It is not recommended to choose drugs for bowel cleansing on your own (prescribed by a doctor)
Carrying out the procedure
Patients' imaginations often run in the wrong direction and they completely misunderstand how an intestinal colonoscopy is performed. It seems to them that real torture awaits them, but medicine has long stepped forward in this regard. During the examination, anesthesia or sedation is usually used.
Colonoscopy with local anesthesia
For these purposes, drugs are used where the active active substance Lidocaine (Luan gel, Dicaine ointment, Xylocaine gel) is used. They are applied to the colonoscope nozzle inserted into the anus, or directly lubricated with the mucous membrane. In addition, local anesthesia can be achieved by parenteral administration of anesthetic agents. But the key here is that the patient is conscious.
Sedation
Another option for premedication. In this case, the person is in a state resembling sleep. He is conscious, but he is not in pain or discomfort. Midazolam and Propofol are used for this.
Colonoscopy of the intestines under general anesthesia
This method involves the parenteral administration of drugs that send the patient into deep drug-induced sleep with complete absence consciousness. Colonoscopy performed in this way is especially indicated in pediatric practice, for people with a low pain threshold and observed by a psychiatrist.
The intestinal examination is carried out in a special booth for proctological examinations. The patient is asked to undress to the waist, in return he is given disposable diagnostic panties and is placed on the couch on his left side. In this case, the legs need to be bent at the knees and moved towards the stomach. When the patient receives the pain relief selected for him, the procedure itself begins.
The colonoscope is inserted into the anus, air is pumped in and it begins to be gently pushed forward. To control, the doctor probes the anterior wall of the peritoneum with one hand to understand how the tube overcomes the bends of the intestine. All this time, a video is shown on the monitor screen and the doctor carefully examines various parts of the intestine. At the end of the procedure, the colonoscope is removed.
If the procedure was carried out under local anesthesia, then the patient is sent home on the same day. And if general anesthesia was used, the patient will be forced to spend several days in the hospital and will be under the supervision of specialists. The procedure usually lasts no more than half an hour. Photos of individual sections of the intestine or video of a colonoscopy can be recorded on digital media.
The doctor compiles all data obtained during the examination into a special protocol, which is given to the patient.
Contraindications and complications
Patients are also interested in in what cases this procedure is contraindicated and what complications may arise after testing. Patients in the following conditions will not be able to undergo this examination:
- peritonitis;
- severe violations blood circulation;
- acute myocardial infarction;
- injury to the intestinal wall;
- severe stages colitis;
- pregnancy.
In addition, there are also a number of relative contraindications, which you can read about in more detail. After examining the intestines, the following complications may occur: rupture of the intestinal wall, internal bleeding, short-term bloating, pain syndrome in the peritoneum, an increase in body temperature to 37.5 ° C for 2–3 days (especially if a small resection was performed).
You should consult your doctor immediately if you experience any symptoms after a colonoscopy. following symptoms:
- feverish condition;
- severe abdominal pain;
- nausea accompanied by vomiting;
- loose stools mixed with blood;
- general weakness, dizziness.
Colonoscopy is a fairly safe research method if it is performed by a highly qualified specialist and the patient follows all recommendations during the preparatory period.
With this pathology, the patient will experience the following symptoms:
- frequent diarrhea mixed with blood, mucus and pus.
- pain, most often in the left side of the abdomen;
- body temperature up to 39 degrees;
- decreased appetite;
- weight loss;
- general weakness.
As a rule, the presence of a benign tumor in the large intestine is not clinically manifested.
With this pathology, the patient may experience the following symptoms:
- pain, usually in the left side of the abdomen;
- frequent constipation, alternating with diarrhea;
- bloating.
This pathology is accompanied by the following symptoms:
- sudden abdominal pain;
- stool retention;
- bloating;
- nausea and vomiting.
Every year, a colonoscopy is mandatory for all people at risk. This group includes patients with ulcerative colitis or Crohn's disease, as well as those who have previously undergone surgery on the large intestine. Another risk group includes people whose direct relatives had tumors or polyps of the colon.
Preparing for a colonoscopy
Before performing a colonoscopy, it is necessary special training, it is this that guarantees the high reliability of the research results. Before undergoing a colonoscopy, the following recommendations should be followed:
- stop taking antidiarrheal and iron-containing medications;
- increase fluid intake;
- Follow all doctor's recommendations regarding preparation.
Preparing for a colonoscopy includes the following steps:
- preliminary preparation;
- purgation.
Preliminary preparation
Currently, preparation for colonoscopy is carried out by ingesting special laxative solutions. However, if the patient has a tendency to constipation, then combined preparation may be recommended.To do this, the patient may first be prescribed:
- ingestion of castor oil or ricin oil.
- performing an enema.
The required amount of oil to take is determined depending on the patient’s body weight. If the weight is, for example, 70–80 kg, then 60–70 grams of oil are prescribed, which must be taken at night. If emptying with oil was successful, it is recommended to repeat the procedure. However, it should be noted that this preparation can be carried out for patients who have no contraindications ( for example, the presence of individual intolerance to oil components).
Performing an enema
If preparation is carried out with the help of laxatives, then cleansing enemas are usually not required. However, if the patient suffers from severe constipation, then cleansing enemas may be recommended as a preliminary preparation.
To give an enema at home you need to:
- It is necessary to purchase an Esmarch mug;
- Fill Esmarch's mug with about one to one and a half liters of warm water ( room temperature), after closing the clamp to prevent water from flowing out of the tip;
- After filling the enema, it is necessary to remove the clamp and release a stream of water from the tip, this is done in order to prevent air from entering the intestines;
- The person lies on his left side ( It is recommended to place an oilcloth under the side and a towel on top), the right leg should be moved forward, bending it at the knee 90 degrees;
- The prepared Esmarch mug must be hung one to one and a half meters from the level of the couch or sofa on which the person is lying;
- Then the tip must be lubricated with Vaseline to prevent injury to the anus, after which the enema should be administered to a depth of approximately seven centimeters;
- Only after the tip has been inserted into the anus should the clamp be carefully removed from the enema;
- After completing the procedure, the tip must be carefully removed, slowly rise and walk a little, retaining the liquid in the intestines for about five to ten minutes in order for the cleansing to be most effective.
Note: It should be noted that performing enemas independently requires special skills, so this method preliminary preparation is rarely resorted to.
After two days of preliminary preparation by taking oil orally or performing enemas, patients with a significant history of constipation are prescribed the main method of preparation for colonoscopy ( laxatives and diet).
Diet
Two to three days before the colonoscopy, you should follow a slag-free diet, the purpose of which is effective cleansing intestines. At the same time, it is recommended to exclude from the diet foods that cause fermentation, bloating, and also increase the formation of feces.| Foods to Avoid | Products that are allowed to be consumed |
| fresh vegetables ( cabbage, radishes, beets, garlic, onions, carrots, radish). | boiled vegetables. |
| fresh fruits ( grapes, peaches, apples, oranges, bananas, apricots, tangerines). | dairy products ( sour cream, cottage cheese, kefir, yogurt, fermented baked milk). |
| legumes ( beans, peas). | vegetable soups. |
| black bread. | white bread croutons, crackers, white bread. |
| greenery ( spinach, sorrel). | boiled eggs. |
| smoked meats ( sausage, meat, fish). | lean meats ( chicken, rabbit, veal, beef). |
| marinade and pickles. | lean fish ( e.g. hake, pike perch, carp). |
| certain cereals ( pearl barley, oatmeal and millet porridge). | cheese, butter. |
| chocolate, chips, peanuts, seeds. | weakly brewed tea, compotes. |
| milk, coffee. | jelly, honey |
| carbonated drinks, alcohol. | still water, clear juices. |
Note: It is recommended to skip dinner the evening before the test, and not to have breakfast on the morning of the test.
Purgation
Currently, special laxatives are most widely used to cleanse the intestines. Before performing a colonoscopy, the doctor individually prescribes a suitable remedy based on the patient’s indications and contraindications.The most commonly used colon cleansing drugs
| Name of the drug | Cooking method | Mode of application |
| Fortrans
| One sachet is designed for 20 kg of body weight. Each sachet should be diluted in one liter of warm, boiled water. If, for example, a person weighs 60 kg, then three sachets will need to be diluted in three liters of water. | The prepared volume of liquid must be drunk in the evening at one time or every fifteen minutes, take 250 ml of solution. |
| Endofalk
| Two sachets must be diluted in 500 ml of warm boiled water, mixed thoroughly, after which another 500 ml of cool water should be added. To completely cleanse the intestines before a colonoscopy, it is recommended to take three liters of solution. That is, for one liter of water you need two sachets of the product, and for three liters - six. This solution is prepared regardless of a person’s body weight. | The resulting solution must be taken from five to ten in the evening. That is, within five hours you need to take three liters of the drug. |
| Fleet Phospho-soda
| The package contains two bottles ( 45 ml each), each of which should be dissolved in 120 ml of boiled cold water before use. | When prescribed in the morning, the prepared solution must be drunk after breakfast. The second portion of the solution should be taken after dinner. When prescribed daily, the solution is drunk after dinner, and the second portion of the drug is taken on the day of the procedure after breakfast. The solutions you drink in both the first and second cases must be washed down with one or two glasses of water. |
| Lavacol
| The package contains fifteen packets containing powder. One package of the drug ( 14g) must be diluted in 200 ml of warm boiled water. | Should be taken eighteen to twenty hours before the upcoming test. Total The solution to be taken is three liters. From two o'clock in the afternoon to seven in the evening, you should drink 200 ml of solution every 15 - 20 minutes. |
The main mechanism of action of the drugs Fortrans and Endofalk is that these drugs prevent the absorption of substances in the stomach and intestines, which leads to faster movement and evacuation of contents ( in the form of diarrhea) gastrointestinal tract. Due to the content of electrolyte salts in laxative preparations, disruption of the water-salt balance of the body is prevented.
The effect of the drugs Fleet Phospho-soda and Lavacol is that there is a delay in the excretion of water from the intestines, which leads to the following changes:
- increase in intestinal contents;
- softening of feces;
- increased peristalsis;
- cleansing the intestines.
What diseases can a colonoscopy detect?
Colonoscopy can detect the following diseases:- colon polyp;
- colon cancer;
- nonspecific ulcerative colitis;
- Crohn's disease;
- diverticula of the large intestine;
- intestinal tuberculosis.
| Disease | Description of the disease | Symptoms of the disease |
| Colon polyp
| Disruption of the cell renewal process of the intestinal mucosa can lead to the formation of growths, that is, polyps. The danger of polyps is that if left untreated, they can transform into malignant tumors. Colonoscopy for this disease is the main diagnostic method. It is also possible to remove a polyp using a colonoscope. | As a rule, this disease is asymptomatic for a long time. In some cases, the patient may develop bleeding from the polyp, which will be manifested by the presence of blood in the stool. |
| Colon cancer
| Colon cancer is a malignant tumor that develops from cells of the mucous membrane of this body. A colonoscopy allows for early diagnosis of cancer development. | In the early stages, an intestinal tumor may not manifest itself in any way. However, more late stages such Clinical signs as a bowel disorder ( constipation or diarrhea), the presence of blood in the stool, anemia, and pain in the abdominal area. |
| Nonspecific ulcerative colitis
| Nonspecific ulcerative colitis is inflammatory disease intestines. The exact reason for the development of this disease not established to date. Damage to the large intestine in ulcerative colitis always begins with the rectum, and over time the inflammation spreads to all parts of the organ. Colonoscopy helps to detect nonspecific ulcerative colitis in a timely manner. Also during treatment with this method The study monitors the healing process. |
|
| Crohn's disease
| Crohn's disease is a chronic nonspecific inflammation of the gastrointestinal tract. As a rule, this disease affects the intestines, but damage to the esophagus and oral cavity. The exact cause of Crohn's disease has not yet been identified, but predisposing factors include heredity, genetic mutations, as well as autoimmune processes. Colonoscopy for this disease allows you to identify and determine the degree of inflammation, the presence of ulcers, and bleeding. |
|
| Colon diverticula
| Diverticula are protrusions on the intestinal wall. This disease is usually observed in older people. The main reason for the development of diverticula is the dominance of meat and flour products in the food consumed, as well as a significant reduction in plant foods. This leads to the development of constipation and the appearance of diverticula. The development of this disease is also influenced by factors such as obesity, flatulence and intestinal infections. Colonoscopy for this disease allows you to see the mouth of the diverticulum, as well as determine the presence of inflammatory processes. | In the uncomplicated form, diverticulitis of the large intestine can be asymptomatic. Later, the patient may experience symptoms such as bowel dysfunction ( constipation and diarrhea), bloating and pain in the abdominal area. In case of inflammation of the diverticulum, diverticulitis may develop, in which the patient will experience an increase in the above symptoms, as well as an increase in body temperature and blood in the stool. |
| Intestinal tuberculosis
| Intestinal tuberculosis is infectious disease which is caused by Mycobacterium tuberculosis. As a rule, this disease is secondary, since mycobacteria initially affect the lungs and only then are introduced into the intestines by hematogenous or lymphogenous routes. Colonoscopy for intestinal tuberculosis is performed to establish a diagnosis and take a biopsy if necessary. | Initially, this disease manifests itself in the patient general symptoms such as fever, heavy sweating, loss of appetite and body weight. Diarrhea, blood in the stool, and pain in the abdominal area are also observed in the intestines. |
Contraindications for colonoscopy
There are relative and absolute contraindications for colonoscopy.Absolute contraindications
| Contraindication | Causes |
| Acute myocardial infarction myocardium | Acute myocardial infarction is a serious condition that can lead to fatal outcome, therefore, any endoscopic interventions during this period are contraindicated. |
| Perforation of the intestinal wall | Perforation of the intestinal wall leads to active bleeding, which is eliminated surgically. |
| Peritonitis | Peritonitis is an inflammation of the peritoneum, in which the patient's condition is extremely severe. IN in this case The treatment is emergency surgery. |
| Final stages pulmonary and heart failure | These disorders are characterized by serious circulatory problems. Patients in these cases are in an extremely serious condition, in which endoscopic interventions, including colonoscopy, are recommended to be excluded. |
Relative contraindications
| Contraindication | Causes |
| Poor preparation for colonoscopy | If the patient has performed poor preparation for a colonoscopy, the presence of intestinal contents in the colon will not allow the examination to be carried out effectively. |
| Intestinal bleeding | In most cases ( 90% ) intestinal bleeding can be stopped using colonoscopy, but in case of massive acute blood loss, bleeding is stopped surgically. |
| General serious condition of the patient | The general serious condition of the patient is a contraindication to many studies. This is due to the fact that such patients are prescribed strict bed rest. Also, patients in serious condition are contraindicated under anesthesia, which in some cases is necessary for colonoscopy. |
| Reduced blood clotting | During a colonoscopy, even minor damage to the intestinal mucosa can cause bleeding. |
