IN modern conditions A colonoscopy takes from 20 minutes to 1 hour, and most The patient spends this time in an unconscious state. But preparation for a colonoscopy can take at least a week. What is a colonoscopy, how to cleanse the intestines before a colonoscopy, which enema to choose, what medications to take and how the procedure is carried out - this article will answer all questions.
Colonoscopy - what is it?
It is well known that such a complex procedure as colonoscopy is necessary for diagnosing pathologies of the rectum. The procedure involves inserting a probe (colonoscope) into the anus. The probe is attached to a flexible tube and contains a tiny video camera that allows the doctor to examine the surface of the mucous membrane throughout the colon. The length of the device is up to 1.45 m, which allows for examination of the cecum, sigmoid, colon and rectum. Colonoscopy does not affect small intestine. If necessary, a colonoscopy can also remove polyps or other types of growths, or take tissue samples for analysis (biopsy).
Why is an intestinal colonoscopy necessary?
The patient is indicated for colonoscopy for chronic pain in the abdomen, bleeding from the anus, chronic constipation, diarrhea and other intestinal problems.
You can also have a colonoscopy to check for bowel cancer. If the patient is over 50 years old and has no history of colon cancer in his family, the doctor may recommend that he undergo an examination. abdominal cavity using a colonoscope every 7-10 years.
If the patient is prone to the formation of polyps on the walls of the large intestine, colonoscopy should be performed at certain intervals in order to find and remove polyps that have arisen during the examination of the walls. This manipulation is performed to reduce the risk of rectal cancer.
Complications during colonoscopy
In the vast majority of cases, the procedure takes place without any incidents, but in some cases the following complications may occur:
- The patient may have an adverse reaction to the pain medication used during the examination;
- When removing a polyp or taking a tissue sample, bleeding may occur;
- In very rare cases, the wall of the colon may be perforated.
Preparing for a colonoscopy
Colonoscopy is a low-traumatic procedure medical procedures, most people experience it under the influence of anesthesia. The examination itself takes no more than an hour, and recovery after – a couple of hours. The biggest challenge for patients is preparing for the study. It is a little consoling that if the procedure is successful and no pathologies are identified, then the next one may not be required for 7-10 years.
It is well known that colonoscopy requires preliminary cleansing of the intestines so that it is empty and as clean as possible (as possible) - otherwise food debris and fecal matter may make it difficult for the doctor to see. As a rule, when a doctor prescribes a diagnostic procedure, he tells the patient exactly how to prepare for it, what to eat, what medications to use, and what body reactions to expect during the preparation process. The method of preparation for colonoscopy is selected for each patient individually.
Seven days before colonoscopy: stock up on everything you need
At least seven days before the colonoscopy, it is recommended to go to the pharmacy and purchase the necessary drugs(after all, it will be much more difficult to do this later). The list includes:
- Laxatives,
- Wet wipes or good toilet paper,
- Moisturizing anti-inflammatory skin cream,
- Food products.
Some more difficult question with toilet paper. After several trips to the toilet in a short period of time, regular cheap toilet paper can begin to scratch and irritate the skin, and if the urge is caught outside the house, wet wipes will help. It is preferable to use wipes with juice or vitamin E - these substances will help soothe inflamed skin.
During preparation, it is recommended to regularly lubricate the anal area with cream - this will relieve irritation and help reduce the risk of inflammation caused by diarrhea and exposure to toilet paper.
Preparation at later stages should include special food. It is required to eat according to the doctor’s instructions; It is advisable to think over your menu in the days preceding the study. It is recommended to stock up on easily digestible food that will not cause constipation and sufficient fluids. These can be either sports drinks or light transparent liquids.
Five days before colonoscopy: diet
At this stage of preparation, the patient needs to adjust his diet to include foods that are easy to digest and easy to pass. naturally(this is especially important for people suffering). This is food with low content fiber, foods such as light bread, pasta, rice, eggs, lean meat (poultry or fish), vegetables without skin, fruit without seeds or skin. About two days before the test, it is recommended to switch to soft foods, such as omelet, vegetable purees and soups, ripe fruits without skin, such as bananas.
Avoid foods that are difficult and take a long time to digest; their remains may make it difficult for a doctor to examine the intestines. These include fatty and fried foods, tough meats, seeds, nuts, grains, raw vegetables, skins of vegetables and fruits, fruits with seeds and skins, cabbage (broccoli, cabbage, cauliflower), lettuce, corn, legumes (beans, peas, chickpeas).
Before preparing the test, you should notify your doctor about any medications you are taking. medicines(especially in case of diabetes, high blood pressure, heart disease or anemia). It is also necessary to report the use of anticoagulants (for example, Warfarin, Tsibor, etc.). The dose may need to be adjusted based on a future study or even discontinued medical supplies during preparation. Attention! The number of medications that you must notify your doctor about taking also includes vitamins, dietary supplements, and other over-the-counter medications that the patient is accustomed to using frequently.
24 hours before colonoscopy
During this period, preparation enters its most important phase. Even if during the previous stage the patient ate only prescribed foods, the day before the procedure you should give up solid food and switch exclusively to liquid nutrition. The reason is that bowel cleansing takes time; It will take at least a day to remove all the solid waste accumulated in the colon.
It is very important that during this period of preparation for the study the body receives sufficient quantity liquids. The patient can drink any clear, colorless liquids; It is advisable to drink at least a glass every hour. This includes pure water, tea and coffee without adding milk or cream, low-fat broth, mineral water. Colored liquids, especially red ones, should be avoided - the doctor may confuse their remains with blood during the examination inner surface intestines, which will complicate the diagnosis.
The night before colonoscopy
Preparation in this moment includes final disposal of any remaining waste. Colon cleansing is done using a laxative prescribed by a doctor. As a rule, it is recommended to take a laxative in two doses: 12 hours before the examination and 6 hours before it. For example, if a colonoscopy is scheduled to be performed at 6-7 a.m., then the first dose is taken at noon the day before, and the second dose is taken shortly before midnight.
After taking a laxative, a person's intestines will begin to push out waste at an accelerated rate, resulting in diarrhea. In addition to diarrhea, the patient may experience abdominal cramps, bloating, discomfort, nausea and even vomiting. If a person has hemorrhoids, they can become inflamed, which will add even more discomfort.
You will have to sit in the toilet for a long time, so it is recommended to arrange it in advance with the greatest possible comfort. A stool for your feet, an interesting book, a tablet with a game - all this will help brighten up long hours on the toilet. Purchased in advance soft toilet paper and wet wipes (or wet toilet paper) with anti-inflammatory and moisturizing impregnation, as well as creams and lotions will help reduce skin irritation after frequent trips to the toilet.
If your doctor has not prescribed specific laxatives, you can take the following:
Castor oil in the amount of 2 tbsp. l. If it is difficult to swallow pure butter, it can be dissolved in a glass of fermented milk product (yogurt, kefir, fermented baked milk).
2/3 cup of a thirty percent solution of magnesium sulfate. Magnesia has an extremely unpleasant taste, so you can wash it down with light sweet juice, squeeze lemon into a glass of laxative, add ginger or other substances with a pleasant smell.
In some cases, the doctor may suggest that the patient use an enema. This is done either the evening before the examination or a couple of hours before it. Usually use a 1.5 liter enema and fill it warm water. The enema is repeated until almost clean and clear drainage water appears.
Preparing for a colonoscopy using osmotic laxatives
Although the enema is certainly effective, its process self-cooking and application can be difficult and unpleasant for the patient. They come to the rescue modern drugs, in particular, osmotic laxatives containing macrogol. The effectiveness of intestinal cleansing with drugs containing macrogol depends only on the volume of the solution drunk. It is necessary to consume at least three to four liters; Fortunately, since the days of magnesium sulfate, medicine has stepped forward and their taste is not so disgusting. IN as a last resort, you can always use a sweetener or flavoring agent like lemon or ginger juice.
The advantage of laxatives based on macrogol is that they do not cause dehydration of the body, and even vice versa - they contain osmotically active substances retain water entering the intestines, thereby facilitating rinsing and cleansing of the intestines at the enema level. Osmotic laxatives are especially good for cleaning the descending colon and sigmoid colon, where the water from the enema may not reach.
Trade names of drugs containing macrogol are Forlax, Lavacol, Fortrans. As a rule, the dose of the drug is calculated based on the patient’s weight - one sachet of the drug dissolved in 1 liter of water for every 15-20 kg of the patient’s body weight. Since it is difficult to immediately drink such a volume of water, the patient is recommended to drink a glass of the solution every 20 minutes.
If Fortrans is suitable for patients without complications, then Forlax is designed specifically for those who, for health reasons, are not able to drink so much fluid (for example, for people suffering from cardiovascular diseases or peptic ulcer stomach). The drug is dissolved in a glass of water and taken either two sachets once a day (in the morning), or two sachets in the morning and evening for three days before the day of the examination. When using Forlax, an enema cannot be avoided - it is advisable to give yourself one small enema a couple of hours before the procedure.
Before colonoscopy: two hours
You can't eat or drink (not even water). This prohibition arose for a reason - due to the presence of water in the stomach, colonoscopy can cause vomiting, which a patient under general anesthesia can choke on. Some medical institutions require a longer period of abstinence from water (up to 8 hours), so it is recommended to clarify this issue in advance.
Colonoscopy, how the procedure works
How is the examination carried out? When it is performed, the patient will wear a gown and, as a rule, nothing more. Anesthesia is usually used. General anesthesia is carried out using intravenous injection, but is sometimes used local anesthesia; in this case, the doctor gives the patient an injection sedative or gives pills.
The patient lies sideways on the table with his knees drawn up to his chest. The doctor inserts the colonoscope into the rectum through the anus. The colonoscope tube is long enough so that the colonoscope can go through all the bends of the intestine, and the doctor can conduct an accurate examination of the entire large intestine, examining each of its mucous folds. The colonoscope has a light element and is capable of pumping air. The air expands the lumen of the intestine, which allows the doctor to better examine it.
At the tip of the tube there is a small video camera that sends an image of the inside of the intestine to the monitor. Colonoscopy also allows the insertion of instruments into the intestines, with the help of which tissue samples are taken and polyps and other abnormal formations are removed.
Typically, a colonoscopy lasts from 20 minutes to 1 hour.
results
A negative result is the best. This means that during the examination the doctor did not identify diseases or signs of inflammation in the colon. For older patients, your doctor may recommend that you be retested for colorectal cancer in 7 to 10 years (unless the patient has other risk factors besides age). If negative result caused by the inability to fully examine the intestines due to residual stool, the doctor will most likely recommend a repeat colonoscopy.
A positive result is when the doctor has identified pathologies in the colon (polyps, altered tissue, and so on). As a rule, if the presence of polyps is detected, then there is nothing to worry about, since most of them are benign formations, but some may be precancerous. Detected polyps are sent to a laboratory for analysis to determine whether they are benign, precancerous, or malignant tumors. Depending on the size and number of polyps, your doctor may prescribe the frequency of subsequent colonoscopy examinations. If the number of polyps is very small, literally one or two, and their diameter is no more than 1 cm, then a subsequent colonoscopy is carried out only after five years. If there are more polyps, their size is increased, or laboratory analysis shows that they have certain characteristics, the doctor may recommend the procedure after three years (in the absence of other risk factors). If the polyps turn out to be malignant, then a colonoscopy may be required after 3-6 months.
When is a repeat colonoscopy performed?
If the doctor is dissatisfied with the results of the examination of the intestinal loops (the study is hampered by residual feces or other obstacles), he may suggest a repeat colonoscopy. If insurmountable obstacles stand in the way of the endoscope, as a rule, air contrast study(barium enema) or virtual colonoscopy - when the intestines are examined using a multislice computed tomograph.
After the procedure
After the examination is completed, it takes about an hour for the patient to begin to regain consciousness. It is advisable that family members, friends or relatives take him home, since it will be possible to completely get rid of the effects of taking a sedative drug only at the end of the day. In this state, it is extremely undesirable to drive independently or engage in activities that require concentration.
As a rule, after the examination, the patient is not recommended to eat for an hour. After this period, you can eat something small, delicate in texture and easily digestible (semi-liquid porridge from well-cooked cereal, liquid cottage cheese, yogurt, and so on). If a polyp has been removed, your doctor may recommend following special diet for a certain period of time.
For some time after the end of the examination, the patient may feel bloating or emit gases - this is how the air that got there during the examination is released from the rectum. You should not strain your stomach in an attempt to force the air out - it will gradually come out on its own. Taking an upright position and walking around the room or taking a short walk will help ease the situation. When saving pain symptoms you can take an analgesic.
At the first bowel movement, small traces of blood may be found in the stool. As a rule, there is nothing to worry about - the blood usually disappears with repeated bowel movements. But if the blood continues to flow, there are blood clots in the stool, the patient experiences abdominal pain, or has a fever, a doctor should be consulted immediately.
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 can begin with screening tests to identify 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 the large intestine and its lower segment (rectum), which is used for the diagnosis and treatment of pathological conditions of this part digestive tract. It shows in detail the condition of the mucous membrane. Sometimes this diagnosis is called fibrocolonoscopy (FCS colonoscopy). 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, they inspect in detail various areas intestines. 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 of the intestine without injuring the tissue or causing pain to the patient.
For children, colonoscopy is performed under general anesthesia.
Indications for use
An intestinal colonoscopy is performed to confirm the 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;
- bowel problems (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, medicinal cleansing intestines. Following these steps accurately will allow you to achieve maximum 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 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 products that cause increased gas formation. You can eat low-fat varieties meat and fish, dairy products, boiled vegetables. Last appointment food 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 anesthetics. 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 intestine under general anesthesia
This method involves parenteral administration medications that send the patient into deep medicated sleep with complete absence consciousness. Colonoscopy performed in this way is especially indicated in pediatric practice, for people with low pain threshold and being seen 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 performed under local anesthesia, the patient is sent home on the same day. And if it was used general anesthesia, then 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 when this procedure is contraindicated and what complications may arise after testing. Pass the this examination Patients in the following conditions will not be able to:
- peritonitis;
- severe violations blood circulation;
- acute myocardial infarction;
- injury to the intestinal wall;
- severe stages colitis;
- pregnancy.
In addition, there are also a number relative contraindications, about which you can read in more detail in this article. 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 stool with blood impurities;
- general weakness, dizziness.
Colonoscopy is a rather safe methods research, if it is carried out 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 in mandatory Colonoscopy is performed 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 antidiarrheals, and iron-containing preparations;
- 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 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 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. | croutons from white bread, 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 laxatives, violations are prevented. water-salt balance body.
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 the cells of the mucous membrane of this organ. A colonoscopy allows for early diagnosis of cancer development. | On 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, and autoimmune processes. Colonoscopy for this disease allows you to identify and determine the degree of inflammation, the presence of ulcers, and bleeding. |
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| 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 | Acute myocardial infarction is a serious condition that can lead to death, 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 extreme in 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 it is possible to stop with 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. |
Today medical diagnostics has in its arsenal a large number of methods that allow you to correctly assess the patient’s condition and identify at the early stages the development of life-threatening pathologies. One of them is the examination of the inner walls of the colon using instrumental equipment: colonoscopy is performed in cases where it is necessary to visually assess the condition of the intestinal tract and perform a biopsy of the affected tissue.
Why is the procedure needed?
The essence of colonoscopy is extremely simple. For its implementation it is used optical instrument(colonoscope, hence the name). Its body is a hollow flexible tube. At one end there is a light and a miniature video camera.
The image is transmitted in real time to the monitor, so the doctor has the opportunity to see the condition of the internal walls of the colon over a distance of two meters, evaluate the shine of the mucous membrane, its color, study the vessels located under it, and changes caused by the inflammatory process.
One packet of Lavacola dissolves in 200 ml of water. To carry out a complete cleansing, you need to drink three liters. The taste of the powder is more pleasant, so its use is easier to tolerate. Doctors recommend taking Levacol from the afternoon until 7 p.m.
The described products were specially designed for preparation for examinations using a colonoscope. They gently cleanse, but in many patients they cause side effects such as flatulence, allergic manifestations and discomfort in the abdominal area. Child have a drink the right dose can’t, so no one is writing off the enema yet.
How is colonoscopy performed?
Many people, going for diagnostic examinations, want to know how they are carried out. Having a complete understanding of the process itself, it is easier to tune in correctly and go through the procedure painlessly.
- So, first the patient is asked to lie on the couch and turn on his left side, tucking his knees to his stomach.
- Then the diagnostician treats the anus with an antiseptic and carefully inserts a probe into it. Anesthesia is not used; if a person is highly sensitive and complains of pain during the insertion of endoscopic equipment, anesthetic gels can be used. Sedation is also practiced, but it significantly increases the cost of a diagnostic examination. Severe pain occurs only if it is necessary to perform a colonoscopy on a patient who is suspected of having acute inflammatory processes or there are adhesions in the rectum. In this case, a short-term general anesthesia is given (for 30 minutes).
- After anesthesia, the doctor carefully inserts a probe into the anus and moves it slowly deep into the intestine. In order to straighten the folds of the tract and more thoroughly examine its mucous membrane, air is pumped through the pipe.
- The probe can move 2 meters deep into the intestine, all this time the camera will show the internal state of the hollow organ. If they are not found on the probe's path pathological changes, colonoscopy is done in about 15 minutes. If necessary, perform therapeutic effects, as patient reviews show, it may take more time.
- To collect tissue for histological analysis, painkillers are first administered through the endoscope tube. local action, then a small piece of diseased tissue is removed with forceps and taken out.
Colonoscopy is used to remove polyps, small single growths. For these purposes, not forceps are used, but a special device similar to a loop. Using it, like a lasso, the doctor grabs the convex part of the growth at the base, tightens it, cuts it off and removes it.
Before the advent of the colonoscope, laparoscopy allowed resection; although it was minimally invasive, it was an operation that required a more complex preparatory process and recovery.
Video: Colonoscopy of the Intestines
Rare complications
When the examination is completed, the doctor must perform certain manipulations: using a probe, he pumps out air from the intestine and gradually removes the instrument. After this, many patients experience a feeling of severe abdominal distension. Pills help eliminate it activated carbon.
If the described procedure is carried out in a specialized institution and is entrusted to an experienced doctor, the risk of complications is minimized. But it still exists. What to watch out for:
- Perforation of the intestinal walls. A complication arises when colonoscopy allows one to identify and show mucosal ulceration, accompanied by purulent processes. The patient is immediately taken to the operating room and the damaged area is surgically repaired.
- Bleeding. This occurs after the removal of polyps and neoplasms. It can be eliminated immediately by cauterizing the area and administering adrenaline.
- Severe pain in a stomach. Appear after a biopsy. Malaise is eliminated by taking analgesics.
- Increased body temperature, nausea, vomiting, bloody diarrhea. Such side effects are extremely rare, but if at least one symptom appears, you should immediately seek medical help.
Contraindications
There are conditions in which it is not possible to examine a patient with a colonoscope. This:
- Acute infections in organism.
- Diseases of the cardiovascular system.
- Pressure drop.
- Pulmonary failure.
- The presence of violations of the integrity of the intestinal tract (perforation with release of contents into the peritoneum).
- Peritonitis.
- Ulcerative colitis accompanied by inflammatory phenomena.
- Massive bleeding.
- Pregnancy.
- Poor blood clotting.
There are no indications for colonoscopy in infants. If it is impossible to use the described method, other methods for diagnosing diseases of the lower colon are selected.
Video: Colonoscopy - answers to questions
Alternative procedure
There is only one examination in the arsenal of doctors that can compete with the described method in terms of information content. This is an MRI of the intestine. Doctors call each other this type virtual colonoscopy examinations. Anyone who has undergone the procedure at least once notes that it feels more comfortable; experts pay attention to the gentle nature of the diagnosis.
It is performed using equipment that allows you to scan and take pictures of the abdominal cavity with different sides, and then create a three-dimensional model of the intestinal tract. Everything is clearly visible on it pathological processes, while the patient does not experience any discomfort.
Why do doctors still use a colonoscope? The fact is that MRI does not allow showing pathological neoplasms whose diameter does not exceed 10 mm. Therefore, magnetic resonance imaging forms a preliminary conclusion, and after it, when the doctor wants to clarify the diagnosis, he prescribes an instrumental examination.
Colonoscopy is diagnostic examination rectum and large intestine special device- colonoscope. The procedure is quite complex and requires lengthy training and highly qualified doctors. To understand how long a colonoscopy can take, you need to understand the technology behind it.
The essence of diagnosis
A colonoscope is a long flexible tube (up to 145 cm). It is equipped with LED lighting, a camera and holes for introducing additional instruments - a coagulator, forceps.
The probe is also equipped with a special air supply device. It is necessary for the intestines to smooth out. This makes it easier to pass the device.
Colonoscopy allows images of the intestines to be transmitted to a monitor. With its help, you can identify even the slightest abnormalities, perform a biopsy, remove small formations and cauterize bleeding ulcers and erosions.
Possibilities
Colonoscopy of the intestine can detect:
- Cancer, even at the cellular level.
- Erosion and ulceration.
- Atypical ulcerative colitis.
- Intestinal tuberculosis.
- Crohn's disease.
- Polyps, diverticula, hemorrhoids, tumors, foreign objects.
- Pathological deviations of the intestinal mucosa, impaired motility, the presence of inflammatory processes.
Indications
Indications for diagnostics are various pathological abnormalities in the functioning of the organ and suspicions of them. A colonoscopy is performed when:
- Chronic constipation or diarrhea.
- Impurities in the stool: mucus, pus, blood.
- Pain in the abdominal area.
- Formations detected by other examination methods.
- Suspicion of cancer, intestinal obstruction, Crohn's disease, ulcerative colitis.
- Sudden, unreasonable weight loss.
- Anemia - to avoid bleeding and ulcers.
Contraindications
Colonoscopy is not always possible. There are a number of situations when the procedure is prohibited:
- Heart or pulmonary failure.
- Inflammatory processes in the intestines.
- Poor blood clotting.
- Exacerbation of ulcerative colitis.
- Periodontitis.
- Acute infectious diseases.
- Diverticulitis.
- Extensive intestinal bleeding.
Preparation
The duration of a colonoscopy includes preparation. This is the longest stage. It consists of a complete cleansing of the intestines.
Before the procedure, the patient is prescribed:
- Three-day slag-free diet. It is prohibited to consume foods that cause gas formation. The diet includes light, dietary soups, fish, dairy products, and juices. The last meal should be no later than lunch on the eve of the study.
- Enemas. They are recommended if the person being examined can use them to thoroughly cleanse the intestines. If not, laxatives are prescribed.
- Taking laxative medications. The most commonly prescribed drug is Fortrans. For 20 kg of weight you need to drink 1 sachet of medicine diluted in a liter of water. The last appointment is no later than 4 hours before the procedure.
The intestines must be completely cleansed along their entire length. If this is not done, the colonoscopy will have to be postponed and all preparatory steps will have to be repeated.
How is a colonoscopy performed?
A colonoscopy of the intestines is performed by a coloproctologist. It is carried out in several stages:
- The subject is placed on the couch in the fetal position. He should lie on his left side, straight left leg and bending the right one.
- The tip of the probe is inserted into the anus with careful circular movements.
- The doctor carefully moves the colonoscope through the colon. At the same time, it delivers a stream of air to smooth out the mucous membrane, and the nurse can apply pressure to the patient's abdomen to guide the tube.
- If small formations were discovered during diagnosis, they are removed immediately using forceps, and the bleeding is cauterized.
- If necessary, a biopsy is done during a colonoscopy.
The examination is always associated with discomfort. Therefore, it is advisable not to do a colonoscopy without anesthesia and to use one of the types of anesthesia: local, general or sedation. Full anesthesia may take the longest.
How long does a colonoscopy take?
How long a bowel examination will take depends on several factors:
- Qualifications and experience of the doctor.
- Quality and modernity of diagnostic equipment.
- The structure of the intestine of a particular patient: how curved it is.
- Presence of neoplasms, bleeding, ulcerations.
- The need to carry out other procedures: biopsy, cauterization, microsurgery.
On average, a colonoscopy takes 15 to 20 minutes. Its duration may vary. If intestinal permeability is good, no pathologies are found, the period is reduced to 10 minutes. If deviations are present or additional manipulations are necessary, the time is increased to 40–60 minutes.
Post-examination period
After a colonoscopy, it is recommended to remain in bed for several hours. It is better to lie on your stomach - this will make it easier for the remaining air to leave the intestines. There are no dietary restrictions. The patient is allowed to eat any food.
Sometimes the doctor may ask you not to drink or eat for several hours. This recommendation is given in cases where microsurgery was performed on the intestines.
Colonoscopy in general safe procedure. Only sometimes (in 1% of all cases) complications may occur:
- Perforation of the intestinal walls. Usually occurs in the presence of purulent processes or ulceration of the mucous membrane. In this case, the doctor conducts surgery and repairs the damage.
- Bleeding. Possibly after removal of polyps and other formations. Eliminates immediately.
- Abdominal pain. Appears after a biopsy or removal of tumors. Analgesics are indicated.
Colonoscopy is the most accurate and informative method intestinal examinations. It allows you to detect most pathologies at the initial stage of development. Its duration depends on the physiological characteristics of the patient, the need for other manipulations, the quality of the equipment and the experience of the doctor.
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