In modern conditions, a colonoscopy takes from 20 minutes to 1 hour, and the patient spends most of this time in an unconscious state. But preparation for a colonoscopy can take at least a week. What is colonoscopy, how to cleanse the intestines before colonoscopy, which enema to choose, what drugs to take and how the procedure goes - this article will answer all questions.
Colonoscopy - what is it?
It is well known that such a complex procedure as a colonoscopy is necessary for the diagnosis of pathologies and the rectum. The procedure consists of 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 mucosal surface throughout the colon. The length of the device is up to 1.45 m, which allows you to examine the blind, sigmoid, colon and rectum. Colonoscopy does not involve the small intestine. If needed, colonoscopy can also remove polyps or other growths, or take tissue samples for analysis (biopsy).
Why is a colonoscopy necessary?
The patient is shown a colonoscopy for chronic abdominal pain, bleeding from the anus, chronic constipation, diarrhea and other bowel problems.
You can also have a colonoscopy to look for bowel cancer. If a patient is over 50 years old and has no history of colon cancer in their family, the doctor may recommend that they have an abdominal examination with a colonoscope every 7 to 10 years.
If the patient is prone to the formation of polyps on the walls of the large intestine, colonoscopy should be carried out at regular intervals in order to find and remove the resulting polyps during the examination of the walls. This manipulation is carried out to reduce the risk of colon cancer.
Complications during colonoscopy
In the vast majority of cases, the procedure goes without any excesses, but in some cases the following complications may occur:
- The patient may develop an adverse reaction to the pain medication used during the examination;
- When removing a polyp, taking a tissue sample, bleeding may occur;
- In very rare cases, perforation of the colon wall is possible.
Preparing for a colonoscopy
Colonoscopy is a minimally invasive medical procedure and most people experience it under the influence of anesthesia. The study itself takes no more than an hour, and recovery after - a couple of hours. The biggest difficulty for patients is preparation for the study. It is a little consoling that if the procedure is successful, and no pathologies have been identified, then the next one may not be required for 7-10 years.
It is well known that a colonoscopy requires the colon to be empty and as clean as possible (as possible), otherwise food debris and stool can 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 drugs to use and what reactions of the body should be expected in the preparation process. The method of preparation for colonoscopy is selected for each patient individually.
Seven Days Before Your Colonoscopy: Stock Up With Everything You Need
At least seven days before the colonoscopy, it is recommended to go to the pharmacy and stock up on 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.
The issue with toilet paper is somewhat more complicated. After several trips to the toilet in a short period of time, ordinary cheap toilet paper can start 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 in the later stages should include special meals. It is required to eat according to the prescriptions of the doctor; it is advisable to think over your menu in the days leading up to the study. It is recommended to stock up on easily digestible food that will not cause constipation, and a sufficient amount of liquid. It can be both sports drinks and 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 easily digested and easily come out naturally (this is especially important for people suffering). These are low fiber foods such as light bread, pasta, rice, eggs, lean meat (poultry or fish), skinless vegetables, seedless and skinless fruit. Approximately two days before the study, it is recommended to switch to soft foods, such as scrambled eggs, vegetable purees and soups, ripe fruits without skins, such as bananas.
Foods that are difficult and take a long time to digest should be avoided; their remains can make it difficult for a doctor to examine the intestines. These include fatty and fried foods, tough meats, seeds, nuts, cereals, raw vegetables, vegetable and fruit skins, fruits with seeds and skins, cabbage (broccoli, white, cauliflower), lettuce, corn, legumes (beans, peas, chickpeas).
Before preparing the study, it is worth informing the doctor about any medications you are taking (especially if you have diabetes, high blood pressure, heart disease, or anemia). It is also necessary to report the use of anticoagulants (for example, Warfarin, Cibor, etc.). You may need to adjust your dose for a future study or even stop taking your medications while you are preparing. Attention! Drugs that you should tell your doctor about taking also include vitamins, supplements, and other over-the-counter drugs 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 refuse solid food and switch exclusively to liquid food. 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 of the study, the body receives a sufficient amount of fluid. 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 the addition of milk or cream, low-fat broth, mineral water. Colored liquids, especially red ones, should be avoided - the doctor can confuse their remains with blood during an examination of the internal surface of the intestine, which makes it difficult to make a diagnosis.
Night before colonoscopy
Preparations now include the final disposal of any remaining waste. Colon cleansing is performed with the help of 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 the colonoscopy is scheduled for 6-7 am, 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 expel waste at an accelerated rate, leading to 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 equip it in advance with the maximum available comfort. A footstool, an interesting book, a tablet with a game - all this will help brighten up long hours on the toilet. Pre-purchased 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 oil, it can be dissolved in a glass of a fermented milk product (yogurt, kefir, fermented baked milk).
2/3 cup of a thirty percent solution of magnesium sulfate. Magnesia is extremely unpleasant in taste, so you can drink it with light sweet juice, squeeze lemon into a glass with a laxative, add ginger or some other substance with a pleasant smell.
In some cases, the doctor may suggest that the patient use an enema. This is done either on the evening before the examination, or a couple of hours before it. Usually use a 1.5 liter enema and fill it with warm water. The enema is repeated until practically clean and clear drain waters appear.
Preparing for a colonoscopy using osmotic laxatives
Although the enema is certainly effective, the process of preparing and applying it yourself can be difficult and unpleasant for the patient. Modern drugs come to the rescue, in particular, osmotic laxatives containing macrogol. The effectiveness of bowel cleansing with preparations containing macrogol depends only on the volume of the drunk solution. 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. As a last resort, you can always use a sweetener or flavoring like lemon juice or ginger.
The advantage of macrogol-based laxatives is that they do not cause dehydration of the body, and even vice versa - the osmotically active substances contained in them retain the water entering the intestines, thereby contributing to the washing and cleansing of the intestines at the enema level. Osmotic laxatives are especially good for cleaning the descending colon and sigmoid colon, where water from an enema may not reach.
Trade names of preparations containing macrogol - Forlax, Lavacol, Fortrans. As a rule, the dose of the drug is calculated based on the weight of the patient - 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 consume such a volume of water, the patient is recommended to drink a glass of 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 liquid (for example, for people suffering from cardiovascular diseases or stomach ulcers). 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 - a couple of hours before the procedure, it is advisable to give yourself one small enema.
Before colonoscopy: two hours before
You can neither eat nor drink (not even water). This prohibition arose for a reason - due to the presence of water in the stomach, colonoscopy can cause vomiting, which can choke a patient under general anesthesia. Some medical institutions require a longer period of abstinence from water (up to 8 hours), so it is recommended to find out this issue in advance.
Colonoscopy, how is the procedure
How is the examination carried out? When it is carried out, the patient will have a gown and, as a rule, nothing more. An anesthetic is usually used. General anesthesia is given by intravenous injection, but local anesthesia is sometimes used; in this case, the doctor gives the patient an injection of a sedative drug or tablets.
The patient lies sideways on the table, pulling his knees to his chest. The doctor inserts the colonoscope into the rectum through the anus. The tube of the colonoscope is long enough so that the colonoscope can go through all the bends of the intestine, and the doctor can accurately examine the entire large intestine, examine each of its mucous folds. The colonoscope has a light element, and it is able to pump air. The air expands the lumen of the intestine, which allows the doctor to better examine it.
At the tip of the tube is a small video camera that sends an image of the inside of the intestine to a monitor. Colonoscopy also allows the insertion of instruments into the intestine, with the help of which tissue samples are taken, polyps and other abnormal formations are removed.
As a rule, 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 reveal diseases or signs of inflammation in the colon. For elderly patients, the doctor may recommend that they be re-examined for rectal cancer in 7-10 years (if the patient has no other risk factors besides age). If a negative result is due to an inability to fully examine the bowel due to residual stools, the doctor will likely recommend a new 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. The discovered polyps are sent to the laboratory for analysis to determine whether they are benign, precancerous or malignant tumors. Depending on the size and number of polyps, your doctor may schedule follow-up colonoscopy exams. If the number of polyps is very small, literally one or two pieces, and their diameter is not more than 1 cm, then the subsequent colonoscopy is performed only after five years. If there are more polyps, their size is increased, or laboratory analysis has shown that they have certain characteristics, the doctor may recommend a procedure in three years (in the absence of other risk factors). If the polyps turned out to be malignant, then in this case 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 bowel loops (residual feces or other obstructions interfere with the examination), he may suggest that you undergo a second colonoscopy. If there are insurmountable obstacles in the path of the endoscope, as a rule, an air contrast study (barium enema) or virtual colonoscopy is used - when the intestines are examined using a multislice computed tomograph.
After the procedure
After the end of the examination, it takes about an hour for the patient to begin to recover. It is advisable that family members, friends or relatives take him home, as it will be possible to completely get rid of the effects of taking a sedative drug only by the end of the day. In this state, it is highly undesirable to get behind the wheel on your own 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-boiled cereals, liquid cottage cheese, yogurt, and so on). If a polyp has been removed, the doctor may recommend a special diet for a certain period of time.
For some time after the end of the examination, the patient may feel bloated or emit gases - this is how air comes out of the rectum, which got there during the examination. Do not strain your stomach in an attempt to squeeze out the air by force - it will gradually come out by itself. To alleviate the situation will help the adoption of an upright position and walking around the room or a short walk. If pain symptoms persist, 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 - usually the blood disappears with repeated bowel movements. But if the blood continues to flow, there are blood clots in the feces, the patient experiences pain in the abdomen, he has a fever, you should immediately consult a doctor.
A proctologist is one of the most disliked by many doctors, a visit to which is postponed until the last. Yes, and talking about any problems in the intestines is considered rather shameful, but meanwhile the colorectal is so confidently gaining momentum and taking many lives.
And this despite the fact that if you turn to specialists for help in time, it is not difficult to diagnose this pathology. And he has a favorable prognosis, unless the patient comes in the last stage of cancer. Examination of patients may begin with screening tests to detect hidden bleeding.
They also undergo colonoscopy, barium enema and sigmoidoscopy. Not all patients understand what is meant by these terms, so patients may have such questions: what is an intestinal colonoscopy? How is the procedure? What does a colonoscopy show? Does it hurt?
general information
The colonoscopy procedure is an instrumental study of the large intestine and its lower segment (rectum), which is used to diagnose and treat pathological conditions of this part of the digestive tract. It shows in detail the condition of the mucous membrane. Sometimes this diagnosis is called fibrocolonoscopy (FCS colonoscopy). Usually, the colonoscopy procedure is carried out by a diagnostician-proctologist, who is assisted by a nurse.
This diagnostic procedure involves inserting a probe into the anus, equipped with a camera at the end, which transmits the image to a large screen. After that, air is forced into the intestines, which does not allow the intestines to stick together. As the probe advances, various parts of the intestine are examined in detail. In some cases, a colonoscopy is performed not only to visualize problems, but it also allows the following manipulations:
- take a biopsy;
- remove polyps or connective tissue strands;
- remove foreign objects;
- stop bleeding;
- restore intestinal patency in case of narrowing.
The colonoscope is a soft and easily bendable probe that allows you to delicately move through all the anatomical structures of the intestine without injuring the tissues and without causing pain to the patient.
Colonoscopy for children is performed under general anesthesia.
Indications for carrying out
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 for histological examination);
- Crohn's disease (granulomatous inflammatory disease);
- nonspecific ulcerative colitis;
- complete violation of the passage of contents through the intestines;
- stool disorders (frequent diarrhea or chronic constipation);
- rapid weight loss for unknown reasons;
- low hemoglobin;
- prolonged subfebrile temperature.
Colonoscopy of the rectum is indicated for prevention 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 with colorectal cancer).
Training
The preparatory process involves the following stages: initial preparation, dietary nutrition, drug cleansing of the intestines. Accuracy of following these steps will allow you to achieve the most reliable results.
Primary preparation
If the patient suffers from constipation for a long time, then cleansing medications alone will not be enough. In advance, such patients are prescribed castor oil (castor oil) or classic enemas. Castor oil is taken 2 days in a row at night. Quantity is calculated by weight. If on average the patient weighs about 70 kg, then 60 ml of the product is enough.
If constipation is persistent and neglected, 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's mug) and 1.5 liters of water at room temperature.
Step by step procedure:
- The patient should lie on the left side, while the right leg should be pushed forward and bent at the knee. It is better to spread 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. The air is then bled off and the clamp is closed again.
- The heating pad must be hung above the level of the sofa / bed by 1–1.5 meters.
- The nozzle should be generously lubricated with petroleum jelly and carefully inserted into the anus to a depth of up to 7 cm.
- The clamp is removed from Esmarch's mug and the entire volume of liquid is let into the patient, after which the tip is removed.
- The patient should not immediately run to the toilet, but first you should move a little, squeezing the sphincter (5-10 minutes). After that, you can relieve the need. This manipulation should be performed 2 evenings in a row.
Doctors do not recommend combining the intake of castor oil inside and at the same time putting enemas. After 2 days of initial preparation, the patient should eat properly and take special cleansing preparations.
Diet food
Another way to qualitatively cleanse the lower parts of the digestive tract is to give preference to a slag-free diet 2-3 days before the scheduled procedure. During this period, products that cause increased gas formation should be abandoned. You can eat low-fat varieties of meat 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 prevent nutrients from being absorbed in the gastrointestinal tract, so food moves rapidly through the intestines and quickly leaves it in liquid form. And another group of drugs (Fleet Phospho-soda and Lavacol) delay the removal of fluid from the intestines, so peristalsis increases, feces soften and bowel cleansing is accelerated.
It is not recommended to choose drugs for bowel cleansing on your own (prescribed by a doctor)
Carrying out the procedure
Patients often run their imaginations in the wrong direction and have a completely wrong idea of how a bowel colonoscopy is done. It seems to them that they are waiting for real torture, but medicine in this regard has long stepped forward. During the examination, as a rule, anesthesia or sedation is used.
Colonoscopy with local anesthesia
For these purposes, drugs are used where the active ingredient is lidocaine (Luan gel, Dicaine ointment, Xylocaine gel). They are applied to the nozzle of the colonoscope, inserted into the anus, or they are lubricated directly with the mucosa. In addition, local anesthesia can be achieved by parenteral administration of 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 at the same time he is not hurt or uncomfortable. For this, Midazolam, Propofol are used.
colonoscopy under general anesthesia
This method involves the parenteral administration of drugs that send the patient into a deep drug-induced sleep with a complete lack of 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 examination of the intestine is carried out in a special cabin for proctological examinations. The patient is asked to undress to the waist, in return he is given disposable diagnostic panties and laid on the couch on his left side. At the same time, the legs must be bent at the knees and moved to the stomach. When the patient receives the anesthesia chosen for him, the procedure itself begins.
The colonoscope is inserted into the anus, air is pumped in and gently pushed forward. For control, the doctor probes the anterior wall of the peritoneum with one hand in order 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, then the patient is allowed to go home on the same day. And if general anesthesia was used, then the patient will be forced to spend several days in the hospital, and will be under the supervision of specialists. The procedure usually takes no more than half an hour. A photo of individual sections of the intestine or a video of a colonoscopy can be recorded on a digital medium.
All the data obtained during the examination, the doctor draws up in a special protocol, which is given to the patient.
Contraindications and complications
Patients are also interested in the cases in which this procedure is contraindicated and what complications may appear after the test. Patients in the following conditions will not be able to undergo this examination:
- peritonitis;
- severe circulatory disorders;
- acute myocardial infarction;
- injury to the intestinal wall;
- severe stages of colitis;
- pregnancy.
In addition, there are also a number of relative contraindications, which can be read in more detail in this article. After examination of the intestine, the following complications may occur: rupture of the intestinal wall, internal bleeding, short-term bloating of the intestine, pain in the peritoneum, fever up to 37.5 ° C for 2-3 days (especially if a small resection was performed).
You should immediately consult a doctor if, after a colonoscopy, the following symptoms appear:
- feverish state;
- severe pain in the abdomen;
- nausea accompanied by vomiting;
- loose stools with blood impurities;
- general weakness, dizziness.
Colonoscopy is a fairly safe research method if it is performed by a highly qualified specialist, and the patient follows all the recommendations during the preparatory period.
With this pathology, the patient will experience the following symptoms:
- frequent diarrhea with impurities of blood, mucus and pus.
- pain, most often in the left side of the abdomen;
- body temperature up to 39 degrees;
- loss of 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, which alternate with diarrhea;
- bloating.
This pathology is accompanied by the following symptoms:
- sudden pain in the abdomen;
- 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 colon polyps.
Preparing for a colonoscopy
Before conducting a colonoscopy, special preparation is required, it is this that is the key to the high reliability of the results of the study. Before performing a colonoscopy, the following recommendations should be observed:
- stop taking antidiarrheal, as well as iron-containing drugs;
- increase fluid intake;
- follow all doctor's recommendations regarding preparation.
Preparation for a colonoscopy includes the following steps:
- preliminary preparation;
- purgation.
Preliminary preparation
Currently, preparation for colonoscopy is carried out by ingestion of special laxative solutions. However, if the patient has a tendency to constipation, then combined preparation may be recommended.To do this, the patient may pre-assign:
- ingestion of castor oil or ricin oil.
- conducting an enema.
The required amount of oil to take is set depending on the patient's body weight. If the weight is, for example, 70 - 80 kg, then 60 - 70 grams of oil is prescribed, which must be taken at night. If emptying with oil was successful, then the procedure is recommended to be repeated. However, it should be noted that this preparation can be performed in patients who have no contraindications ( for example, the presence of individual intolerance to the components of oils).
Conducting an enema
If the 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 in this case, cleansing enemas may be recommended as a preliminary preparation.
To give an enema at home, you must:
- It is necessary to purchase Esmarch's mug;
- Dial about one and a half liters of warm water into Esmarch's mug ( room temperature), after closing the clamp to prevent water from flowing out of the handpiece;
- After filling the enema, it is necessary to remove the clamp and release the flow of water from the tip, this is done in order to prevent air from entering the intestines;
- The person lies on the left side it is recommended to put an oilcloth under the side, and a towel on top of it), the right leg should be pushed forward, bending it at the knee 90 degrees;
- The prepared mug of Esmarch must be hung one to one and a half meters from the level of the couch or sofa on which the person lies;
- Then the tip must be lubricated with petroleum jelly to prevent injury to the anus, after which the enema should be administered to a depth of about seven centimeters;
- Only after the tip has been inserted into the anus should the clip be carefully removed from the enema;
- After completing the procedure, the tip must be carefully removed, slowly rise and walk a little, holding 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 self-conducting enemas require special skills, so this method of preliminary preparation is rarely resorted to.
After two days of pretreatment with oil ingestion or enemas, patients with a history of constipation are given the main method of preparing for colonoscopy ( laxatives and diet).
Diet
Two to three days before the colonoscopy, a slag-free diet should be followed, the purpose of which is to effectively cleanse the intestines. At the same time, it is recommended to exclude foods from the diet that cause fermentation, bloating, and also increase the formation of feces.| Foods to Avoid | Products that are allowed to be consumed |
| fresh vegetables ( cabbage, radish, beet, garlic, onion, carrot, radish). | boiled vegetables. |
| fresh fruits ( grapes, peaches, apples, oranges, bananas, apricots, tangerines). | dairy products ( sour cream, cottage cheese, kefir, yogurt, ryazhenka). |
| 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. | low-fat varieties of fish ( e.g. hake, zander, carp). |
| certain cereals ( 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: On the evening before the study, it is recommended to refuse dinner, and in the morning on the day of the study, breakfast should not be eaten.
Purgation
Currently, special laxatives are most widely used to cleanse the intestines. Before performing a colonoscopy, the doctor individually prescribes the appropriate remedy based on the patient's indications and contraindications.Most commonly used bowel cleansers
| 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 it will be necessary to dilute three bags 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 the 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. For a complete bowel cleansing before a colonoscopy, it is recommended to take three liters of the solution. That is, for one liter of water you need two bags of funds, and for three liters - six. This solution is not prepared depending on the body weight of a person. | The resulting solution must be taken from five to ten in the evening. That is, for five hours it is necessary to take three liters of the drug. |
| Flit Phospho-soda
| The package contains two bottles 45 ml), each of which should be dissolved in 120 ml of boiled cold water before use. | When administered in the morning, the prepared solution should be drunk after breakfast. The second portion of the solution should be taken after dinner. With a daily appointment, the solution is drunk after dinner, and the second portion of the drug is taken on the day of the procedure after breakfast. Drinking solutions in both the first and second cases should be washed down with one or two glasses of water. |
| Lavacol
| The package contains fifteen bags containing the powder. One sachet ( 14g) must be diluted in 200 ml of warm boiled water. | It should be taken eighteen to twenty hours before the upcoming study. The total amount of solution to be taken is three liters. From two in the afternoon to seven in the evening, every 15 to 20 minutes, you should drink 200 ml of the solution. |
The main mechanism of action of Fortrans and Endofalk drugs is that these drugs prevent the absorption of substances in the stomach, as well as the intestines, which leads to faster movement and evacuation of the contents ( in the form of diarrhea) gastrointestinal tract. Due to the content of electrolytes in laxative preparations of salts, a violation of the water-salt balance of the body is prevented.
The effect of Fleet Phospho-soda and Lavacol is that there is a delay in the removal of water from the intestines, which leads to the following changes:
- increase in intestinal contents;
- softening of feces;
- increased peristalsis;
- bowel cleansing.
What diseases are detected by colonoscopy?
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
| Violation of the process of cell renewal, 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 in this disease is the main method of diagnosis. 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, a patient may develop bleeding from a 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. Colonoscopy allows timely diagnosis of the development of cancer. | In the early stages, a bowel tumor may not manifest itself in any way. However, at later stages, clinical signs such as impaired stool develop ( constipation or diarrhea), the presence of blood in the stool, anemia, as well as pain in the abdomen. |
| Nonspecific ulcerative colitis
| Nonspecific ulcerative colitis is an inflammatory bowel disease. The exact cause of the development of this disease has not been established to date. The defeat of the large intestine in ulcerative colitis always begins with the rectum, and over time, inflammation spreads to all parts of the organ. Colonoscopy helps to identify nonspecific ulcerative colitis in time. Also during treatment with the help of this research method, the healing process is monitored. |
|
| Crohn's disease
| Crohn's disease is a chronic non-specific inflammation of the gastrointestinal tract. As a rule, this disease affects the intestines, but the esophagus and oral cavity can also be observed. The exact cause of the development of Crohn's disease has not yet been identified, but factors such as heredity, genetic mutations, and autoimmune processes are distinguished as predisposing factors. Colonoscopy for this disease allows you to identify and determine the degree of inflammation, the presence of ulcers, as well as bleeding. |
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| Diverticula of the large intestine
| Diverticula are protrusions on the intestinal wall. This disease is observed, as a rule, in the elderly. The main reason for the development of diverticulum is the dominance of meat and flour products in the food consumed, as well as a significant decrease in plant foods. This leads to the development of constipation and the appearance of diverticula. Also, the development of this disease is influenced by factors such as obesity, flatulence and intestinal infections. Colonoscopy in this disease allows you to see the mouth of the diverticulum, as well as determine the presence of inflammatory processes. | In the uncomplicated form, colonic diverticulitis may be asymptomatic. Later, the patient may experience symptoms such as impaired stool ( constipation and diarrhea), bloating and pain in the abdomen. In case of inflammation of the diverticulum, diverticulitis can 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 feces. |
| Tuberculosis of the intestine
| Intestinal tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. As a rule, this disease is secondary, since initially mycobacteria affect the lungs and only then are they brought into the intestine by the hematogenous or lymphogenous route. Colonoscopy for intestinal tuberculosis is performed to establish a diagnosis and take a biopsy if necessary. | Initially, this disease manifests itself in the patient with general symptoms, such as fever, severe sweating, loss of appetite and body weight. Also from the intestines, diarrhea, blood impurities in the feces, as well as pain in the abdomen are observed. |
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, so any endoscopic intervention during this period is contraindicated. |
| Perforation of the intestinal wall | Perforation of the intestinal wall leads to active bleeding, which is eliminated by surgery. |
| Peritonitis | Peritonitis is an inflammation of the peritoneum, in which the patient's condition is extremely severe. In this case, emergency surgery is performed as a treatment. |
| Late stages of pulmonary and heart failure | These disorders are characterized by severe circulatory disorders. 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 colonoscopy preparation | If the patient has performed poor-quality preparation for colonoscopy, then the presence of intestinal contents in the colon will not allow an effective study. |
| Intestinal bleeding | In most cases ( 90% ) intestinal bleeding can be stopped with the help of colonoscopy, however, in the case of massive acute blood loss, bleeding is stopped surgically. |
| The 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 in anesthesia, which in some cases is necessary for colonoscopy. |
| Reduced blood clotting | During 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 correctly assessing the patient's condition and identifying the development of life-threatening pathologies at an early stage. One of them is the study 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 biopsy the affected tissues.
What is the procedure for?
The essence of colonoscopy is extremely simple. For its implementation, an optical device (colonoscope, hence the name) is used. Its body is a hollow flexible tube. At one end, a backlight and a miniature video camera are fixed.
The image is transmitted in real time to the monitor, so the doctor has the opportunity to see the condition of the inner walls of the colon over a distance of two meters, evaluate the luster of the mucosa, its color, study the vessels located under it, and changes caused by the inflammatory process.
One sachet of "Lavacol" dissolves in 200 ml of water. For a complete cleansing, you need to drink three liters. The taste of the powder is more pleasant, so its reception is easier to tolerate. Doctors recommend taking "Levacol" in the afternoon until 19.00.
The tools described here have been specifically designed to prepare you for colonoscopy examinations. They gently cleanse, but in many patients they cause side reactions in the form of flatulence, allergic manifestations and discomfort in the abdomen. The child will not be able to drink the required dose, so no one writes off the enema yet.
How is a colonoscopy performed?
Many, going to 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 down on the couch and turn on his left side, pulling his knees to his stomach.
- Then the diagnostician treats the anus with an antiseptic and gently inserts the probe into it. Anesthesia is not used if the person is highly sensitive and complains of being in pain during the insertion of the endoscopic equipment, anesthetic gels may be used. Sedation is also practiced, but it significantly increases the price of a diagnostic examination. Severe pain occurs only if you need to do a colonoscopy in a patient who is suspected of acute inflammatory processes or there are adhesions in the rectum. In this case, short-term general anesthesia is performed (for 30 minutes).
- After anesthesia, the doctor gently inserts the probe into the anus, moves it slowly deep into the intestine. In order to straighten the folds of the tract and more carefully examine its mucosa, 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 pathological changes are not detected on the path of the probe, colonoscopy is done for about 15 minutes. If necessary, it may take more time to perform therapeutic actions, as patients' reviews show.
- To collect tissue for histological analysis, local anesthetics are first introduced through the endoscope tube, then a small piece of diseased tissue is removed with forceps and removed.
Colonoscopy is used to remove polyps, small single neoplasms. For these purposes, not tongs are used, but a special device similar to a loop. With her, like a lasso, the doctor grabs the convex part of the outgrowth at the base, pulls it, cuts it off and removes it.
Before the advent of the colonoscope, resection was possible through laparoscopy, although this is a minimally invasive operation, it requires a more complex preparatory process and recovery.
Video: Colonoscopy of the Intestine
Rare Complications
When the examination ends, the doctor must perform certain manipulations: with the help of a probe, he pumps air out of the intestine and gradually removes the instrument. After this, many patients experience a feeling of strong distension of the abdomen. Activated charcoal tablets help to eliminate it.
In the event that the described procedure is carried out in a specialized institution, and it is trusted by an experienced doctor, the risk of complications is minimized. But he still exists. What to beware of:
- Perforation of the intestinal wall. A complication occurs when colonoscopy allows you to identify and show the expression of the mucosa, accompanied by purulent processes. The patient is immediately taken to the operating room and the damaged area is surgically restored.
- Bleeding. This occurs after the removal of polyps and neoplasms. Eliminated immediately by cauterization of the site and the introduction of adrenaline.
- Severe pain in the abdomen. Appear after biopsy. The malaise is eliminated by taking analgesics.
- Fever, 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 the body.
- Diseases of the cardiovascular system.
- Pressure drop.
- Pulmonary insufficiency.
- The presence of violations of the integrity of the intestinal tract (perforation with the release of contents into the peritoneum).
- Peritonitis.
- Ulcerative colitis, accompanied by inflammation.
- 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 to the procedure
There is only one examination in the arsenal of physicians that can compete with the described method in terms of information content. This is an MRI of the intestines. Doctors among themselves call this type of examination a virtual colonoscopy. Anyone who has ever gone through the procedure notes that it feels more comfortable, experts pay attention to the sparing nature of the diagnosis.
It is performed using equipment that allows you to scan and take pictures of the abdominal cavity from different sides, and then create a three-dimensional model of the intestinal tract. All pathological processes are clearly visible on it, while the patient does not experience any discomfort.
Why do doctors still use a colonoscope? The fact is that MRI does not allow to show pathological neoplasms, the diameter of which 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 a diagnostic examination of the rectum and large intestine with a special device - a colonoscope. The procedure is quite complicated, requires long preparation and high qualification of the doctor. To understand how long a colonoscopy can last, you need to understand the technology of its implementation.
The essence of diagnostics
The colonoscope is a long flexible tube (up to 145 cm). It is equipped with LED illumination, a camera and holes for the introduction of 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 facilitates the passage of the device.
Colonoscopy allows you to transfer an image of the intestine to the monitor. With its help, you can identify even the slightest deviations, conduct a biopsy, remove small formations and cauterize bleeding ulcers and erosions.
Opportunities
Colonoscopy of the intestine can detect:
- Cancer, even at the cellular level.
- Erosions and ulcerations.
- Atypical ulcerative colitis.
- Tuberculosis of the intestine.
- 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 work of the organ and suspicions of them. Do a colonoscopy for:
- Chronic constipation or diarrhea.
- Impurities in the stool: mucus, pus, blood.
- Pain in the abdomen.
- Formations detected by other methods of examination.
- Suspicion of cancer, intestinal obstruction, Crohn's disease, ulcerative colitis.
- Sudden, unreasonable weight loss.
- Anemia - to exclude bleeding and ulcers.
Contraindications
Colonoscopy is not always possible. There are a number of situations where the procedure is prohibited:
- Heart or lung failure.
- Inflammatory processes in the intestines.
- Poor blood clotting.
- Exacerbation of ulcerative colitis.
- Periodontitis.
- Acute infectious diseases.
- Diverticulitis.
- Extensive intestinal bleeding.
Training
The duration of a colonoscopy includes preparation. This is the longest stage. It consists in a complete cleansing of the intestines.
Before the procedure, the patient is prescribed:
- Three-day slag-free diet. It is forbidden to use products that lead to gas formation. The diet includes light, dietary soups, fish, dairy products, juices. The last meal should be no later than lunch on the eve of the study.
- Enemas. They recommend if the subject can clean the intestines with their help. If not, laxatives are prescribed.
- Taking laxative medications. Most often, the drug "Fortrans" is prescribed. 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 throughout. If this is not done, the colonoscopy will have to be postponed and all preparatory steps repeated.
How is a colonoscopy performed?
Colonoscopy of the intestine is carried out 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, straightening his left leg and bending his right.
- The tip of the probe is inserted into the anus with careful circular movements.
- The doctor carefully advances the colonoscope through the intestine. At the same time, he delivers a jet of air to smooth out the mucosa, and the nurse can press on the patient's abdomen to guide the tube.
- If small formations were found during the diagnosis, they are removed immediately with the help of forceps, and the bleeding is cauterized.
- If necessary, a biopsy is taken during a colonoscopy.
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. Most of the time can take full anesthesia.
How long does a colonoscopy take?
How long a bowel examination will take depends on several factors:
- Physician qualifications and experience.
- Quality and modernity of diagnostic equipment.
- The structure of the intestines of a particular patient: how curved it is.
- The presence of neoplasms, bleeding, manifestations.
- The need to carry out other procedures: biopsy, cauterization, microsurgery.
On average, a colonoscopy takes 15 to 20 minutes. Its duration may vary. If the intestinal patency is good, no pathologies are found, the period is reduced to 10 minutes. If deviations are present or additional manipulations are necessary, the time increases to 40-60 minutes.
Post-survey period
After a colonoscopy, it is recommended to stay in bed for several hours. It is better to lie on your stomach - it will be easier for the passage of residual air from 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 on the intestine was performed.
Colonoscopy is generally a safe procedure. Only occasionally (in 1% of all cases) complications may occur:
- Perforation of the intestinal wall. Usually occurs in the presence of purulent processes or ulceration of the mucosa. In this case, the doctor performs surgery and eliminates the damage.
- Bleeding. Perhaps after the removal of polyps and other formations. Removed immediately.
- Soreness in the abdomen. Appears after a biopsy or removal of neoplasms. Reception of analgesics is shown.
Colonoscopy is the most accurate and informative method for examining the intestines. 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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