What is intestinal colonoscopy and how to carry out the procedure

Colonoscopy is a diagnostic procedure performed with an endoscopic instrument with a small camera at the end - a colonoscope.

It is inserted into the rectum and slowly moves forward so that the doctor can examine in detail the condition of the intestines. This manipulation allows you to enlighten existing suspicious tumors using ultrasound, as well as take a piece of tissue for a biopsy.

In addition, colonoscopy is not only a diagnostic, but also a medical procedure, during which you can remove small polypous growths, or monitor their development over time.

What it is?

Colonoscopy is a diagnostic procedure during which the doctor assesses the condition of the colon mucosa. Such an examination is carried out using an endoscope, which is inserted into the rectum. This method allows you to identify polypous lesions, ulcers and other defects. If necessary, a tissue sample is taken for histological examination.

In addition, during colonoscopy, small polyps can be removed, the size of which does not exceed 1 mm in diameter. Immediately after this, the neoplasm can be examined in detail for the presence of atypical cells.

How painful is the procedure?

Since we are talking about the penetration of an external object into the body, almost all patients who have been prescribed a colonoscopy for the first time ask their doctor how painful this procedure is. Therefore, the doctor must give a detailed explanation of what will happen during the manipulation, and decide whether anesthesia is necessary in a particular case.

In most cases, anesthesia is not carried out, since a colonoscopy does not provoke particular pain. However, there may be a feeling of a certain discomfort associated with the injection of air, which is necessary for smoothing out the folds of the colon. Also unpleasant sensations can cause the probe itself, moving in the intestinal cavity.

But usually the manipulation is transferred easily. If the patient is worried about severe pain, he should inform the specialist conducting the colonoscopy. This will help to avoid unpleasant complications of the procedure in the form of damage to the intestinal wall. Sometimes during the passage of the probe through the intestine there is a feeling of urge to defecate. In such a situation, it is recommended to take a deep breath and relax as much as possible.

A severe pain syndrome during colonoscopy is not excluded. In most cases, it develops in a situation where the patient has adhesive or acute inflammatory processes in the rectum. In such a situation, a colonoscopy is performed under general anesthesia. It takes about half an hour.

Indications for

Colonoscopy is prescribed to patients for the purpose of verifying a preliminary diagnosis. The procedure is advisable when:

  • bleeding from the rectum and colon (in this case thermocoagulation is performed);
  • the presence of benign neoplasms (during the procedure, small polypous growths are removed);
  • suspected oncological damage (a tissue biopsy is performed, followed by a histological examination of the biopsy);
  • Crohn's disease;
  • NK;
  • violation of the process of promoting content through the intestines;
  • bowel disorders (frequent or chronic constipation);
  • rapid weight loss for no apparent reason;
  • reduced hemoglobin;
  • stable subfebrile condition.

For patients over 50 years old, colonoscopy is performed as a prophylactic measure once a year. Perhaps more frequent examination of people with poor heredity (especially if someone from close relatives were diagnosed with colorectal cancer).

How is the procedure?

Colonoscopy is performed in a special room using the following algorithm.

  1. The patient removes the underwear and lies on a special couch. Position - lying on the left side, legs pulled to the stomach.
  2. The doctor makes anesthesia using a special gel, which lubricates the mucous membranes. Perhaps intravenous anesthetic, or the use of sedative drugs. In the latter case, the patient is conscious, but does not feel pain.
  3. Next, the doctor introduces a colonoscope and promotes it in the intestine, following its curves. Along with this, manipulation is controlled by palpating the patient's abdomen.
  4. During the procedure, air is supplied to the intestines to smooth out folds. This makes inspection much easier.

Air supply can cause short-term discomfort. The duration of the manipulation varies from 15 minutes to half an hour. After the procedure, the specialist removes air from the intestine with a special sponge. Only then is the colonoscope removed. Next, the doctor records the data in the patient's card and sends it to the attending physician for further recommendations.

Preparation for colonoscopy

To obtain reliable results of the examination, the patient must first prepare for it. The basic rules for preparing for colonoscopy are:

  • stopping antidiarrheal and iron supplementation;
  • increasing the volume of fluid consumed;
  • following the recommendations below.

The basic principles of preparation are as follows.

Preliminary preparation

This is the first preparatory stage, based on the intake of laxative solutions. But with the tendency to constipation, patients are prescribed a combination preparation. It implies:

  • oral intake of castor oil or ricin oil;
  • climatization

Ingestion of castor oil or ricin oil. Oil dosage is selected individually, taking into account the weight of the patient. With a body weight of 70-80 kg, 60-70 g of product is prescribed, which is taken before bedtime. If the procedure is successful, the oil intake is repeated. Such preparation is carried out only if the patient has no contraindications to the use of oils (for example, individual intolerance).

Conduct enemas. When preparing for a colonoscopy with laxatives, no clipping is usually performed. But frequent or chronic constipation is a good reason for this kind of preliminary preparation.

Diet

Within 2-3 days before the procedure, you must follow a special diet. Its main goal is to remove toxins and slags from the body. Products that cause flatulence, intensifying or provoking fermentation processes and enhanced formation of fecal masses are necessarily excluded from the diet.

The list of prohibited and permitted products:

Products to be excludedProducts that are allowed to consume
fresh vegetables (cabbage, radishes, beets, garlic, onions, carrots, radish).vegetables boiled.
fresh fruit (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 crackers, crackers, white bread.
greenery (spinach, sorrel).boiled eggs.
smoked meat (sausage, meat, fish).lean meats (chicken meat, rabbit, veal, beef).
marinade and pickles.low-fat fish varieties (for example, hake, pike perch, carp).
certain porridges (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.

The last meal should be done 8-10 hours before the procedure. ads3

Bowel cleansing

It is carried out by taking medication with a laxative effect. Such drugs are selected strictly individually, because when choosing a medicine by a doctor, all the nuances concerning the use of a particular remedy are taken into account.

TitleCooking methodMode of application
Fortrans
One bag is calculated on 20 kg of body weight.
Each bag should be diluted in one liter of warm, boiled water. If, for example, a person has a weight of 60 kg, then it will be necessary to dilute three sachets in three liters of water.
The prepared volume of liquid should be drunk in the evening at one time or every 250 minutes to take 250 ml of solution.
Endofalk
Two sachets should be diluted in 500 ml of warm boiled water, mix well, after which another 500 ml of cool water should be added. For complete bowel cleansing before the colonoscopy is recommended to take three liters of solution. That is, two bags of money are needed for one liter of water, and six bags for three liters. This solution is prepared not depending on the human body weight.The resulting solution must be taken from five to ten in the evening. That is, for five hours, you must take three liters of the drug.
Flit Phospho-soda
In the package are two bottles (45 ml), each of which before use should be dissolved in 120 ml of boiled cold water.For morning appointments, the prepared solution should be drunk after breakfast. The second portion of the solution should be taken after dinner.
For daily administration, the solution is drunk after dinner, and the second portion of the drug is taken on the day of the procedure after breakfast.
Drunk solutions in the first and in the second case, it is necessary to drink one or two glasses of water.
Lavacol
The package contains fifteen bags containing powder. One drug pack (14g) must be diluted in 200 ml of warm boiled water.Should be taken for eighteen to twenty hours before the upcoming study. The total amount of solution that must be taken is three liters. From two o'clock in the afternoon until seven in the evening, every 15 to 20 minutes you should drink 200 ml of solution.

Most often, patients who are preparing to undergo a colonoscopy are prescribed medicines Fortrans and Endofalc. The mechanism of action of these funds is based on the inhibition of the absorption of substances in the intestine, as a result of which they move faster along it, and are evacuated from the body with feces. Fortrans, Endofalk and their analogues contain in their composition electrolytes of salts, which prevent disturbances in the water-salt balance.

No less popular are such means as Phospho-soda and Lavacol. Under the influence of their components, fluid is delayed in the intestine, provoking:

  • increase in intestinal contents;
  • softening feces;
  • increased intestinal peristalsis;
  • bowel cleansing.

Contraindications and complications

Like any diagnostic or therapeutic procedure, a colonoscopy has its own contraindications. It is categorically unacceptable to prescribe such an examination to patients with:

  • peritonitis;
  • severe circulatory disorders;
  • acute phase of myocardial infarction;
  • injuries of the intestinal walls that the patient had before the appointment of a colonoscopy;
  • severe degrees of colitis.

This procedure is not assigned to women during pregnancy. Colonoscopy during lactation is possible.

Possible consequences

Such a diagnostic event does not always go smoothly, so some patients who have undergone a colonoscopy may develop complications in the form of:

  • rupture of the intestinal wall;
  • opening internal bleeding;
  • short swelling;
  • pain in the peritoneum;
  • 2 - 3-day subfebrile condition (especially if resection was performed at the time of diagnosis).

You should immediately consult a doctor when:

  • the occurrence of a persistent feverish state;
  • intense abdominal pain;
  • nausea and vomiting;
  • loose stools with bloody inclusions;
  • general malaise and weakness;
  • dizziness.

But such complications are rare, since colonoscopy is considered a safe procedure. If it is carried out by an experienced specialist, then the patient’s fears and experiences will be unjustified.

After the procedure

After a colonoscopy, the patient may need time for separation from anesthesia or sedation. It usually takes about an hour and it will be better if the person spends this time at home in a relaxed atmosphere. In this case, self-driving is strictly prohibited, so relatives should take the patient home.

Do not eat for an hour after the manipulation. After that, it is recommended to use something light, non-greasy. An excellent option would be semi-liquid porridge from boiled cereals, yogurt and cottage cheese. If during the colonoscopy, the doctor removed the polyps on the intestinal walls, then the diet will be prescribed for a longer period.

During a certain time after the manipulation of the patient, abdominal distension and flatulence may disturb. The release of gases is considered to be a completely normal phenomenon associated with the removal of air, which was used to expand the gut and smooth its folds. But it is important to remember that you should not force the stomach to force to get rid of the air as quickly as possible - gradually he will come out himself. To speed up the process, you can just lie down or walk around a bit.

If the pain persists, you can take a painkiller. The first defecation after colonoscopy may be accompanied by the release of feces mixed with blood. You should not worry - such streaks disappear already at the next emptying of the intestines. But in the case when the situation is not corrected, large blood lumps appear in the stool, the patient is tormented by pains and pains in the stomach, or any other disturbing and suspicious symptoms are present, and you cannot hesitate to visit the doctor. It should take place as soon as possible, otherwise the patient’s condition may deteriorate significantly.

Alternative research methods

Sometimes there is a need to cancel the colonoscopy. In such a situation, prescribe:

  1. Rectoromanoscopy. For this purpose, a special device, the sigmoidoscope, is used, which makes it possible to assess the state of the rectum at a depth of 20–30 cm.
  2. Irrigoscopy. This is one of the varieties of radiological examination with contrast. This technique helps to identify defects on the walls of the intestine, but during its implementation it is impossible to detect small tumor tumors.
  3. MRI of the intestine. This is the most reliable modern diagnostic method that can serve as an alternative to colonoscopy. The information content of the procedure is almost the same, besides its advantages are complete painlessness and comfort of performance. With the help of a special scanner, images (sections) of the abdominal cavity are made in 2 projections — front and back, after which a three-dimensional model of the large intestine is formed from the material obtained. On it, the doctor can note the localization of lesions, see bleeding, study in detail the condition of the intestinal walls and identify pathological tumors. This procedure does not cause discomfort or pain.

But, nevertheless, in terms of its informativity, MRI of the intestine is much inferior to colonoscopy. So, on the tomogram the doctor cannot see the pathological neoplasms of small size - up to 10 mm. For this reason, magnetic resonance imaging in most cases is carried out as a preliminary diagnosis, after which a colonoscopy is still assigned.

People reviews

Reviews of patients who underwent a colonoscopy procedure:

  1. Long could not decide whether to settle for a colonoscopy. He was afraid that it would be very painful, and it was inconvenient to somehow undergo such a procedure. But when I was examined for another reason, the doctor revealed polyps in my intestines and said that it would not be possible to do without colonoscopy. I had to go through this and, as it turned out, not everything was as bad as it seemed to me at first. To my surprise, the procedure almost did not cause any pain or discomfort.
  2. A week ago I had a colonoscopy. At first, like many, she was very afraid of pain. And although my fears were partially justified, in general, the procedure was successful. The main thing, as my doctor said, is to properly prepare for it - there is nothing to eat the night before the diagnosis and in the morning, just before the manipulation. I was told that one day before the colonoscopy, you need to start taking Fortrans - 3 sachets per 3 liters of water. During the procedure, practically did not experience pain, except for the moment when the doctor blew through the bowel loops to straighten them. Well, that made a colonoscopy, as I found several small polyps, and they were immediately removed.
  3. My impression of a colonoscopy is just awful. Perhaps the young doctor's inexperience made itself felt, but it was terribly painful and unpleasant! In addition, the specialist could not display the image on the screen, so the procedure was delayed. Soothes only that they did not find anything terrible in me, but if I have to undergo a colonoscopy again, I will go to another doctor.
  4. When the doctor said that I needed to undergo a colonoscopy, I cannot say that I was very happy about this. Not only that during the day almost nothing can be eaten, so also you have to drink solutions for cleansing the intestines. I was advised that Flit was the only drug that tasted more or less pleasant. In the morning, on the day of the study, I felt overwhelmed, almost exhausted. The only thing that made me happy was that the procedure itself was quick and painless. The doctor did not find anything suspicious, he said to repeat the colonoscopy after 5 years.

Colonoscopy is an unpleasant diagnostic procedure that causes pain and discomfort in many patients. But today it is the most informative manipulation, without which it is impossible to do in some cases.

Watch the video: Prepare for a Colonoscopy (November 2019).

Leave Your Comment