Colon colonoscopy preparation, indications,contraindications, under anesthesia, the results of the procedure

Update: October 2018

Colonoscopy refers to endoscopic techniques.
diagnostic examination of the colon with a special
optical instrument – fibrocolonoskop.

Many people are skeptical and skeptical of this
research method, and refuse to do a colonoscopy, which
in many cases is the only technique that allows
accurately establish the nosological form.

There are also some myths related to the procedure, such as the gap
bowel examination, subsequent incontinence of feces, etc.,
which are completely unfounded. In America, this
The procedure is included in the list of mandatory annual surveys.
for all citizens who have reached the age of 45 years, and in Germany –
over 47 years old.

History of colonoscopy

The colon test represented certain
difficulties due to the anatomical location of the body. Earlier for
these targets were used radiography, through which not
able to diagnose serious pathologies such as polyps and
bowel cancer. Hard rectosigmoidoscopes used for examination
intestine through the anal opening, allowed to explore
only 30 cm gut.

In 1964 – 1965, the first flexible fibrocolonoscopes were created,
and in 1966 the model of the colonoscope was invented, which became
a prototype of modern devices, with the possibility of photographing
the studied structures and the taking of material on the histological
study.

What is a colonoscopy used for?

To date, this type of diagnosis is the most
reliable in determining the condition and diseases of the fat
intestine. In addition to visual inspection, colonoscopy allows
perform a diagnostic tissue biopsy and remove polyps from the wall
guts.

A fibrocolonoscope or optical probe is a thin,
soft and flexible device that allows you to pass all
natural anatomical bowel bends without risk of injury
and pain for the patient. The length of the device is 160 cm. At the end
probe has a minicamera that transmits an image to the monitor screen
with multiple zoom. The probe is equipped with a source
cold light that completely eliminates the possibility of burn
слизистой guts.

Possibilities of colonoscopy:

  • extraction of foreign bodies;
  • restoration of intestinal patency during its narrowing;
  • removal of polyps and tumors;
  • stop intestinal bleeding;
  • взятие материала на гистологическое study.

Special preparation for the procedure

Preparation for colonoscopy of the intestine, made in strict
in accordance with the recommendations of the doctor, is the guarantee of one hundred percent
validity of the study. How to prepare for a colonoscopy for 3
days before the procedure:

Stages of preparation:

  • Preliminary preparation;
  • Special diet;
  • Очищение intestine.

Preliminary preparation – 2 days

When the patient is prone to constipation of drugs alone,
prescribed for bowel cleansing may not be enough. For
This can be pre-assigned: intake of castor oil
inside (in the absence of allergies) or an enema.

The amount of oil is calculated depending on body weight.
person: weighing 70 kg is enough to take 60 grams of oil for the night. With
effective bowel movement in the morning should be repeated
carry out this procedure the next evening.

Cleansing enema is indicated for severe constipation.
the patient. For домашней постановки клизмы необходима кружка Эсмарха
(sold in a pharmacy) and a half liter of water at room temperature
(see how to do an enema correctly).

  • In a mug with a closed clamp pour half a liter of water;
  • Carefully remove the clamp and release the air, close
    clamp;
  • A man fits on a sofa laid with oilcloth on his left side
    with the right leg extended forward and bent at the knee;
  • Esmarch’s mug must be suspended 1-1.5 m above the level
    couch;
  • The tip is lubricated with petroleum jelly and injected into the anus.
    hole to a depth of 7 cm;
  • Remove the clamp from the enema;
  • After all the water flows out, the tip is removed;
  • A person should stand up and be like 5-10 minutes, delaying
    defecation, then you can empty your intestines.

It is recommended to perform an enema twice (once every 2 pm
contract).

Method of preliminary preparation if necessary
is selected by a doctor. Cannot use castor at the same time.
oil inside and enema!

After 2 days of successful pre-training assigned
method of direct preparation for research in the form of
laxatives drugs and diets.

Diet 2-3 days

2-3 days before the diagnosis, a slab-free diet is prescribed,
allowing to effectively clean the intestines. Pay attention to her
those who are fans of all kinds of body cleansing –
a diet of such a plan, maintained 2-3 days once a month, is
безопасным и эффективным способом очищения intestine. In the evening
on the eve of the diagnosis, dinner should be abandoned altogether. In a day
procedures before it is also excluded food.

Prohibited Products Permitted Products
  • Fresh vegetables: cabbage, beets, radishes, garlic, carrots, onions,
    radish, peas, beans
  • Fresh fruits: grapes, apples, peaches, oranges, apricots,
    bananas, tangerines
  • Black bread
  • Green vegetables – spinach and sorrel
  • Smoked products (sausage, cheese, meat, fish)
  • Pickles and pickles
  • Pearl barley, oatmeal and millet porridge
  • Chocolate, peanuts, chips, seeds
  • Milk, coffee, alcohol, soda
  • Boiled vegetables
  • Fermented milk products: yogurt, ryazhenka, sour cream, yogurt,
    cottage cheese, kefir
  • Vegetable liquid soups
  • White bread crackers, yesterday white bread, crackers
  • Boiled eggs
  • Low-fat meat and fish in boiled, steam form (chicken,
    veal, rabbit, beef, hake, pike perch)
  • Butter, cheese
  • Jelly, honey
  • Compotes, weak tea, still water and diluted
    juices

Bowel cleansing

For очищения кишечника в индивидуальном порядке назначаются
special laxatives that are prescribed by a doctor.
To choose their own drugs can not.

  • Fortrans

Colonoscopy is most often performed after preparation.
Fortransом. This is a packaged drug at the rate of 1 pack per 20 kg.
body mass. Each bag of the drug is diluted in 1 liter
boiled warm water. So do with each bag to
obtain the required volume of liquid that you need to drink
in the evening for 1 reception or drink 250 ml of solution after 15 minutes.

  • Endofalk

Packaged drug. The dose does not depend on weight. 2 bags
diluted in half a liter of boiled warm water, stirred,
add another half liter of cool water. For полноценной очистки
intestines must be gradually taken 3 liters of solution, starting with
17.00 and until 22.00.

  • Flit Phospho-soda

Two vials of the drug in the package. Two drug vials
volume of 45 ml is dissolved in 120 ml of cold boiled water. With
appointment with the morning prepared solution is drunk after
breakfast, and the second portion is taken after dinner. With назначении
in the afternoon the solution is drunk after dinner, the second portion is taken after
Breakfast on the day of the procedure. Drunk solution must be drunk 1-2
glasses of water.

  • Lavacol

Подготовка к колоноскопии Lavacolом — это пакетированный
drug, one package is diluted in 200 ml of warm boiled water.
The total amount of cleansing solution – 3 liters, which follows
take 18-20 hours before the procedure. From 14.00 and until 19.00 take on
200 ml of Levacol solution in 5-20 minutes.

Fortrans и Endofalk предотвращают всасывание питательных
substances in the digestive tract, which leads to rapid progress and subsequent
evacuating the contents of the gastrointestinal tract in the form of a liquid
the chair. The electrolytes contained in the preparations prevent the development
imbalance of water-salt balance.

Flit Phospho-soda и Lavacol задерживают выведение жидкости из
intestine, thereby increasing the volume of intestinal contents,
softening the feces, increasing peristalsis and accelerating cleansing
intestine.

Also, the preparation for the procedure includes the following
recommendations:

  • stop taking iron and antidiarrheal
    drugs;
  • increase fluid intake;
  • strictly follow all recommendations of the doctor.

How is the colonoscopy

The colonoscopy procedure is performed in a specialized for
this office. The patient undresses below the belt, fits on
a couch on the left side. The legs must be bent at the knees and
move up to the stomach.

The procedure can be performed under local or under general
pain relief, as well as under sedation.

  • Local anesthesia – local anesthesia is usually suggested.
    using one of the lidocaine-based drugs: luan
    гель, дикаиновая мазь, ксилокаин гель и др. With нанесении на
    mucous membranes and lubrication of the tip of the colonoscope
    local anesthetic effect is achieved, with the patient
    is in full consciousness. Local anesthesia may be
    achieved by intravenous anesthetic.
  • Sedation is the second option in which a person is in
    able to sleep, does not feel pain and discomfort, however
    consciousness is not turned off. Used medications midazolam, propofol and
    others.
  • General anesthesia involves the introduction of drugs, immersing
    пациента в глубокий сон с полным выключением сознания the patient.
    Despite the level of development of medicine, general anesthesia carries
    certain risks, has contraindications and requires some
    времени для восстановления the patient. Colonoscopy under general anesthesia
    shown in the examination of children under 12 years old, patients with mental
    заболеваниями, людей с выjuicesм порогом болевой чувствительности и в
    some other cases.

After anesthesia, the doctor inserts a colonoscope into the anus.
and consistently examines the walls of the large intestine, promoting
probe forward and palpatory across the surface of the abdomen controlling
продвижение трубки по изгибам intestine. To the picture was
Objectively, the intestine expands with the help of
of air.

Air ingress is accompanied by bloating and discomfort.
for the patient, plus everything during the study can not be done
any movements, which is why patients prefer a common
anesthesia or sedation for a period research.

The procedure lasts 15-30 minutes. A video is being recorded.
colonoscope through the intestines. With необходимости берется биопсия тканей,
polyps are removed. At the end of the study through a special channel
the colonoscope removes gas and the probe is gently removed from
intestine.

After the procedure, the doctor draws up the examination protocol, gives
recommendations to the patient and sends him to a specialist.

If the anesthesia was local, immediately after the procedure you can
go home. General anesthesia requires observation during
a certain time until the patient fully recovers.

After the examination, you can eat and drink. If
intestinal overcrowding with gases persists, 10 can be taken
tablets of crushed activated carbon and drink it with water.
A belly massage will also help.

Possible complications of colonoscopy

  • Perforation of the intestinal wall (frequency 1%);
  • Flatulence, which passes independently;
  • Bleeding in the intestines (0.1%);
  • Respiratory arrest during general anesthesia (0.5%);
  • Abdominal pain and hyperthermia up to 37.5 C for 2-3 days, if
    polyps were removed.
  • See colonoscopy provokes appendicitis.

If, after a colonoscopy, the following occurrences,
Seek immediate medical attention:

  • weakness;
  • prostration;
  • dizziness;
  • abdominal pain;
  • nausea and vomiting;
  • loose stools with blood;
  • hyperthermia above 38 C.

Indications for colonoscopy

This procedure has a strict list of indications. But,
Given the experience of Western countries, healthy people over 50 should
annually undergo this examination, especially if relatives
relatives had problems with the large intestine, especially
oncopathology.

A colonoscopy is performed annually for people at risk.
(with Crohn’s disease, ulcerative colitis), as well as those patients
которые ранее были оперированы по поводу заболевания intestine.

Colonoscopy is indicated if the following symptoms occur:

  • frequent and severe constipation;
  • frequent pains in the colon;
  • discharge of mucous or bloody species from a straight
    guts;
  • frequent abdominal distention;
  • sudden weight loss;
  • suspected colon disease;
  • preparation for some gynecological operations (removal
    tumors of the uterus, ovary, etc).

The main purpose of colonoscopy is the early diagnosis of various
pathologies, which is especially true in the case of cancer
neoplasms.

Colonoscopy results – normal

The method allows to objectively assess the condition of the mucous membrane
large intestine throughout its length. Trustworthy
endoscopic signs of unchanged thick mucous
The intestines are the following indicators:

  • Color – normal intestinal mucosa has a pale pink or
    pale yellow color. Erosion, inflammation and other pathologies alter
    color mucous.
  • Gloss – normal mucous reflects light, which determines it
    shine. Haziness of the mucous suggests insufficient production
    mucus, which is characteristic of pathological changes.
  • The nature of the surface – the surface should be smooth and slightly
    striated, without ulceration, protrusion and tubercles.
  • Vascular pattern – must be uniform without areas
    enhancement or absence of blood vessels.
  • Overlay mucous membranes – associated with clusters of mucus and
    have the appearance of bright lumps, without seals, impurities of fibrin, pus
    or necrotic masses.

Any deviations from the described variants of the norm indicate
specific disease.

Diseases diagnosed with colonoscopy

  • Colon polyp;
  • Oncological pathology;
  • Nonspecific ulcerative colitis;
  • Intestinal diverticula;
  • Crohn’s disease;
  • Туберкулез intestine.

Contraindications for colonoscopy

The conditions under which this procedure is contraindicated can be
divided into absolute and relative. With абсолютных показаниях
research is excluded, with relative – can be carried out
vital indications.

Absolute contraindications Relative contraindications
  • Peritonitis is a serious condition requiring emergency
    surgical treatment.
  • Terminal stages of pulmonary and heart failure –
    severe conditions with serious impairments
    blood circulation.
  • Acute myocardial infarction – acute ischemia of the heart muscle,
    threatening death.
  • Perforation of the intestinal wall – a condition followed by
    internal bleeding and requiring emergency surgery.
  • Severe forms of ulcerative and ischemic colitis, in which
    possible intestinal perforation during the procedure.
  • Pregnancy – the procedure can lead to premature
    maternity.
  • Poor preparation with the study when the patient did not follow.
    doctor’s recommendations – the effectiveness of colonoscopy is deteriorating.
  • Intestinal bleeding. Minor bleeding at 90%
    stop with a colonoscope, but appreciate the massiveness
    bleeding is not always possible.
  • Тяжелое состояние the patient. In this case, it is impossible
    general anesthesia, which is sometimes necessary
    condition for normal diagnosis.
  • Low blood coagulability – minor damage
    mucosal examination may lead to intestinal
    bleeding.

Alternative to colonoscopy

A painless and safe alternative to colonoscopy (as well as
EGD) is a capsular examination in which the patient
swallows a special endocapsule with a built-in video camera, she
passes through the entire gastrointestinal tract and naturally exits through the anal
hole.

This type of survey is carried out only on a fee basis.
(quite expensive) and does not always give a complete picture. Moreover,
when there are pathological changes in the intestines for
confirming the diagnosis the patient will still have to go through
colonoscopy procedure.

Despite the specifics of carrying out and some psychological and
physical discomfort during colonoscopy, this kind of diagnosis
is the most reliable for assessing the state of thick
intestine.

Автор: врач-гигиенист, эпидемиолог

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