Colonoscopy relates to endoscopic diagnostic methods of colon investigation by a special optical device - fibrocolonoscopy.
Many people treated with some caution and skepticism to this method of investigation, and refused to do a colonoscopy, which in many cases is the only method that allows to accurately set the nosological form.
There are some myths associated with the procedure, such as intestinal rupture in the survey, followed by fecal incontinence et al., Which are totally unfounded.In America, this procedure is included in the list of mandatory annual surveys for all citizens who have reached the age of 45 years, and in Germany - have reached 47 years.
colon study presents certain difficulties due to the anatomical location of the body.Previously used for this purpose x-ray, with which it was not possible to diagnose serious diseases such as polyps and colon cancer.Hard rektosigmoidoskopy used for inspection of the intestine through the anus, allowed to investigate only 30 cm intestine.
In 1964 - 1965, the first flexible fibrocolonoscopy, and was invented by model colonoscope in 1966 were created, which became the prototype of the modern devices, with the possibility of photographing the structures under study and sampling of material for histological examination.
What applies colonoscopy
Until now, this type of diagnosis is the most reliable in determining the status and colon diseases.In addition to visual inspection, diagnostic colonoscopy allows tissue biopsy and remove polyps from the colon wall.
fibrocolonoscopy or optical probe is a thin, soft and flexible instrument that allows the passage of all the natural anatomy of the intestine bends without the risk of trauma and pain for the patient.the device length is 160 cm. At the end of the probe has minikamera transmitting the image on the screen with multiple images increases.The probe is equipped with a cold light source that eliminates the possibility of intestinal mucosa burns.
- extraction of foreign bodies;
- recovery of intestinal obstruction when narrowing;
- removal of polyps and tumors;
- stop intestinal bleeding;
- taking material for histological examination.
Special preparation for the procedure
Preparing for a colonoscopy bowel, made in strict accordance with the doctor's recommendations, is the key to absolute reliability of the study.How to prepare for a colonoscopy at least 3 days prior to the procedure:
- special diet;
- Colon Cleansing.
Pretreatment - 2 days
When propensity of the patient to constipation alone drugs prescribed to cleanse the bowel, may not be enough.To this can be pre-assigned to: reception of castor oil orally (in the absence of allergy) or holding enema.
number of oil depends on the weight of the human body: in the weight of 70 kg is enough to take 60 grams of oil at night.If a meaningful bowel movement in the morning should be re-conduct the procedure on the next night.
cleansing enema shown in the case of severe constipation in patients.For home staging requires a mug Esmarch enemas (available at pharmacies), and a half liter of water at room temperature (see. How to do an enema).
- in a mug with a closed clamp pour half a liter of water;
- Carefully remove the clamp and release the air, close the clamp;
- man laid on the laid oilcloth sofa on the left side with extended forward and bent at the knee, right foot;
- necessarily mug Esmarch suspended at 1-1.5 m above the level of the sofa;
- tip smeared with Vaseline and injected into the rectum to a depth of 7 cm;
- Take off the clip from the enema;
- After streaming the entire water volume of the tip is removed;
- man should stand up and is like 5-10 minutes, delaying bowel movements, then you can empty the bowel.
recommended to make an enema twice (1 time 2 nights in a row).
preconditioning method when it is necessary to choose a doctor.You can not use both inside and castor oil enema!
After 2 days of successful pre-treatment method is assigned to the immediate preparation for the study in the form of laxatives and diet.
Diet 2-3 days
2-3 days prior to the diagnosis assigned besshlakovaya diet that allows you to effectively clean the intestines.Pay attention to her who is a fan of all kinds of cleansing the body - this diet plan, comply with 2-3 days once a month, is a safe and effective way to cleanse the bowel.The night before the diagnosis of the dinner should be abandoned altogether.On the day of the procedure before it also excludes meal.
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for bowel cleansing in individually appointed special laxatives that are prescribed by the doctor.Choose your own products can not.
Colonoscopy is most often carried out after preparing it Fortrans.This packaged preparation the rate of 1 packet per 20 kg body weight.Each pack of the drug is diluted in 1 liter of boiled warm water.Since each sachet made to produce the desired volume of liquid that should be consumed in the evening for one reception or drink 250 ml of the solution after 15 minutes.
Packaged drug.The dose is not dependent on weight.2 sachets diluted in half a liter of boiled warm water, stir, add another half a liter of cold water.For a complete intestinal cleansing is necessary to gradually take 3 liters of solution, starting from 17.00 until 22.00.
Two vials of the drug in the package.Two drug vial of 45 ml is dissolved in 120 ml of cold boiled water.In appointing the reception in the morning prepared solution drink after lunch, and the second portion taken after dinner.In the appointment of the day after dinner drink liquor, a second crop after taking breakfast in the day of the procedure.Drunk solution should drink 1-2 glasses of water.
Preparing for a colonoscopy Lavacolla - a packaged preparation, one packet diluted in 200 ml of warm boiled water.Total solution for cleaning - 3 liters, which should be taken 18-20 hours before the procedure.From 14.00 to 19.00 and taking 200 ml Levakola solution in 5-20 minutes.
Fortrans Endofalk and prevent the absorption of nutrients in the gastrointestinal tract, which leads to rapid promotion and the subsequent evacuation of the contents of the gastrointestinal tract in the form of loose stool.Electrolytes contained in preparations prevent the development of an imbalance of water-salt balance.
Fleet Phospho-soda and Lavacolla delayed excretion of intestinal fluid, thereby increasing the volume of intestinal contents, softening the stool, increasing peristalsis and accelerating intestinal cleansing.
also preparing procedure includes the following recommendations:
- stop taking iron and antidiarrheal medications;
- increase fluid intake;
- comply strictly with all the doctor's recommendation.
How is colonoscopy
colonoscopy procedure is carried out in a specialist office for this purpose.The patient undresses from the waist down, is laid down on the couch on the left side.The legs need to bend the knees and move up to the stomach.
procedure can be carried out under local or general anesthesia and under sedation.
- Local anesthesia - usually offered local anesthesia with the use of one of the drugs on the basis of lidocaine: Luan gel dikainovaya ointment Xylocaine gel, etc. When applied on mucous and lubricate the drug tip of the colonoscope reached a local anesthetic effect, at the same time.the patient remains fully conscious.Local anesthesia can be achieved, and intravenous administration of the anesthetic.
- Sedation - the second option, in which a person is in a state similar to sleep, does not feel pain or discomfort, but consciousness is not off.Drugs used midazolam, propofol, and others.
- General anesthesia involves injecting drugs, embedding patient into a deep sleep with a complete shutdown of the patient unconscious.Although the level of development of medicine, general anesthesia carries some risks, contraindications, and requires a certain time for patient recovery.Colonoscopy under general anesthesia is indicated for examination of children under 12 years of age, patients with mental illness, people with high pain threshold and in some other cases.
After anesthesia, the doctor inserts a colonoscope into the anus and consistently inspecting the wall of the large intestine, propelling the probe forward and palpation over the surface of the stomach tube on monitoring the promotion of intestinal bends.To picture was objective, intestines expands using supply air.
air Contact accompanied by bloating and discomfort for the patient, plus everything in the study can not make any movements, which is why patients prefer general anesthesia or sedation in the study period.
procedure lasts 15-30 minutes.It is promotion video colonoscope through the intestine.If necessary, a biopsy of tissue is taken, removed polyps.At the end of the study through a special channel colonoscope gas is removed and the probe gently removed from the intestine.
After the procedure, the doctor prepares a survey report, makes recommendations to the patient and sends it to a specialist.
If local anesthesia was, immediately after the procedure you can go home.General anesthesia requires observation for a certain time until the patient wakes up completely.
After the examination, you can eat and drink.If overcrowding is stored intestinal gases can take 10 tablets comminuted activated charcoal and wash it down with water.Also help massage the abdomen.
Possible complications of colonoscopy
- perforation of the intestinal wall (frequency 1%);
- flatulence, which runs independently;
- bleeding in the gut (0.1%);
- Respiratory arrest during general anesthesia (0.5%);
- abdominal pain and pyrexia to 37.5 C for 2-3 days, if carried out removal of polyps.
If, after having a colonoscopy the following phenomena, should immediately consult a doctor:
- abdominal pain;
- nausea and vomiting;
- loose stools with blood;
- hyperthermia above 38 C.
Indications for colonoscopy
This procedure has a strict list of indications.However, given the experience of Western countries, healthy people over 50 years of the survey should be held annually, especially if close relatives have had problems with the large intestine, especially oncopathology.
colonoscopy is conducted annually to people, consisting in a risk group (with Crohn's disease, ulcerative colitis), as well as those patients who had previously been operated on for intestinal diseases.
Colonoscopy is assigned if the following symptoms:
- frequent and severe constipation;
- frequent pain in the large intestine;
- mucous or bloody discharge from the rectum of the form;
- frequent bloating;
- sudden weight loss;
- suspected colon disease;
- preparation for some gynecological operations (removal of tumors of the uterus, ovary, etc.).
main purpose of a colonoscopy - is early diagnosis of the different pathologies, which is especially important in the case of cancers.
colonoscopy results - the norm
method allows to objectively assess the state of the mucous membrane of the large intestine along its entire length.Authentic endoscopic signs intact colonic mucosa are the following figures:
- Color - normal intestinal mucosa is pale pink or pale yellow color.Erosion, inflammation, etc.. Pathology change the color of the mucous membrane.
- Shine - normal mucosa reflects light, which determines its brilliance.mucous Mattes says of insufficient production of mucus, which is characteristic of pathological changes.
- nature of the surface - surface should be smooth and slightly striated, without ulcerations, tubercles and protrusions.
- vascular drawing - should be uniform, without areas of gain or absence of blood vessels.
- Overlays mucosa - associated with accumulations of mucus and have a view of the bright clumps, unsealed, impurities fibrin, pus or necrotic masses.
Any deviation from the rules described embodiments indicate a specific disease.
disease that is diagnosed using colonoscopy
- Polyp of colon;
- Oncologic pathology;
- Ulcerative Colitis;
- bowel diverticula;
- Crohn's disease;
- Tuberculosis bowel.
contraindications to colonoscopy
Conditions for which this procedure is contraindicated, can be divided into absolute and relative.In absolute testimony study possible at relative - can be carried out for health reasons.
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