home Thyroid How to undergo a colonoscopy procedure. How to do an intestinal colonoscopy: indications, methods and results. When is a bowel examination indicated?

How to undergo a colonoscopy procedure. How to do an intestinal colonoscopy: indications, methods and results. When is a bowel examination indicated?

Colonoscopy of the intestine is a special medical procedure that is used for both diagnostic and therapeutic purposes. The procedure has a number of contraindications and can be performed under local or general anesthesia. In order for the study to proceed without consequences, it is necessary to properly prepare for it.

Colonoscopy is a procedure for examining the rectum, cecum, and colon. This makes it possible to diagnose the disease and determine further tactics for managing the patient.

Description of the method

The examination is carried out using a colonoscope. It is a thin flexible tube with a camera at the end, which allows you to smoothly pass through the bends of the intestine and avoid injury to it.

As the colonoscope moves, the condition of the organ is displayed on the screen at multiple magnification. Thus, the doctor can examine the intestines online over a distance of 1.5 meters from the anus.

Indications for use

pain along the intestines;
prolonged constipation or diarrhea;
bloating;
weight loss;
presence of a foreign object;
discharge of blood and mucus from the anus;
decrease in hemoglobin for no apparent reason;
prolonged low-grade fever.

In addition, undergoing an intestinal colonoscopy is advisable if you suspect:

presence of polyps;
diverticulosis;
malignant tumor;
inflammatory diseases;
developmental anomalies.

Colonoscopy is performed to determine the extent of cancer in case of malignant lesions of surrounding organs (uterus, prostate, bladder, stomach).

What does a colonoscopy show?

Checking the intestines using an endoscopic device makes it possible to:

assess the condition of the mucous membrane;
visualize inflammatory foci;
identify neoplasms, polyps, diverticula, foreign elements in the intestine;
determine the diameter of the intestine;
detect areas of scar narrowing;
visualize ulcerative defects;
take tissue for a biopsy necessary for differential diagnosis between a benign process and cancer;
take pictures that other specialists can look at and evaluate the dynamics of changes in the condition of the intestine.

You can learn more about the indications and algorithm of the study in the video. Presented by netgemorroya channel. ru.

Contraindications and restrictions

Before undergoing an intestinal examination, it is necessary to establish the presence of contraindications to the procedure.

Restrictions for performing a colonoscopy include:

infectious intestinal diseases (salmonellosis);
severe cardiac and respiratory failure;
severe hypocoagulation (blood clotting disorder);
acute ulcerative colitis;
peritonitis (due to violation of the integrity of the intestinal wall);
pregnancy;
severe intestinal bleeding.

For the purpose of early diagnosis of intestinal cancer, WHO recommends colonoscopy once every five years for all people over 40.

Preparing for a colonoscopy

To make a colonoscopy as informative as possible, you need to properly prepare for the diagnosis.

It consists in:

following a diet on the eve of the study;
thorough cleansing of the intestines.

Diet

3 days before the study, the patient should adhere to a dietary diet, which includes:

exclusion of foods that increase gas formation (legumes, fresh vegetables, baked goods, cabbage, mushrooms, carbonated drinks, kvass, berries, oatmeal, barley, dairy products);
consumption of broths, lean fish, boiled beef, poultry, semolina, corn porridge, coarse white bread;
complete refusal of food 12 hours before the study.

Purgation

The main rule of the preparatory period is a thorough cleansing of the intestines, since the presence of feces:

makes it difficult to conduct research;
makes diagnostic results inaccurate;
increases the duration of the procedure;
increases the risk of complications (intestinal perforation).

There are two ways to cleanse the intestines:

using enemas;
by taking laxatives.

Using enemas

The enema is administered the evening before the examination, as well as in the morning on the day of diagnosis (4-6 hours before).

There are some nuances of the procedure:

the water for the enema should be 38 degrees (cold water can provoke muscle spasms, and hot water can burn the intestinal mucosa);
the maximum enema volume should not exceed 1.5 liters;
the procedure requires an Esmarch mug (2 liter capacity with a rubber tube and tip);
To facilitate insertion of the tip into the anus, it is recommended to use Vaseline or fatty cream.

The procedure is carried out as follows:

the couch must be covered with oilcloth, since there is a risk of fluid leaking out of the anus;
the patient takes a certain position (on his side with his knees brought to the chest or knee-elbow);
Esmarch's mug is filled with warm water;
air is released from the rubber tube, after which it is pinched;
the tip is lubricated with Vaseline and slowly inserted into the anus to a depth of 8 cm;
if there is an obstacle in the intestine, you should stop and change the direction of movement of the tip;
remove the clamp from the rubber tube;
water enters the intestines, and the person feels fullness in the abdomen;
at the end of the procedure, the tip is removed from the anus;
the urge to defecate must be restrained for 5-10 minutes;
Next you should visit the toilet.

In case of insufficient bowel cleansing, it is recommended to repeat the enema after 45 minutes.

Using laxatives

Today, macrogol-based laxatives are most often used to cleanse the intestines before a diagnostic procedure. They are distinguished by their mild action, good effectiveness and lack of addiction.

The mechanism of colon cleansing is:

an increase in fluid in the intestinal lumen by reducing the rate of its absorption;
increased hydrostatic pressure;
irritation of the intestinal walls.

Here are some popular laxatives:

Fortrans. The effect occurs 1-1.5 hours after administration. Available in powder form. The contents of the package should be dissolved in a liter of water and drunk. Typically, 3-4 packets are required to completely cleanse the intestines. You should drink Fortrans in the evening and in the morning (no later than 4 hours before the test);
Endofalk – not absorbed into the bloodstream, acts locally. Manufactured in powder form. The contents of the package must be dissolved in 500 ml of water. To thoroughly cleanse the intestines, up to 3.5 liters of laxative is required. It is recommended to drink a glass every quarter of an hour.

There is another group of laxatives based on lactulose. They are practically not used to cleanse the intestines before a colonoscopy, but they help overcome constipation.

The mechanism of their action lies in the following properties:

decreased pH in the intestines;
stimulation of peristalsis.

Duphalac is one of these products.

As for the use of microenemas (Microlax), in most cases one is not enough to completely cleanse the intestines. Thus, it is recommended to use 1-2 microenemas the night before and in the morning on the day of the study.

Duphalac - 475 rubles Endofalk - 550 rubles Fortrans - 450 rubles Microlax - 560 rubles

How is the procedure done?

Colonoscopy takes place in an office with endoscopic equipment. The study can be carried out on an outpatient basis. After a conversation with the patient, the doctor chooses a method of pain relief. If sedation or general anesthesia is necessary, consultation with an anesthesiologist is required.

With or without anesthesia?

The choice of pain relief method depends on the following factors:

patient's age;
presence of concomitant diseases;
purposes of colonoscopy (examination of the intestines or removal of a polyp).

Colonoscopy usually does not cause severe pain in women, unlike men, who have a lower pain threshold.

Colonoscopy may be performed:

Without general anesthesia using local anesthetics based on lidocaine (Xylocaine, Luan gel). The drug is applied to the anus and colonoscope, which reduces the severity of pain. In this case, the patient is in clear consciousness.
With sedation, when the patient is “as if in a fog”, he does not feel discomfort or pain. Propofol is used for this purpose.
Under general anesthesia. The patient sleeps and does not feel pain. It is worth noting that such anesthesia has its contraindications, risks and complications.

Anesthesia is often required:

children;
with pronounced adhesive process;
patients with mental disorders;
people with a low pain threshold.

The success of a colonoscopy largely depends on the emotional state of the patient. Panic complicates the research process and increases the risk of developing diagnostic complications.

Technique and duration of colonoscopy

The duration of the study is 10-25 minutes.

Time depends on:

goals of colonoscopy;
thorough preparation for diagnosis;
doctor's qualifications.

Methodology and procedure of examination:

the patient sits on a couch with a disposable diaper;
takes a position “on the left side” and presses the knees to the chest;
the anus is treated with an antiseptic solution, then with lubricant (to facilitate insertion of the colonoscope into the anus);
The colonoscope moves through the intestine, simultaneously pumping air into the intestine;
The doctor controls the movement of the colonoscope with his hand through the anterior abdominal wall;
After examining the intestines, the colonoscope is slowly removed.

Complications and side effects

After the examination, the patient may still feel bloating and discomfort in the abdomen for some time, which is due to the presence of air in the intestines.

Complications are observed in 1-3% of cases and are represented by the following problems:

perforation of the intestinal wall with the entry of feces into the abdominal cavity and the development of peritonitis;
bleeding;
pain that occurs after removal of polyps;
undesirable consequences of anesthesia (hypotension, respiratory failure).

If after the procedure the patient experiences blood in the stool, weakness, abdominal pain and hyperthermia, you should consult a doctor.

Survey results

The interpretation of the results is carried out exclusively by a specialist who evaluates:

The conclusion may include:

normal picture;
polyps;
tumor;
ulcerative lesions of the mucous membrane;
intestinal tuberculosis;
diverticulosis.

Norm

The normal picture of the condition of the intestine is presented:

pale pink color of the mucous membrane;
shiny, which indicates a sufficient amount of mucus produced;
smooth surface with slight striations;
uniform vascular pattern without areas of enhancement and absence of vessels;
small accumulations of clear mucus.

Polyps

Due to disruption of the renewal process of the intestinal mucosa, outgrowths, so-called polyps, can form. They can have a wide base or a thin stem. Polyps are not accompanied by severe symptoms, but with prolonged inflammation they can become malignant, that is, degenerate into cancer.

Colonoscopy is an endoscopic method for examining the intestines (large section), with which the doctor can visually assess the condition of the mucous membrane of the lower parts of the digestive tract. Diagnostic colonoscopy of the intestine is considered the most reliable method for identifying most pathologies localized in all parts of the colon, but, like other methods, it has its own characteristics and contraindications. This article will tell you why and to whom a colonoscopy examination is prescribed, how the procedure is carried out and a conclusion is drawn up on it.

Colonoscopy is a procedure that is an endoscopic examination of the internal surfaces of the large intestine. It is carried out using a special device consisting of several elements:

a thin tube about 1.5 meters long;
high resolution video cameras;
light source;
tubes for supplying carbon dioxide into the intestinal lumen;
manipulators for taking biological material.

In coloproctology, the following types of colonoscopy are distinguished:

Diagnostic, in which the doctor examines the intestinal mucosa, records pathological changes and evaluates its structure, vascular pattern, the presence of tumors, sources of bleeding, and much more. During a diagnostic examination, a specialist may pinch off a small piece of mucous membrane or tumor for further examination in the laboratory.
Curative or therapeutic, in which the doctor removes previously diagnosed pathologies, most often polyps, cysts and foreign objects. Using a colonoscopy unit, the doctor can eliminate minor bleeding in the intestines by coagulating open wounds on the mucous membrane of the organ.

Classic colonoscopy, which was widely practiced just a few years ago, has now almost been replaced by examination using video colonoscopy. In general, the essence of the examination remained the same, and only the diagnostic apparatus underwent modifications: the fiber-optic tube was replaced with a thinner and more flexible one, and the doctor can look at the mucous membranes of the colon not through an eyepiece, but through a monitor. An enlarged image from cameras is fed to it, thanks to which the test reveals the smallest neoplasms, the diameter of which does not exceed 1 mm.

What parts of the intestine are looked at during a colonoscopy?

Unlike methods similar in technique, for example, sigmoidoscopy, a colonoscopy examination allows you to examine the large intestine along its entire length, which is about 150 cm.
The examination of the large intestine begins with an examination of the rectum. The doctor inserts a colonoscope tube into the anus and advances it to a depth of about 15 cm, examining the mucous membranes of this section. During colonoscopy of the rectum, the doctor supplies carbon dioxide, since its mucosa is covered with deep folds, and visualizing the mucosa without straightening it will be problematic.

First, the sigmoid section is examined, which opens into the rectum;
then the descending colon, which is located on the left in the abdominal cavity and is located vertically;
Next, the transverse section, located horizontally in the upper abdomen, is examined;
The last thing the doctor examines is the ascending and proximal sections, and also evaluates the orifices of the small intestine and appendix.

During advancement, the endoscopist records all changes present on the surface of the mucous membrane and, if necessary, pinches off small fragments for microscopic and histological analysis.

When to do a colonoscopy - indications

Direct indications for intestinal colonoscopy are conditions indicating diseases of the colon:

nonspecific ulcerative colitis;
Crohn's disease;
colon polyps;
irritable bowel syndrome;
diverticulosis and diverticulitis;
malignant tumors of the colon and others.

The listed pathologies have extensive symptoms, which are not always specific. Nevertheless, experts identify a number of clinical manifestations that require a colonoscopy. These include:

the presence of blood in the stool;
the presence of mucus and pus discharge during bowel movements;
chronic abdominal discomfort - bloating, colic, pain of various localizations;
chronic constipation;
unstable stool, when diarrhea alternates with constipation.

In addition, indications for colonoscopy include progressive anemia. This condition may signal hidden intestinal bleeding, which is not manifested by the release of blood in the stool. Colonoscopy of the intestines is mandatory when the patient, for unknown reasons, begins to rapidly lose weight and does not gain weight when changing his diet. This symptom may be a consequence of sluggish ulcerative colitis or tumor processes in the intestines.

Important! Patients with previously identified and treated benign intestinal pathologies undergo colonoscopy regularly every 3 years.

Indications for colonoscopy include conditions not related to existing problems. First of all, this is the age of the patient. According to statistics, various pathologies, such as polyposis, develop in older people. To prevent their degeneration into cancer, it is necessary to perform a colonoscopy in patients over 50 years of age and remove benign tumors in a timely manner.

Another category of patients for whom colonoscopy is mandatory are those with a hereditary predisposition to colorectal cancer (tumors of the large intestine). The procedure can be prescribed to them at any age, which depends on the age at which cancer was discovered in their closest relatives. So, if cancer pathology was diagnosed at 40-50 years old, indications for colonoscopy begin at 30-40 years old, that is, 10 years earlier.

Contraindications to the procedure

Colonoscopy has a lot of contraindications: these include conditions that increase the risk of bleeding, the spread of infections, and that do not allow visualization of the intestinal mucous membranes. All these restrictions can be divided into the following groups:

conditions that are accompanied by bleeding in the intestines or an increased risk of colorectal bleeding, as well as blood pathologies associated with impaired blood clotting;
infectious diseases of the intestines and other organs and systems in an acute state, accompanied by fever, febrile states and a specific symptom complex characteristic of dysfunctions of a particular organ system (cough with lung damage, headache with meningitis, lack of appetite and diarrhea with intestinal infection, etc. .);
non-infectious lesions of vital internal organs and systems - especially strict prohibitions during colonoscopy apply to severe forms of organ failure (pulmonary, cardiac, renal), as well as post-infarction conditions;
traumatic and other damage to the intestinal wall with a violation of its integrity - perforation or perforation, peritonitis with melting of the intestinal wall, acute injury of the anterior abdominal wall and retroperitoneal organs.

In addition to the listed situations, there are contraindications to colonoscopy, which are also included in the list of indications. These include chronic diseases and pathological conditions of the intestine - nonspecific ulcerative colitis, Crohn's disease - in a state of exacerbation. Doctors recommend first stopping the symptoms of exacerbation, and only then examining the colon using colonoscopy.

The procedure is contraindicated for pregnant women, especially if the fetus is already quite large and significantly affects the location of intestinal loops in the retroperitoneal space. At the initial stage (up to 4-6 weeks), the doctor may allow diagnosis by this method, but only if the pregnancy is progressing well.

Contraindications for intestinal colonoscopy may include other diseases and conditions that may be complicated by diagnostic procedures. In each case, the doctor weighs all possible complications and risks and compares them with the potential benefits of the procedure for the patient.

How is a colonoscopy performed?

Most patients who are about to undergo a bowel examination for the first time have a very vague understanding of colonoscopy and do not understand how it is done or what it is. This can make the procedure somewhat difficult, because a lot depends on the patient’s emotional state and ability to relax. Therefore, shortly before the diagnosis, the doctor explains in detail how the examination will be carried out and what to expect from it.

The inspection consists of several stages:

Treatment of the perianal area and the colonoscope itself with antiseptics. At the same time, if required, the doctor uses local or general anesthesia. The second option is used more and more often, as it allows the patient to survive the diagnosis without the slightest discomfort.
The end part of the colonoscope probe is treated with lubricant. If general anesthesia was not used, the doctor uses a lubricant containing an anesthetic.
The doctor inserts the colonoscope tube into the anus and begins the examination. On the outer part of the tube there are marks with numbers that indicate how many centimeters deep the inserted hose has penetrated into the colon. This helps to find pathological areas during subsequent colonoscopy procedures.
If necessary, the doctor plucks off pieces of the mucous membrane. This does not cause any noticeable discomfort.

The colonoscopy is completed by slowly removing the instrument tube from the intestine and drawing up a conclusion.

If general anesthesia was used, the patient will have to stay in the clinic for some time under the supervision of specialists. If the colonoscopy was performed under local anesthesia, the patient can go home immediately.

Is it painful to have a colonoscopy?

When performing a colonoscopy, pain may bother patients only in the absence of general anesthesia. They are described as bursting, and their localization depends on where exactly the end of the colonoscope tube is located at the moment:

when examining the sigmoid region - in the lower abdomen and in the rectal area;
when examining the ascending section - in the left half of the abdomen;
when examining the transverse section - in the upper abdomen and in the stomach area;
When examining the descending and distal sections, unpleasant sensations appear in the area of appendicitis and in the right half of the abdomen.

Good to know! Discomfort during a colonoscopy occurs due to the injection of carbon dioxide into the colon. With this manipulation, the doctor can examine in detail the surface of the intestinal mucosa.

If the patient is overly concerned about whether the colonoscopy procedure is painful, the doctor may suggest testing under general anesthesia.

How long does a colonoscopy take?

In terms of duration, intestinal colonoscopy does not take as long as it might seem. On average, the procedure lasts from 10 to 25 minutes. Its duration depends on several factors:

Proper preparation for the examination - the procedure that takes the least time is carried out with a well-cleaned intestine. If fragments of food or feces remain in its lumen, the diagnosis will take longer, but more often the doctor postpones the examination to another date, since it will be extremely difficult to determine pathological changes in the condition of the intestine due to the lack of a normal view.
The purpose of the examination is that a survey colonoscopy will take less time than an examination that involves the need to take a biopsy for further cytology. If during the diagnosis the doctor discovers polyps or other benign neoplasms that can be removed immediately, the colonoscopy will take even longer, since it will also be necessary to “cauterize” the resulting wounds.
Qualification and experience of the doctor - for endoscopic diagnostic doctors with extensive experience, intestinal colonoscopy takes approximately the same amount of time as a standard external examination, while a novice diagnostician needs more time for a detailed examination of the mucous membranes.

If it is important for the patient to know exactly how long he will be in the doctor’s office, this point is discussed in advance at a preliminary appointment.

What does a colonoscopy show?

During a colonoscopy procedure, the doctor literally examines the inside of the intestine for various changes. Key points to pay special attention to:

color and vascular pattern of the mucous membrane;
the shape of the intestinal bends and their correspondence to the anatomical norm;
pathological formations - inflammatory foci, polyps, erosions, ulcerations, suppuration, diverticula, cracks;
the width and degree of patency of intestinal sections, signs of stenosis (narrowing) and adhesions;
accumulation of mucus and purulent discharge;
sources and causes of bleeding.

Based on a visual examination, the doctor makes a conclusion about the condition of the intestines. If there are no critical changes, the mucous membrane is smooth, light, with a moderate vascular pattern and glossy sheen, it is considered that there are no pathologies. If any indicator deviates from the norm, the doctor makes a diagnosis corresponding to these changes.

The list of what a colonoscopy can reveal, as well as changes inherent in diseases, is as follows:

inflamed mucous membrane with areas of dystrophy or atrophy indicate colitis;
inflamed foci with ulcerations, suppuration and erosions, purulent discharge, bruising indicate nonspecific ulcerative colitis;
thickened mucous membrane, which doctors describe as “cobblestone pavement”, scars located longitudinally, ulcers and fistulas indicate Crohn’s disease;
swelling of the mucous membrane, colored purplish-bluish, hemorrhagic foci, abnormal narrowing of the intestine, ulcers indicate ischemic processes in the intestine;
bleeding of the mucous membrane, its swelling, narrowing of the intestinal lumen may indicate the development of amyloidosis of the large intestine (the final diagnosis is made after examining a biopsy);
numerous or single protrusions in the intestinal walls, which look like honeycombs, indicate divetriculosis;
convex yellow plaques on the surface of the intestinal mucosa indicate the development of pseudomembranous colitis;
neoplasms of various sizes on the colon mucosa can mean both benign (polyposis) and malignant tumor process (cancer).

Unfortunately, colonoscopy does not allow you to accurately determine the nature of some formations at the time of examination. To make a diagnosis, microscopic and histological analysis of neoplasm tissue is required. Confirmation of the presence of oncology is also carried out using an occult blood test, but more often this type of diagnosis is used before a colonoscopy.

Benefits and harms of the procedure

Colonoscopy is an absolutely safe type of diagnosis that does not cause negative consequences or complications. Despite this, many patients doubt whether to undergo this procedure, because there are other methods of visualizing the intestines: computed tomography with contrast or X-ray of the intestines, for example. Experts say that other types of examination are not as informative as colonoscopy.

Most patients who are about to undergo examination doubt whether additional trauma to the intestines is harmful for their condition. Such doubts are not unfounded, because the risk of injury to the mucous membrane of the large intestine is always present, albeit insignificant (less than 0.1%). According to experts, it is dangerous to do a colonoscopy only in the stage of exacerbation of diseases, when additional effects on the intestinal walls can be fatal.

Important! Before prescribing a diagnosis, doctors carefully weigh the pros and cons, and if there is the slightest concern about the safety of the procedure, it is postponed to a later date or replaced with another method.

Doubts about whether colonoscopy is dangerous are in most cases unfounded. The benefits of the procedure far outweigh the risks. Complications such as bleeding, intestinal infection and pain are extremely rare. Their appearance is often associated with improper preparation or contraindications hidden by the patient.

How often can you have a colonoscopy?

The frequency of intestinal examination using colonoscopy is regulated by international standards. It is performed at any age if there are direct indications. In addition, there are instructions on how often certain categories of patients should have a colonoscopy:

those who have previously identified intestinal pathologies (polyposis, colitis and diverticula) are recommended to visit the endoscopist’s office every 3-5 years to undergo a colonoscopy;
for patients who have previously undergone intestinal surgery, examinations are indicated every 5 years;
patients at risk for bowel cancer after 50 years of age undergo colonoscopy at intervals of 3-5 years;
Patients over 60 years of age are examined at intervals of 3 years.

For patients whose relatives suffered from intestinal cancer, examination is necessary after 40 years of age or earlier, depending on the age at which malignant processes were discovered in relatives.

Colonoscopy results and interpretation

Examination of the intestine through colonoscopy allows you to detect almost all pathologies of the large intestine known in medicine already at the time of examination. Therefore, preliminary results become known during the inspection. Upon completion, the doctor who diagnoses the disease (endoscopist) begins to draw up a conclusion. It includes:

description of the appearance of the intestinal mucous membranes (normal, hyperemia, erosion, edema, neoplasms);
localization of areas where pathological changes are visible;
nature, size and extent of pathological areas;
the nature of the contents and discharge of the intestine;
the presence or absence of intestinal narrowing.

After the examination is completed, a detailed transcript of the results is compiled, which is then transferred to a gastroenterologist or coloproctologist along with printed images of pathological areas. If the doctor took a biopsy during the study, the final results of the colonoscopy become known after 1-2 weeks, when the results of laboratory tests of the biopsy are ready.

Modern methods of intestinal diagnostics make it possible to see the first changes in the structure of the mucous membranes and reliably establish the cause and consequences of clinical manifestations. One of these methods is an endoscopic therapeutic and diagnostic procedure - intestinal colonoscopy.

Colonoscopy is a method of therapeutic and diagnostic examination of the intestine along its entire length. The manipulation is carried out using special equipment - a colonoscope. The equipment has several barrels for a probe and surgical instruments.

During the study, you can not only assess the condition of the intestines, but also carry out a number of simple therapeutic procedures:

Removal of polyps and local pathological foci;
Stopping bleeding;
Elimination of adhesions;
Collection of biological material for histological examination.

A modern colonoscope is equipped with an optical device and lighting to improve visualization. The resulting image is transmitted to a computer monitor, which allows the doctor to thoroughly study the condition of pathological foci, the nature of changes in the mucous membranes, and the anatomical features of the intestinal sections.

You can also video record the resulting image online and transfer it to specialized specialists for evaluation:

proctologist,

oncologist,

gastroenterologist.

Why is a colonoscopy done: indications

Colonoscopic examination is a promising direction in making a final diagnosis, as it involves the simultaneous implementation of a wide range of manipulations. The main indications for colonoscopy are atypical symptoms and patient complaints.

The objective of the study is to:

differentiation of various diseases of the lower and upper parts of the digestive system;
manifestation of the final diagnosis based on the obtained image data;
histological and cytological analysis.

The following complaints are indications for the procedure::

pain during bowel movements;
the appearance of atypical discharge from the rectal canal (blood, mucous component, serous exudate, pus);
nagging pain in the lower abdomen without connection with bowel movements;
suspicion of inflammatory processes in the intestines:
risks of developing a malignant tumor.

Today, colonoscopy is included in the list of mandatory preventive examinations in patients with a hereditary predisposition to intestinal cancer, as well as at the age of 40-45 years.

Given the high oncological risks, it is necessary to regularly undergo examination of the intestines using endoscopic methods.

What does the research reveal and show?

Using colonoscopic equipment, the doctor is able to discern any atypical changes in the mucous membranes relative to the norm and assess the extent of the lesion in accordance with the patient’s clinical history.

The research has the following capabilities:

visualization of scars, ulcerative lesions, erosions, polypous neoplasms (types of polyps in the intestine);
sources of bleeding;
the nature of hemorrhoids;
simultaneous elimination of bleeding areas;
the ability to obtain photographs and video images of the pathological area.

With the help of colonoscopy, you can easily identify a foreign body and remove it, perform a biopsy of a suspicious fragment of the mucosa and assess the oncological risks.

On a note: often after minimally invasive diagnostic methods, doctors decide to perform a colonoscopy due to the high information content and accuracy of the manipulation.

What does bowel cancer look like?

Cancerous tumors are not particularly diverse endoscopically. This is especially true for a cancer tumor localized in the right side of the colon (this is what is usually diagnosed in the terminal stages).

The main symptoms of bowel cancer are:

stable bowel movements and frequent alternation of constipation and diarrhea;
blood (explicit or hidden) in the stool;
night sweats;
intestinal stenosis and the appearance of pencil-shaped feces.

Often, regular confirmation of occult blood tests is the only symptom characterizing the appearance of cancer cells in a tumor or, more recently, a benign polyp.

Colonoscopically, the resulting image visualizes a changed area of the mucous epithelium. To confirm oncological risks, a biopsy sample is taken for further research. Even if there is evidence of the appearance of atypical cells, it is not always possible to make a final diagnosis.

An oncologist surgeon sometimes needs more information than a laboratory technician’s report. The main difficulty lies not in diagnosing a typical cancer, but in its differentiation and the ability to see individual features.

Which doctor performs colonoscopy?

An appointment for a colonoscopy is issued by a proctologist, surgeon, or gastroenterologist. The procedure itself is performed by an endoscopist. During the manipulation, an anesthesiologist (if anesthesia is necessary) and junior medical personnel may be present in the office.

How is the procedure done?

The colonoscopy examination procedure follows a certain algorithm. After additional examinations, a date for the manipulation is set.

A few days before the procedure, patients switch to a waste-free diet, and the day before the colonoscopy they undergo additional bowel cleansing using a classic enema or medication. Information on what you can eat 3 days before a colonoscopy.

Given the characteristic discomfort during manipulation, the procedure involves pain relief.

There are several main methods of pain relief during the procedure.:

Local anesthesia— treatment of the tip of the colonoscope with anesthetic;
Sedation— light medicated sleep without deep depression of the patient’s consciousness (price of colonoscopy with sedation);
General anesthesia— absolute depression of consciousness and complete painlessness (cost of colonoscopy under anesthesia).

The advantage for the doctor is local anesthesia, which maintains communication with the patient and control over the progress of the entire procedure. However, in some cases the procedure is only possible using general anesthesia or sedation.

To ensure deep drug-induced sleep, patients undergo additional examination for allergic reactions so that the doctor has an idea of all the possible risks when administering a particular medication.

How is colonoscopy done?

The examination is carried out with a colonoscope - equipment with several surgical passages, a flexible hose of 1.5 m, a lighting and magnifying device, and a camera. The appearance of the equipment may vary depending on the modification, model and functionality.

Every year, medical engineering allows colonoscopes to be equipped with new capabilities.

Algorithm and technique

The procedure takes place in a specially equipped room. On the day of the examination, the patient may be given an additional enema. The patient enters the room, undresses, changes into a special hospital gown and lies on the couch on his side with his legs bent at the knees.

Preparation and setup of equipment;
Antiseptic treatment of the anus;
Administration of anesthesia (or treatment of the tip of the colonoscope);
Inserting the tip 3-4 cm into the rectal canal to inject air atmospheres;
Gradual insertion of the probe along the entire length of the intestine;
Surgical procedures (if necessary);
Removing the probe upon completion of the manipulation;
Removal of excess air;
Antiseptic treatment of the anus.

The total duration of a typical diagnostic study usually does not exceed 15-30 minutes. If surgical correction is necessary, the time can be increased to 60 minutes.

Colonoscopy results

A description of the results of a colonoscopy examination is usually ready within 2-3 days from the date of the procedure. The time frame can be extended if a biopsy is performed at the time of colonoscopy (time to obtain histology results), or surgical procedures (time to assess the healing of the mucous membranes).

If additional data is necessary to reliably assess the condition of the intestines, then final results can be obtained 10 days after the procedure.

The diagnostic criteria are based on the following theses::

Condition of mucous membranes (shade, deformation, humidity);
Anatomical structures relative to the norm (location, size, bends of the intestinal sections);
Size and quantitative composition of tumors, polyps;
The presence of foci of bleeding, hemorrhoids. How to do a colonoscopy if you have hemorrhoids;
The presence of inflammatory foci, pus;
Cleanliness of the folds of the mucous membranes (fecal stones, mucus, excrement);
The patient’s age and compliance of the intestinal sections with this criterion.

In the conclusion, the additional manipulations performed must be indicated, and a disk with a photo or image of the ongoing process is issued. Patients pass on the information received to a specialized specialist to determine further tactics for patient management.

How dangerous is the procedure - possible complications

Colonoscopy is not a pleasant or painless procedure:

Firstly, there is obvious discomfort when air is pumped in to straighten the mucous membranes and improve visualization.
Secondly, moving the probe further than 15 cm can cause a feeling of pain and contraction of smooth muscles.
Thirdly, involuntary contraction makes it difficult to advance the probe and causes even greater discomfort to the patient.

Complications can arise due to the unprofessionalism of the doctor or the lack of many years of experience in carrying out such manipulations.

The following possible risks and complications are identified::

Perforation or perforation of mucous membranes. A rare complication that usually occurs against the background of existing ulcerations and thinning of the mucous membranes associated with erosive damage to the intestinal walls. The pathology requires immediate surgical intervention.
Bleeding. Intestinal bleeding can occur both during and after manipulation, especially with a complicated coloproctological history. Bleeding of varying intensity can occur after surgical interventions.
Pain in the lower abdomen. Discomfort with slight nagging pain after the procedure is normal. They usually go away on their own after a few days or after taking antispasmodic drugs. If symptoms intensify or persist, it is recommended to consult a specialized specialist.
Infection. A rare complication that occurs due to insufficient antiseptic treatment of the colonoscope or non-compliance with personal hygiene by the patient after surgical procedures.
Traumatic damage to the walls. Injury to the intestinal mucosa can occur in the presence of adhesions, as well as during colonoscopy under sedation or general anesthesia. It is for this reason that doctors prefer local anesthesia to keep the patient conscious and control the reaction during the passage of the probe.

Complications are also possible after anesthesia in the form of spontaneous or unexpected allergic reactions such as rash, urticaria, itching, and partial depression of consciousness.

Attention! If after the procedure there is nausea, general weakness and malaise, or heavy bleeding from the rectal canal, you should immediately contact a specialist or call an ambulance.

Typically, endoscopic colonoscopy is uneventful. Compliance with all medical recommendations during the preparation period and after the manipulation reduces all potential risks to zero.

Types of research

Endoscopic colonoscopy is a collective term for many procedures that examine the condition of the intestinal tract.

The following types of research are distinguished::

Ultrasound colonoscopy. A new minimally invasive method of examination, involving rectal insertion of a sensor or examination of the intestinal sections through the peritoneum. The main advantage is the ability to diagnose tumors at early stages of development. Contraindications are signs of peritonitis, ulcerative colitis, exacerbation of chronic diseases.
Capsule colonoscopy. A modern method of examining the colon, which is often combined with the examination of the epigastric and stomach organs. The uniqueness lies in the ability to examine in detail the entire length of the intestinal sections, follow all the digestive stages, and examine the condition of the walls of the esophagus, stomach, and intestines. The patient simply swallows a capsule with a built-in video camera and goes about his usual activities. The capsule comes out with the natural process of defecation. The only drawback is the high cost. What is capsule colonoscopy?
Virtual colonoscopy. The virtual research method essentially resembles MRI diagnostics, but it helps to identify only large growths on the mucous membranes. During the manipulation, you can obtain clear pictures with a three-dimensional image of the large intestine and even cover a separate part of the small intestine. What is better: colonoscopy or virtual colonoscopy?
Rectosigmoscopy. A research method used when it is necessary to study the rectal lumen at a distance of up to 45-50 from the anus.
Sigmoidoscopy. The method allows you to estimate only 30-35 cm of the length of the rectum from the anus. Which is better: colonoscopy or sigmoidoscopy?

In all cases, standard preparation is required: diet and maximum bowel cleansing to improve visualization.

Unfortunately, in many cases, minimally invasive methods are a preliminary stage of diagnosis. Often, after the examination, doubts remain, and doctors prescribe a full-fledged colonoscopy.

What parts of the intestine does a colonoscopy check?

Colonoscopy allows you to evaluate the condition of all parts of the large intestine: rectum, colon, cecum and sigmoid colon.

First, the endoscopist examines the area of the lower parts of the gastrointestinal tract, and then assesses the condition of the cecum and sigmoid colon. The cecum borders the small intestine, so part of the small intestine can also be examined.

How is colonoscopy done for adhesions after surgery?

There are many myths and various unclear questions about colonoscopy. Fear of pain, delicacy and specificity of the manipulation frighten many patients.

The procedure can be performed for the following conditions:

Colonoscopy and adhesions. Adhesions increase pain during the procedure and make the passage of the probe difficult or impossible. During a colonoscopy, surgical removal of the pathology is possible.
Colonoscopy after intestinal surgery. In the early postoperative period or after ostomy, patients are recommended to turn to minimally invasive diagnostic methods (irrigoscopy, ultrasound, virtual colonoscopy). In the later period, it is important to assess the general condition of the patient, the extent of the intervention performed, the degree of healing of the wound surfaces and the feasibility of the procedure.
Treatment for endometriosis. Intestinal endometriosis is usually diagnosed through colonoscopy. There are no other specific diagnostic methods. The manipulation is carried out on a certain day of the menstrual cycle, since both processes are closely related.

Whatever the purpose of the diagnostic procedure, you should trust your doctor and undergo an examination.

Contraindications

There may be absolute and relative contraindications for colonoscopy. The only exception is the need for emergency intervention.

The procedure cannot be performed for the following conditions and diseases:

Cardiovascular diseases;
Insufficiency of liver and kidney function;
Diseases of the lungs and respiratory system;
Instability of blood pressure, arterial hypertension;
history of diverticulitis;
Inguinal-scrotal or umbilical hernia;
Exacerbation of inflammatory diseases;
Signs of peritonitis;
Pregnancy;
Blood diseases.

Carrying out an examination of the intestines requires special preparation, so the need for its appointment is decided by the doctor based on the totality of data from the clinical history, current condition and age of the patient. If it is impossible to perform traditional colonoscopy, alternative research methods are used.

How much does a colonoscopy cost?

The average cost of a colonoscopy in Moscow varies from 7,500 to 10,000 rubles.

The final cost is formed from the following criteria:

clinic level;
physician experience;
consultations and preparation for research;
goals and need for implementation;
anesthesia;
hospital stay;
type of colonoscopy.

The final cost can reach several tens of thousands of rubles.

Watch a virtual video of an intestinal colonoscopy:

Colonoscopy is an informative and accurate method for diagnosing intestinal sections, aimed at identifying and treating many pathological processes. Considering the difficult oncological situation in modern society, endoscopic research methods are constantly gaining popularity.

You can make an appointment with a doctor directly on our website.

Be healthy and happy!

Our health is of great importance to each of us. But in order to make sure that the organs and systems are in perfect order, you need to decide on unpleasant procedures and diagnostics. One type of these procedures is intestinal colonoscopy.

If the patient complains of abdominal pain, rectal bleeding, frequent constipation, weight loss, poor blood tests (high ESR, low hemoglobin), in such cases the coloproctologist prescribes intestinal diagnostics.

What is intestinal colonoscopy

Colonoscopy is one of the modern instrumental diagnostic methods. Used to check for pathologies of the rectum and colon.

The colonoscopy procedure is performed using a colonoscope, and after a few minutes it gives a visual result of the condition of the large intestine.

A colonoscope is a long, flexible device, at the end of which there is a special eyepiece with illumination and a mini video camera.

With its help, the image of the intestine is transmitted to the monitor.

The set consists of a tube that supplies air to the intestine and forceps designed for collecting histological material.

The video camera is capable of taking photos of those parts of the intestine through which the umbrella has a passage, and shows a large image on the monitor screen.

With this, the coloproctologist has the opportunity to carefully examine the intestinal mucosa and examine minor pathologies of changes in the intestine. The colonoscopy procedure is not replaced by anything in the diagnosis and treatment of intestinal diseases.

Colonoscopy options

The following options make the colonoscopy procedure more valuable than an informative diagnostic method. It is carried out in many medical institutions. Therefore, the advice of the World Health Organization in the form of prevention should be carried out after 35 years once every five. When a person consults a doctor with characteristic symptoms, diagnosis is mandatory.

Simultaneously during diagnosis, the doctor has the opportunity to visually assess the state of intestinal motility, colon and rectum, mucous membrane, and identify the inflammatory process.

Determine the diameter of the intestinal lumen. If necessary, enlarge areas of the intestine narrowed due to scar changes.

On the monitor, the doctor observes minor simplifications in the intestine and other defects (tumors, hemorrhoids, fissures, intestinal polyps, ulcers, diverticula or various bodies).

Colonoscopy procedures can destroy foreign bodies in the colon or remove tissue for further diagnosis.

If small benign tumors or polyps are found, there is a chance to remove them. The patient does without surgery.

During diagnosis, there is the option of identifying the causes of intestinal bleeding and eliminating them using high temperature.

Video

During the colonoscopy procedure, the specialist takes pictures of the inside of the intestine.

Indications for colonoscopy

The colonoscopy method for intestinal diagnostics is prescribed in the following situations:

If you are worried about abdominal pain in the area of the large intestine;
There is discharge from the rectum or pus;
Bleeding from the rectum;
Problems with intestinal motility such as persistent constipation or diarrhea;
Excess weight, high degree of anemia, body temperature within 37.1-38.0 °C, relatives with cancer;
Presence of a foreign body in the intestine;
Detection of benign tumors or. In these situations, colonoscopy is needed to diagnose the upper colon;

Contraindications from doctors

There are situations in which a colonoscopy procedure is inappropriate, because the procedure will lead to disastrous consequences. Colonoscopy is not performed in the following cases:

In such cases, the danger to human health is too high. The Clonoscopy procedure should be replaced by other diagnostic methods.

Preparing for intestinal colonoscopy

The preparatory process of bowel cleansing for colonoscopy is done independently. The result will be visible from the level of quality of preparatory activities before the procedure. Read more about preparation.

The doctor will prescribe two things to do before the procedure and thoroughly prepare for the diagnosis:

Maintain a slag-free diet.
Empty the intestines of feces.

If one of the conditions is not met, the colonoscopy procedure cannot be performed. Preparing your bowels is easy. Each process is described in detail below.

Colon cleansing with an enema:

The procedure is done three times in the evening before the procedure and in the morning.
The enema is washed and disinfected.
The water in the enema should not exceed 36 degrees, cold is prohibited.
The first enema is given at 19:30, the second at 21:00 the day before the procedure.
The volume of liquid is one and a half liters.
In parallel with the evening enema, you can use a laxative.
In the morning at 6:00 – 7:00 repeat the enema procedure.

Diet before colonoscopy

Diet takes priority in this cleansing process. The slag-free diet is different from other diets.

There is a list of foods that must be avoided for the colonoscopy procedure.

These foods include those that can cause gas in the intestines and heavy stool. You should stop taking the products 3-4 days before.

Foods that are prohibited before a colonoscopy procedure:

Various grass;
oatmeal, millet porridge, barley;
, carrots, onions, cabbage, turnips, radishes, garlic;
beans, beans, peas, lentils;
nuts of all varieties;
from fruits: tangerines, peach, bananas, apple, pear, grapes, dried fruits;
berries;
carbonated drinks;
all products containing rye flour;
only fermented milk products.

Breakfast: One glass, buckwheat porridge, a piece of white bread (butter is fine).

Dinner: Lean beef broth, maybe chicken breast, fish (not fatty), a piece of lean meat and rice, a cup of green tea without sugar.

Afternoon snack: A piece of bread, hard cheese.

Dinner: Ryazhenka with crackers.

On the day of diagnosis, the last meal should be no later than 12:00 noon. At other times, drink unsweetened or plain water. Do not eat dinner or afternoon snack. Before the colonoscopy procedure, you are prohibited from drinking or eating. Water is allowed.

How is the colonoscopy procedure performed?

This type of diagnosis is quite quick and simple. The patient needs to undress from the waist down. Soon place yourself on a hard surface, with a slope to the left side. Bend your legs at the knees and press them to your stomach.

After the patient has been prepared for the examination, the doctor gradually, carefully and carefully inserts the device directly into the opening of the colon. If the patient has a high level of sensitivity to such procedures, lubricate the anus with Vaseline in advance.

Video

The colonoscope moves slowly inside the colon. Its mucous membrane is examined. In order for the intestines to straighten, a little air is pumped into them. The procedure lasts approximately 10-15 minutes.

At the end of the colonoscopy procedure, the patient experiences slight drowsiness and weakness.

Other diagnostic methods

With modern diagnostic methods, doctors detect many intestinal diseases in the early stages. Modern doctors offer the following methods for diagnosing intestinal diseases:

Endoscopy;
Irrigoscopy;
Magnetic resonance imaging ();
Ultrasound examination (ultrasound);
Computed tomography (CT).

The capsule examination is considered minimally invasive. It allows you to examine all parts of the gastrointestinal tract.

Diagnosis occurs using an enterocapsule with a video camera.

Diagnostics of the intestines using a capsule makes it possible to find stomach or intestinal cancer.

Intestinal endoscopy is used to diagnose polyps and tumors. Endoscopy is a safe and painless method that allows you to analyze the condition of the intestines.

The doctor can make a visual result of the condition of the intestinal mucosa.

Irrigoscopy diagnoses the intestines using x-rays. The diagnosis is safe. The level of rays is low.

Magnetic resonance imaging (MRI)- one of the ways to obtain a tomographic medical image for the diagnosis of internal organs and tissues using nuclear magnetic resonance.

Ultrasonography (ultrasound)- study of the human body using ultrasonic waves.

CT scan (CT)- this is one of the best methods of modern diagnostics of internal organs.

What is better: colonoscopy or its analogues?

People say that the colonoscopy procedure is very unpleasant. Therefore, they try to avoid it or ignore it.

The question arises, what is better: colonoscopy or some of its analogues?

Colonoscopy of the intestines remains the highest quality.

A computed tomography scan may be prescribed, but it may not be relevant in all cases.

I would like to say that referrals for colonoscopy procedures are given only by a specialist based on tests and the patient’s symptoms.