What can be detected on a colonoscopy. What is a colonoscopy of the intestine and preparation for the procedure. Foods to Avoid

In the presence of violations in the functioning of the intestine, the most optimal method to study it in detail is the colonoscopy procedure.

Thanks to her, the specialist can see the contents of the internal organ. Based on the results of the study, doctors determine the cause of the disorder in the diagnosed organ, as well as prescribe an effective treatment.

What is the procedure?

Colonoscopy is a medical procedure that allows a thorough examination of the intestinal mucosa.

It is performed using special equipment called a colonoscope. It, in turn, is presented in the form of an optical fiber device.

Thanks to modern developments, doctors have a unique opportunity to study the processes that occur in the human colon.

Who is assigned the study?

Most often, the procedure allows you to identify such deviations:

inflammatory processes in the body, these include ulcerative colitis and Crohn's disease;
the presence of polyps in the intestine;
colorectal cancer.

During a colonoscopy, the specialist, depending on the situation, may decide to take a tissue sample for further study.

If necessary, during the examination, polyps can be removed. They are benign. But if they are not removed in a timely manner, then the polyps develop into a cancerous tumor.

Even though this procedure is the best for examining the intestinal mucosa, in some situations the doctor may not see everything that interests him. Such cases occur in approximately 5% of studies.

This situation can be caused by a full intestine or the inability of the colonoscope to move along the entire length of the intestine.

Colonoscopy is a modern study, so its capabilities are quite wide range:

using the procedure removal of foreign bodies from the rectum;
can restore intestinal patency if there was a sharp narrowing;
polyps and tumors are removed;
procedure makes it possible to stop bleeding in the intestines in a timely manner;
using this method tissue sampling possible for further histological study of their origin.

Colonoscopy is mandatory in cases where there are relatives with colon cancer. It is also carried out with suspicion of any bowel disease.

Contraindications for colonoscopy

You need to know that colonoscopy is strictly prohibited in such cases:

infectious diseases of the acute nature of the course;
diagnosis of peritonitis;
severe degree of pulmonary or heart failure;
severe course of ulcerative and ischemic colitis.

In order to establish whether such violations exist in the patient, it is necessary to undergo a preliminary examination. But on its basis, the specialist will draw a conclusion and decide on further measures to treat the disease.

Preparation for the procedure

In order to obtain accurate and correct examination results, the intestines should be free of fluid and feces.

For this, special preparation for colonoscopy is carried out, which consists in the following:

A couple of days before the study, the patient must follow a diet, which should consist of legumes, fresh vegetables and fruits, cabbage, black bread and some types of cereals.
Be sure to do a complete bowel cleansing.. This can be done in several ways. The first is to take the drug "Fortrans". It must be consumed for one day before the study itself. The second consists of carrying out 2-3 cleansing enemas. They need to be done before going to bed, as well as the day before the event itself.

In order to choose the safest preparation option, you need to consult with your doctor!

How is the research done?

The duration of a colonoscopy lasts from 30 to 45 minutes. The patient is required to wear a special shirt and shorts with a slit.

Diagnostic steps:

You can learn more about how a colonoscopy is performed and what intestinal polyps look like in the video:

Painless result

The colonoscopy procedure is painless, as pain medications are administered intravenously to the patient during the examination.

The patient may feel only some discomfort and bloating while the colonoscope is in his intestines.

Possible complications

Most of the time, there are no complications.

In rare cases, the following deviations may occur:

After removing the polyp or taking a sample, there is some bleeding. They are not plentiful and stop quite quickly.
Side effects can be caused by injected medications.
Tears in the walls of the intestines practically do not occur. Everything will depend on the experience of the specialist who conducts the study.

In this article, we will consider how an intestinal colonoscopy is performed - under anesthesia or without anesthesia. The lifestyle of modern people affects the nature of the most common diseases. Therefore, due to an unhealthy diet, along with a sedentary lifestyle, doctors are increasingly registering diseases in the lower regions of the digestive system. But if before doctors could examine the intestines only by palpation, by feeling the stomach of patients, then modern specialists have a more extensive choice of diagnostic methods.

Many people wonder which is better - a colonoscopy under anesthesia or without it?

Colonoscopy as part of the diagnosis

A progressive way to assess the general condition of the colon in humans today is a procedure called a colonoscopy. It is an examination of the digestive system of patients through a video camera, which is placed at the end of a flexible tube of a special device - an endoscope. During this procedure, the doctor examines the patient's intestines from the inside centimeter by centimeter, simultaneously collecting samples for analysis, in addition, removes polyps, which are various changes in the mucous membrane. Such polyps can degenerate into a malignant tumor. It is important to know how to prepare for a colonoscopy. More on that below.

When this procedure was only introduced into the practice of state clinics, this manipulation was considered painful. Any specialist could cause significant discomfort to the patient during the insertion of the tube. But at the same time, such a procedure did not imply any anesthesia. It is for this reason that many people, when they heard about the need for such an examination, tried to find a possible alternative because of the fear of pain. Where to do a colonoscopy, not everyone knows.

In fact, it is possible to examine the large intestine with the help of irrigoscopy, which is an x-ray examination, in which a contrast agent is injected into the organ cavity by means of an enema. The disadvantages of these methods include radiation exposure to the patient along with less information content, which today is recognized worldwide as the gold standard for colon cancer screening.

Let's figure out which is better - a colonoscopy under anesthesia or without it?

Colonoscopy and use of anesthesia

The problem associated with the pain of this procedure has already lost its relevance, as modern medical centers offer to perform it under anesthesia. The introduction of medications before performing the manipulation implies a different degree of anesthesia:

Colonoscopy under local anesthesia involves lubricating the tip of the endoscope with a substance that slightly reduces discomfort during insertion of the tube into the rectum. True, the feeling of pain during the procedure, as a rule, can be caused not by direct contact of the device with the mucous membrane, but by forcing air into the intestines. Unfortunately, local anesthesia does not relieve this discomfort.
Colonoscopy during sleep. For this version of the procedure, superficial anesthesia is used, in other words, sedation. The patient is injected with a drug that has a hypnotic effect. Under its influence, discomfort is significantly dulled, and the examination itself is completely painless. You do not need to use it. You also do not have to stay in the clinic for a long time after a colonoscopy, since the effects of anesthesia pass very quickly, and there is no memory of the procedure.
Colonoscopy using This type of diagnosis is carried out in an operating room. Patients under the supervision of an anesthesiologist are immersed in a deep sleep. This sleep lasts, as a rule, a little longer compared to the procedure itself. This option is usually used to examine people with a low threshold of pain sensitivity, as well as against the background of adhesive bowel disease, when a colonoscopy is performed on a child under the age of twelve. Consider the indications for this procedure.

Indications for colonoscopy under general anesthesia

People often ask: "Which is better - a colonoscopy with or without anesthesia?". Most often, patients prefer to opt for such a diagnosis using anesthesia in the form of sedation. This method is painless and eliminates the possible complications of general anesthesia. As a rule, a referral for this examination is issued by the attending general practitioner or a narrow specialist who notices deviations in the state of health of his patient. So, a colonoscopy under anesthesia is prescribed in a number of the following situations:

low hemoglobin level in the general analysis, that is, anemia without any obvious reasons;
the presence of bleeding in the intestines or black stools;
problems associated with bowel movements, which are expressed in chronic constipation, diarrhea, sensation of a foreign body in the rectal area, and the like;
a regular feeling of fullness in the intestines, which is accompanied by increased gas formation along with chronic indigestion;
unexplained weight loss along with increased fatigue;
an excess of specific oncomarkers as a result of a blood test;
examination of patients suffering from nonspecific ulcerative colitis or Crohn's disease;
examination of people at risk of developing tumors in the colon.

Such patients include relatives in whose families there were cases of bowel cancer. This category also includes people who have been treated for cancer in the past.

It must be emphasized that screening colonoscopy can be indicated for all people who are over forty-five years of age. Starting from the indicated age, it is recommended to undergo this procedure annually.

You can get pre-colonoscopy instructions from your doctor.

Contraindications for the procedure

Despite the fact that an anesthetic colonoscopy is a common procedure, some people would still be better off skipping the procedure. So, the examination is contraindicated in the following cases:

in the presence of acute infectious diseases;
peritonitis or suspicion of it;
severe blood clotting disorders;
late stages of heart failure;
the presence of stenosis of the heart valves;
allergy to anesthetic medications;
neurological and psychiatric diseases;
epilepsy;
during pregnancy.

It should be noted that none of the listed conditions is a complete contraindication to performing a colonoscopy examination under general anesthesia. It is extremely important to discuss the individual characteristics of the organism with the endoscopist so that the specialist can decide on the appropriateness of diagnosing, taking into account the possible benefits and risks of the procedure. In the case of the appointment of a study, it is required to pay attention to the preparatory measures. Such a measure will help facilitate the task of the doctor, in addition, it will positively affect the patient's condition during and after the procedure.

Given that during the diagnosis, the doctor will examine the colon, it is extremely important to first clean the mucous membrane. The desired effect is difficult to achieve with an enema. That is why patients are advised to prepare in advance with the help of diets and medicines sold in any pharmacy. Proper preparation for a diagnostic colonoscopy typically involves the following two steps:

Three days before the procedure, it is required to stop eating fatty meats. It is forbidden to eat fish along with dairy products, cereals, cereals, rye bread. It is also important to avoid fresh fruits and vegetables. Alcoholic drinks, carbonated water, hot spices and canned food are prohibited. It is allowed to eat white bread and broths along with lean meat, eggs, pasta, rice, boiled potatoes, butter. You can drink juice or jelly. Bowel cleansing for colonoscopy is essential.
On the eve of the procedure, the patient must take a laxative. As part of the preparation of the intestine for the examination, a solution of polyethylene glycol or drugs such as Duphalac and Fortrans are prescribed. In addition, the person will need to drink two liters of fluid the day before the examination. Two more liters are drunk on the day of the procedure if it is scheduled for the afternoon. If less than a day is allotted for preparation, the entire volume of the solution is drunk from four to eight in the evening.

Preparation for anesthesia during colonoscopy is carried out directly on the day of the procedure itself. In this case, in the morning you should refuse to eat and drink. It is also important to remove contact lenses with dentures before the corresponding manipulation.

Where to do a colonoscopy? The procedure can be performed at any medical institution or diagnostic center.

Under anesthesia

In the treatment room, patients are asked to remove their clothing below the waist. The person is laid on the left side on the couch. In this case, the patient should pull his knees to his chest. Next, the anesthesiologist injects the drug for anesthesia into the vein, after which the patient falls asleep. According to the general sensations, this, as a rule, is similar to a normal dream, however, a very short one. During this period of time, the doctor inserts a tip lubricated with special oil.

The endoscope is inserted through the anus into the rectum. The device then enters the large intestine. Using the image that is displayed on the monitor screen, the specialist examines the mucous membrane. In the event that the need arises, the doctor may stop in order to take an x-ray, or remove the polyp, or take a sample. After the examination is completed, the doctor removes the tube from the intestines, and the anesthesiologist wakes the patient up and asks about his well-being.

Duration

The total duration of a colonoscopy procedure using anesthesia based on a sedative drug is from fifteen to thirty minutes. Patients usually feel well at the same time, noting only mild weakness upon awakening. Immediately after the completion of this procedure, a person can drink or eat, and after half an hour he is sent home or to work.

What are the possible complications after a colonoscopy?

In the vast majority of situations, colonoscopy is performed without any complications. The patient does not experience discomfort, pain, bloating, or severe weakness. But in the event that these symptoms are noted immediately or a few hours after this procedure, if the patient has a fever and nausea along with bloody discharge from the rectum, then you should immediately seek medical help.

Rare, but very dangerous complications include damage to the intestinal walls and respiratory arrest during anesthesia, rupture of the spleen and infection of the patient with hepatitis B, as well as other infectious diseases. For this reason, it is extremely important to approach the choice of the clinic where you plan to undergo a colonoscopy with responsibility. Preference should be given to a medical institution, which is famous for its impeccable reputation, extensive experience in carrying out this manipulation.

Cost of a colonoscopy

The cost of this procedure with anesthesia in Russian clinics ranges from 4,000 to 20,000 rubles. Such a large gap in price is associated not only with the level and quality of equipment, it depends on the service in a particular medical institution, on different approaches to the formation of the cost of the presented methodology.

As a rule, the clinics that offer the lowest price for colonoscopy do not include anesthesia fees and anesthesiologist fees in the price. Diagnostic and therapeutic manipulations required during the procedure may also not be taken into account. For example, we are talking about taking samples of the mucosa with their further histological examination, removal of small polyps, and the like. The total cost of this diagnostic method is very impressive and unexpected for patients.

Expensive consultation

In other cases, the attractive cost of colonoscopy under anesthesia can be combined with an expensive consultation of gastroenterologists, without which the passage of this procedure according to the rules of the clinic is considered impossible. Therefore, patients should clarify all the conditions for undergoing a colonoscopy in advance, do not hesitate to ask additional questions. We should also not forget that it is not worth saving on diagnostics, since health directly depends on the quality of work of a specialist and general standards of medical care.

And yet, what is better - a colonoscopy under anesthesia or without it, the doctor must decide.

With this pathology, the patient will experience the following symptoms:

frequent diarrhea with impurities of blood, mucus and pus.
pain, most often in the left side of the abdomen;
body temperature up to 39 degrees;
loss of appetite;
weight loss;
general weakness.

With the help of colonoscopy, a detailed examination of the sections of the large intestine is performed with the aim of early detection of small erosions and ulcers in the mucous membrane. benign tumor(polyps) Polyps are formed due to the growth of tissue and have various sizes and shapes. These can be mushroom-shaped or flat villous tumors ranging in size from a few millimeters to several centimeters.
As a rule, the presence of a benign tumor in the large intestine is not clinically manifested. In about 60% of cases, a benign tumor degenerates into a malignant formation ( crayfish). To avoid possible complications, it is important to detect the tumor as soon as possible and remove it. Both are done with colonoscopy. Diverticula A diverticulum is a pathological formation that is characterized by a protrusion of the wall of the large intestine.

With this pathology, the patient may experience the following symptoms:

pain, usually in the left side of the abdomen;
frequent constipation, which alternate with diarrhea;
bloating.

Colonoscopy is the most informative method for diagnosing diverticulitis. Intestinal obstruction Intestinal obstruction may occur due to mechanical obstruction ( e.g. foreign body), as well as due to impaired motor function of the large intestine.

This pathology is accompanied by the following symptoms:

sudden pain in the abdomen;
stool retention;
bloating;
nausea and vomiting.

With the help of colonoscopy, the true cause of intestinal obstruction is revealed. Also, with the help of a colonoscope, foreign bodies are removed.
Every year, a colonoscopy is mandatory for all people at risk. This group includes patients with ulcerative colitis or Crohn's disease, as well as those who have previously undergone surgery on the large intestine. Another risk group includes people whose direct relatives had tumors or colon polyps.

Preparing for a colonoscopy

Before conducting a colonoscopy, special preparation is required, it is this that is the key to the high reliability of the results of the study.

Before performing a colonoscopy, the following recommendations should be observed:

stop taking antidiarrheal, as well as iron-containing drugs;
increase fluid intake;
follow all doctor's recommendations regarding preparation.

Preparation for a colonoscopy includes the following steps:

preliminary preparation;
purgation.

Preliminary preparation

Currently, preparation for colonoscopy is carried out by ingestion of special laxative solutions. However, if the patient has a tendency to constipation, then combined preparation may be recommended.

To do this, the patient may pre-assign:

ingestion of castor oil or ricin oil.
conducting an enema.

Ingestion of castor oil or ricin oil
The required amount of oil to take is set depending on the patient's body weight. If the weight is, for example, 70 - 80 kg, then 60 - 70 grams of oil is prescribed, which must be taken at night. If emptying with oil was successful, then the procedure is recommended to be repeated. However, it should be noted that this preparation can be performed in patients who have no contraindications ( for example, the presence of individual intolerance to the components of oils).

Conducting an enema
If the preparation is carried out with the help of laxatives, then cleansing enemas are usually not required. However, if the patient suffers from severe constipation, then in this case, cleansing enemas may be recommended as a preliminary preparation.

To give an enema at home, you must:

It is necessary to purchase Esmarch's mug;
Dial about one and a half liters of warm water into Esmarch's mug ( room temperature), after closing the clamp to prevent water from flowing out of the handpiece;
After filling the enema, it is necessary to remove the clamp and release the flow of water from the tip, this is done in order to prevent air from entering the intestines;
The person lies on the left side it is recommended to put an oilcloth under the side, and a towel on top of it), the right leg should be pushed forward, bending it at the knee 90 degrees;
The prepared mug of Esmarch must be hung one to one and a half meters from the level of the couch or sofa on which the person lies;
Then the tip must be lubricated with petroleum jelly to prevent injury to the anus, after which the enema should be administered to a depth of about seven centimeters;
Only after the tip has been inserted into the anus should the clip be carefully removed from the enema;
After completing the procedure, the tip must be carefully removed, slowly rise and walk a little, retaining the liquid in the intestines for about five to ten minutes, in order for the cleansing to be most effective.

For preliminary preparation, an enema is recommended to be performed twice in the evening.

Note: It should be noted that self-conducting enemas require special skills, so this method of preliminary preparation is rarely resorted to.

After two days of pretreatment with oil ingestion or enemas, patients with a history of constipation are given the main method of preparing for colonoscopy ( laxatives and diet).

Diet

Two to three days before the colonoscopy, a slag-free diet should be followed, the purpose of which is to effectively cleanse the intestines. At the same time, it is recommended to exclude foods from the diet that cause fermentation, bloating, and also increase the formation of feces.

Foods to Avoid	Products that are allowed to be consumed
fresh vegetables ( cabbage, radish, beet, garlic, onion, carrot, radish).	boiled vegetables.
fresh fruits ( grapes, peaches, apples, oranges, bananas, apricots, tangerines).	dairy products ( sour cream, cottage cheese, kefir, yogurt, ryazhenka).
legumes ( beans, peas).	vegetable soups.
black bread.	white bread croutons, crackers, white bread.
greens ( spinach, sorrel).	boiled eggs.
smoked meats ( sausage, meat, fish).	lean meats ( chicken, rabbit, veal, beef).
marinade and pickles.	lean fish ( e.g. hake, zander, carp).
certain cereals ( barley, oatmeal and millet porridge).	cheese, butter.
chocolate, chips, peanuts, seeds.	weakly brewed tea, compotes.
milk, coffee.	jelly, honey
carbonated drinks, alcohol.	still water, clear juices.

Note: On the evening before the study, it is recommended to refuse dinner, and in the morning on the day of the study, breakfast should not be eaten.

Purgation

Currently, special laxatives are most widely used to cleanse the intestines. Before performing a colonoscopy, the doctor individually prescribes the appropriate remedy based on the patient's indications and contraindications.

Most commonly used bowel cleansers

Name of the drug	Cooking method	Mode of application
*Fortrans*	One sachet is designed for 20 kg of body weight. Each sachet should be diluted in one liter of warm, boiled water. If, for example, a person weighs 60 kg, then it will be necessary to dilute three bags in three liters of water.	The prepared volume of liquid must be drunk in the evening at one time or every fifteen minutes, take 250 ml of the solution.
*Endofalk*	Two sachets must be diluted in 500 ml of warm boiled water, mixed thoroughly, after which another 500 ml of cool water should be added. For a complete bowel cleansing before a colonoscopy, it is recommended to take three liters of the solution. That is, for one liter of water you need two bags of funds, and for three liters - six. This solution is not prepared depending on the body weight of a person.	The resulting solution must be taken from five to ten in the evening. That is, for five hours it is necessary to take three liters of the drug.
*Fleet Phospho-soda*	The package contains two bottles 45 ml), each of which should be dissolved in 120 ml of boiled cold water before use.	When administered in the morning, the prepared solution should be drunk after breakfast. The second portion of the solution should be taken after dinner. With a daily appointment, the solution is drunk after dinner, and the second portion of the drug is taken on the day of the procedure after breakfast. Drinking solutions in both the first and second cases should be washed down with one or two glasses of water.
*Lavacol*	The package contains fifteen bags containing the powder. One sachet ( 14g) must be diluted in 200 ml of warm boiled water.	It should be taken eighteen to twenty hours before the upcoming study. The total amount of solution to be taken is three liters. From two in the afternoon to seven in the evening, every 15 to 20 minutes, you should drink 200 ml of the solution.

The main mechanism of action of Fortrans and Endofalk drugs is that these drugs prevent the absorption of substances in the stomach, as well as the intestines, which leads to faster movement and evacuation of the contents ( in the form of diarrhea) gastrointestinal tract. Due to the content of electrolytes in laxative preparations of salts, a violation of the water-salt balance of the body is prevented.

The effect of Fleet Phospho-soda and Lavacol is that there is a delay in the removal of water from the intestines, which leads to the following changes:

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

What diseases are detected by colonoscopy?

Colonoscopy can detect the following diseases:

colon polyp;
colon cancer;
nonspecific ulcerative colitis;
Crohn's disease;
diverticula of the large intestine;
intestinal tuberculosis.

Disease	Description of the disease	Symptoms of the disease
*colon polyp*	Violation of the process of cell renewal, the intestinal mucosa can lead to the formation of growths, that is, polyps. The danger of polyps is that, if left untreated, they can transform into malignant tumors. Colonoscopy in this disease is the main method of diagnosis. It is also possible to remove a polyp using a colonoscope.	As a rule, this disease is asymptomatic for a long time. In some cases, a patient may develop bleeding from a polyp, which will be manifested by the presence of blood in the stool.
*colon cancer*	Colon cancer is a malignant tumor that develops from the cells of the mucous membrane of this organ. Colonoscopy allows timely diagnosis of the development of cancer.	In the early stages, a bowel tumor may not manifest itself in any way. However, at later stages, clinical signs such as impaired stool develop ( constipation or diarrhea), the presence of blood in the stool, anemia, as well as pain in the abdomen.
*Nonspecific ulcerative colitis*	Nonspecific ulcerative colitis is an inflammatory bowel disease. The exact cause of the development of this disease has not been established to date. The defeat of the large intestine in ulcerative colitis always begins with the rectum, and over time, inflammation spreads to all parts of the organ. Colonoscopy helps to identify nonspecific ulcerative colitis in time. Also during treatment with the help of this research method, the healing process is monitored.	diarrhea; impurities of mucus or blood in the stool; loss of appetite; weight loss; pain in the abdomen; increase in body temperature; weakness.
*Crohn's disease*	Crohn's disease is a chronic non-specific inflammation of the gastrointestinal tract. As a rule, this disease affects the intestines, but the esophagus and oral cavity can also be observed. The exact cause of the development of Crohn's disease has not yet been identified, but such causes as heredity, genetic mutations, and autoimmune processes are distinguished as predisposing factors. Colonoscopy for this disease allows you to identify and determine the degree of inflammation, the presence of ulcers, as well as bleeding.	pain in the abdomen; diarrhea; loss of appetite; nausea and vomiting; weight loss; decrease in working capacity; increase in body temperature; weakness.
*Diverticula of the large intestine*	Diverticula are protrusions on the intestinal wall. This disease is observed, as a rule, in the elderly. The main reason for the development of diverticulum is the dominance of meat and flour products in the food consumed, as well as a significant decrease in plant foods. This leads to the development of constipation and the appearance of diverticula. Also, the development of this disease is influenced by factors such as obesity, flatulence and intestinal infections. Colonoscopy in this disease allows you to see the mouth of the diverticulum, as well as determine the presence of inflammatory processes.	In the uncomplicated form, colonic diverticulitis may be asymptomatic. Later, the patient may experience symptoms such as impaired stool ( constipation and diarrhea), bloating and pain in the abdomen. In the case of inflammation of the diverticulum, diverticulitis may develop, in which the patient will experience an increase in the above symptoms, as well as an increase in body temperature and blood in the feces.
*Tuberculosis of the intestine*	Intestinal tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. As a rule, this disease is secondary, since initially mycobacteria affect the lungs and only then are they brought into the intestine by the hematogenous or lymphogenous route. Colonoscopy for intestinal tuberculosis is performed to establish a diagnosis and take a biopsy if necessary.	Initially, this disease manifests itself in the patient with general symptoms, such as fever, severe sweating, loss of appetite and body weight. Also from the intestines, diarrhea, blood impurities in the feces, as well as pain in the abdomen are observed.

Contraindications for colonoscopy

There are relative and absolute contraindications for colonoscopy.

Absolute contraindications

Contraindication	The reasons
*Acute myocardial infarction*	Acute myocardial infarction is a serious condition that can be fatal, so any endoscopic intervention during this period is contraindicated.
*Perforation of the intestinal wall*	Perforation of the intestinal wall leads to active bleeding, which is eliminated by surgery.
*Peritonitis*	Peritonitis is an inflammation of the peritoneum, in which the patient's condition is extremely severe. In this case, emergency surgery is performed as a treatment.
*Late stages of pulmonary and heart failure*	These disorders are characterized by severe circulatory disorders. Patients in these cases are in an extremely serious condition, in which endoscopic interventions, including colonoscopy, are recommended to be excluded.

Relative contraindications

Contraindication	The reasons
*Poor colonoscopy preparation*	If the patient has performed poor-quality preparation for colonoscopy, then the presence of intestinal contents in the colon will not allow an effective study.
*Intestinal bleeding*	In most cases ( 90% ) intestinal bleeding can be stopped with the help of colonoscopy, however, in the case of massive acute blood loss, bleeding is stopped surgically.
*The general serious condition of the patient*	The general serious condition of the patient is a contraindication to many studies. This is due to the fact that such patients are prescribed strict bed rest. Also, patients in serious condition are contraindicated in anesthesia, which in some cases is necessary for colonoscopy.
*Decreased blood clotting*	During colonoscopy, even minor damage to the intestinal mucosa can cause bleeding.

Colonoscopy of the intestine is a modern method of examining most of the area of the large intestine using a colonoscope - a special device in the form of a long and fairly flexible probe, which has an eyepiece, a backlight, a tube through which air is supplied to the intestine, and forceps for taking tests. . The colonoscope makes it possible to examine the condition of the colon at a distance of more than one meter from the entrance. Some devices also have a camera that allows you to not only capture visible parts of the intestine, but also display them on the screen.

Colonoscopy allows:

analyze the color and reflection of the mucous membrane, as well as the vessels of the mucous layer;
assess the size of the lumen and the motor function of the colon;
see all inflammatory processes and formations located on the mucous membrane (hemorrhoids, ulcers, cracks, scars, etc.);
take a sample of a small piece of the neoplasm and biopsy the result;
in some cases, remove the pathological tumor;
remove any foreign body;
eliminate the source of bleeding.

When should a colonoscopy be done?

Experienced experts believe that a colonoscopy examination should be done by any healthy person over the age of 30 once every five years. If the patient has pain, characteristic burning sensations, or any other symptoms of a violation of the normal functioning of the intestine, a colonoscopy is carried out immediately. You urgently need to see a doctor if you notice that you have:

pus, blood or mucus began to stand out from the large intestine;
for several days they do not stop, but, on the contrary, pain in the abdominal cavity becomes more frequent;
broken stool;
there is an inexplicable bout of anemia;
irrigoscopy diagnosed a tumor of the abdominal cavity;
a foreign object got into the intestine, etc.

Some patients have contraindications for colonoscopy. So, this study is not carried out in cases where the following inflammatory processes occur in the body: infectious diseases, poor blood clotting, peritonitis, ulcerative colitis.

Preparing for a colonoscopy

In order for the process of examining the intestinal mucosa to go without interference and side effects, the patient needs to properly prepare for colonoscopy. This preparation is no different from preparing for other types of bowel examinations. For several days before the colonoscopy, the patient must follow a sparing diet and thoroughly cleanse his body of foreign objects. The diet of a slag-free diet includes a list of foods and dishes that contain a large amount of dietary fiber. The patient should not eat flour and confectionery products, bread, any vegetables (especially cucumbers, herbs, radishes) and fruits, berries, legumes, buckwheat and barley cereals, as well as sour-milk products and carbonated drinks. The diet should include lean boiled meat, poultry or fish, vegetable soups and meat broths, clean water, infusions and tea without sugar. On the eve of the procedure, you need to do with dinner in the form of a small amount of tea or water, and in the morning empty the intestines with an enema. During the preparation for the colonoscopy, the patient is allowed to drink laxatives (Fleet, Fortrans, etc.).

How is a colonoscopy procedure performed?

The technique for conducting this type of examination is quite fast, simple and easy. The patient needs to be naked below the waist and lie down on a hard surface, leaning on the left side. The legs are bent at the knee and pressed to the stomach. After the patient is ready to start the examination, the doctor slowly, carefully and gently inserts the device directly into the colon. For those who are hypersensitive to such procedures, the anus is lubricated in advance with various gels and ointments that have anti-inflammatory and anesthetic effects. The colonoscope slowly moves into the colon, examining its mucous membrane. In order to straighten the intestines, a small amount of air is pumped into them. The whole procedure takes no more than 10-15 minutes. After its completion, the patient may experience slight drowsiness and weakness.

Diseases of the large intestine are most often accompanied by defecation disorders (passage or constipation), bloating, mucus or blood in the stool. Most patients are embarrassed to talk about these problems to the doctor. However, the frequency of oncological lesions of the large intestine is steadily increasing. Most often, the problem is detected already in the late, untreatable stages. For early diagnosis of intestinal pathologies, an endoscopic colonoscopy method is used, which allows you to assess the structure and functioning of the organ, as well as carry out minor medical manipulations.

What is the study

Colonoscope - a device for conducting research (photo: www.tehnopark-service.narod.ru)

Colonoscopy (from "colon" - large intestine, "scopeo" - to explore) is a method for diagnosing diseases of the intestine using a colonoscope.

A colonoscope is an endoscopic fiber optic device, which is a long flexible tube. Inside the device there are about 3000 thin glass fibers through which light enters the area under study. On the monitor screen or in the eyepiece - an image. The instrument is inserted into the intestinal lumen through the anus, the area from the otkhodnik to the final section of the small intestine is examined.

The flexibility of the instrument allows manipulations with rotation for a more detailed examination of the area of interest. In addition, there are two additional channels:

For supply and intake of air or liquid. Inflating the intestinal loops allows you to increase the field of view or detect changes in areas hidden by folds.
Working channel through which instruments are passed. During the study, a biopsy is often taken (taking a piece of tissue for laboratory analysis) with special forceps, or bleeding is stopped with a coagulator.

The study is carried out by an endoscopist in a specially equipped office of a hospital or clinic. The duration of the procedure is from 10 to 60 minutes, depending on the need for medical manipulations.

Indications for a colonoscopy

The appointment of the study is carried out in the presence of symptoms of damage to the large intestine: blood in the stool, pain in the lower abdomen, diarrhea, violations of the act of defecation or to confirm the diagnosis established by other methods (computed tomography or ultrasound). The procedure is indicated for such diseases:

Nonspecific ulcerative colitis or Crohn's disease - inflammatory diseases of the large intestine, accompanied by a violation of the integrity of the wall, the occurrence of superficial and deep ulcers. These pathologies are a common cause of blood in the stool.
Intestinal polyps are benign neoplasms from the mucous membrane that look like a mushroom: a thick head on a thin stalk. Most often, there is a genetic predisposition to the appearance of polyps (familial polyposis).
Colon cancer is a malignant lesion of an organ, which can be in the form of a tumor that blocks the movement of feces and causes constipation. Another option is a deep ulcer, which is often the source of intestinal bleeding.
Diverticula - pathological protrusions of the intestinal wall, often occur in the elderly due to muscle weakness.

In addition, the method is used to diagnose congenital anomalies in the development of the intestine, stop small bleeding and remove benign tumors.

The incidence of cancer increases in people over 50 years of age. At a young age, inflammatory pathologies are more often detected.

Doctor's advice. For people who have no complaints, a colonoscopy is recommended at age 50 and every 10 years thereafter. The frequency of the procedure for people with a burdened history is determined by the attending physician

Contraindications for the study

The procedure is associated with the filling of the intestine with air and an increase in intra-abdominal pressure, which limits the possibility of conducting a study. The colonoscopy procedure is contraindicated in such cases:

The presence of symptoms of an acute abdomen: acute cutting pain and muscle tension in the affected area, positive symptoms of peritoneal irritation. Most often, these signs are characteristic of acute appendicitis, cholecystitis, or perforation (breakthrough of a hole in a hollow organ) of an ulcer.
In the early postoperative period after intervention on the organs of the abdominal cavity and small pelvis.
In the presence of a hernia: an increase in pressure within the intestinal lumen can cause the protrusion to be incarcerated. This condition is an indication for emergency surgery.
Decompensated diseases of the cardiovascular and respiratory systems.
Pregnancy at all times.
Bowel perforation transferred within the last 6 months.

In addition, the study should be postponed in patients who feel cramping pain or severe abdominal discomfort on the day of the colonoscopy.

Study preparation

Before a colonoscopy, tell your doctor about all medications you are taking. This is especially true for patients who use drugs that affect blood clotting (Aspirin, Warfarin).

Important! Dose adjustment and withdrawal of the drug is carried out only after consultation with the attending physician.

Patients who have an artificial heart valve are given antibiotics for 3 days before the procedure.

Good visualization of the intestinal walls is possible only after its complete cleansing. For this, the patient is recommended the day before the study:

Drink at least 1.5 liters of water or a special cleaning solution.
Taking laxatives (for example, Dufalac).
3-4 hours before the procedure - a cleansing enema.

The objectivity and information content of the study depends on the implementation of the recommendation. In case of insufficient visualization of the walls of the colon (for example, in the presence of residual feces in the lumen), the procedure is terminated and a date for re-conduct is assigned.

How is a colonoscopy performed?

The study may be accompanied by unpleasant sensations: pressure in the abdomen, pain, cramps. Therefore, before the procedure, patients are intravenously injected with sedatives (sedatives) that reduce pain and relax the tense muscles of the anus. In addition, when a feeling of fullness in the abdomen appears, the patient is advised to take a deep breath, which relieves the tension of the intestinal muscles.

During the study, the patient takes off his clothes and lies on his left side. The end of the colonoscope is lubricated with petroleum jelly or glycerin for easy passage through the anus. The device is gradually advanced to the lumen of the blind or final part of the small intestine.

Analysis of the state of the intestine is carried out during the reverse movement of the colonoscope. The doctor evaluates the color, relief and integrity of the wall, the presence of formations. To increase the field of view, a small amount of air is introduced through an additional channel, which straightens the wrinkles. If a suspicious area is found, a tissue sample is taken for examination (biopsy).

Therapeutic colonoscopy involves the introduction of special tools to remove polyps and stop bleeding from small vessels. In case of unsatisfactory visualization of the intestine, the doctor decides on the need for a second study.

The average duration of the study is from 10 to 60 minutes.

Advantages of the method

After the introduction of colonoscopy into clinical practice, the number of patients who decided to study the colon has increased significantly. The choice of this method is due to high information content and safety.

Comparative characteristics of colonoscopy and the previously used barium enema X-ray examination are shown in the table.

Criterion	Colonoscopy	barium enema
How to get information	Visualization of the intestinal lumen in real time using a miniature camera placed at the end of the instrument	X-ray of intestines filled with barium sulfate contrast solution
Diagnostic capabilities	Detection of pathology, shape, size and localization. The structure is assessed and the effect on surrounding tissues is assessed.	Pathologies of considerable size are diagnosed. Often there are "false positive" results when residual feces are taken for pathology
Method safety	In the case of taking into account contraindications and observing the rules for preparing for the study, complications do not arise.	The dangers of x-rays
Reliability of results	Colonoscopy allows diagnosing tumor formations with an accuracy of up to 90%. The possibility of biopsy allows you to establish an accurate diagnosis	The method is uninformative for small formations

In addition, the method is the "gold standard" for diagnosing diseases of the large intestine, since it allows for therapeutic manipulations and sampling of material for histological examination.

Possible complications after the procedure

After a colonoscopy, undesirable consequences occur extremely rarely. Possible complications include:

Bleeding that occurs at the site of a biopsy or polyp removal. Most often, blood loss is insignificant and tends to self-destruct due to the formation of blood clots that clog the vessel.
Perforation (perforation) of the intestine. The condition occurs due to rough advancement of the colonoscope or thinning of the intestinal wall. This condition occurs less frequently than bleeding and is treated without surgery.
Allergic reaction to the drugs used: localized (redness and swelling at the injection site) and generalized (with damage to the general blood flow). The frequency of occurrence is less than 1%.

Despite the fact that undesirable consequences of colonoscopy are rare, it is necessary to identify early signs of complications for timely emergency care. In case of fever, chills, severe abdominal pain or massive bleeding from the anus, the colonoscopist must stop the study.

How to interpret colonoscopy results

The study involves not only treatment, but also the final diagnosis of pathologies of the large intestine with a biopsy. During the procedure, the doctor evaluates the length and lumen of the final section of the digestive tract, the color of the mucous membrane and its structure, the presence of neoplasms, indicating the shape and size. If a suspicious area is found, material is taken for laboratory analysis.

Normally, the mucous membrane of the large intestine is pale pink, smooth and shiny. The diameter and shape of the intestinal lumen varies in different sections (for example, in the transverse rim - 3-coal, due to the muscle layer, represented by bundles of ribbons). In the lower parts of the rectum, the mucous membrane acquires a fine-grained surface due to the large number of lymphatic follicles in the wall of the organ.

Changes that are characteristic of individual pathologies are presented in the table.

Disease	Colonoscopy picture
Diverticular bowel disease	Increased tone in the affected segment. Spasm and thickening of the folds. The presence of mouths of diverticula (diameter from 0.5 to 2 cm). In the lumen of the formation - intestinal contents
Nonspecific ulcerative colitis	The mucous membrane is bright red, edematous. The surface is rough, grainy. With the progression of the disease - small hemorrhages and superficial defects (erosion). White formations are found in the thickness - “microabscesses”. narrowing of the lumen
colorectal cancer	In the lumen of the intestine, a neoplasm of irregular shape. Uneven polyp color, rough (granular) surface. Contact bleeding of the tumor. Increased blood flow in the area of education. Local discoloration of the mucous membrane, swelling of adjacent tissues

In case of insufficient information content of the study, the doctor decides on further diagnostic tactics. It is possible to repeat colonoscopy without prior preparation or use video capsule endoscopy to assess the condition of the digestive tract from the esophagus to the rectum.

The video below shows the research technique.