To date, the main means of diagnosis of the intestine is endoscopy. Thanks to this procedure, you do not need an operation to see the doctor personally - what happens inside the digestive organs of the patient.
For this research, a flexible thin probe with a micro-camera on the end is often used. In addition, through this device you can conduct medical activities.
- Indications for endoscopic examination of the intestine
- Methods for endoscopic intestinal diagnostics
- How to prepare for intestinal endoscopy?
- Patient's sensations and complications
Indications for endoscopic examination of the intestine - diseases and pathologies that help to identify endoscopy
This manipulation is performed when the following pathologies are suspected:
- Malignant neoplasms in the intestine. When and how to start looking for cancer?
- Multiple adenomatous polyps in the large intestine. The reason for endoscopy of the intestine is the presence of family polyposis in close relatives of the patient.
- Erosive colitis.
- Systemic diseases of the body, in which the organs of the gastrointestinal tract are involved in the degenerative process: amyloidosis, vasculitis, collagenosis.
- Peptic ulcer of the duodenum.
- Celiac disease.
- Crohn's disease.
The following pathological conditions may serve as an occasion for endoscopic examination of all parts of the intestine:
- Discomfort in the rectal area.
- Blood, mucus or pus in stool. Rectal bleeding requires an emergency colonoscopy.
- Unexplained weight loss.
- Alternation of constipation with chronic diarrhea.
- Pain sensations in the area of the large intestine. Localization is determined by the doctor during palpation.
- Increased body temperature, which is accompanied by a violation of the stool, vomiting, bloating.
During follow-up, repeated studies are performed to assess the rate of healing of the ulcer, the presence / absence of inflammatory processes, swelling, and other pathological phenomena in the intestinal cavity.
Methods of endoscopic intestinal diagnostics - pros and cons, indications for the research
To date, there are several methods for studying the state of the bowel with the use of endoscopic techniques:
It can be used to study the structure of the lower part of the large intestine.
The size of a flexible endoscopic tube allows you to inspect the intestine at a distance of about 60 cm from the anus.
Often, this manipulation is prescribed for the following diseases:
- Malignant and benign neoplasm in sigmoid and / or rectum.
- Diffuse family polyposis.
The method of endoscopic diagnostics, through which it is possible to study the condition of the rectum, as well as the lower section of the sigmoid colon.
The general site of manipulations is 15-30 cm from the anus.
This type of examination is used for diagnostic and therapeutic purposes. With its help, you can identify a variety of neoplasms in the lower part of the colon: abscesses, fistulas, sores, hemorrhoids, inflamed tissues, infectious processes.
In contrast to the two previous techniques, this allows you to inspect the entire intestine. Due to its length and flexibility, the colonoscope is able to penetrate deep into the large intestine.
The doctor resorts to the type of endoscopy of the intestines under consideration when he is not sure of the exact location of the affected area - or he has suspicions of having multiple pathologies.
If the doctor is convinced that the problem area is in the rectum or sigmoid colon - the choice is made, respectively, in favor of sigmoidoscopy or rectosigmoscopy.
In addition, sigmoidoscopy is performed annually by individuals aged 50 years, for the purpose of prevention.
Provides an opportunity to assess the condition of the duodenum - and, if necessary, to conduct therapeutic activities.
The endoscopic tube is inserted through a plastic ring, which is pre-installed between the patient's teeth.
Thus, the technique in question allows us to study the state of the esophagus, stomach, and also take a biopsy sampling.
The most modern non-invasive technique that allows to diagnose the operation of the small intestine.
The main attributes of the examination - a capsule-tablet, equipped with a miniature video camera;belt or waistcoat that is fixed on the patient.
The process of passing the capsule through the gastrointestinal tract is recorded on a special device. The received information is processed on the computer for several hours. The diagnostic decrypts and gives its conclusion to the patient along with the pictures.
At the time of diagnosis, the patient is allowed to engage in routine activities - this does not affect the results in any way.
After 8 hours, the capsule is removed from the body naturally.
Capsular endoscopy is topical in cases where there are contraindications to alternative methods of research.
This type of diagnosis is painless, and is not fraught with any side effects. However, due to the high cost, not every patient can afford this manipulation.
In addition, when capsular endoscopy, in contrast to the above methods, it is impossible to take a biopsy specimen - or to perform therapeutic measures.
How to prepare for endoscopic examination of the intestine - recommendations for patients
Large intestine examination using endoscopic equipment, as well as before capsule endoscopy, requires long preparation.
It consists of the following activities:
- Consultation of doctor regarding the taking of certain drugs.
- Diet. 5 days prior to the manipulation, it is necessary to exclude foods containing grains: cucumbers, tomatoes, figs, raspberries, gooseberries, raisins, whole grain bread, etc. For three days, it is necessary to abandon the products that favor the formation of slags and gases. The most successful choice these days will be rice / buckwheat porridge, low-fat cheese / cottage cheese, fish / meat broth, steamed cabbage. Of the drinks allowed kefir, tea, compote. On the last day before the diagnosis, doctors are advised to refrain from food, but only to drink liquid: at least 3.5 liters. The last meal should be 14-15 hours before the examination.
- Bowel cleansing
There are several options for cleansing the intestine:
- Use of Esmarch mug( cleansing enema). The procedure should be done 2 times: the previous evening( about 22.00) to clean water and similarly in the morning, the day of the procedure. This method of cleaning is considered ineffective: it is not always possible to completely empty the intestine, and this can affect the result of the study.
- Reception in the evening with Fortrans .One packet of this powder is designed for 20 kg of body weight and it should be diluted in 1000 ml of warm water. One liter of the prepared solution should be drunk within an hour. A large amount of fluid can provoke attacks of nausea. To avoid this, after a glass of the mixture you can eat on a slice of lemon.
- Purification of the intestine with the help of Lavakol. It is advisable to do this a couple of hours after lunch the day before endoscopic diagnosis. This drug is divided into portions in such a way as to drink the whole necessary dose for 4-5 hours. In breaks, it is permissible to eat food, but exclusively liquid. For the same purpose, you can use the drug Endofalk or Pikoprep.
If patients are embarrassed by this moment, they must take care of purchasing special briefs for colonoscopy in advance. They are seamless, hypoallergenic, with a special hole. They can be found without any problems in almost any pharmacy.
Esophagogastroduodenoscopy does not require any preliminary preparation.
Patient sensations during intestinal endoscopy and after diagnosis - can there be complications, and how to avoid them?
In endoscopic examination of the intestine, a short-term intravenous anesthesia can be used only in a few cases:
- A child under 10 years of age is to be diagnosed.
- The patient has spikes in the intestine.
- The previous procedure was accompanied by severe pain.
- At the request of the patient.
- In the study of the duodenum through esophagogastroduodenoscopy.
The procedure for anesthesia requires prior consultation and the presence of an anesthesiologist.
Recto-manoscopy is a more painful procedure than sigmoidoscopy and colonoscopy. This is due to the inflexible rectoscope. For the other two manipulations, a flexible-and thinner-endoscope is used.
During the introduction of the endoscope, the patient experiences a feeling of gullet overflow, which can be felt by the urge to defecate and minor pain.
Soreness will intensify at the time of intestinal loops. After the completion of the manipulation, all these negative sensations disappear in connection with the evacuation of air.
Exacerbations in endoscopy of the intestine are often due to inadequate medical skills.
- Perforation of the gut. In this situation, urgent assistance is required from the surgeon.
- Bleeding in the intestine as a result of rupture of blood vessels. Hemorrhagia is stopped by cauterization of the damaged vessel.
- Intolerance to anesthesia. Eliminated through resuscitation.
- Pain sensations in the lower abdomen, fever, abdominal bloating the first few days after removal of polyps - a normal phenomenon. However, if such a condition is observed with routine diagnosis, as well as with rectal bleeding, vomiting should immediately consult a doctor.
- Hepatitis C may be the result of poor disinfection of instruments.
The first chair can be on the 3rd day after the study. With a limited amount of fiber in the diet, the first emptying occurs later.