Endoscopic methods of examination of the intestine: description and preparation. Diagnosis of the small intestine - methods and features of the examination Endoscopic examination of the intestine

Capsule endoscopy is often used in modern gastroenterology.

This method is very informative and progressive, allowing you to examine the inside of the esophagus and gastrointestinal tract completely safely and painlessly for the patient. Features of the use of capsule endoscopy are discussed in our information.

Types of capsules for diagnostics, their structure and application

The basis of the method is the use of special capsules equipped with a miniature camera, a sufficient battery supply and backlight to take pictures.

The camera works completely autonomously, capturing the entire path traveled at a frequency of up to two shots per second. Recording is carried out on an information carrier and allows you to review the received images any number of times.

The capsule is small in size, so it does not create difficulties when swallowed. The device comes out naturally, and the data obtained using such a capsule is analyzed by narrow specialists.

If necessary, the capsule endoscopy method is used in, as well as to detect neoplasms in the early stages.

The main manufacturers of capsules:

pillcam- made in Israel, the system's capabilities are able to diagnose the small intestine along its entire length.
Bravo- made in Switzerland, mainly used for diagnosing gastro-food reflexes.
Smart Pill- the invention of American specialists, is used in the examination of the entire gastrointestinal tract.
Motilis- a Swiss manufacturer, in addition to fixed images, gives a complete picture of the digestive processes.
AES-GTI- the development of Russian scientists, known as the "Kremlin tablet".

All capsules are single use and sterile, so there is no risk of infection from a previous patient. It is this factor that largely affects the cost of the procedure.

Advantages and disadvantages of the study

The capsule endoscopy method is extremely convenient for the patient and informative for the specialist.

It was first patented in 2001 by American scientists, but has since gained worldwide popularity.

Among its advantages: information content, the ability to repeatedly review the received images and analyze it by narrower specialists.

Do not forget that, unlike colonoscopy, the capsule technique is completely painless for the patient and does not cause discomfort.

Capsule endoscopy can detect the following conditions:

The presence and localization of internal .
Damage to the mucous membrane of all parts of the esophagus, stomach and intestines.
The presence and dynamics of development, and other neoplasms.
Ulcerative formations in the stomach.

Among the disadvantages of the method, one can note the impossibility of taking samples for analysis, as well as slowing down the shooting process and paying more attention to a certain area of the digestive tract. In addition, the technique is still not widely used and relatively expensive.

Not all clinics have such equipment, as well as specialists specially trained on it. Typically, capsule endoscopy is used as part of the research, and when problems are found, narrower diagnostic methods are used.

Indications and contraindications

Not always the method will be safe for the patient. If found, swallowing the capsule can cause additional problems, so this is the main contraindication.

In addition, the capsules are not used during pregnancy, in children under 16 years of age and in the elderly after 70 years of age.

Also, electromagnetic radiation, with the help of which a signal is given and an image is broadcast, can damage the operation of the pacemaker.

Indications for capsule endoscopy are:

Prolonged indigestion.
Chronic constipation.
Weight loss without objective reasons.
Pain and discomfort in the stomach.
Suspicion of, or other diseases of the gastrointestinal tract.

One of the indications is to monitor the progress of treatment. In this case, the procedure is more gentle than with traditional endoscopy, but the main obstacle may be the high cost of the examination.

How is capsule endoscopy of the intestine and stomach performed?

When contacting the clinic, if the doctor advised to undergo this particular diagnostic method, all questions of interest can be clarified with him. The patient before undergoing such an examination should know the basic rules for using the capsule.

Endoscopy algorithm:

The last meal should be approximately 10-12 hours before the start of the examination.
Special sensors are attached to the patient's belt, capturing the signal of the capsule and recording information.
The patient should swallow the activated capsule. Usually this is not difficult, because the dimensions of the device are no larger than standard medicinal capsules, for example, vitamins.
Within 8-9 hours, the device records the entire path of the capsule through the gastrointestinal tract.
Already four hours after the examination, the patient can eat. During the entire study, there is no need for bed rest (except for medical indications), as well as a change in habitual lifestyle.
As a rule, it is best to observe the patient in a hospital setting, but this is not necessary.
At the end of the procedure, the data is read from the device, the capsule itself comes out naturally within one to three days. If this does not happen, and the capsule is stuck, it will need to be removed using a conventional endoscope. Such situations occur in about 5% of the total number of observations.

Before the procedure, it is better to follow a diet for a couple of days, avoid alcohol, heavy and fatty foods, as well as products that give a contrasting color.

Depending on the purpose of the study, you must either refrain from eating for the next 12 hours, or eat a small portion immediately after swallowing the capsule.

In the latter case, an additional study of the evacuation function of the stomach and intestines is possible.

Where can I get an examination in Moscow, its cost

The choice of a clinic that performs such a procedure is quite limited.

Examination with capsules is not the most affordable, which explains the relative lack of prevalence of this type of endoscopy. In addition, the cost of the survey is affected by the equipment used.

Israeli or American capsules are considered more progressive, but domestic counterparts will cost less.

Estimated cost of capsule endoscopy:

Private medical center "Capital". The cost of the examination will be from 45,000 rubles.
FMBC im. Burnazyan. The largest clinic in Moscow with relatively low prices, the cost of an examination in which is from 15,000 rubles. The only drawback is that you need to pre-register and wait in line.
Institute of Surgery. The examination is carried out with domestic and imported capsules. The cost depends on this criterion, which on average ranges from 20,000 to 35,000 rubles.
Private clinic JSC "Medicina". It is part of the Swiss medical centers. The quality of service is consistently high, but the cost will be much more expensive - from 70,000 rubles.

Endoscopy of the intestine is prescribed for the diagnosis of diseases of the digestive organs. The procedure allows you to determine the cause of the pathology, identify deviations that cannot be seen with other examinations, eliminate some problems - polyps, ulcers, and so on.

Endoscopy is an examination of the intestinal walls for the presence of pathologies. The procedure is carried out using an endoscope - a special flexible tube equipped with LEDs, a camera, an air supply system, and tools for taking tissue for examination. The diameter of the device is 8 - 15 mm, and its length reaches 1.5 meters.

Additional Information! The word endoscopy is translated as looking inward (“endo” - “inside”, “scopy” - “look”.

Manipulation allows you to examine in detail the large intestine, duodenum, esophagus and stomach. And with the help of modern equipment it is possible to carry out capsule endoscopy of the small intestine.

Endoscopic examination of the intestine is indispensable for internal bleeding, ulcers, benign and malignant tumors.

Types of bowel endoscopy

There are 4 types of endoscopic examination:

Sigmoidoscopy. Performed using a sigmoidoscope. It allows for endoscopic examination of the large intestine, rectum and sigmoid colon. The device is inserted through the anus to a depth of 20 - 35 cm. The sigmoidoscope is equipped with an air supply system - it is necessary to straighten the walls and improve visibility.
Colonoscopy. An improved version of sigmoidoscopy. The length of the tube reaches 1.5 meters, and its diameter is thinner than that of a sigmoidoscope. With the help of colonoscopy, it is possible to examine all parts of the large intestine. The device has LEDs and a virtual camera that transmits the image to the screen. In addition, it is equipped with an air supply device and special tools. In addition to a diagnostic examination, with the help of colonoscopy, you can take material for research or perform a minor intervention - cauterization of an ulcer, removal of a polyp. This type of endoscopy is indispensable for colonic obstruction - it allows you to identify and eliminate the pathology.
Esophagogastroduodenoscopy (EGDS). Allows you to explore the esophagus, stomach and duodenum 12. The gastroscope is inserted through the throat, having previously anesthetized it. The survey is carried out to a depth of 30 cm.
capsule study. An innovative method of endoscopy for the study of the small intestine. The latter, due to its structure, was considered inaccessible for a full examination for a long time. For the procedure, a special capsule is used, which contains a camera and a transmitter. The patient swallows the device like a regular tablet. Passing along the walls, the apparatus takes tens of thousands of photographs. By comparing them, the doctor can identify pathological processes in the intestine and diseases of the stomach. After collecting information, the capsule is excreted naturally along with feces.
Intestinoscopy. Another method for examining the small intestine. It does not give such a clear picture as capsule endoscopy, but allows you to take a tissue biopsy. Endoscopy is performed through the rectum or mouth using fiber instruments. The method is rarely used, since it is uncomfortable for the patient, requires careful preparation, highly qualified doctor. But its main disadvantages are that only 30% of the area of the organ is examined, and in some places, due to the curvature of the walls, the endoscope cannot be performed.

Indications and contraindications for bowel endoscopy

Endoscopic examination of the intestine is prescribed for:

spotting during bowel movements;
chronic constipation or diarrhea;
unreasonable weight loss;
abnormal structure and color of feces;
the presence of a foreign object;
detection of polyps and other neoplasms;
with diseases of the digestive system and suspicions of them.

However, endoscopy is not always allowed. There are contraindications - absolute and relative. The first ones include:

diseases of the cardiovascular system in the acute stage;
respiratory pathology;
infectious and inflammatory processes in the intestine;
weakened or shock state of the patient;
the presence of tumors in the rectum, due to which it is impossible to insert an endoscope.

Relative contraindications can interfere with the test:

poor blood clotting;
psychological illnesses;
colitis;
wall perforation;
colon hypertrophy - an increase in its length and lumen, thickening of the walls.

How to prepare for research

The main goal of preparing for endoscopy of the intestine is to completely cleanse it of feces. It takes place in 3 stages:

Preparation of the patient for studies of the large intestine begins 3-4 days before the manipulation. Adhere to a certain diet, food should be light. From the diet exclude food, leading to increased gas formation. You can not eat foods containing fiber (vegetables, fruits, berries, dried fruits, greens, buckwheat, oatmeal, pearl barley), fatty meats, pastries, sweets, carbonated drinks, smoked meats and marinades.
On the eve of the endoscopy of the rectum, the main preparation begins. Take strong laxatives. Usually appoint "Fortrans", less often use enemas. Drink from 3 to 4 liters of water with the drug dissolved in it. The last meal is allowed no later than 6 pm. It must be easily digestible.
Preparation for the study of the large intestine continues immediately on the day before the procedure. In the morning you need to drink another bag of Fortrans. After that, it is forbidden to eat any food and liquids.

Additional Information! Preparation for capsule endoscopy of the small intestine is easier. It is only necessary not to eat on the eve of the procedure. It is allowed to drink fruit drinks, kissels, unsweetened tea.

How is a bowel endoscopy performed?

Any type of endoscopy, with the exception of capsule, is performed with anesthesia. Local anesthetics are usually used, less often sedation or general anesthesia. The nature of the manipulations is somewhat different for different types of procedures.

Capsule endoscopy is performed as follows:

The sensors are attached to the patient's skin. They will transmit information and image.
The capsule is inserted through the mouth. The patient simply swallows it and drinks it with water.
The device comes out on its own during defecation after passing through the gastrointestinal tract.
Decipher diagnostic images. The capabilities of the endoscope allow you to see the full picture, on the basis of which the diagnosis is made.

EGDS is carried out as follows:

Lay the patient on the left side.
Anesthetize the throat with an anesthetic spray.
A mouthpiece is inserted into the mouth, which will limit the movement of the tongue and prevent the probe from biting with the teeth.
The endoscope is inserted through the mouth opening to a depth of 20-30 cm, the stomach and duodenum are examined.
During manipulation, it is recommended to evenly inhale and exhale air through the nose. To reduce vomiting, you can take pills for motion sickness shortly before the endoscopy.
If an EGDS is necessary for a child, use a device with a smaller diameter tube.

For sigmoidoscopy and colonoscopy it is necessary:

Place the patient in the fetal position or put him in the knee-elbow position.
Lubricate the tip of the endoscope and the anus with petroleum jelly immediately before endoscopy of the rectum.
Immerse the tube with gentle rotational movements into the anus to a depth of 5 cm.
Gently move the tube up to 1.5 m long over the area of interest. At the bowel folds, the nurse assistant presses on the abdomen to facilitate the passage of the endoscope. From time to time air is supplied to straighten the closed walls and improve visibility.

The procedure time is about 15 minutes. If a biopsy is performed using endoscopy, removal of a neoplasm in the intestine or stopping bleeding, the manipulation is delayed up to half an hour. An exception is a capsule type of manipulation, which lasts from 6 to 14 hours.

Important! Any type of endoscopy is accompanied by unpleasant, sometimes painful sensations. Any discomfort should be reported to the doctor immediately. Complications are also possible: perforation of the walls, bleeding from the upper part of the intestine, allergy to anesthetics.

What Can Endoscopy Find?

Any endoscopy can detect pathologies of the gastrointestinal tract. Also during the procedure, you can remove small neoplasms, stop internal bleeding, remove foreign objects. Of no small importance is the ability to take material for a biopsy and conduct an endoscopic analysis of the tumor in rectal cancer. However, each type of manipulation is designed to identify specific diseases.

Capsule endoscopy reveals:

causes of anemia and chronic pain in the stomach of unknown etiology;
intestinal diseases - celiac disease (deviations in the work of the small intestine of a genetic nature), Crohn's disease, polyps;
localization of internal bleeding of the digestive system.

EGDS allows you to detect:

- gastritis;
- stomach ulcer and 12 duodenal ulcer;
- bleeding of the esophagus, stomach, upper intestines;
- oncological processes;
- inflammation of the pancreas.

Endoscopic examinations of the colon (sigmoidoscopy and colonoscopy) are carried out in order to detect:

hemorrhoids;
polyps;
paraproctitis - inflammation of the fiber of the large intestine;
prostate dysfunction;
pathological processes of the sigmoid and colon;
causes of chronic diarrhea or constipation, pus, blood and other secretions in the stool;
areas of ulceration;
Crohn's disease;
any inflammatory processes in the intestines.

Endoscopy of the intestines and stomach is the most accurate type of examination of the digestive organs. It is unpleasant, requires lengthy preparation, but in some cases without it it is impossible to establish an accurate diagnosis and identify pathological abnormalities. Another significant plus of the procedure is the ability to remove foreign objects, remove polyps and cauterize bleeding ulcers without resorting to abdominal surgery.

In the modern medical field, endoscopic examination of the intestine is considered the most accessible and informative way of early diagnosis and clinical differentiation of pathological processes in the digestive and excretory organs.

This method allows you to visualize the mucous membranes of various parts of the gastrointestinal tract using a flexible probe, the end of which is equipped with a small video camera that displays the image on the machine's monitor. Despite some discomfort and discomfort that the patient experiences during the examination, no damage occurs.

Thanks to endoscopic methods, it is possible to accurately diagnose such serious pathologies as:

Crohn's disease - a chronic immune-mediated granulomatous inflammatory process in the digestive tract;
colonic metaplasia - a precancerous threat in which the cells of the epithelium of the stomach are replaced by cells of the large intestine - this leads to a disruption in the normal formation of the gastric glands and a disorder of the digestive function;
Colo-rectal cancer is a malignant tumor of the large intestine and its appendage (vermiform appendix).

In this article, we want to provide complete information about the types of intestinal endoscopy, that they allow you to find out in which cases it is necessary to undergo such an examination, how to prepare for it and how to decipher its results.

Diagnostic possibilities of inspection

Depending on the department studied, bowel endoscopy is divided into the following types. Anoscopy, which allows you to assess the condition of the mucous membranes of the anal canal and identify the inflammatory process, cracks, fistulas, polyps, tumor-like formations, warts, the earliest stages of hemorrhoids. Endoscopy of the rectum and sigmoid colon - this technique has rightfully won the "gold standard title" for the diagnosis of all diseases of the lower intestine.

examine the walls of the intestines, which are located at a distance of more than 50 cm from the anus;
assess their relief, shade, state of the vascular pattern and muscle tone;
remove the foreign body;
remove the polyp;
perform coagulation of the source of internal bleeding or tissue biopsy of the tumor formation.

Colonoscopy - it is carried out to study the large intestine and establish the etiological causes of a violation of the functional activity of the excretory system. With the help of a thin probe - a fibrocolonoscope, latent forms of a malignant focus can be detected. Capsule endoscopy is the latest completely painless way to examine the small intestine. The length of the capsule with a built-in video camera, which moves naturally and takes pictures, does not exceed two centimeters.

So that the patient does not feel pain, the diagnostic measure can be carried out in a state of medical sleep.

Thanks to this technique, it is possible to visualize hard-to-reach parts of the alimentary canal. This type of examination is not performed for children under 15 years of age and patients over 70 years of age, as well as for acute intestinal obstruction, peritonitis, dysentery, swallowing disorders, pregnancy.

Fibrogastroduodenoscopy is a study of the state of the esophagus, stomach, duodenum using a flexible probe equipped with a video camera, a device for obtaining a biopath (a tissue sample of the pathological focus) and forcing air to straighten the walls of the digestive tract. Such a study is much more informative than radiography and allows you to:

to detect a unique pathogenic bacterium - Helicobacter pylori;
remove foreign body;
stop the bleeding;
administer medications;
localize ulcerative and inflammatory processes.

When is bowel endoscopy performed?

This study is prescribed as part of a preventive examination of patients:

over 40 years old;
having a burdened family history of colorectal cancer;
with a tumor-like formation in the digestive tract;
with ulcerative colitis.

Therapeutic endoscopy of the intestine is carried out with polyposis of the large intestine (the presence of benign formations on its walls) and ingestion of a foreign body into the digestive tract.

Indications for a diagnostic procedure are:

constant pain in the lower abdomen;
intolerance to any food;
putrid smell from the mouth;
bloating;
change in the shade and composition of feces;
violation of the mechanism of defecation;
suppuration of the skin of the anus;
weight loss without dietary restrictions;
anemia of unknown origin;
bloody, mucous or purulent discharge from the anus during bowel movements.

Possible contraindications

To avoid the occurrence of undesirable complications after the diagnostic manipulation, the patient should tell the attending physician in detail about his state of health. Based on the patient's complaints and anamnesis data, a qualified specialist makes a preliminary diagnosis and chooses the type of examination. When performing any diagnostic procedure, there are a number of restrictions that are divided into absolute and relative.

Absolute - a high risk of life-threatening conditions for the patient: pathologies of the cardiac and vascular systems, inflammation of the mucous membranes of the rectum, respiratory diseases, tumor-like formations in the rectum. Relative - temporary conditions in which the use of this technique can cause a deterioration in the patient's health: shock, psycho-emotional instability, impaired blood coagulation, duodenal ulcer.

With relative contraindications, it is possible to perform an examination of the intestine using an endoscope - all manipulations are carried out with extreme caution, provided that the patient follows all the recommendations of specialists

Study preparation

On the eve of the diagnostic manipulations, the patient must comply with the following rules. Within three days, adhere to a strict diet - the following should be excluded from the diet:

dishes with fresh vegetables, berries and fruits;
cereals from buckwheat, barley and oatmeal;
mushrooms;
greens;
mineral water with gas;
dairy;
sausage;
legumes;
fresh bread;
kvass;
nuts;
fatty meat and fish;
canned food;
alcoholic and sweet carbonated drinks.

The day before the study, measures are taken to cleanse the intestines with enemas or laxatives. For this purpose, Fortrans is most often used - it is taken throughout the day. On the day of diagnosis, until 6.00, Fortrans is taken for the last time. It is forbidden to drink liquids and eat food - the study is carried out on an empty stomach!

In the case when anesthesia is used for intestinal endoscopy, in order to get home, the patient will need outside help - he must be accompanied by someone close to him.

Diagnostic procedure

Before conducting sigmoidoscopy, the doctor first examines the anus area and assesses its tone during palpation. For manipulation, the patient lies on his left side. Before inserting the probe into the rectum, it is lubricated with gel. Local anesthetics are used to relieve pain. To perform a colonoscopy, the patient assumes a knee-elbow position.

A long, thin tube is inserted into the rectum. During the diagnostic manipulation, you will need to take a different position. Endoscopic examination of the intestine can be performed in a state of medical sleep. This method is often used to examine children under 12 years of age. The main advantage of this method is the absence of emotional stress of the patient.

However, the use of sedatives has a number of contraindications:

violation of the functional activity of the heart muscle;
respiratory depression;
allergic reaction.

Possible Complications

Endoscopic examination of the anorectal region is an invasive manipulation - they penetrate into the human body from the outside. However, negative consequences (pain shock, intestinal perforation, internal bleeding, abscess) of such a study are extremely rare. At the end of the procedure, the patient may feel pain in the abdomen - this is due to the accumulation of gases in the intestines. In this case, you can take 2 No-shpy tablets.

If the feeling of discomfort does not leave the patient for more than 2 days, there is an increase in body temperature and bloody discharge appears in the feces - this may indicate damage to the intestinal walls, an urgent need to visit a doctor

In conclusion of the above information, I would like to emphasize once again that intestinal endoscopy is a reliable way to diagnose diseases of the digestive tract. The patient should not be afraid of this manipulation - after all, it can be used to identify the disease at an early stage of development and prevent its serious consequences. To avoid the formation of pathological processes in the intestine, it is necessary to control your diet.

Excessive addiction to fast food and sweets increases the risk of intestinal diseases. In the diet, fats, carbohydrates and proteins should be balanced, the required amount of liquid should be consumed. In addition, due attention should be paid to the fulfillment of hygiene requirements, the rational distribution of physical activity, and the timely treatment of infectious and inflammatory diseases.

Preparing for colon endoscopy is a very important step. If you come to the examination without following a special diet the day before or having previously poorly cleansed the intestines, it may be interrupted and rescheduled for another time. These are both material costs and the need to undergo a difficult procedure again. It is also possible that the doctor decides to continue the examination after all. Then the probability of missing areas of inflammation or a number of other pathological changes in the intestine increases dramatically. After such an incomplete examination, the doctor cannot be sure of the accuracy of the data obtained.

Based on the foregoing, it becomes clear why an important condition for endoscopy is a thorough cleansing of the intestine from the contents. At the preparatory stage, it is necessary to switch to a diet 2 days before the examination, and if the patient has a tendency to constipation - 3-4 days before. This diet provides for the exclusion from the diet of foods that cause bulky stools and bloating. The diet before colonoscopy should not contain fruits (peaches, apricots, dates, apples, bananas, oranges, grapes, tangerines), fresh vegetables (carrots, beets, white cabbage, radishes, turnips, radishes, garlic, onions), greens (spinach, sorrel), some cereals (barley, oatmeal, millet), seeds, nuts, black bread, berries (raspberries, gooseberries), nuts, mushrooms, legumes (beans, lentils, beans, peas), carbonated drinks, milk, kvass. Low-fat boiled poultry, fish, clear broth, sour-milk products, tea, non-carbonated drinks, jelly, non-bread cookies are allowed. It is important to note that on the eve of the study and on the day of the procedure, only liquid products are allowed - broth, boiled water, tea. Also, in the process of preparing for fibrocolonoscopy, there is no need to stop taking the necessary medications. Only iron preparations, activated charcoal should be excluded.

The day before the endoscopic examination, you should begin to cleanse the intestines. For this purpose, cleansing enemas are usually given and laxatives are taken. - a very affordable method of cleansing the intestines, but in addition to this advantage, there are also negative aspects. First, it is extremely inconvenient and often requires the help of another person. Secondly, this procedure has a rather low efficiency.

Currently, the market of Ukraine presents drugs for bowel cleansing. Some of them are quite effective. However, they are rather inconvenient to use, since they require the patient to drink at least 4 liters of liquid. There are tools that are more convenient to use, but they are significantly inferior in efficiency and safety. The optimal choice in this case is the drug MOVIPREP, since it allows you to reduce the amount of solution used to 2 liters, guaranteeing complete bowel cleansing. This is due to the special composition of the drug. It is the content of ACO in it (an ascorbate complex consisting of ascorbic acid and sodium ascorbate) that allows you to reduce the volume of the drug solution to 2 liters and at the same time increase the volume of stool. Polyethylene glycol 3350 (macrogol) increases the volume of feces and stimulates intestinal motility, sodium sulfate causes a strong osmotic effect. Sodium chloride and potassium chloride, which are part of MOVIPREP®, make up for the loss of electrolytes that were passed out with the stool.

MOVIPREP® significantly facilitates preliminary preparation for endoscopic examination of the intestine. The advantage of this drug is the simplicity and ease of use. In addition to the fact that the patient only needs to consume 2 liters of the drug solution, instead of the usual 4 liters, the preparation of MOVIPREP® is also available. To prepare the first liter of the solution, it is necessary to dissolve the content of one sachet A and one sachet B in a small volume of water, and then bring it to 1 liter with water. The resulting solution should be drunk within 1-2 hours (approximately 1 glass every 15-20 minutes). The procedure for preparing and taking the second liter of the solution is similar.

The first liter of the diluted drug is drunk in the evening, the second liter - in the morning on the day of the study. Also, MOVIPREP can be used according to another scheme: drink 2 liters of the diluted drug on the evening before the colonoscopy. The interval between the end of any fluid intake and the start of the clinical procedure should be at least 1 hour. The solution can be refrigerated before use.

When using MOVIPREP®, it is recommended to additionally take a clear liquid in a volume of 1 liter to prevent disturbances in the water and electrolyte balance, reduce the risk of dehydration. You should drink boiled water, tea, non-carbonated drinks, jelly.

According to the above, we can conclude that endoscopic methods for diagnosing colon pathologies are indispensable, as well as the need for proper preparatory measures before them. Compliance with the diet and complete bowel cleansing is the key to successful research and obtaining reliable results.

Endoscopic examination of the intestine is a method by which many diseases of the large and final sections of the small intestine can be detected at the earliest stages. Intestinal examination can be carried out both for diagnostic purposes and for therapeutic measures. For example, during the procedure, you can take material for research, stop bleeding, remove polyps.

This article will discuss how an endoscopic examination of the small and large intestine is carried out, whether it hurts, what indications and contraindications exist, and much more.

Colonoscope Insertion Tubes

What is endoscopy of the large and small intestines? Let's try to imagine. With the help of a fibrocolonoscope, you can examine all parts of the large intestine: from the rectum and sigmoid colon, to the lower sections of the small intestine.

Doctors do this procedure using a special device called an endoscope. It is a long flexible tube with a movable controlled end with optical equipment at the end. The device is inserted into the patient's intestines, and on the image displayed on the screen during the examination, the endoscopist can see the mucosa in all details. It can even enlarge the image. Doctors are also armed with special dyes that allow diagnosing many precancerous conditions.

Indications and contraindications

Intestinal endoscopy can be performed at the slightest suspicion of pathology of the large or small intestine. If the following symptoms appear, you should think about contacting a doctor and performing an endoscopy:

The appearance of blood or other pathological inclusions in the stool.
Change in stool color or consistency (for example, black stools).
Frequent diarrhea or alternating diarrhea with constipation.
Pain syndrome of unknown etiology.
Iron deficiency anemia of unknown etiology.
Unmotivated weight loss, loss of appetite.

Prolonged lack of appetite - a reason to see a doctor

With your complaints, you can come to the local therapist in the clinic, gastroenterologist, proctologist. The doctor will collect anamnesis, prescribe an additional examination, evaluate the feasibility of endoscopy to confirm his diagnosis.

This study of the intestine is contraindicated in:

An active inflammatory process in the body or an active local inflammatory reaction (for example, an exacerbation of inflammatory bowel disease).
Blood clotting disorders (hemorrhagic diathesis).
Severe general somatic pathology (decompensated cardiac, respiratory, renal, hepatic insufficiency).
Some mental disorders in which the patient loses the ability to follow the instructions of the doctor.

Sometimes the study can be carried out even if there are contraindications. The final decision in favor of endoscopy is made by the attending physician, if he decides that the benefits of the procedure will outweigh the risks.

Study preparation

Preparing for a colonoscopy involves several steps.

Preparation for bowel endoscopy begins a few days before the study.

First of all, foods that cause active gas formation are excluded from the diet: black bread, kvass, legumes, cabbage and others like that. You should also avoid foods that can give the feces a red color (beets). Three days before the procedure, they stop taking iron-containing products. On the eve of the study, after a light lunch, they stop eating, it is allowed to drink only water.
The day before the endoscopy, it is necessary to follow the instructions of the attending physician for the preparation of the intestine for the study. To do this, you can use several cleansing enemas, up to clean washings, or resort to laxatives specially designed for this, for example, Fortrans, Endofalk. They allow you to gently cleanse the intestines for several hours. It is important to strictly follow the order of administration, which the doctor will indicate, and also to ensure that the body receives a sufficient amount of fluid and that there is no dehydration.
Directly on the day of the study, it is better not to take any medications. If permanent therapy is prescribed and medication is necessary, you should discuss this with your doctor. Perhaps the reception should be continued before the procedure, but in this case it is important to warn the endoscopist. Sometimes it is possible to delay taking regular medications immediately after the procedure.

Its result largely depends on the preparation of the intestine for endoscopy.

During the procedure

Colonoscope in the lumen of the colon

Before endoscopy, the patient must be informed about all the drugs that he takes (if any) and the presence of drug allergies.
Usually, anesthesia is not used during colonoscopy, but the study is performed using local anesthesia or sedation.
The patient is asked to partially get rid of clothing and lie on his left side. The colonoscope is then inserted into the rectum and the bowel loops are expanded with forced air (which can cause a feeling of pressure or even pain).
Move through the large intestine to the lower parts of the small intestine.
If necessary, painkillers are used during the examination and manipulation.

Depending on the purpose of endoscopy, it can take from 15 minutes to 1 hour. Everything seen by the endoscopist is recorded in a special research protocol, which is given to the patient. A more detailed interpretation of the results and a plan for further action can be obtained from your doctor.

Immediately after the study, you can take liquid food. When using anesthetics, some pain medications, you should refrain from driving a vehicle on this day.

In the event that a feeling of bloating persists for a long time, it is possible to use enterosorbent (Activated charcoal) or carminative agents (Espumizan).

Medicine for bloating

Complications

When conducting an endoscopic examination of the intestine, complications occur infrequently, but they do occur. Among them:

Small or large bowel bleeding.
Perforation of the intestinal wall.
Allergic reactions to the drugs used in the study.
infectious complications.

Colonoscopy of the intestine provides accurate, highly informative results that cannot be achieved using other diagnostic methods. In the process of colonoscopy, you can not only examine the intestinal mucosa in all its details in its various sections, confirm the diagnosis, take a biopsy, but also perform therapeutic manipulations. It is this study that is preferred by many doctors involved in the treatment of diseases of the digestive system and intestines, in particular, since it has no analogues.