A colonoscopy is a diagnostic procedure used by doctors to examine the large intestine and the internal lesions of the colon. A colonoscope is a thin, bendable instrument, about 1 cm in diameter, that passes through the anus into the rectum and up to the large intestine, allowing the doctor to see the inside of the colon and large intestine. Primitive colonoscopes are mostly used for quarantine and are more rudimentary compared to modern colonoscopes. Modern colonoscopes are more often equipped with cameras and are longer in size, allowing them to go deeper to examine lesions, etc. It is the best choice for diagnosing mucosal lesions of the colon, which can be observed by transmitting the images of the colon mucosa to the electronic computer processing center through the electronic camera probe installed at the front of the colonoscope, and then displaying them on the monitor screen.
Colonoscopy
Colonoscopy is the easiest, safest and most effective method to detect intestinal tumors and precancerous lesions. However, after all, endoscopy is an invasive examination method with certain discomfort and complications, therefore, many people are afraid of this kind of examination, resulting in some colorectal lesions or even tumors cannot be diagnosed at an early stage, and the best time for treatment is delayed. In recent years, with the advancement of anesthetic drugs and medical monitoring technology, painless colonoscopy has emerged. The essence is to inject an anesthetic drug with fast onset, short effective time and exact effect before the examination, so that the patient can fall asleep within a few seconds and wake up early after completing the whole examination, and there will not be any discomfort and pain during the examination, so it is more and more popular among patients. However, there are shortcomings of colonoscopy, such as anesthesia accidents, sometimes longer anesthesia resuscitation process, and more expensive.
The clinical significance of colonoscopy
Applicable diseases: colorectal polyps; inflammatory diseases of the colon such as ulcerative colitis; chronic colitis; colon cancer, etc.
Indications for colonoscopy
Since the incidence of colitis, intestinal polyps, rectal cancer and other intestinal diseases has been on the rise in recent years, it is advocated that the first colonoscopy should be done after the age of 40. Moreover, the following groups of people are recommended to have regular colonoscopy in professional anorectal hospitals.
People who should do colonoscopy.
1, long-term stomach pain, stomach acid, stomach distension treatment is ineffective;
2, diagnosed gastritis, enteritis, long-term medication, but not cured;
3, the need for dialectical classification of gastritis, enteritis disease typing;
4, long-term diarrhea, abdominal pain, constipation treatment is ineffective;
5, long-term habitual abdominal rise, diarrhea;
6, the diet is normal, the stool is not formed for a long time;
7, long-term daily stool more than two people;
8, long-term two-day stool once;
9, abnormal stool, the body has recently lost weight sharply;
10, mucus, pus and blood in the stool;
11, long-term itching in the anus;
12.Long-term perianal drop;
13, without any reason abnormal body weight loss.
Contraindications of colonoscopy
Patients with the following conditions are temporarily unsuitable for colonoscopy.
1.Severe purulent inflammatory disease of the anus and rectum such as perianal abscess, or the presence of painful lesions such as anal fissures. In this case, the examination may lead to the spread of infection and cause unbearable pain to the patient;
2, various acute enteritis, severe ischemic diseases and radiological colitis, such as bacterial dysentery active phase, ulcerative colitis acute phase, especially fulminant cases. Because in the case of intestinal inflammation edema, congestion, thin intestinal wall tissue, compliance decline, prone to intestinal perforation;
3, women during pregnancy, should strictly control the indications, cautiously, women during menstruation is generally not suitable for examination to avoid the occurrence of episodic infection;
4, peritonitis, intestinal perforation and other conditions should not be examined to avoid aggravating the condition;
5, extensive adhesions in the abdominal cavity and various causes of intestinal stenosis resulting in difficulties in entering the mirror should not be forced to continue the examination to avoid the occurrence of adhesions, ties or tears in the intestinal wall;
6.Patients with extreme physical weakness, advanced age and a history of serious cardiovascular and cerebrovascular diseases, resulting in intolerance to the examination, must be cautious;
7, pediatric and psychiatric patients should not perform the examination, if it is necessary, consider performing the examination under anesthesia.
Precautions
The cleanliness of the intestinal tract is one of the key factors in the success or failure of colonoscopy. If there is still a lot of feces in the intestine at the time of examination, it will affect the access and observation, and even the whole colon examination cannot be completed. Therefore, it is important to prepare the intestinal tract for cleansing before the examination. Oral laxatives are one of the most commonly used, reliable and safe methods in clinical practice today. Since the vast majority of outpatients undergo bowel preparation at home, how to perform safe and effective bowel preparation at home is an issue of great concern to patients and their families.
The following is recommended: Eat a semi-liquid, less crumbly diet, such as thin rice, without vegetables and seeded fruits such as watermelon, for dinner the day before the examination. About 4 hours before the examination, adults 50 grams, children 25-35 grams of magnesium sulfate powder with 100 ml of warm boiled water orally, and then within 1 hour oral warm boiled water 2000-2500 ml. Generally about half an hour after the start of defecation, even diarrhea 5-7 times can be basically cleared of feces in the large intestine. Some patients in the process of intestinal preparation will occur vomiting, which may be related to the stimulation of magnesium sulfate and a large amount of water in a short period of time, can be mixed into the magnesium sulfate drink after oral intake, and then slowly oral plain water, in order not to feel obvious abdominal distension as the standard. If there is no bowel movement after 4 hours after the end of drinking water, it is ineffective, that is, you should go to the hospital for clean enema.
If the following symptoms persist for two weeks or more, you should go to the hospital for examination
(1) Change in bowel habits: Recent diarrhea or constipation; change in stool shape or thinning compared to before;
(2) Mucus and blood stool: the stool often contains bright red or dark red blood and mucus;
(3) Urgency and heaviness: always feel that the stool is not finished, but can not defecate;
(4) Persistent abdominal pain; the pain is mostly in the middle and lower abdomen, with varying degrees of severity, mostly vague or distending pain;
(5) Anemia is often accompanied by fatigue and unexplained sudden weight loss.
Examination procedure
1.You must lie on your left side with both knees flexed.
2.The doctor will slowly insert the colonoscope through the anus and observe the intestinal cavity in order to see if there are any lesions, you may feel a sensation of distension in the abdomen and the urge to have a bowel movement, at this time you should breathe deeply to relax yourself.
3.The whole examination process usually takes about 10~30 minutes.
Precautions after the examination
1.After the biopsy or polypectomy, please rest in bed, do not exercise strenuously for three days, and do not do barium enema examination. After the polypectomy, the doctor will generally fast for three days and give intravenous fluids according to your condition. If there is no blood discharge and the situation is satisfactory, you can be discharged from the hospital.
2.In the initial stage, you may feel bloated and uncomfortable because of the air accumulation in the large intestine, but it will gradually disappear after a few hours. If the bloating is obvious, you should tell the doctor or nurse, and the doctor will give you the appropriate treatment.
3.If there is no special, you may take a general diet or eat according to the doctor’s prescription.
4.If there is persistent abdominal pain or large amount of bleeding in the stool, you should tell the doctor in time to avoid accidents.
Painless colonoscopy
Painless colonoscopy is a new technology of painless gastroscopy, also known as sedation and awake gastroscopy. It can improve the patient’s tolerance and reduce the stress reaction, thus eliminating the fear and discomfort and allowing the endoscopy and treatment to proceed smoothly. It has the advantages of less complications and faster recovery. According to incomplete statistics, complete amnesia after gastroscopy accounts for about 30% and partial amnesia accounts for about 40%, while those who have complete amnesia have no memory of the whole gastroscopy process after surgery.
Introduction
Although painless gastroscopy is a great improvement over previous gastroscopy, there are certain contraindications, as the drug used is a central depressant and is metabolized in the liver, people with severe respiratory disease, cardiovascular disease, liver failure and those in poor general condition should not undergo this examination. Before the examination, we should explain in detail, explain the precautions, pound weight, in order to accurately calculate the amount of drugs, keep the infusion of fluids; during the examination process, pay attention to observe the patient’s breathing, face, heart rate, oxygen saturation, etc.; prepare oxygen, all kinds of resuscitation equipment and drugs; after the examination, pay attention to observe the general condition of the patient, fully awake before leaving, the morning of the examination is prohibited to drive a motor vehicle, in order to avoid accidents, and it is recommended that a family member It is recommended that a family member accompany the examination and that the inpatient lathe be sent back.
Indications for colonoscopy
1, where there is epigastric discomfort, epigastric pain, reduced feeding, black stool, vomiting, suspected chronic gastric and duodenal diseases, not yet confirmed by various tests, should be made for colonoscopy to clarify the diagnosis.
2, barium X-ray examination found intestinal ulcers, intestinal polyps or intestinal tumors, but is not sure of the nature of the need for colonoscopy, biopsy to determine the nature.
3.Patients who have chronic enteritis and need regular colonoscopy, or those who need clear pyloric obstruction.
4.Patients with intestinal cancer, in order to understand the type of tumor, the scope of the lesion, need to do colonoscopy before surgery, in order to determine the surgical program. After intestinal surgery, regular review is also needed to observe the changes of the disease.
5. For upper gastrointestinal bleeding (black stool or vomiting blood), emergency gastroscopy should be performed (within 24-48 hours after bleeding) in order to find the bleeding site, and local hemostasis treatment is available.
6.If foreign body is found during the colonoscopy, it can be removed and polyps can be treated by microwave therapy or electrocoagulation and electrodesiccation.
7, persistent or recurrent obstructive jaundice, the cause and nature of which cannot be determined with general examination.
8.As treatment for intestinal lesions.
Contraindications to colonoscopy
Contraindications to electronic colonoscopy: endoscopy is contraindicated when the anal canal is rectally narrow and the endoscope cannot be inserted. Patients with symptoms of peritoneal irritation, such as intestinal perforation and peritonitis, are contraindicated to do this examination. Acute infection of the anorectum or painful lesions, such as anal fissure and perianal abscess, etc., are contraindicated for colonoscopy. Women should not be examined during menstruation and should be cautious during pregnancy. Endoscopy should not be done in old age, severe hypertension, anemia, coronary artery disease, or cardiopulmonary insufficiency. Early after abdominal and pelvic surgery, suspected perforation, intestinal fistula or extensive abdominal adhesions are contraindicated to do this examination.
What are the points to note for painless colonoscopy
1.No smoking the day before the examination.
2, to be accompanied by adult relatives and friends, remove dentures before the operation, ladies to remove makeup.
3.No food should be eaten after dinner the day before the examination, and no water should be drunk in the morning of the examination.
4.No spicy food within 24 hours after the examination, and no alcohol within 12 hours.
5.No driving motor vehicles, mechanical operation and overhead work within 24 hours after the examination.
Advantages of painless colonoscopy
Painless, comfortable and easy: A new painless technology is adopted, so that patients can complete the whole examination and treatment process in a painless state, without painful feeling and discomfort, which reduces the patient’s fear and improves the patient’s tolerance.
High diagnostic rate and safety: High definition and high resolution, no dead angle in the examination, therefore high diagnostic rate and good effect, and no damage to the patient itself, no side effects, safe treatment.
Short time consuming, professional and fast: professional doctors operate, the whole process of gastroscopy only takes 2 – 3 minutes, while colonoscopy only takes 3 – 5 minutes; recovery after examination and treatment is also fast, patients generally only need to rest 5 – 10 minutes to go home. Patients usually only need to rest for 5-10 minutes before they can go home.