Colonoscopy is an examination method that inserts the colonoscope through the anus to the ileocecal region and observes the colonic lesions from the mucosal side. It is the best choice for diagnosing colonic mucosal lesions. It is performed by transmitting the images of colonic 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, which can observe the small changes of colonic mucosa.
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 a kind of anesthesia drug with fast onset, short effective time and exact effect before the examination, so that the patient can fall asleep within 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 the anesthesia resuscitation process is long, and the cost is expensive.
Precautions
The cleanliness of the intestine is one of the key factors in the success or failure of colonoscopy. If there is still a lot of stool 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 a great concern for patients and their families.
Colonoscopy process and steps
1, dietary requirements: enter a liquid diet the day before the colonoscopy, and fast the morning of the examination.
2, intestinal preparation: patients take 3000ml of polyethylene glycol electrolyte bulk solution 5 hours before the scheduled examination time. That is, (6A+6B) dissolved in a total of 750ml of warm water (1 cup) and 4 cups taken within two hours. The cleanliness of the intestine is a key factor affecting the success or failure of colonoscopy; the cleaner the intestine, the more ideal the examination results. Therefore, be sure to choose a safe and effective bowel preparation method.
3, observe the end point: 7-8 bowel movements until the discharge of clear water-like stool (basic emptying of the intestine) can be performed colonoscopy.
4.Remove pants, put on crotch pants for colonoscopy, lie on your side on the examination bed table, relax your whole body, and prepare for the examination.
A thin tube with a camera lens is inserted through the anus into the intestine and is continuously pushed inward after insertion. There is a strong sensation of distension because the intestine may be expanding with air during insertion to facilitate the entry of the colonoscope. When the colonoscope reaches the examination site, both the doctor and the patient can observe the inside of the intestine in the computer monitor on the side. If needed, the doctor will also use the colonoscope to take a sample of the intestine for the next biopsy.
5. The examination is completed. After the biopsy or polypectomy, please take absolute bed rest, do not exercise strenuously for three days, and do not do barium enema. After polypectomy, your doctor will give you three days fasting and intravenous fluids according to your condition. If there is no blood in your stool and your condition is satisfactory, you can be discharged from the hospital. If there is persistent abdominal pain or large amount of bleeding in the stool, you should tell your doctor in time to avoid accidents.
Which symptoms require colonoscopy
The indications for e-colonoscopy are quite broad, and e-colonoscopy is feasible in all of the following cases without contraindications
1, lower gastrointestinal bleeding of unknown origin.
2, chronic diarrhea of unknown origin.
3.Unexplained abdominal masses, and lesions of the large intestine and the end of the ileum cannot be excluded.
4.Unexplained lower and middle abdominal pain.
5.Suspected benign or malignant colon tumor, which cannot be diagnosed by x-ray examination.
6.Suspected of chronic intestinal inflammatory diseases.
7.Abnormalities are found in barium enema or intestinal system examination, and the nature and scope of lesions need to be further clarified.
8.Determine the scope of lesions before surgery for colon cancer, postoperative review and follow-up of the efficacy of colon cancer and polyps.
9.Low-grade intestinal obstruction of unknown cause.
Colonoscopy – Bowel preparation methods
Method I
1, the day before the colonoscopy into a liquid diet (dregs-free diet, dairy products are prohibited), the day of the examination breakfast fasting.
2.Take time: take polyethylene glycol electrolyte bulk 5 hours before the examination in the morning for patients who are examined in the morning, and take polyethylene glycol electrolyte bulk at 6:00 am for patients who are examined in the afternoon.
3. Dissolve 6 sachets of polyethylene glycol electrolyte bulking agent A + 6 sachets of agent B in 750ml of warm water and take 750ml every 30 minutes for a total of 3000ml, to be taken within two hours.
4.During the dosing period, the patient was instructed to walk back and forth and gently rub the abdomen to speed up the excretion rate.
5.Observation end point: clear water-like stool.
6.After purging the bowel should be strictly fasted.
Method 2
1, the day before the examination dinner into semi-liquid less residue diet, such as thin rice, etc., no vegetables and watermelon and other seeded fruits.
2, about 4 hours before the examination, adults 50 grams, children 25-35 grams of magnesium sulfate powder with warm water 100 ml orally, after 1 hour oral warm water 2000-2500 ml.
3, generally about half an hour after the start of defecation, even diarrhea 5-7 times can be basically clear of feces in the large intestine.
4, 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 to not feel obvious abdominal distension as the standard.
5, if the end of drinking water 4 hours later still no bowel movement, it is ineffective, that 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: Recently, diarrhea or constipation is frequent; compared with the previous, the shape of the stool has changed or become thinner;
2, mucus and blood stool: the stool often with bright red or dark red blood and mucus;
3, the feeling of urgency: always feel that the bowel movement is not finished, but defecation but can not defecate;
4.Persistent abdominal pain; the pain is mostly in the middle and lower abdomen, with varying degrees of severity, mostly hidden pain or distension;
5. Anemia is often accompanied by fatigue and unexplained sudden weight loss.
Contraindications
Patients with the following conditions are temporarily unsuitable for colonoscopy.
1, anus and rectum in severe purulent inflammatory disease 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 necessary, consider performing the examination under anesthesia.