Sometimes, in order to recognize the pathology, hiding somewhere in the depths of the human body, there is no other way than to look at it from the inside. For example, fibrogastroskopiya allows you to see in minute detail the pathological processes occurring inside the stomach, and with the help of a colonoscopy, which is understandably less popular procedure, you can identify pathologies hidden from the human eye behind the walls of the intestine. Both procedures require a certain amount of preparation for their qualitative implementation. And the diet before colonoscopy is an important point of such preparation.
Since non-observance of the food regime adversely affects the results of the study of the intestines with a probe, this issue should be given special attention, which we will do.
Before going directly to the question of diet before colonoscopy, let's try to figure out what it is all about for the procedure, for what and in what cases it is conducted and what dangers it allows to avoid.
Colonoscopy is a diagnostic procedure identical to FGDES. Only the purpose of its conduct is not the upper, but the lower sections of the gastrointestinal tract, i.e. Intestines. Endoscopic study called colonoscopy allows you to carefully examine the internal surface of the large intestine and rectum with the help of a probe, where many pathogenic microorganisms nest, capable of causing various diseases dangerous to human life and health when immunity is reduced.
This procedure should ideally be carried out regularly, because it allows you to prevent many diseases of the large intestine (colitis, including ulcerative colitis, diverticulosis, the appearance of polyps and neoplasms on the walls of the intestine, Crohn's disease, etc.).
Indications for colonoscopy are the appearance of the following symptoms:
pain and discomfort in the lower abdomen,
flatulence, or in a popular bloating,
disorders of the stool, manifested in the form of constipation or diarrhea (sometimes these two phenomena can alternate, which also requires a careful study of the causes of this condition)
"Causeless" weight loss on the background of normal nutrition during the last 5-6 months,
a low content of hemoglobin in the blood, confirmed by appropriate analysis,
change in color and character of the stool (feces are black, although the person did not take either iron preparations, or activated charcoal, there are bloody streaks in the stool, etc.)
Such a survey can be prescribed to women in connection with the implementation of planned gynecological operations, especially if they are associated with oncology.
Colonoscopy should be held regularly and those who are already 45 years old, because during this time, and the immunity is noticeably weakened, and pathogenic microorganisms accumulated in the intestine enough. In addition, endoscopic research helps to identify in the bud the oncological processes and perforations of the intestinal wall, which are a threat to the life of the patient at any age, especially if he is not so young and healthy.
By analogy with fibrogastroscopy, a qualitative procedure requires a complete cleaning of the intestine from stool. This will allow the probe to move freely along the intestine, reducing the discomfort of, let's say, an unpleasant procedure, and the doctor conducting the endoscopic examination will get the maximum of interesting information about the patient's colon status.
Preparing for a colonoscopy is more labor-intensive than under the FGDs, and takes more than one day. Usually this takes 3-5 days, during which the patient must adhere to a special slag-free diet and fasting on the last day of preparation, as well as carry out manipulations and take medications that contribute to a qualitative cleaning of the intestine.
Slag-free diet before colonoscopy of the intestine
The appointment of a slag-free diet is an important stage in the preparation for a colonoscopy. It is indicated in order to exclude the delay of fecal masses inside the intestine and to prevent the formation of gases during the procedure.
It should be understood that endoscopy is carried out using a long flexible tube with an integrated mini camera at the end, and any obstacle in its path can distort the information sent to the monitor. And the products that we use in everyday life often contain substances and toxins that are unnecessary for the body, which subsequently settle down in the form of slags on the walls of the intestine.
It is the slag that can obstruct the progress of the probe, cause unwanted phenomena and painful sensations during the procedure, and also slightly "correct" information on the state of the intestinal tissues. All this is considered unacceptable, therefore, before a colonoscopy, a doctor prescribes a special diet designed to prevent the formation of slags within 3 days before the date of the procedure, and the already existing unnecessary layers are removed by qualitative cleaning of the intestine with enemas or medications.
The purpose of the diet is to help the intestines to be cleansed as much as possible and not to accumulate new harmful substances that are commonly called slags. Therefore, such a diet is called slag-free.
A slag-free diet is prescribed by doctors in the event that a thorough cleansing of the body of harmful or simply unnecessary substances accumulated in it is required. When examining the intestine from the inside, there is a need for it to be completely released from the contents, therefore it is customary to appoint a diet before the colonoscopy for all patients who are preparing for this somewhat intimate procedure.
In parallel with the diet, bowel cleansing is prescribed, which is carried out on the evening of the last day of the diet and in the morning 3-4 hours before the colonoscopy.
It remains to understand when it is better to start a diet before colonoscopy? Usually, doctors advise starting preparation for the procedure 3 days before the procedure. However, if a person has certain problems with digestion, which often result in constipation in the form of constipation, it will be necessary to take care of the quality of the colonoscopy in advance (for 5-7 days). This will to some extent help normalize the stool and facilitate the passage of stool.
If the intestines do not want to purify themselves, they will have to help him by taking the usual laxatives (for example, "Senadexin").
General information of the diets before colonoscopy
As we have already said, a slag-free diet is necessary for the best cleansing of the intestine before colonoscopy. But what is its feature, we still have to figure out.
So, a non-fat diet means the use of products that are useful for the body and do not contain any slag, which means that they will be absorbed as much as possible and leave no traces on the walls of the small and large intestines. It is clear that the dishes cooked from such products should not be distinguished by high caloric content, which will make their digestion more difficult.
The main requirement of the diet is the exclusion of foods rich in fiber from the diet that are not fully digested, and those that can cause fermentation and gas formation in the intestine.
Despite the fact that the products allowed for the diet are low in calories, they can be used to prepare a lot of tasty and healthy dishes that will supply the body with all the necessary nutrients and will not lead to the formation of a large amount of fecal matter.
As with most diets that facilitate the work of the digestive tract, it is better to stick to the principle: more often and gradually. It is better to eat 5 or 6 times a day in small portions than 3 times to eat so that even breathing was difficult. Eating on the last day of the diet on the eve of the colonoscopy should be particularly easy with the predominance of liquid clear dishes, with the last meal recommended to be conducted no later than 2 pm.
The slag-free diet prepares the intestines for final cleansing on the eve of the colonoscopy, and no matter by what means it will be carried out.
What can and what can not?
So, what is a slag-free diet and why it is needed before colonoscopy, we have figured out, it remains to find out what foods can be eaten before the examination of the intestine, and which ones should be abandoned for a while.
What can you eat?
Slag-free diet allows the use of only light, low-fat products. To such it is possible to carry:
Low-fat varieties of meat: poultry (chicken, turkey, quail and other types of meat without skins and internal fat), low-fat beef, young veal, rabbit meat. Meat dishes should be boiled or steamed.
Low-fat varieties of sea and river fish (hake, pollock, pike perch, pike, etc.). Fish boiled or baked on the grill.
Low-fat milk in limited quantities.
Sour-milk products, low-fat cottage cheese, cheeses with low fat content.
Butter, vegetable oils and fats and even a little mayonnaise (preferably home-made).
Non-stubborn broths and soups cooked on their basis.
White bread from wholemeal without bran and biscuit from it.
Bake without adding poppies and nuts.
Macaroni products from white flour.
Semi-liquid semolina porridge.
Chicken or quail eggs (preferably soft-boiled or in the form of a steam omelet).
Vegetable broths and vegetables (boiled, baked without skin), except white cabbage, which contains hard fibers in any treatment
Lean (biscuit) biscuits, crackers.
Natural green or weak black tea is better without sugar.
Fruit juice, except for plum juice and grapes (you can drink juices only in a diluted form and without pulp).
Mousse and soufflé from fruits.
Compote or jelly from fruits or dried fruits (clear without a dense fruit mass).
Coffee (not necessarily strong).
Mineral still or purified drinking water.
Natural sweets without additives and dyes: sugar, honey, syrups, jelly from fruit juice (preferably on pectin).
What can not be?
Prohibited products with a slag-free diet are those that increase the total volume of stool and cause the formation of gases in the intestine:
Fatty meat (fat beef, pork, duck, lamb, etc.).
Oily fish (herring, sprat, carp, crucian carp, etc.).
Black bread (especially with the addition of rye flour).
Bread with bran.
Whole grains and cereals (except for semolina).
Dishes and pastries, which contain crushed grain, poppies, nuts, coconut shavings and other indigestible additives.
Vegetables in fresh, dried and fried form, various root vegetables.
Fresh fruits and berries, especially those that have small bones.
Any fresh greens.
Dishes from white cabbage, including borsch, salads, cabbage soup.
Soups cooked on milk.
Dishes from whole milk.
Sausage, sausages and sausages, smoked meat, salted hard fat.
Any salting and conservation.
Mushrooms in any form.
Sea kale in Korean or pickled.
Spicy condiments and sauces.
Any kinds of alcoholic beverages, including beer.
Mineral and especially sweet water with gas.
All types of beans: beans, peas, beans, soybeans, etc.
Seeds and any nuts, flax seed.
Sweets, cakes, chocolate, rahat-lukum and other sweets, not included in the list of allowed.
Products are better to boil, stew or bake. Do not eat fried foods, especially crusts on meat and vegetables. It is necessary to exclude strongly salty and spicy dishes. Old, hard and sinewy meat is better not to use, even if it is lean and is considered dietary.
As for white bread and baking, the day before the procedure, they will have to be abandoned altogether. And boiled vegetables and mashed potatoes are removed from the diet 2 days before the appointed date of the colonoscopy.
In the early days of the diet, a small amount of fresh fruit is allowed: a mashed apple, half a peach or a banana, a small piece of melon. But 2 days before the procedure of this dessert, too, will have to give up.
As for the use of water and other types of liquids, there are no special restrictions. Water can be drunk up to 2 liters, as usual. Tea should be limited to 5 cups, which is also quite familiar. But with regard to broths, it's better to be careful. A day is enough to consume up to ½ liter of vegetable or meat broth.
Slag-free diet is also sometimes called a diet consisting of transparent liquids. The matter is that broths, compotes, juices and drinks should be transparent, they do not allow the content of solid particles. Fatty and boiling broth should be excluded from the diet. On the last day of the diet all the liquid used should not have a saturated color, especially the content of various dyes in them is not allowed.
Diet menu for 3 days
As we have already figured out, it is necessary to compose a diet before colonoscopy from products with a minimum content of fiber and transparent liquids. If in connection with the problems of the gastrointestinal tract there is irregular stool and constipation, the diet will last not 5, but 5-7 days. In this case, the first few days you can not severely limit yourself in choosing dishes, but you need to drink at least 2.5 liters of water and take laxatives, which should facilitate the emptying of the intestines.
The main thing is to start a diet to remove from the diet foods and dishes containing small bones and whole grains. Refuse should also from rye bread, grapes and tomatoes, which can cause fermentation in the intestines.
3 days before the colonoscopy procedure, the diet becomes even tougher. The diet menu for 3 days is based on prohibited and allowed products.
Consider an example of this menu:
The first day
1st breakfast: spicy semolina porridge, soft coffee with milk, white bread with honey
2nd breakfast: fruit jelly and cracker
Lunch: soup with vegetables, boiled rice with a lean turkey cooked steamed
Afternoon snack: a glass of yogurt with a biscuit biscuit
Dinner: salad from boiled beets and carrots, a piece of boiled fish, green tea
1st breakfast: a white bread sandwich with low-fat cheese, a weak tea with sugar
2nd breakfast: baked apple without peel
Lunch: soup with pasta on a thin chicken broth, 1-2 eggs, rolls
Afternoon snack: cottage cheese with sugar or honey
Supper: stewed vegetables (except cabbage) with a slice of dietary boiled meat, clear light compote without pulp
1st breakfast: fruit jelly (not red), tea with honey
2nd breakfast: a glass of fruit juice
Lunch: a plate of loose meat broth, jelly, green tea with mint
Diet on the day before colonoscopy is considered to be the most stringent, since in this period it is advisable to limit oneself only to liquid transparent dishes. This may be a weak black or green tea, clear compotes without pulp, mineral water without gas, clear fruit juices (not red), jelly, light lean meat and vegetable broths.
Such food does not contribute to the formation of stool, and therefore nothing will interfere with the examination of the intestine. But even if for some reason a person could not refrain from eating semi-liquid or thick food from the allowed products, it's okay, because in the evening of this day and the morning before the procedure the intestine will still need to be cleared with enema or special preparations. If a person with difficulty suffers a slag-free diet and constantly wants to eat, then you can make small snacks with a biscuit biscuit, which is easy to digest.
To help the intestines get rid of food leftovers on the day before colonoscopy, you can drink 3 liters of salted water within 2-3 hours, which will work like a cleansing enema.
Diet before colonoscopy in combination with Fortrans
People who are negative about cleaning the bowels with an enema (it's clear that the procedure is not pleasant, and Esmarch's circle, the most suitable in this case is not available to everyone), you can advise using such medicines as "Fortrans" and " Dufalac. "
Diet before colonoscopy with "Fortrans" is an ideal and relatively comfortable way to prepare for the procedure of endoscopic examination of the intestine. True, this method is suitable only for adults and adolescents over 15 years.
The packet of the drug is calculated for 1 liter of water, in turn, 1 liter of the solution is used for every 15-20 kg of weight. It turns out that with a body weight of 50-60 kg, 3 packets of the drug are needed, diluted in 3 liters of water, and at a weight of more than 100 kg - 5 or more bags that need to be diluted in the appropriate volume of liquid.
The drug is taken on the last day before the procedure. At 14 o'clock the last meal is carried out according to the requirements of the slag-free diet before colonoscopy, and in the evening they take a preparation that facilitates the emptying of the intestine.
Powder from bags "Fortrans" should be poured into prepared water and carefully stirred. After that, or drink the whole composition in the evening (you can start after the dinner a little, since it is simply impossible to drink such a quantity of liquid) or divide it in half (one part to drink in the evening and the other in the morning no later than 4 hours before the scheduled time of the colonoscopy) . Improve the taste of the prepared solution can be, adding it freshly squeezed lemon juice without pulp. The action "Fortrans" begins somewhere 1.5 hours after taking the entire dose.
For a qualitative cleaning of the intestine, you can only use Fortrans, or use both recommended drugs. In the second case, "Dufalac" is taken from the evening, diluting 250 ml of the drug in 2 liters of water, and in the morning - "Fortrans", dissolving the powder package in 1 liter of liquid. In the evening, the medicine should be taken no later than 19 hours, the morning - up to 7 hours.
After two o'clock in the afternoon on the eve and during reception of preparations it is possible to drink only pure water without special restrictions.
The procedure of a colonoscopy can be carried out both under anesthesia, and without it. In the first case, the amount of liquid drunk in the morning will have to be limited. After the morning reception of Fortrans, we do not eat or drink anything else. If you need to take any other oral preparations, you can drink them with a small amount of clean water. But do it no later than 2 hours before the survey.
A slag-free diet, which can be used both for preventive purposes to cleanse the body of harmful substances, and before colonoscopy for complete cleaning of the intestine, does not cause any harm to human health. And even on the contrary, it helps him get rid of unnecessary ballast in the form of slags and toxic substances, which does not represent even the slightest value.
There are practically no contraindications to the diet. The only point is that with diabetes mellitus diet before colonoscopy may present some danger, and it must be discussed with the doctor. In addition, this pathology prescribes hypoglycemic and insulin-containing medications, which should be taken at a strictly prescribed time, which should also be reported to the doctor who performs the colonoscopy in advance, even before the preparation for the procedure with the help of a diet.
In principle, this point should be stipulated for any chronic diseases, if refusal to eat food / drugs or use of certain types of food can harm the health.
So, in diabetes mellitus, the consumption of foods rich in carbohydrates and glucose, baking from white flour, etc. Is minimized. In addition, eating should be regular. And with gastritis and many other pathologies of the gastrointestinal tract, refusing food on the eve of a colonoscopy can cause an exacerbation of diseases. Accounting for all these points will help different risks associated with diet.
In a slag-free diet before colonoscopy, there are virtually no contraindications (in cases of illness, the diet is usually adjusted), but they are in the very procedure of the endoscopic examination of the intestine.
Colonoscopy is not performed:
In a state of shock, in which there is a spasm of muscles, which greatly complicates the survey.
If the intestine is obstructed, when there is no possibility to carry out its thorough cleaning.
In case of heavy bleeding from various organs of the gastrointestinal tract or mouth, when blood enters the intestine and can distort the existing picture.
With inflammation of the peritoneum (peritonitis) due to the danger of deterioration of the situation.
In the case of perforation of the intestine, when in its wall breaks are formed with the release of contents into the abdominal cavity.
When inguinal or umbilical hernia, when a colonoscopy can promote the bulging of the intestine through the opening of the umbilical ring.
If a patient recently underwent surgery for pelvic organs and a colonoscopy washes the divergence of the sutures.
If preparation for a colonoscopy was not sufficient because the patient ignored the requirements of a slag-free diet or did not perform sufficient cleaning of the intestine with enemas or special preparations. In such cases, all the preparatory procedures will have to be carried out again.
Colonoscopy is not performed under anesthesia with intolerance to anesthetics. In addition, the procedure is better to abandon with exacerbation of ulcerative colitis, the presence of acute infectious diseases, coagulation, severe cases of cardiac and pulmonary insufficiency.
Possible complications after a colonoscopy:
Perforation of the intestinal wall during the procedure. It happens in 1 person out of 100 and requires an early operation to eliminate the gap.
Bleeding in the intestine, which most often occurs due to damage to the inner wall of the organ (1 person per 1000 patients). If bleeding is detected during or immediately after the procedure, the procedure is stopped and immediately taken to stop it (cauterization, adrenaline, etc.). If the appearance of blood from the rectum is noted later (in a few hours or even a day), the patient must be urgently taken to the hospital for a surgical operation related to the problem that caused bleeding.
The development of infectious diseases, due to infection in the intestine with insufficient processing of the probe or a violation of the procedure (hepatitis, syphilis, etc.). Occasionally, a colonoscopy can provoke the "awakening" of bacteria that have been in an inactive state up to this time.
Irritation of affected areas of the intestine (polyps, inflammation, swelling), accompanied by pain and fever.
Spleen rupture occurs in isolated cases and requires urgent measures to eliminate the problem.
Complications of varying severity can be triggered by the introduction of anesthesia.
All of the above complications are directly related to the procedure, and not to a slag-free diet on the eve of it. An unpleasant consequence of the diet itself may be a complication of existing chronic diseases if the diet is not adjusted in accordance with the requirements of a diet with the corresponding disease.
Exit from the diet should also be gradual. It is not necessary immediately after the colonoscopy to run home and sweep away from the table everything that lies on it. For 2-3 days it is recommended to eat light meals in small portions, gradually increasing the amount of food eaten to the initial values. Products that cause gas formation, for a time will have to be excluded from the diet.
If nevertheless there is some discomfort in the intestine, several tablets of activated charcoal can be taken. Stimulate the process of defecation (its absence within 2-3 days after a colonoscopy is considered normal) with enemas or laxatives can not.
The diet before colonoscopy is considered to be an obligatory and very effective procedure that promotes the complete cleansing of the intestine for detailed examination by an endoscope. Thanks to her, the doctor is able to identify the smallest pathologies of the mucous organ and prevent the development of dangerous pathologies. It is for this reason that the issue of dieting before the procedure of endoscopic examination of the intestine should be approached with all seriousness and responsibility.
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Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"