Colonoscopy

A colonoscopy is a medical procedure that uses a special flexible tube called a colonoscope to visualize the inside of the large intestine and the end of the small intestine. Colonoscopy can be performed for a variety of medical purposes, including diagnosis, screening, and treatment of various bowel diseases and conditions.

Here are the main aspects of the colonoscopy procedure:

1. Preparation: Before a colonoscopy, the patient must prepare to ensure a clean bowel. This usually involves taking special cleansing solutions and following dietary restrictions for several days before the procedure. Detailed instructions will be provided by your doctor or health care provider.
2. How the procedure is performed: During the procedure, the patient lies on his or her side or back. The doctor inserts a flexible colonoscope through the anus and moves it along the colon. The colonoscope is equipped with a camera that transmits images to a monitor, allowing the doctor to visualize the inside of the colon.
3. Diagnosis and treatment: Your doctor may do a variety of things during a colonoscopy, such as taking biopsies (tissue samples) for diagnosis, removing polyps or other abnormal growths, stopping bleeding, and other treatments.
4. Completion of the procedure: Once the colonoscopy procedure is complete, the colonoscope is removed and the patient is taken to a recovery area where they can recover from anesthesia, if any. The doctor will discuss the results of the procedure with the patient.
5. Post-procedure recovery: The patient may experience some discomfort and gas after the procedure, but these symptoms usually improve quickly.

Colonoscopy is often used to detect conditions such as polyps, colon cancer, inflammatory bowel disease (such as Crohn's disease or ulcerative colitis), and to screen and monitor bowel health. It is important to discuss all aspects of the procedure and preparation with your doctor, and to receive detailed advice and instructions before your colonoscopy.

Indications for the procedure

Colonoscopy may be prescribed for various medical reasons. The main indications for colonoscopy are listed below:

1. Colon cancer screening: Colonoscopy can be used for regular screening for colon cancer. Recommendations for when to start screening may vary based on age and risk factors, but typically begin at age 50 and are done every 10 years.
2. Symptom Investigation: A colonoscopy may be ordered if you have symptoms such as bleeding from the anus, changes in stool (such as blood or change in consistency), abdominal pain, unexplained weight loss, or other bowel-related complaints.
3. Following previous tests: If previous screening methods, such as annual stool tests for occult blood (hemocult tests), have revealed abnormalities, a colonoscopy may be ordered to confirm the diagnosis and provide further evaluation.
4. Polyp Removal: Colonoscopy can be used to remove polyps from the colon. Polyps can be precancerous growths, and removing them helps prevent cancer from developing.
5. Diagnosis of inflammatory bowel disease: Colonoscopy can help diagnose and evaluate patients with inflammatory bowel diseases such as Crohn's disease and ulcerative colitis.
6. Monitoring and follow-up: Patients who have already had changes in the colon or have had a colonoscopy may be scheduled for periodic repeat procedures to monitor and evaluate the effectiveness of treatment.

Preparation

Preparing for a colonoscopy, an examination of the large intestine using a special tube with a camera (colonoscope), is very important to ensure a clear view and accuracy of the procedure. Here are the basic steps to prepare for a colonoscopy:

1. Discuss the procedure with your doctor: Before your colonoscopy, you should discuss all aspects of the procedure with your doctor. Find out what medications you should temporarily stop taking before the procedure.
2. Prepare for your diet: In the days leading up to your colonoscopy, your doctor may recommend following a liquid or low-fiber diet. This will help clean out your bowels and provide better visibility during the exam.
3. Use of laxatives: Your doctor may prescribe laxatives to help clean out your bowels. These medications are often taken the night before your colonoscopy and the morning of the procedure. It is important to follow your doctor's instructions and take these medications correctly.

Colonoscopy bowel cleansing medications and the choice of medication may depend on your doctor's recommendations and availability in your area. Here are some examples of medications that may be used to cleanse the bowel before a colonoscopy in Russia:

• Fortrans: Fortrans is one of the most widely used colon cleansers in Russia. It contains polyethylene glycol and electrolytes and is provided as a powder to be mixed with water.
• Lavacol: This is another polyethylene glycol based medication used for bowel cleansing. It is also available as a powder for solution.
• Fleet Phospho-soda: Some doctors may prescribe this medication to cleanse the colon. It contains phosphorus and is used in solution form.
• Exportal: Exportal is a magnesium sulfate-based medication that can be used to cleanse the bowel prior to a colonoscopy.
• Magnesium Citrate: This magnesium supplement may also be suggested for colon cleansing.

4. Fasting: You will usually need to stop eating and drinking the night before your colonoscopy. Your doctor may give you specific instructions about when you should stop eating and drinking.
5. Prepare yourself for the procedure: Plan to have someone with you to drive you home after the procedure, as you may be a little drowsy from the sedation that is often used during a colonoscopy.
6. Remove jewelry: On the day of your procedure, avoid wearing jewelry such as rings, earrings, and necklaces to prevent loss.
7. Medication Sequence: If you have a chronic medical condition and are taking medications, talk to your doctor about which ones you can continue taking on the day of your colonoscopy and which ones you should stop temporarily.
8. Follow your doctor's instructions: It is important to follow the instructions provided by your doctor carefully to ensure a successful colonoscopy.

Preparing for a colonoscopy can be a bit uncomfortable, but it is an important part of the procedure to ensure accurate results and to identify any potential problems in your colon. Be sure to discuss any questions or concerns with your doctor so you are prepared for the procedure.

How to take fortrans before colonoscopy?

When taking Fortrans before a colonoscopy, it is important to follow your doctor's instructions and the instructions on the drug package. Typically, the instructions for taking Fortrans are as follows:

1. Prepare in advance: Preparation for a colonoscopy using Fortrans usually begins 1-2 days before the procedure. Check with your doctor to see when you should start taking the medication.
2. Preparing the solution: Fortrans comes as a powder that needs to be mixed with water. Follow the exact instructions on the package. This usually involves the following steps:
   • Dissolve the contents of one or more Fortrans packets in a large amount of water. Typically, 1 packet per 1 liter of water is used to prepare the solution.
   • Stir the solution until the powder is completely dissolved. It is important that the solution is clean and without lumps.
3. Schedule of doses: You may be given a schedule of doses of Fortrans, which may involve several doses of the solution. This usually involves drinking a certain amount of the solution at a certain time before your colonoscopy. For example, you may drink the first dose in the evening and the last dose in the morning of the procedure.
4. Fluid Guidelines: It is important to drink plenty of fluids after taking Fortrans to prevent dehydration. Drink an additional 8 ounces (about 240 ml) of fluid every 15 to 30 minutes after each serving of solution.
5. Be prepared to go to the toilet frequently: Fortrans will cause frequent, loose stools, so you will need to be close to a toilet.
6. Finish before your colonoscopy: Typically, Fortrans is finished 4-6 hours before your scheduled colonoscopy.
7. Follow your doctor's instructions: It is important to follow your doctor's instructions and package directions exactly to ensure a successful and effective procedure.

If you have any questions or concerns about taking Fortrans or preparing for a colonoscopy, please do not hesitate to discuss them with your doctor.

What can you eat before a colonoscopy?

Preparation for a colonoscopy usually includes a special diet and bowel cleansing to ensure good visibility and improve the quality of the procedure. Before undergoing a colonoscopy, it is important to follow the instructions of your doctor and/or medical staff to ensure a successful examination.

Typically, dietary recommendations before a colonoscopy include the following aspects:

1. Limiting Hard-to-Digest Foods: You may be advised to avoid foods rich in fiber and seeds, such as nuts, seeds, corn, and other hard vegetables and fruits.
2. Limiting Dairy Products: You may be told to avoid milk and dairy products as they can make your bowel movements thicker.
3. Limit Red Meat: It is recommended to limit your consumption of red meat prior to your colonoscopy.
4. Moderate protein intake: Your doctor may recommend a moderate amount of protein in your diet.
5. Drinking clear liquids: On the day before your colonoscopy, you can only drink clear liquids such as broths, tea, coffee without milk, jelly, lemonade, and other drinks without chunks.
6. Avoiding alcohol and red drinks: You should avoid alcohol and drinks containing red or purple dyes, as they may make it difficult to see during the procedure.
7. Dietary guidelines: Follow your doctor's instructions regarding timing and amounts of meals.

It is important to carefully follow the diet and bowel cleansing instructions to ensure a successful colonoscopy and accurate detection of any abnormalities. Therefore, always discuss the diet and recommendations with your doctor before you begin your preparation.

The device for carrying out the procedure

A colonoscopy procedure uses a special medical instrument called a colonoscope. Here's what the device looks like and how it works:

1. Flexible Tube: A colonoscope is a long, flexible tube made of soft plastic with a viewing tube at one end and a handle at the other.
2. Optical system: At the end of the colonoscope is a miniature camera and a light source. These components allow the doctor to visualize the inside of the colon and bladder.
3. Control: The doctor uses the handle of the colonoscope to maneuver it inside the intestine. Optical information is transmitted to a monitor, where the doctor can watch the image and evaluate the condition of the intestine.
4. Air inflation: To improve visibility and maneuverability, your doctor may inflate a small amount of air into your intestines during the procedure.
5. Biopsy forceps and polyp removal instruments: There is also a channel inside the colonoscope through which biopsy forceps or polyp removal instruments can be inserted if needed.
6. Monitor: A monitor that displays images from the colonoscope's optical system allows the physician to visualize the condition of the colon in real time.

Colonoscopes come in a variety of types and lengths, including standard and pediatric sizes, to meet the needs of patients of different ages and physiological characteristics. Colonoscopy procedures are performed in specially equipped procedure rooms at medical institutions under the supervision of experienced medical personnel.

Technique colonoscopies

Below are the main steps of the colonoscopy technique:

1. Patient preparation:

   • The patient must be prepared for the procedure, which includes following a diet and taking laxatives as instructed by the doctor.
   • Before the procedure, the patient may be asked to remove clothing and put on a hospital gown.

2. Introduction of sedation:

   • At the patient's request or for medical reasons, sedation may be used to ensure comfort during the procedure.
   • Sedation makes the patient more relaxed and less sensitive to discomfort.

3. Insertion of a colonoscope:

   • The doctor inserts the colonoscope through the anus and gently moves it up the colon.
   • A flexible colonoscope allows the doctor to maneuver around the twists and turns of the colon to gain the best access to its inner surface.

4. Visualization and research:

   • As the colonoscope moves, the doctor carefully examines the inside of the colon on a monitor to look for any abnormalities such as polyps, tumors, inflammation, or ulcers.
   • If necessary, your doctor may take a biopsy or remove polyps for further examination.

5. Completion of the procedure:

   • Once the examination is complete, the colonoscope is slowly removed.
   • The patient may require some time to recover from the procedure, especially if sedation was used.

6. Monitor inspection and consultation:

   • The physician discusses the results of the procedure with the patient based on the imaging and, if necessary, biopsy results.
   • The patient can ask questions and discuss further actions.

Colonoscopy is usually performed in specialized clinics or hospitals in the presence of a qualified gastroenterologist or surgeon. This procedure allows for the diagnosis and detection of colon diseases at an early stage and is an important screening method for the prevention of colon cancer.

Colonoscopy under anesthesia

Colonoscopy under anesthesia, also called anesthesia or sedation, is a procedure in which the patient is put under general anesthesia or deep sedation during the colonoscopy. This is done to ensure maximum comfort and reduce pain and discomfort during the examination. Here are some key points about colonoscopy under anesthesia:

1. Need for anesthesia: Colonoscopy is usually performed using local anesthesia and sedation to ensure patient comfort. However, in some cases, such as high pain sensitivity, a tendency to panic, or patient preference, the procedure may be performed under general anesthesia.
2. Preparing for anesthesia: If your doctor decides to perform a colonoscopy under anesthesia, you will need to follow specific preparation instructions, including limiting food and fluid intake before the procedure.
3. Anesthesia Procedure: During the procedure, an anesthesiologist (a doctor who specializes in providing anesthesia) will monitor the patient and administer general anesthesia or deep sedation. This allows the patient to sleep during the colonoscopy.
4. Patient Monitoring: During the procedure, the anesthetist will closely monitor the patient's condition, including heart activity, blood pressure, and blood oxygen levels to ensure safety during anesthesia.
5. Colonoscopy Procedure: A gastroenterologist will perform a colonoscopy, looking at the inside of your colon with a flexible tube with a camera. Under general anesthesia, you won't feel any pain or discomfort during the procedure.
6. Recovery from anesthesia: After the procedure is complete, the patient will slowly wake up from the anesthesia. This may take some time and the patient will be monitored by medical staff.
7. Follow-up and discharge: After the patient has recovered, he or she may be offered light snacks and drinks. Once the patient has fully recovered and the medical staff is satisfied that he or she is stable, the patient is discharged home or to a recovery unit.

Colonoscopy under general anesthesia may be considered if there are certain medical indications and depending on the patient's wishes. The decision to perform anesthesia should be made by the physician and anesthesiologist based on the individual circumstances.

Virtual colonoscopy

Virtual colonoscopy, also known as CT colonoscopy (computed tomography colonoscopy), is a non-invasive technique for examining the colon using computed tomography (CT). It can be an alternative to traditional optical colonoscopy for examining the colon and detecting abnormalities such as polyps or tumors.

Here's how a virtual colonoscopy procedure works:

1. Preparation: Preparation for a virtual colonoscopy may include following a diet similar to what you would do before a traditional colonoscopy and cleansing your bowels using special medications or enemas.
2. Scan: The patient lies on a CT scanner table and the doctor performs a scan using X-rays and CT scans. The scan involves creating a series of images of the colon.
3. Virtual reconstruction: After scanning, the computer creates a virtual 3D model of the colon that can be viewed and examined in different projections.
4. Analysis and diagnosis: The radiologist analyzes the images obtained, identifies abnormalities such as polyps, tumors or other changes, and makes appropriate conclusions.

Benefits of virtual colonoscopy include:

• Non-invasive: Virtual colonoscopy does not require inserting an endoscope into the colon, making the procedure less uncomfortable for patients.
• Speed: Virtual colonoscopy is usually performed faster than traditional colonoscopy.
• Fewer risks: The procedure does not involve the risks associated with the insertion of an endoscope.

However, virtual colonoscopy may have its limitations, including:

• Limited ability to biopsy or remove polyps: If abnormalities are found during the procedure, additional testing or a procedure may be needed to biopsy or remove polyps.
• Radiation Exposure: The procedure involves the use of x-rays, which may result in a small dose of radiation.
• Limited visibility of minor abnormalities: Virtual colonoscopy may not always detect minor abnormalities or changes in the lining.

Doctors decide which type of colonoscopy is best for each individual patient based on their medical history, symptoms, and the purpose of the exam. If you have questions or concerns about virtual colonoscopy, discuss them with your doctor, who can provide you with additional information and recommendations.

[ 1 ]

Contraindications to the procedure

There are some contraindications that may make colonoscopy undesirable or dangerous. Here are some of the main contraindications:

1. Active bleeding: If a patient has active or severe bleeding from the intestines, performing a colonoscopy may be dangerous and may cause further blood loss.
2. Peritonitis: Peritonitis is an inflammation of the abdominal cavity that is often caused by an infection. In this case, performing a colonoscopy may spread the infection and make the patient's condition worse.
3. Severe cardiovascular disease: If you have severe cardiovascular disease, colonoscopy may not be safe due to the risk to the patient's cardiac system.
4. Severe respiratory disease: Patients with severe lung disease or breathing problems may have difficulty during a colonoscopy.
5. Acute inflammation of the abdominal cavity: If the patient has acute inflammation in the abdominal cavity, performing a colonoscopy may be unsafe.
6. Severe structural narrowing of the bowel: If there is a severe structural narrowing (stenosis) in the bowel that could prevent the passage of the endoscope, colonoscopy may be technically impossible or risky.
7. Allergy to anesthesia or contraindication to anesthesia: If a patient has a known allergy to anesthesia or has a contraindication to general anesthesia, this may be a contraindication to performing a colonoscopy in some cases.

This is only a general list of contraindications, and the decision to perform a colonoscopy should be made by a physician based on the individual characteristics and condition of each patient. The physician always evaluates the benefits of the procedure compared to the risks and contraindications for a particular patient.

[ 2 ], [ 3 ], [ 4 ]

Normal performance

Interpretation of colonoscopy results depends on what was found during the procedure and what changes were detected in the colon. Normal values and interpretation of results may vary depending on the purpose of the colonoscopy and the age of the patient. However, in general, the following values may be considered normal:

1. Normal Mucosa: Visually, the colonic mucosa appears pink and smooth. The absence of visible tumors, ulcers, or other abnormalities is considered normal.
2. No polyps: Polyps are abnormal outpouchings of the lining of the colon. It is normal to find polyps during a colonoscopy, but they may be removed (polypectomy) for biopsy and evaluation.
3. No bleeding: Normal mucosa should not bleed. If bleeding is detected, it may indicate a problem such as ulcers or vascular abnormalities.
4. Absence of inflammation: The mucosa should be free of signs of inflammation. Inflammation may indicate a medical condition such as inflammatory bowel disease (IBD) or an infectious disease.
5. No stenosis or narrowing: Areas that are too narrow (stenosis) may be a sign of a problem, such as a tumor or inflammation.
6. No ulcers: Ulcers are deep, ulcerating sores on the mucous membrane and are usually pathological.
7. No stones (calculi): Stones are stones that form in the intestines and can cause a blockage.

It is important to emphasize that the interpretation of colonoscopy results should be performed by a qualified physician with experience in this field. Results may vary depending on the individual patient characteristics and the purpose of the procedure. If any changes or abnormalities are detected during the colonoscopy, your physician will conduct additional tests and discuss the next steps with you.

Complications after the procedure

Colonoscopy, like any medical procedure, can cause complications. However, colonoscopy complications are quite rare, and most patients undergo the procedure without serious problems. Here are some of the possible complications of colonoscopy:

1. Bleeding: After removal of polyps or biopsy from the intestinal lining, minor bleeding may occur. This is the most common complication and is usually easily controlled by the medical staff.
2. Perforation (rupture of the intestinal wall): This is a very rare but serious complication. Perforation can occur as a result of the mechanical action of the colonoscope on the intestinal wall. If this happens, surgical intervention will be required.
3. Reaction to anesthesia: If the procedure is performed under general anesthesia or sedation, some patients may have allergic reactions to the medications used or experience breathing problems. This is rare, but requires immediate medical attention.
4. Infection: Infection may develop, although such cases are extremely rare and medical instruments are strictly sterilized.
5. Pain or Discomfort: Patients may experience mild discomfort, abdominal pain, or bloating after the procedure. These symptoms usually subside within a short time.
6. Bloat Syndrome: Sometimes, as a result of air being introduced into the intestines to improve visibility, patients may experience discomfort, bloating, and a feeling of fullness after the procedure.
7. Allergic reaction to medications: In rare cases, patients may have an allergic reaction to the medications used.

It is important to remember that complications from colonoscopy are extremely rare and often predictable, which is why the procedure is often performed to diagnose and treat bowel disease. Doctors always try to minimize risks and provide patients with the necessary information and care before, during, and after the procedure. If you have any concerns or questions about colonoscopy, discuss them with your doctor before the procedure.

[ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ]

Care after the procedure

Following a colonoscopy procedure, it is important to follow certain aftercare guidelines to minimize the risk of complications and make your recovery more comfortable. Here are some general guidelines for aftercare after a colonoscopy:

1. Monitoring the condition:

   • After the procedure, you will be monitored in a medical facility until you have fully recovered from the sedation. This may take several hours.
   • You may be offered light snacks and liquids to help replace lost fluids after the procedure.

2. Food and drinks:

   • After the procedure, it is usually recommended to start with a light diet and gradually move on to regular food over a few hours.
   • Avoid drinking alcohol for the remainder of the day after your procedure.
   • Unless your doctor has given you any specific dietary recommendations, try to eat foods that do not cause abdominal pain or discomfort.

3. Help with food and fluid intake:

   • If you have difficulty coordinating swallowing movements due to sedation, ask your companion to help you with eating and drinking.

4. Limitation of physical activity:

   • Avoid physical activity and driving for several hours after the procedure, as sedation may reduce your coordination and reaction time.

5. Seek medical attention if complications occur:

   • If you have complications after your colonoscopy, such as bleeding, severe pain, fever, or difficulty breathing, seek medical attention right away.

6. Prevention of infection:

   • Practice good hygiene, including thorough hand washing, to prevent infection.

7. Conditions of discharge:

   • You may be given instructions and recommendations for care after discharge from the medical facility. Follow them carefully.

8. Recovery:

   • After the procedure, some patients may feel mild internal pressure or flatulence. These symptoms usually subside within a few hours.

9. Follow your doctor's instructions:

   • Follow all directions and appointments provided by your doctor for follow-up care and recovery.

If you have any concerns or complications after a colonoscopy, do not hesitate to contact your doctor. Most patients recover quickly and without complications from this procedure.