Colonoscopy is an imaging procedure performed with the use of flexible endoscope (colonoscope). The instrument is equipped with a precise control mechanism that enables bending required to insert the instrument deeper into the colon. The aim of this procedure is to obtain macroscopic assessment of the mucous membrane of the large intestine. During the procedure there is a possibility to collect a section of mucosa for a histopathology test as well as to perform many endoscopic treatments, like excision of polyps or stopping of bleeding.
The indication for colonoscopy would be:
– bleeding from anus or presence of blood in the stools, as the proctological examination alone (by palpation or with a stiff instrument), even if the potential source of bleeding was found, is insufficient.
– change of the nature of the stools (change in the diameter, consistency, frequency of defecation), abdominal pains unclarified by other examinations, unclarified loss of body mass or anemia
– doubts regarding the former imaging test (e.g. X-rays, USG)
– suspicion of colon cancer, presence of polyps, inflammations
– follow-up after surgical or endoscopic treatments of colon
Attention! An absolute contraindication for performing colonoscopy is a diagnosed peritonitis. It is not recommended to perform colonoscopy in women in the 2nd and 3rd trimester of pregnancy, in patients with abdominal aneurysm or coagulation disorders.
Anoscopy
This examination is performed as a continuation of the per rectum examination. With the use of an anoscope is introduced into the retum and the anal canal is assessed. The procedure enables a more precise assessment of certain changes, like fissures or clots. Generally it is an examination enabling the assessment of the dystal section of rectum and the anal canal in the way no other examination, like rectoscopy or colonoscopy, could provide.
Rectoscopy
This examination, similarly to anoscopy, serves diagnostics of the distal section of the gastrointestinal tract. A rectoscope, equipped in the source of light, is used to assess the state of the mucous membrane of the section up to 20 cm deep into the rectum. It enables colleting the samples for histopathology tests from the changed areas. The examination is performed in the knee-elbow position.
Sigmoidoscopy
Sigmoidoscopy is an endoscopic examination of the final 60-80 cm part of the colon, that is the rectum, the sigmoid and a part of the desending colon. It can serve diagnostic purposes (like discovering ulcers, polyps, tumors, deformations, vessel changes, bleeding sites) or therapeutic purposes (stopping active bleeding with laser). Sigmoidoscopy enables collecting sections of tissues for histopathology.
Indications:
– prolonged diarrhoea of unclear origin
– blood in stools
– alternation from norm of the bowel movement rhythm – pencil thin stools
– feeling of incomplete emptying of bowels
– involuntary defecation
– painful defecation
– complications in rectoclysis
– reoccurance of colitis ulcerosa.
Preparation before the examination:
FORTRANS
48 hours prior to the examination refrain from eating foods containing seeds, (like poppy, grapes or watermelon) as well as foods of intensive red colouring (beetroots) and hard skin (tomatos)
24 hours before colonoscopy you are allowed to eat light breakfast and take cardiac, antihypertensive or antiepileptic drugs
at noon take 2 tablets of Bisacodyle with one glass of water
at around 3pm drinking one glass of clear bulion is allowed, as well as water and tea. You can also suck candies or honey
one hour after dissolve 3 sachet of fortrans in 3 liters of still mineral water (1 sachet / 1 liter) and drink 1 glass every 15 minutes.
remember not to follow regular eatisng habits – it is best to refrain from any food intake in this period of time
to the examination the patient should be assissted by a relative or a friend
FLEET PHOSPHO-SODA
48 hours prior to the examination the patient must refrain from eating foods containing seeds, (like poppy, grapes or watermelon) as well as foods of intensive red colouring (beetroots) and hard skin (tomatos)
in this period the patient is allowed to eat: rice, pasta, bulion, bread, cooked or fried meat, fish, and to drink juices, tea and drinks without gas
in the morning – after 7 am – the patient should stop any food intake, but should drink at least one glass of water. The patient should also take the first dose of the drug – the first bottle of the drug should be mixed with ½ glass of cold water. The solution should be drunk with at least 1 glass of cold water.
at noon drink at least 3 glasses of water or other bewerage and refrain from eating lunch
in the evening the patient mustn’t eat dinner and should drink at least 1 glass of water or other bewerage. Then the second bottle of medicine should be mixed with ½ glass of cold water. Drink the solution with at least 1 glass of cold water.
Surgical consultations are recommended and relevant in diseases of the whole body, thus naming all important ones here would be impossible.
The most common reasons for patients to seek surgical consultation are:
lumps on the skin, in the subcutaneous tissue or salivary glands, artheromas
thyroid diseases
mammarry disorders
groin, navel hernias and hernias in the postoperative scars
gallstones in the gallbladder and the bile ducts
duodenal and gastric ulcers
disturbed swallowing, indigestion, constipation, diarrhoeas, blooding from colon
diverticular disease, and bowel inflammatory diseases
ascites
abdominal pain of unclear origin
varicose veins of the lower limbs and varicocele
stomach, intestine, rectum and anus tumors and carcinomas
intestinal fistulas
anal diseases – hemorrhoids, anal fissures, anal venous thrombosis, anal fistula
pilonidal abscess in the coccygeal area
some nail diseases
venous ulcers of the lower legs
diabetic foot – ulceration and rotting changes on the feet in the course of diabetes
inflammatory and obliteral diseases of the lower leg arteries
testicular hygromas
cysts in different areas of the body.