Rectosigmoscopy: indications, preparation, conduct
Diseases of rectum and sigmoid colon is of diseases of the colon leading position, therefore we are constantly developing new diagnostic and therapeutic methods. Rectosigmoscopy – endoscopic examination of the inner lining of rectum and sigmoid. At the same time, during the procedure it is possible not only external examination of the mucous membrane, but also perform a biopsy, and small medical procedures. The technique is widely used in clinical practice for the detection and diagnosis of diseases of the lower parts of large intestine.
Rectosigmoscopy – what is it? It is a method of endoscopic examination of the mucous membrane of the colon using special equipment.
The availability of these readings in the patient, is an important argument to conduct endoscopic examination of rectum and sigmoid. It is important to exclude the patient possible contraindications:
- Decompensated diseases of the cardiovascular and respiratory systems.
- Expressed disorders of cerebral blood flow.
- Inflammation in the rectal region in the form of fissures, hemorrhoids, abscess, etc.
- The inability to ensure adequate training for the procedure.
If the detected state data of the procedure should be abandoned by choosing its counterpart.
As the survey is conducted?
The procedure is done in a special endoscopy room with all the necessary equipment. General anesthesia is not carried out, since the procedure does not require shutting down the consciousness of the patient. Can be used in local anesthetics to reduce discomfort during introduction of the endoscope.
A preliminary stage in carrying out rectosigmoscopy – finger examination of the rectum to detect obstruction of the rectum. After this injected directly the interior, gently inflating the bowel with air. This procedure allows you to straighten the bowel wall, allowing for easier inspection and detection of pathological processes. In case of pain or urge to defecate is necessary to stop pumping air and a little to withdraw the endoscope. For visual observation use videoretroperitoneoscopic. In this case, use an endoscope with a mounted video camera and a light source.
If necessary, possible biopsy, which consists in taking a small piece of mucosa rectum or sigmoid colon, with subsequent morphological study. This procedure is necessary if there is suspicion on the tumor process, as well as for the differential diagnosis of certain diseases, such as Crohn’s disease and ulcerative colitis. In addition, it is possible to conduct medical procedures, involves the removal of small polyps or stop bleeding from vessels of small calibre.
Adherence to proper technique of rectosigmoscopy allows to avoid the development of complications and improve the effectiveness of the procedure.
Preparing the patient for rectosigmoscopy
The preparation is the most important factor in ensuring its effectiveness and safety for the patient. Typically, the preparation starts two days before rectosigmoscopy and requires compliance with special diets and cleansing the colon.
Not later than two days before the procedure from the diet should exclude all foods that increase flatulence and the intensity of fermentation in the gut. Such foods include legumes and dishes from them, foods with a high fiber content (vegetables and fruits), some cereals (wheat, barley, etc.). Also, the patient should be excluded from a food bread, flour and confectionery products, sodas etc. are Allowed to eat boiled lean meat (fish, chicken), rice porridge, drink weak tea and biscuits. The day of the test you must give up eating. It is possible to drink only plain, clean water.
The day before the survey you need to clean the colon. For this purpose, use an enema or conventional or modern medicines. When choosing the enema it needs to be two-fold statement – the night before the study and in the morning, a few hours before the procedure.
The use of laxatives, is a more modern approach. The most commonly used drugs such as Fortens, Lavacol or fleet. Drugs are produced in the form of a dry substance or a gel-like substance in packages that must be prepared immediately before use. The effect occurs within a few hours. This is a high degree of cleaning of the colon without the use of enemas, always associated with great discomfort for the person. Before using such medications is necessary to ensure no allergic reactions, and portability of their components.
Scheme of the use of each medications differ. You should carefully read the instructions to the drug and to consult a specialist.
When conducting rectosigmoscopy may develop complications related to human factor and features of the body of a patient. The most dangerous are:
- Internal intestinal bleeding, resulting from mechanical damage to the wall of the large intestine or the careless removal of a polyp.
- Perforated holes in the intestinal wall, leading to peritonitis and shock.
With the development of complications it is urgent to carry out surgical operations aimed at their elimination. It is important to observe the procedure and to thoroughly prepare the patient to it.
Rectosigmoscopy is modern, efficient and safe method for the study of the status of rectum and sigmoid. The possibility of visual inspection of the mucous membrane allows the doctor to detect even small changes, which is especially important in the diagnosis of neoplastic diseases. It is important to remember that before using these procedures, you should always consult with your doctor to identify indications and contraindications. In state hospitals the investigation is performed on a free basis. However, the patient may pass rectosigmoscopy and in private centers, there is consultation with the doctor-proctologist. The average cost of study – 2-3 thousand rubles.