Colonoscopy, proctoscopy

What is colonoscopy?

Colonoscopy is a highly informative endoscopic method of diagnosing the condition of the colon. The diagnosis is performed using a colonoscope (a special flexible tube with a built-in optic fiber or a video chip), which is inserted through the anus into the colon. The tube is 160 cm long, which allows the doctor to examine the mucous lining of the colon from the anus to the cecum.

Colonoscopy helps to examine:

  • inflammatory diseases of the intestine (ulcerative colitis, Crohn’s disease).
  • other types of colitis (inflammatory processes, irritable bowel syndrome).
  • polyps (benignant tissue growths of the mucous lining) and other neoplasms.
  • diverticula (pouching) and other structural features of the colon wall.
  • foreign bodies.

If necessary, a biopsy is performed during the procedure. A biopsy is the removal of mucous lining tissue for in-depth laboratory analysis (histological and/or cytological).

Colonoscopy at Kivach Clinic

The clinic has the ability to perform colonoscopy under sedation when a patient is put in a sleep-like state for a short period of time. Having colonoscopy under sedation helps to avoid discomfort during the procedure. If necessary, it can be combined with EGD.

At Kivach Clinic colonoscopy is performed with certain indications:

  • abdominal pain, spasms.
  • constipation, diarrhea.
  • excess gas production.
  • abnormal substances in the stool (mucus or blood).
  • anemia of unknown origin.
  • monitoring of existing disease and controlling the effectiveness of treatment.
  • cancer prevention (to exclude the presence of cancer in the lower digestive tract).
  • for people over 40 to exclude or early diagnose cancer.

Another type of endoscopy is proctoscopy – a method of an endoscopic visual examination of the rectum and the lower part of the sigmoid colon. The proctoscope (an instrument used by the doctor to examine the mucous membrane) is inserted through the anus at 25 cm. This procedure is indicated if:

  • there is blood in the stool
  • it is painful to defecate
  • there is pain or cramps in the left lower part of the abdomen
  • hemorrhoids
  • aggravated medical history of rectum cancer.

What to expect during the procedure?

The procedure is performed after special preparation.

The patient lays down on the examination table with the knees bent. The doctor inserts a sterile colonoscope through the anus. In order to expand the rectum, the air is pumped in by a special device. The doctor examines the mucous membrane of the colon. When the procedure is over, the air is pumped out of the colon.

The examination lasts for 20-30 minutes, and the patient might return to his/her daily routine and eat right after that. If a patient is sedated, additional time is required for awakening, about 15-20 minutes, and the patient might resume his/her normal activities after that.

Contraindications

Absolute contraindications are:
Acute stage of myocardial infarction, acute stage of stroke, decompensated cardiovascular or respiratory failure, permanent and paroxysmal forms of atrial fibrillation with circulatory failure stage IIA and above, life threatening heart beat disorders, hypertensive emergency, blood clotting disorders, vast ulcerative lesions of the colon, abdominal adhesions, peritonitis, critical condition of a patient.

Question-answer

  1. Is the procedure safe?
  2. Yes, the procedure does not have any effects on the patient's health.

  3. Is the procedure painful?
  4. Individual characteristics (abdominal adhesions, colonic elongation), inflammatory diseases of the rectum (hemorrhoids), anal fissures might affect the painfulness of the procedure. In such cases, it is recommended to perform the procedure while being sedated.

  5. How to prepare for the procedure?
  6. The result of the procedure is directly linked to the preparation.

    Three days before the procedure, the patient should exclude tomatoes, grapes, sunflower seeds, nuts, berries, activated charcoal, and iron supplements from his/her diet.

    The last meal should be 14 hours before the procedure. The patient can continue drinking transparent fluids.

    A laxative (Fortrans) is dissolved in 2-4 liters of water, depending on the patient's weight. The patient has to drink the solution in the evening, starting from 16:00, about 1 liter an hour. It allows the colon to be cleansed naturally. 3-4 hours before the procedure, one should stop drinking any fluids.

    A nurse will inject a painkiller in advance. If the procedure is performed when the patient is sedated, an anesthesiologist is present in the room before and during the examination.

  7. Are complications possible?
  8. After the procedure, there might be a feeling of fullness which goes away on its own.

    In order to avoid complications, one should inform the doctor about his/her condition, allergic reactions, and the details of previous endoscopic examinations.

  9. What is the difference between colonoscopy and proctoscopy?
  10. Colonoscopy allows the doctor to examine the mucous membrane of the whole colon, in particular of the rectum, sigmoid colon, ascending, descending, and transverse colon.

    Proctoscopy takes less time (about 10 minutes) since only lower parts of the intestine are examined – the rectum and the sigmoid colon.

    There are no substantial differences in the contraindications and preparation.

    Even though colonoscopy is a complicated examination, it is as safe and painless as proctoscopy, but its diagnostic capabilities are way bigger.

    The doctor orders a certain procedure based on the indications.

  11. What ensures that the procedure is successful?
    • Qualified medical specialists with extensive practical experience.
    • Advanced equipment.
    • Compliance with the standards of medical care.