Fibrocolonoscopy: preparation for the procedure and how the procedure goes

Fibrocolonoscopy is a diagnostic procedure that allows you to visually assess the condition of the colon mucosa. Other names are colonoscopy and lower endoscopy.

FCC is performed if the following diseases are suspected:

• Crohn's disease;
• diverticulitis;
• ulcerative colitis;
• Hirschsprung's disease;
• oncological pathologies;
• intestinal polyposis, etc.

If indicated, along with a visual assessment of the inner surface of the intestine, the endoscopist can take material for a biopsy. This small piece of tissue will be further examined in the laboratory in order to determine the cellular composition and pathological changes.

Features of preparation for the procedure

In order for fibrocolonoscopy to be sufficiently informative, the patient is required to properly prepare for it. It is necessary to take measures aimed at cleansing the intestines. To do this, use laxatives or an enema.

A comparison of the main methods of bowel cleansing before colonoscopy is presented in the following table:

Characteristic	Cleansing enema	Laxatives
Safety of use	If you have some bowel problems, using an enema can lead to complications.	Fewer contraindications
Execution speed	About two hours to complete several procedures	Five to six hours
Price	Low	Relatively high

Important! In order for the cleansing procedures to be most effective, it is recommended to adhere to a slag-free diet three days before the prescribed diagnostic procedure. On the evening before and the morning before the colonoscopy, absolute hunger is shown.

Cleansing enema

This is the easiest method to cleanse the intestines on the eve of a diagnostic procedure. However, it has several disadvantages. For example, the use of a cleansing enema leads to unpleasant sensations, discomfort, and also negatively affects the state of the intestinal microflora. If performed incorrectly, this method may not be effective enough.

Despite all the disadvantages, many patients who are assigned a colonoscopy prefer this method of bowel cleansing.

This is due to the following features:

• low cost;
• ease of use;
• quick result - in comparison with other methods of bowel cleansing, this method is the fastest;
• does not cause side effects like some laxatives.

Important! For patients with inflammatory diseases and intestinal tumors, this procedure is contraindicated, as it can lead to the development of complications. The same goes for people with hemorrhoids and anal fissures.

Execution technique

To cleanse the intestines, at least three procedures are required. The first two, with a break of 1-2 hours, are performed in the evening, and the rest in the morning. Each infusion should have a volume of at least one and a half liters. It is desirable that the water is boiled; bottled water is also allowed.

Important! The temperature of the liquid should be between 20-36 degrees. Colder water should be given to patients with hypotonic constipation, and warm water should be given to people with intestinal spasms.

Before starting the procedure, you must lie on your left side or get on all fours. The tip is lubricated and inserted into the anus about 10 cm. Thereafter, a slow infusion of water is started. After there is no content left in Esmarch's mug, you need to pull out the tip and keep the water in the intestines for 10-15 minutes. If the urge to have a bowel movement becomes unbearable, then you can empty the colon earlier.

Fortrans

This method is modern and safe, but it takes more time. However, it allows for more informative data when performing colonoscopy.

The active ingredient in Fortrans is Macrogol 4000. Each package contains four sachets of the drug, which is equal to the required dose for one cleansing procedure. Compared to a cleansing enema, this method is more expensive - the cost of the drug is about 500 rubles.

Important! Despite the fact that manufacturers recommend using four sachets for each cleaning procedure medications, the doctor may recommend a different amount of the drug, depending on individual characteristics the patient. Therefore, it is not recommended to start using Fortrans on your own.

Depending on what hours the procedure is scheduled for, preparation for it may differ. Let's consider the features of using Fortrans in cases when the FCC is appointed for the first and second half of the day.

Procedure in the first half of the day

If fibrocolonoscopy is prescribed to the patient for up to 14 hours, it is recommended to use Fortrans to cleanse the intestines. This laxative allows you to cleanse the intestines quite effectively, you do not need to adhere to a slag-free diet or put a cleansing enema in advance.

To prepare, you need to purchase four packages of the drug. This amount of funds will be sufficient for patients with increased body weight, adhesive disease intestines, constipation and other conditions in which the activity of the muscle wall of the thick and thin intestines.

Do not eat 12 hours before the procedure. Each package of Fortrans should be dissolved in a liter of warm boiled water. For such a volume of liquid, it is better to take a 1.5 liter plastic bottle.

Within four hours, starting at 15:00, you need to drink 3-4 liters of the dissolved product. On average, it is recommended to drink one liter of solution per hour. It can be difficult for patients with gastrointestinal diseases to drink this amount of liquid in a short time. In this case, belching, nausea, and other symptoms may appear. To avoid this, it is recommended to drink one Motilium tablet an hour before the start of the procedure. It is a prokinetic agent that improves intestinal motility and accelerates the movement of contents.

After one to two hours after starting the preparation, loose stools should appear. The urge to defecate should occur several more times before 10-11 pm. In some cases, loose stools may be present later. Preparation can be considered complete when the urge stops completely.

A small breakfast is allowed in the morning. Food should be with a minimum amount of fiber. If you plan to use anesthesia during the procedure, then it is contraindicated in the first half of the day.

Afternoon procedure

Colonoscopy is rarely done at 2 pm or later. However, if the procedure is scheduled for this time, it is necessary to use Fortrans according to a different scheme.

The basic principles of bowel cleansing in this case do not differ from the previous one. It is also recommended to follow a slag-free diet, and the amount of the drug is four sachets. However, they start taking the remedy at 20:00.

Breakfast, lunch and a small dinner are allowed the day before the colonoscopy. The last meal is allowed no later than 18:00. Refuse should be from carbonated drinks and other products that can lead to flatulence.

During the time interval from 20:00 to 22:00, you need to drink two liters of the product diluted in warm water. The urge to have a bowel movement should appear after 1 to 2 hours, and stool may appear until about midnight. After their termination, the first stage of bowel cleansing is considered complete.

The second stage also includes two doses of the medicine on the day of the procedure. You need to drink two liters of solution between 8:00 and 10:00. Eating at this time is prohibited, only weak tea or water is allowed to drink in small quantities.

Important! If the patient has poor tolerance to Fortrans, you can replace it with two cleaning enemas on the day of the examination with a break of 1-2 hours.

If all the recommendations are followed, then the urge to defecate should stop by about 13:00. After that, you can drink a glass of plain water or tea. When it is planned to use anesthesia during the procedure, you can drink fluids no later than two hours before the FCC.

Diet before fibrocolonoscopy

As mentioned earlier, three days before the scheduled procedure, you must adhere to a slag-free diet. Patients need to avoid fatty foods, foods high in fiber, coffee and sweets. If the patient is taking medications for diarrhea, they must be abandoned for a while.

The following products are allowed:

• low fat kefir;
• lean fish or meat, steamed or boiled;
• fruit juices, jelly, compotes;
• buckwheat, rice;
• coarse flour bread.

Menu Options Allowed Before Testing:

Eating	Dishes	Image
Breakfast	Steamed vegetables, low fat cheese bread, weak tea
Dinner	Vegetarian soup, lean meat broth, compote
Afternoon snack	A glass of low fat kefir, yogurt
Dinner	Boiled fish with rice, low-fat cottage cheese, jelly, compote

It is worth remembering that fasting on the eve of fibrocolonoscopy is a prerequisite for a successful diagnostic procedure. This will help enhance the benefits of other bowel cleansing methods.

Proper preparation for the FCC is imperative for the results of the study to be informative. Colonoscopy is an unpleasant procedure. Therefore, it is better for the patient to spend energy on a sufficient bowel cleansing and adherence to the diet for several days than to re-undergo the study.

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Video - Fibrocolonoscopy