How to prepare for sigmoidoscopy? Find out from our article!

Diseases of the rectum are pathologies of the anorectal and pararectal space and occur in every tenth patient. Treatment of many diseases of the anus begins already at an intermediate or advanced stage, since the symptoms of such pathologies can be rather scarce, and most patients do not pay attention to minor discomfort: moderate itching, burning or unexpressed painful Feel. One of the most formidable diseases of this group is rectal cancer (colorectal cancer) - a malignant growth of the epithelium lining the inner surface of the intestine.

For early diagnosis of cancer and other diseases, in most cases, hardware diagnostic methods are used. The safest and most informative method for examining the rectum is sigmoidoscopy (rectoscopy). This is one of the types of endoscopic examination. During rectoscopy, the doctor may conduct a visual examination of the mucous membranes of the rectum for ulceration. and erosive defects, as well as assess their color, approximate thickness, structure, the presence of foci of bleeding, polyps. Despite the almost complete absence of contraindications, the procedure can lead to complications, therefore, the most important stage of diagnosis is the correct preparation for the study.

What is sigmoidoscopy for?

Sigmoidoscopy is considered a fairly informative method for diagnosing diseases of the rectum and is one of the the main preventive measures in persons at risk for the development of colorectal malignant tumors. Most often, rectal and anus cancer occurs on the streets of the elderly, so this study indicated for all patients over 60 years of age at least 1 time per year (in patients over 40 years of age - 1 time in 2-3 years). The risk group also includes people suffering from chronic alcoholism or smoking, workers whose activities associated with prolonged sitting (for example, drivers), women giving birth, patients with various forms of hemorrhoids.

Sigmoidoscopy also allows you to identify inflammatory processes of the anal canal and other intestinal pathologies, including inflammation in the distal part of the sigmoid colon, which is located in the lower part of the digestive tract and is a segment of the colon intestines. Diseases that can be diagnosed with rectoscopy are listed in the table below.

Diseases detected by sigmoidoscopy

Disease	Image	What it is?
Haemorrhoids		Dilation of the venous arteries that form the hemorrhoidal plexus of the rectum, with characteristic symptoms: bleeding, soreness, prolapse of the nodal elements outside the anus
Proctitis		Inflammation of the mucosal (inner) layer of the rectum
Anal fissure		A defect or ulcer of the mucous membrane of the anus with a linear or elliptical longitudinal rupture and arising spontaneously as a result of chemical or mechanical damage (for example, during anal sex)
Cryptite		Formation of mechanical depressions in the terminal part of the anal canal with subsequent inflammation as a result of clogging of feces, mucus and dead epithelial cells into the crypts
Pararectal abscess		Inflammation of adrectal tissue, which can be acute or chronic and occurs in about 20-40% of the adult population

Important! Sigmoidoscopy allows not only to reveal signs of a tumor process in various parts of the straight and sigmoid intestines, but also to take samples of biological material for histological examination, which is necessary for diagnosis cancer.

Indications for appointment

Sigmoidoscopy can be performed for prophylactic purposes in individuals at increased risk of colorectal cancer or prescribed for certain indications, which may include:

• stool instability in the absence of signs of an infectious or inflammatory process;
• change in color, consistency and odor of feces;
• the appearance in the feces of mucus, blood, white blotches;
• pain during and after bowel movements;
• itching of varying intensity, arising both in the anus itself and around the anus.

For men, sigmoidoscopy can be prescribed as an additional study as part of a comprehensive diagnosis of prostatitis and other pathologies of the prostate gland. For women, in some cases, rectoscopy is required to draw up a complete clinical picture in diseases of the small pelvis and genitourinary system.

How is the procedure carried out?

Rectoscopy, unlike many other types of endoscopic diagnostics, practically does not deliver to the patient of painful sensations, therefore, local anesthesia during it is used extremely seldom. The rectoscope, with which the examination is performed, looks like a thin hollow tube, at the end of which there is an obturator that provides air supply and an optical device. Before the procedure, the patient is placed on his left side, asked to bend his knees and bring them to the stomach. Some institutions use classic postures for rectoscopy (kneeling with support on the elbows or shoulders), but most specialists refuse such techniques due to pronounced psychological discomfort sick.

Uncomplicated sigmoidoscopy is performed in several stages:

• the tube of the rectoscope is abundantly lubricated with petroleum jelly or other fatty base and inserted into the rectum by about 5 cm;
• using the air supply, the doctor advances the device by the sphincter and removes the obturator;
• at a height of 13-14 cm, the patient is asked to take a deep breath and relax the right shoulder - at this stage, the tube penetrates into the distal part of the sigmoid colon.

Important! The appearance of pain during the procedure is an important symptom indicating possible tumors or other formations of extraintestinal localization. If the tube rests against some obstacle during its passage through the rectum, and its advance is difficult, the study must be stopped immediately.

Proper preparation for the procedure: what can and cannot be eaten before rectoscopy?

Diet before sigmoidoscopy is an important stage of preparation, which is necessary not only to improve the visibility, but also for the accuracy of the diagnosis. Compliance with a special diet will also help reduce psychological discomfort, since dietary restrictions allow reduce slagging of the intestines and get rid of flatulence, as well as avoid the arbitrary discharge of gases during survey.

It is necessary to follow the diet for 3 days. The main principle is the rejection of foods with a high content of coarse plant fibers, which take a long time to digest and can provoke increased intestinal peristalsis and gas formation. These products include raw fruits and vegetables, cereals, baked goods, legumes. It is also worth giving up alcohol, chocolate, products that include baker's and brewer's yeast. It is not recommended to consume drinks with a high caffeine content the day before the procedure, as they have a pronounced tonic effect and can cause spasm of the vessels of the rectum during administration rectoscope.

During this period, the following are also prohibited:

• confectionery;
• sucrose;
• nuts and seeds;
• pasta (especially made from durum wheat);
• carbonated drinks;
• whole milk and dairy products that are too acidic (for example, kefir);
• spices.

You should avoid eating fatty meats: pork, lamb. Sausages (sausage, small sausages, sausages), smoked meats, pickled vegetables during this period should also not be present in the patient's diet.

What you can eat: the basics of nutrition before rectoscopy

Boiled vegetables and meat are the basis of nutrition for three days before the procedure. Preference should be given to lean meats with high nutritional value: rabbit, turkey, chicken. From vegetables for medical nutrition, zucchini, eggplants, bell peppers, tomatoes (in limited quantities) are perfect. Vegetables with a high starch content (carrots, beets, potatoes) are allowed to be consumed, but only in boiled form and no more than 150 g per day.

It is better to bake fruits in the oven - this method of heat treatment destroys coarse plant fibers, while retaining most of the nutrients and vitamins. Green apples and pears are best suited for medical nutrition - they contain less sugar and are better absorbed by the body. For people prone to flatulence and other digestive disorders, instead of vegetables, it is better to use vegetable broths and completely abandon fruits in any form.

You can eat dairy products, but it is important to monitor their fat content - it should not exceed 1.8%. Best for patients preparing for sigmoidoscopy, fat-free fermented baked milk, cottage cheese and yogurt are suitable. Fermentation processes are intensified in many patients from kefir, so it is better for people with weak intestines to refuse it.

Sample menu for preparation for sigmoidoscopy

This diet is suitable for patients of any age. It can be adjusted in accordance with your taste preferences, but the principles of nutrition during the preparation for rectoscopy should remain unchanged.

Eating	Dishes	Image
Breakfast	Cauliflower casserole with cheese and pasteurized milk, green tea	Cauliflower casserole with cheese
Lunch	Banana soufflé with cottage cheese	Banana soufflé with cottage cheese
Dinner	Vegetable soup without meat and without adding cabbage, steamed turkey meatballs with mashed potatoes garnished, rosehip broth	Vegetable soup
Afternoon snack	Sour milk (it is allowed to add some lingering cookies to the afternoon snack)	Yogurt
Dinner	Baked cod with tomato sauce, tea	Baked cod with tomato sauce
Before bedtime	Some natural yogurt without additives and sugar	Some natural yogurt without additives and sugar

Note! The recommended serving size during this period is 220 g. The volume of drinks should not exceed 150 ml at a time.

Colon cleansing: enemas and drugs

Bowel cleansing is a mandatory procedure for preparing for sigmoidoscopy. It is necessary to improve the overview, correct diagnosis and prevention of involuntary discharge of feces during the study. The main method of cleansing is enemas. It is recommended to do them 2 times:

• the evening before the procedure (2-4 hours after the last meal);
• 3 hours before the examination.

If the patient cannot cope with setting the enema on his own, he can seek help from the procedure room of the institution in which the rectoscopy will be performed. For an enema, it is recommended to use ordinary purified water at room temperature. The minimum enema volume is 1 liter, but it is better to bring it to 1.5-2 liters. Before starting the procedure, the patient is advised to empty the intestines on his own, and then lie on his right side, bend your knees and gently insert the tip greased with petroleum jelly (or any vegetable oil) into a straight line intestine.

The water flow rate should be medium. The muscles of the anus should be as relaxed as possible. The average time for one procedure should be from 3 to 5 minutes. If the infusion is completed earlier, the feces will not have time to soften; mostly water will come out of the intestines. After the end of the procedure, you should clamp the anus with a diaper and wait another 10 minutes. If you can't stand that much time, you can limit yourself to an interval of 5-7 minutes.

Laxatives

Laxative medications in most cases must be taken orally 24 hours before the procedure. The choice of the drug should be carried out by the doctor, taking into account possible contraindications and the patient's age.

Fortrans

The most popular drug from the group of laxatives. It is produced in the form of a powder for solution preparation, contains macrogol as an active ingredient (64 g in 1 sachet). The product contains electrolytes, therefore, against the background of its use, there is no violation of the water-electrolyte balance. "Fortrans" is suitable only for use in adult patients and adolescents over 15 years of age.

To prepare one liter of solution, you must use 1 sachet, dissolving it in water. For every 15-20 kg of weight, you need to drink 1 liter of solution, that is, a patient weighing 75 kg will need about 4 liters of the finished medicine. The product can be taken once (in small sips) or divided into 2 applications. Finish taking "Fortrans" should be 3-4 hours before the procedure.

The cost of 1 package is 460-560 rubles.

Advice! The prepared solution has a very salty taste, causing nausea and vomiting in most patients. To reduce discomfort, experts advise drinking Fortrans through a straw.

"Lavacol"

An inexpensive drug (the cost of a package is about 149 rubles), prescribed for preparation for diagnostic examinations of the gastrointestinal tract. It must be taken 18-20 hours before sigmoidoscopy, and after taking it, only liquid food is allowed. To prepare a solution, you need to dilute 1 sachet in 200 ml of water and drink it immediately. In total, you need to take about 10-15 sachets with an interval of 20 minutes. After 22 pm, it is forbidden to eat (until rectoscopy).

If the patient follows all the doctor's recommendations for preparation for the procedure, the likelihood of discomfort and complications during the examination will be minimal, so do not neglect the advice of specialists costs.

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