How to prepare for a colonoscopy: detailed information

Colonoscopy is an effective diagnostic coloproctology procedure that allows you to get the most accurate and quick result of patient examination.

The procedure is performed using a special medical device, a colonoscope, consisting of a thin flexible probe, illumination, air tube and micro forceps for taking tissue samples for further examination of histological material.

Modern equipment is equipped with mini cameras, with the help of which doctors have the opportunity to display the image on the screen and get high-precision images. On the image with high resolution, it is possible to determine the composition and zones of pathological changes in tissues.

What information does a colonoscopy provide?

The procedure gives the doctor information about the patient's condition, which would take a lot of time to obtain by other methods. In addition, this is the most accurate data on changes in the mucous membranes. Based on the study of the results of colonoscopy, the doctor has the opportunity to:

• assess the condition of the intestinal mucosa, see the diameter of the lumen, the state of the vessels. The video camera allows you to determine cracks, their size and location, scars, foreign bodies, nodes, polyps, tumors;
• to assess the type of process taking place in the body, to clarify the preliminary diagnosis;
• urgently stop intestinal bleeding, remove a foreign body, remove polyps and small benign tumors.

The attending physician can prescribe a colonoscopy for the patient, both during routine and emergency examinations. The reason for an urgent examination may be the appearance of purulent discharge from the intestines, sharp pain in colon area, anemia, sudden weight loss, suspicion of the presence of foreign objects in intestines.

Preparing for a colonoscopy

To improve the effectiveness of the endoscopic examination of the intestine, the patient must be prepared in advance. The process is complex and includes both a special diet and the use of modern medications. The training scheme is developed by the attending physician, taking into account the actual condition of the patient. Preparation for the examination consists of several stages.

General medical activities

1. The intake of medical preparations containing iron, bismuth, activated carbon is completely excluded or critically limited. These substances cause discoloration of the intestinal mucous membranes, which distorts the actual picture. The regimen for taking hormonal, cardiac and antihypertensive drugs does not change.
   

   It is forbidden to drink activated charcoal before the procedure

2. To relieve strong psycho-emotional stress, sedatives. The list of sedatives is not limited, the decision is made by the doctor, taking into account the characteristics of the patient's nervous system.
   

   Depressant

3. If the patient has chronic constipation, then laxatives to stimulate the contraction of the rectum, in difficult cases, a combination of osmotic and stimulating drugs is allowed.
   

   Laxatives

To improve the efficiency of colonoscopy of the intestine, additional measures are needed to free it from digestion residues. For this purpose, a special diet is prescribed.

Local preparation for the procedure through diet

Local preparation of the bowel for the examination should be started 3-4 days before the start of the procedure. In limited quantities it is allowed to use:

• fresh melon, 2-3 bananas, peaches and apples with pre-peeled skin, boiled soft-boiled eggs;
  

  Scrambled eggs

• homemade dairy products, butter, hard cheeses;
  

  Homemade fermented milk products

• white meat and lean veal, fish, boiled meatballs, steamed cutlets;
  

  Steamed cutlets

• clear meat broths, vegetable broths, mashed potatoes;
  

  Mashed potatoes

• white bread, crackers, baked goods. Sweet flour products in very limited quantities.
  

  Pastry and bread

It is not recommended to eat:

• fresh cabbage, onions, garlic, seafood containing iodine, all types of greens, legumes, pickles and marinades;
• black bread, wheat and pearl barley porridge, rye flour food products;
• fresh dairy food, carbonated drinks, alcohol;
• canned food, smoked meat products, hot spices;
• fatty poultry, fatty fish, rich borscht and cabbage soup.
  

  It is not recommended to use rich soups.

If the patient is diagnosed with chronic diarrhea or constipation, then the list of permitted products is adjusted by the attending physician. A diet to reduce the amount of waste in the intestines should be applied 5 days before the colonoscopy. If there is a diagnosis of colostomy, the diet is maintained for at least 7 days before the start of the examination.

Example of a Recommended Diet

Three days before your colonoscopy examination	Two days before the colonoscopy examination	On the day of the colonoscopy examination
For the first breakfast, porridge on water from polished rice, a glass of weak tea, preferably without sugar. For lunch 200 ml. kefir of low fat content. For lunch, a rare soup made from any vegetables, fresh fruit or dried fruit compote. For an afternoon snack, 75-100 g of hard cheese. For dinner, boiled fish with a minimum fat content (sea or freshwater) with rice, a glass of weak tea.	For the first breakfast, you can eat a casserole or low-fat cottage cheese, drink compote or tea. For lunch, a few crackers, a glass of tea. For lunch, 250 ml. Chicken broth, 100–150 g of white meat or lean veal or beef, fresh steamed cabbage, tea. For an afternoon snack, a glass of fermented baked milk or other fermented milk product. For dinner 200–250 g of buckwheat porridge on the water, tea.	If the examination is scheduled for the evening, then eating is allowed only before lunch. For breakfast, dairy products in reduced quantities. For the second breakfast, a glass of tea or kefir.

The diet is selected by the attending physician individually for each patient, taking into account his actual condition and the presence of concomitant acute and chronic diseases.

Drug preparation of the intestines for examination

It is impossible to achieve a high-quality colonoscopy of the intestines due to a single diet, restriction of the diet serves only as an additional measure before preparation. To improve the process of emptying the intestines from food debris, special medical prescriptions must be used.

Cleansing enemas

It is recommended to do at least two enemas with boiled water at a temperature of 36–36 ° C. In the absence of constipation, enemas are done two days before the start of the examination, immediately after stool. Each enema up to two liters. 2 hours before the start of the colonoscopy, the last one should be prescribed. The number of procedures may vary depending on the state, but the total is limited to eight in most cases. The increase is allowed only in the case of severe chronic constipation.

Laxatives

Fortrans

The dose is determined at the rate of one factory package for 20 kg of the examined person; for a patient weighing 80 kg, four packages are required. Each package is prepared in a liter of boiled non-carbonated water, you need to drink in small sips, a single dose is one glass of 150-200 ml. You need to take a solution in a volume of a liter per hour. Improving the taste of the drug is done by adding lemon juice to the container. The second option is to end the intake with freshly made citrus juice.

The drug can be taken in one or two stages. With a one-stage scheme, the entire dose is used on the eve of the examination. With two-stage, ¾ of the volume is drunk the day before the start of the procedure, the rest 3-4 hours before the colonoscopy. To improve the effect, it is recommended to drink 240 mg of simethicone with the last glass, you can replace it with 30 ml of espumisan suspension.

The appearance of vomiting or nausea is not considered to be the reason for discontinuation of the drug, when such symptoms appear it is recommended to pause in admission for 30 minutes, after the disappearance of symptoms, treatment should be continued. To improve bowel cleansing while taking medication, it is recommended to constantly move, massage well or self-massage the abdomen. In the case when, after taking Fortrans, the stool does not become transparent or yellowish, then on the day and on the day of the examination, the patient is additionally prescribed enemas.

"Moviprep"

The generally accepted form of packaging is powder; taking into account the weight of the patients, it is necessary to prepare 2–4 liters of a warm solution. Two packets will dissolve in a liter of water, you need to drink at a rate of one liter per hour. The action of the drug occurs in 1-2 hours, if unpleasant sensations appear, it is allowed to additionally drink up to 1 liter of liquid (water, broth, broth, juice). At least one hour must be taken between the last appointment and the beginning of the colonoscopy.

Sleep disturbances, dizziness, and rarely headaches can occur as side effects. Often there are discomfort in the abdomen, bloating, and anal discomfort. "Moviprep" should not be drunk by patients in whom the gag reflex is impaired or a tendency to aspiration is expressed. For patients with kidney problems, weakened by concomitant diseases, who are at risk of electrolyte imbalance, the doctor makes preliminary tests. Conservative measures are quite sufficient to relieve negative symptoms, patients are advised to drink plenty of clean water.

Endofalk

One packet dissolves in 500 ml of liquid. For complete cleaning, you need to use 3-4 liters of endofalk in solution. The drug should be drunk in small portions with an interval of 10-15 minutes. Reception is done until the rectal water is clear. "Endofalk" is prescribed approximately four hours before the start of the colonoscopy, before taking food with solid inclusions is prohibited.

While taking the solution, there may be vomiting, nausea, bloating, and a feeling of fullness in the intestines. Other deviations from the normal state are extremely rare and not clinically described. Elderly subjects who have a pronounced sinoatrial blockade should take the drug only under the supervision of the attending physician.

Too large a dosage causes severe diarrhea, a violation of the water, acid-base and electrolyte balance. In all cases, adequate fluid recovery and monitoring of the concentration of electrolytes in the subject's blood are required.

"D-Forject"

Osmotic action, contains a medicinal substance macrogol and body electrolytes. Macrogol, due to its hydrogen polystructure, binds water molecules, which subsequently liquefy the contents of the intestine, its volume increases significantly, the internal pressure rises, the urge becomes more frequent to the toilet. Evacuation of fluid and waste products occurs during frequent bowel movements. The presence of electrolytes prevents the initial balance from being disturbed.

The content of one package must be dissolved in a liter of boiled water, a liter of the finished solution must be taken for 20 kg of mass.

Preparation for colonoscopy can be one-stage (4 liters in the evening, you can in the morning on the eve of the examination) or two-stage (half the dose in the evening, and the second half in the morning). The preparation regimen is chosen by the attending physician, he must take into account the patient's state of health, and take into account the potential risks of negative phenomena.

As side effects, vomiting or nausea may occur, complications disappear simultaneously with discontinuation of the drug. Sometimes there may be slight bloating, as for allergic reactions, they are extremely rare.

Contraindications are problems with intestinal obstruction, severe general condition of the patient. Detection by previous analyzes of a malignant tumor with large lesions of the mucous membrane. Elderly and patients with complex concomitant diseases of the examined drug can be used only under the supervision of a personal physician.

Fordrive

Active ingredients: sodium sulfate, macrogol, potassium chloride and sodium bicarbonate. "Fordrive" does not cause acceleration of the electrolytic exchange of plasma with the intestines, does not cause negative changes, replenishes the secretion of chlorine to a normal level, regulates the content of potassium and sodium. Not prescribed for children under 15 years old, adults can use up to 4 liters at a time at the rate of one liter per 20 kg. "Fordrive" of one package is dissolved in a liter of boiled water, taken orally. Depending on the patient's clinical well-being, the attending physician can change the Ford drive regimen.

Vomiting and nausea may occur only in the initial period of bowel cleansing, sometimes gas and bloating are observed. Negative phenomena that worsen the patient's well-being stop after stopping the drug intake. "Fordrive" is not assigned when an increased sensitivity of the subject's body to one of the components, severe disorders of the general condition, progressive carcinoma and other significant damage to the mucous membrane shell.

special instructions

Additional prescriptions of drugs are made by a doctor when negative reactions of the body to preparatory measures are manifested.

1. If during the preparation for the examination there is bloating, then before the procedure, in the morning and at lunchtime, two tablets "Mezim-forte" or another enzyme preparation are prescribed. It is allowed to prescribe two capsules three times in 24 hours of espumisan (the dose corresponds to 240 mg of the active substances of simethicone) the day before the examination and two capsules of espumisan in the morning two hours before the start procedures.
   

   "Mezim-forte"

2. If a biopsy is planned during a colonoscopy, then physical activity is excluded the day before the procedures and the day after them.
   

   It is best for the patient to rest before the biopsy.

3. One day after colonoscopy, it is not recommended to eat sour vegetables and fruits, drink carbonated water. All foods that contribute to the release of gas in the intestines are excluded.
   

   List of foods that cause bloating

For the first 2–4 hours after the examination, patients should be under the supervision of the attending physician.

Video - How to prepare for a colonoscopy