Video colonoscopy: what is it, contraindications and preparation for the procedure

Patients suffering from chronic intestinal diseases are well aware of the specificity of diagnostic studies of this organ. Several effective methods have been developed, each of which is aimed at identifying certain pathologies. The leading survey is video colonoscopy: what it is and the features of its conduct will be discussed in this article.

What is video colonoscopy?

Video colonoscopy (colonoscopy, fibrocolonoscopy) is one of the most informative methods for diagnosing diseases of the colon. With the help of the built-in camera in the colonoscope, an image of the intestinal surface is displayed on the monitor in multiple magnification.

An examination is performed using a colonoscope, a mechanism consisting of a video sensor and a flexible tube that is inserted through the rectum. The device makes it possible to thoroughly examine the state of the intestinal mucosa, including all subtle changes that occur there.

Table 1. Advantages of video colonoscopy

Advantages	Specifications
The use of modern equipment.	The new models are distinguished by good bending properties, which makes it possible to painlessly penetrate into every bend of the intestine. A 10x magnification of the image produces a clear picture with contour detail.
Safety	Modern technologies for creating the apparatus have minimized the risk of organ injury. An automated method of cleaning the device is responsible for sterility.
Painlessness	Recently, it became possible to undergo the procedure in a state of medication sleep. According to experts, this is the gold standard for endoscopy. In developed countries, this method is used in 90% of studies. Given the stability of the subject during the "sleepy" procedure, the specialist can more scrupulously analyze the state of all parts of the intestine.
Biopsy.	The device makes it possible to take a tissue fragment for laboratory analysis. This method is used when there is a suspicion of the presence of erosions, ulcers, tumors or polyps. Prolonged inflammatory processes also require analysis of the affected tissue.

Indications and contraindications

Colonoscopy video is the best way to early diagnosis of cancer of all parts of the intestine. This method provides an opportunity to identify and localize the disease, as well as to study the features of the structure of the affected tissues and the intensity of development. The obtained data allow choosing the optimal direction of treatment.

Cancer problems are not the only pathologies that can be detected with the help of the device. During the examination, a specialist can identify the following diseases and processes:

• swelling;
• internal hemorrhage;
• cracks;
• purulent exudate;
• changes in the vascular pattern;
• Crohn's disease;
• microscopic ulcers;
• ulcerative colitis;
• abscesses.

This diagnosis is widely used in patients with poor heredity. If the relatives of the examinee have had intestinal diseases in the past, he must undergo a video colonoscopy every 6 months. Many diseases, especially adenoma, which is a precursor to cancer, are asymptomatic. It is important for patients at risk not to miss scheduled check-ups with a specialist.

Colorectal cancer is considered a very dangerous disease, claiming tens of thousands of lives every year. Most deaths can be prevented with just one simple procedure. If the percentage of the population regularly screened increases, doctors will be able to diagnose the disease at an early stage, thereby increasing the survival rate.

Another frightening pathology that is successfully determined using video colonoscopy is Crohn's disease. This is an inflammatory process that affects all layers of the intestinal wall. It leads to the formation of formations resembling nodules that arise during the growth of affected cells.

Until recently, this pathology was known only from textbooks. However, over the past decades, statistics have left much to be desired: every 50 out of 100,000 people suffer from this disease. The disease is very difficult. Specialists have not yet achieved success in a complete cure from the disease: the efforts of doctors are aimed only at achieving long-term remission. The lack of an effective treatment plan is due to a lack of understanding of the mechanism of the onset of the disease.

Table 2. Indications and contraindications for the procedure

Recommended	Forbidden
• persistent constipation; • frequent painful sensations in the abdominal cavity; • suspicion of the formation of neoplasms; • regular diarrhea; • bloody or mucous discharge in the feces; • operated polyps; • an increase in body temperature within 37.5, lasting more than several weeks; • acute inflammatory process; • anemia of undetermined origin; • the presence of seals during palpation.	• peritonitis; • atherosclerosis; • intestinal perforation; • infectious diseases; • aortic aneurysms; • adhesions in the peritoneum; • pulmonary or heart failure in advanced form; • violation of the heart rhythm; • poor blood clotting; • heart attack and stroke; • ulcerative colitis; • hypertension stage II and III.

This examination is not recommended in the presence of inguinal or umbilical hernias, since the procedure can aggravate the condition of the subject. Patients who have been implanted with artificial heart valves are allowed to the procedure only after a course of antibiotics. People who have reached the age of 50 are required to undergo the procedure.

How is video colonoscopy going?

Video colonoscopy is performed coloproctologist or an endoscopist. Referral can be obtained from a general practitioner, surgeon, or proctologist.

Only 5% of the subjects are unable to endure this manipulation due to severe pain that occurs as the apparatus moves through the intestines. This can be caused by the presence of adhesions, mechanical damage or neoplasms on the walls of the organ. In other cases, the patient feels a slight tingling sensation and a feeling of fullness in the abdominal cavity.

Features of the procedure

• The patient changes into a special medical gown worn over the naked body.
• He lies down on the couch and assumes a position lying on his side, while his knees are pressed as much as possible to the chest.
• After palpation of the rectum, the specialist slowly inserts the device through the anus, gradually moving towards the rest of the organ. Under favorable conditions, the doctor examines up to 1.5 m of the intestine.
• Due to the fact that the intestine is equipped with a large number of sphincters, the examined person may be asked to take a supine position for a more comfortable procedure.
• If, during the examination, the doctor discovered pathologies of the mucous membrane, he takes tissue for examination to detect tumors. The duration of manipulation in this situation is increased by several minutes.
• Particularly sensitive patients sometimes feel overflowing with gas bubbles and violent urges to defecate. However, with proper preparation for the procedure, such manifestations can be avoided.
• At the end of the examination, the coloproctologist carefully removes the apparatus from the anus. Excess air generated during the colonoscopy is sucked out through the endoscopic canal. If the patient underwent the procedure in a state of medication sleep, an anesthesiologist is invited, who brings him to consciousness.
• While the subject is getting dressed, the doctor draws up a conclusion based on the results of the study.

Note. For 2 hours after this manipulation, it is advisable to be in a state of lying on your stomach. If there is increased gas formation, it is recommended to drink activated carbon at the rate of 1 tablet per 10 kg of weight.

Video colonoscopy in a state of drug sleep

Putting the patient to sleep during the colonoscopy is considered the world standard for this procedure.

Such a measure provides many advantages for both the examinee and the doctor:

• a specialist freely examines all parts of the intestine, which enhances the informative component of the procedure;
• the patient does not feel pain or discomfort possible with the traditional method of passing the examination;
• the risk of injury to the walls of the organ is reduced.

For anesthesia, a gentle anesthesia is used, which has a short duration of exposure and low toxicity.

Due to the fact that it is administered intravenously, there is no need to use a mechanical ventilation system. Thanks to this, muscle tone is reduced, and there is no tension in the abdominal wall, which greatly facilitates the diagnosis for a specialist.

Before the colonoscopy, the anesthesiologist examines the patient and, if necessary, administers pain relievers or antiallergic medications.

Preparing for video colonoscopy

3 days before the start of the procedure, the subject should follow a special diet.

The following products are prohibited for use:

• potato;
• onion;
• mushrooms;
• black bread;
• artichokes;
• cabbage;
• sour fruits and berries;
• legumes.

You can compensate for the absence of these products in the usual diet with eggs, light chicken broths, doctor's sausage, fish and meat of low-fat varieties, steamed, buckwheat, rice or wheat porridge. Fermented milk products are also permitted. On the evening before video colonoscopy, you should switch to liquid drink.

Note. If possible, 2 weeks before the procedure, do not take "Aspirin", "Activated carbon" and medicines, which contain a large amount of iron. These drugs can cause bleeding, which can lead to bowel perforation.

Features of preparation

1. If the procedure is scheduled for the morning, at 14:00 of the day preceding the manipulation, you must drink 1 tablespoon. castor oil. If the video colonoscopy is planned for the afternoon, the time for taking castor oil is shifted from lunchtime to evening.
2. In the evening, you should put a mug of Esmarch or use mini-enemas to completely cleanse the intestines.
3. In the morning, on the day of the examination, you need to do a few more enemas, having achieved a clear liquid exit from the rectum.
4. Before the examination, it is allowed to use non-carbonated mineral water, tea or kefir.
5. Patients undergoing a therapy that includes taking specific drugs should discuss with the treating doctor and endoscopist the possibility of using them on the day of the study.
6. If the subject suffers from frequent constipation, 3 days before the procedure, you should start taking laxatives or medications, the action of which is aimed at cleansing the intestines.

In order to prevent injuries and to facilitate the diagnosis of a specialist, the examinee must strictly follow the rules of preparation.

Video colonoscopy is one of the most informative ways to study intestinal diseases. Given the diagnostic value of this procedure and its practical painlessness, it is advisable to have an examination every 6 months. Bad taste in the mouth after eating, study the link.

Video - Colonoscopy. What is this procedure and who needs to undergo it?