Preparing for colonoscopy of intestines "Fortrans": instructions, diet and tips

Colonoscopy of the intestine is a method for diagnosing diseases of the large intestine, in which it is inserted into the anus an endoscope that allows a visual examination of the intestinal walls and assess their appearance and functional condition. Colonoscopy is included in the list of mandatory procedures included in the primary diagnostic complex, which are prescribed if suspected for ulcerative colitis, autoimmune disorders of the intestine, as well as tumor processes in the mucous membranes of the colon (including colorectal cancer). In some cases, colonoscopy is prescribed for hemorrhoids and proctitis, diseases of the rectum, which are the distal part of the large intestine.

The procedure for endoscopic examination of the intestine is not the most pleasant, but the patient should not experience severe pain. Slight discomfort, a feeling of fullness and heaviness associated with the presence of a foreign body in the large intestine is allowed. To avoid complications associated with the procedure and improve the accuracy of the results obtained,

it is important to properly prepare for the study. Preparation for colonoscopy includes a special diet, mechanical bowel cleansing and salt-based laxatives. The most popular drug in this group, widely used in the diagnosis of intestinal diseases, is "Fortrans".

What is this drug?

"Fortrans" is a medicine in the form of a powder, which is used to prepare a saline solution. According to its pharmacological properties, the drug belongs to laxative drugs and is used in surgical practice to prepare for surgical interventions, as well as as an aid in a set of measures required before diagnostic procedures, for example, irrigoscopy, sigmoidoscopy, or colonoscopy.

Powder "Fortrans" has a white color, dissolves well in water and other liquids, and in dissolved form has a pronounced salty taste. The main active ingredient of the drug is a laxative mixture macrogol, which normalizes stool, restores intestinal motility and the evacuation reflex excrement and regulates the volume and consistency of chyme - partially digested food mixed with bile, epithelial cells, bacteria and gastrointestinal juices. Salt components in the preparation are auxiliary substances.

The action of the drug is provided by retention of water molecules and an increase in osmotic pressure. Feces, absorbing liquid, increase in volume, become softer and easier to evacuate from the intestine under the influence of peristaltic waves of the intestinal walls. The salts in Fortrans prevent electrolyte imbalance and dehydration.

How to take and dilute?

Fortrans powder is packaged in sachets, each of which contains 64 g of active ingredient. This dose is calculated for 15-20 kg of a person's body weight, that is, a patient weighing 70 kg needs 4 sachets (this is one package). It is necessary to dilute the product at the rate of 1 liter of water per 1 sachet of powder. If the individual dose for a person is 4 bags, he should get 4 liters of the ready-made solution. The drug can be diluted immediately in a large container or prepared separately for each liter.

It is necessary to drink the solution in small portions so as not to provoke a gag reflex. It is considered optimal to consume 200-300 ml of solution every 15-20 minutes. To dilute the powder, use only room temperature water without gas.

Advice! The finished solution has a very specific salty taste, which is why many people stop taking the medicine. This cannot be done. To reduce discomfort, you can add sour fruit juice (such as orange) to the solution. The taste will also be less pronounced if you drink the solution through a straw.

If the procedure is scheduled for the morning

If colonoscopy is scheduled for the morning hours (before 12.00), you should start taking Fortrans at about 17 hours the day before. For 1 hour you need to drink 1 liter of the prepared solution. The last bowel movement should occur approximately 2-2.5 hours after the last dose. The contents of the intestines should be in the form of pure water, without any impurities of feces.

The last meal at 2 pm (or 3 hours before the start of Fortrans) should consist of lungs foods that do not create a burden on the digestive tract and do not contribute to gas formation and bloating. It can be milk porridge, omelet, vegetable casserole with meat soufflé. Cabbage, peas, carbonated drinks must be discarded.

If the examination is carried out in the afternoon

In this case, bowel cleansing is carried out in 2 stages. The required amount of the drug must be divided into two parts. The first stage begins on the eve of the procedure. After 2-3 hours after lunch, you should drink half of the prescribed dose of Fortrans (usually 2 liters of ready-made solution). After that, it is recommended to refuse any food until the next day.

The second half (the remaining 2 packets) should be drunk in the morning, from about 7 to 8 o'clock. The estimated time is adjusted taking into account the fact that the medication should be completed 3-4 hours before the examinations, that is, if the colonoscopy is scheduled for 15 o'clock in the afternoon, you need to drink the last portion of the solution before 11 o'clock in the morning.

Contraindications and drug tolerance

If we study the patient reviews about the tolerability of "Fortrans", we can conclude that most are faced with side effects in the form of severe nausea and even vomiting. Often such a reaction is associated with the specific taste of the finished solution, but in some cases it may be an individual reaction to the components of the preparation. If these phenomena have not passed after using 1-2 liters of solution, further use should be discarded. Patients should also take into account that while using Fortrans, bloating may occur, accompanied by a feeling of fullness and overcrowding.

This reaction is considered normal and is associated with a large volume of the finished product, which must be consumed in a relatively short period of time. The discomfort should completely disappear within 2-3 hours after taking the last dose of the solution. If this does not happen, it is necessary to notify the attending physician, who will decide on the possibility of carrying out the procedure.

Important! Against the background of the use of "Fortrans" and other laxatives, which include macrogol, were recorded isolated cases of severe allergic reactions manifested by skin rash, itching, broncho- and laryngospasm. Patients with impaired renal function may experience localized or generalized edema associated with fluid retention in the body. Anaphylactic reactions were diagnosed in 0.4% of patients.

Who shouldn't take Fortrans?

The drug is suitable for use only in adult patients and adolescents over 15 years of age, as there is no data on the safety of Fortrans in young children. Also contraindications for the appointment of laxatives based on macrogol are:

• chronic heart failure;
• dehydration of the body (dehydration);
• malignant bowel disease (any of its parts);
• extensive damage to the mucous membrane of the large or small intestine;
• intestinal obstruction.

Prescription of "Fortrans" is not recommended for patients who have previously been diagnosed with allergic reactions or poor tolerance of polyethylene glycol, since the active ingredient of the drug - macrogol - is a high molecular weight linear polymer.

Drug analogs

There are quite a lot of Fortrans analogs (pharmaceutical equivalents), but the prescribed drugs without consulting a doctor, as they may differ in the list of contraindications and side effects effects. If a person, for some reason, cannot undergo cleansing with "Fortrans" (for example, with severe vomiting reflex), you can use other medicines from the group of laxatives listed in the table below.

Table. Analogs of the drug "Fortrans".

Name	Mode of application	Contraindications	Price
Mikrolax	Introduce 5 ml of the drug (1 micro enema) rectally. Repeat if necessary after 4 hours.	The drug is available in the form of a solution for rectal administration, so the only contraindication for use is hypersensitivity to macrogol.	325 rubles
Forlax	Dilute 1-2 bags with boiled water at room temperature and drink in the morning or in the evening on the eve of the procedure.	Inflammatory processes in the large intestine, perforation of an ulcer, gastric or intestinal bleeding, unspecified abdominal pain.	252 rubles
"Tranzipeg"	Dissolve 1-2 bags in water (use 100 ml of liquid for 1 bag) and take at one time.	All contraindications listed in the Fortrans annotation, as well as phenylketonuria (the product contains aspartame).	170 rubles

Diet before colonoscopy

It is very important that there is no gas in the intestines during the procedure, which can make it difficult to see and make an accurate diagnosis. In order to reduce gas formation and prevent bloating, the patient is assigned a special diet, which must be adhered to for three days before the study. At this time, the patient is allowed to eat weak chicken or beef broths with a small amount of wheat croutons. Fresh bread, baked goods must be removed from the diet, as it promotes fermentation processes in the intestines. Rye croutons are also not suitable for nutrition during this period - they contain a large amount of coarse vegetable fiber, which can cause bloating and flatulence.

The basis of the diet before colonoscopy should be:

• vegetable casseroles (with the exception of cabbage, spinach, sorrel);
• fruit puree;
• meat soufflé (can be replaced with finely chopped lean meat);
• boiled eggs (no more than 1-2 pieces per day);
• buckwheat porridge in water or diluted milk;
• cheese;
• puree soups.

It is completely necessary to exclude sugar and confectionery, drinks with the addition of gas, sausages and sausages, fatty meat (including lard, bacon, ham). During this period, the use of legumes, nuts, peanuts, spices, spices is not allowed. You can not eat canned or pickled vegetables, drink alcohol. If possible, you should stop smoking.

Note! Patients undergoing colonoscopy in the morning are not allowed to eat on the day of the procedure. If the examination is scheduled for the afternoon, you can afford a light breakfast, for example, a cottage cheese casserole with fruit puree or buckwheat porridge in the water. Breakfast on the day of the colonoscopy should take place no later than 7 am.

Sample menu to prepare for the procedure

Breakfast:

• curd soufflé;
• banana;
• chamomile drink with lemon balm.

Lunch:

• baked pears.

Dinner:

• beef broth with croutons and dill;
• steamed turkey meatballs and mashed potatoes;
• compote.

Afternoon snack:

• dry biscuits;
• some natural yogurt.

Dinner:

• vegetable casserole;
• boiled fish;
• infusion of fennel seeds (reduces gas formation).

Colonoscopy is an unpleasant procedure, but if the patient prepares correctly for it, the likelihood of discomfort and discomfort will be minimal, so it is important to listen to the advice of experts and not violate the prescribed diet the day before research.

Video - Poor preparation for colonoscopy