Endoscopic examination of the intestine. What is intestinal endoscopy: how to prepare and undergo the examination, limitations Endoscopic method for examining the large intestine

The coordinated functioning of the gastrointestinal tract is an important condition for the well-being of every person. Therefore, if discomfort occurs (abdominal pain, stool upset, flatulence, bloating, nausea, vomiting), it is necessary to perform a diagnosis. Checking the intestines helps detect even early, subtle stages of pathological processes. And this makes it possible to carry out treatment in a timely manner, as well as avoid complications. There are also indications for an intestinal examination. It is recommended for people with a family history of malignant pathologies. People over 40 years of age also need to have their lower intestines examined every 5 years. Modern techniques, based on innovative technologies and combined with the latest equipment, make it possible to perform diagnostics in a hospital without the slightest discomfort.

General examination of the patient

How is the intestine checked? When a patient contacts a doctor, the first thing he does is clarify the duration of the discomfort period, he asks to list the unpleasant symptoms, and asks about the presence of gastrointestinal diseases in close relatives. Then a general examination of the patient begins. The ratio of weight and height, skin color, whites of the eyes, and mucous membranes are assessed.

Then palpation of the abdominal cavity is performed. It occurs counterclockwise, from the left iliac region upward, then from the sigmoid colon down to the splenic angle. The specialist also palpates the transverse colon, right hepatic angle, and descending section. The examination ends with palpation of the cecum and appendix. If the manipulation is carried out correctly, it will not be difficult for an experienced doctor to suspect the beginning of changes in the intestines.

Another option for examination by a specialist is palpation of the rectum. To do this, the patient is recommended to get on all fours. Upon examination, pathological changes can be detected: hemorrhoidal enlargement of lymph nodes, tumors, ulcers, fistulas, and abscesses. Anoscopy is also performed - a visual examination of the rectal mucosa at a level of 10-15 cm. The doctor also often recommends taking blood and stool tests.

Bowel research methods

All methods of examining the intestines are divided into several types:

• X-ray (irrigoscopy, virtual colonoscopy);
• endoscopic (gastroscopy, fibrocolonoscopy, sigmoidoscopy, capsule endoscopy);
• ultrasound (ultrasound);
• magnetic resonance imaging (MRI).

Any of the diagnostic methods provides important information about the condition of the organ, but choosing the one that is suitable for a particular patient is the prerogative of a specialist who is able to correctly assess the need for a particular procedure in each specific case.

X-ray diagnostics

Irrigoscopy is a radiation technology for contrast examination of the intestine with obtaining X-ray images. It allows you to diagnose congenital malformations of the organ, fistulas, ulcerative lesions, scars. Before performing it, sigmoidoscopy is usually prescribed. Before the examination, the patient must empty the intestines (using an enema or laxatives) and take a special solution - barium sulfate. Once in the gastrointestinal tract, it will fill the entire intestine, allowing you to see areas of deformation and changes in the organ mucosa in the photographs.

Virtual colonoscopy is a method of radiological diagnosis performed by a multislice computed tomograph. It helps detect changes and neoplasms in the intestines. Before the examination, the organ needs to be cleaned with an enema or laxative. The patient is asked to lie down on the couch, and a special flexible tube is directed into the anus. Air is released through it, filling the walls of the mucous membrane. Then the person is placed in the scanner. Images are taken during the procedure. At the doctor's request, sometimes you need to change your position and hold your breath. A special program displays three-dimensional images of layer-by-layer sections of the intestine with a thickness of 0.5-1 mm on the monitor screen. The examination takes about 30 minutes.

Irrigoscopy and virtual colonoscopy are not recommended for children, women during lactation and pregnancy.

Endoscopic diagnostics

What is intestinal endoscopy? This is the name for studying the condition of an organ using special devices. It is prescribed for suspected pathological changes in the intestines. Before the procedure begins, the person is advised to thoroughly prepare the body - cleanse it with an enema or mild laxatives. The most commonly used endoscopic methods are gastroscopy, fibrocolonoscopy, retromanoscopy and capsule endoscopy.

During a colonoscopy, the doctor directs a fiber colonoscope into the rectum with an attached video camera, a lighting lamp and magnifying lenses, which allows a detailed examination of the condition of the colon. To clarify the results during the examination, a portion of the mucosa may be taken for histological analysis. In addition to diagnostic functions, colonic endoscopy makes it possible to remove polyps or small benign formations. The diagnosis takes about half an hour, the patient lies on his side all this time with his legs pulled up to his stomach. When examining the large intestine, local anesthesia can be used to eliminate discomfort; sometimes general anesthesia is required.

Gastroscopy is a method of studying the condition of the esophagus, the inner surface of the stomach, and the duodenum using an endoscope inserted through the mouth. On the eve of the procedure, you need to give up dinner, and on the day of the examination, you should also skip breakfast. To reduce discomfort and gagging, the doctor anesthetizes the tongue (its root) and pharynx using an aerosol. It is also necessary to psychologically tune in to the inevitable discomfort. The procedure usually lasts no more than 10 minutes. The technique is very common and not liked by patients, but it is highly informative.

Retromanoscopy is an examination of the rectum and sigmoid colon with a special device inserted through the anus. The patient needs to remove clothes below the waist and stand in a knee-elbow position. The procedure begins only after a digital examination of the rectum. Retromanoscopy helps to visually assess the condition of the lower intestine at a distance of up to 35 cm from the anus. This makes it possible to detect rectal fissures, ulcerative colitis, proctosigmoiditis, organ development abnormalities, polyps and tumors. Usually the procedure lasts no more than 10 minutes. If necessary, you can take material for a biopsy and carry out therapeutic manipulations (coagulation of blood vessels during bleeding, remove polyps, cauterize tumors, remove foreign objects).

Capsule endoscopy is considered to be a sufficiently informative and absolutely painless method. However, the procedure is extremely expensive. How do you check your intestines this way? The patient takes a capsule equipped with a video camera. She moves through the gastrointestinal tract, taking a photo every 2 seconds. The collected information is processed by a special program. Based on the results obtained, the doctor makes a conclusion.

Preparation for capsule endoscopy consists of stopping food intake 20 hours before the procedure. A special device is also attached to the body to record the results of the procedure. The diagnostic examination takes approximately 8 hours. At this time, a person leads his usual lifestyle, without limiting his movements. Only colorless liquids are allowed to drink. 4 hours after the start of the procedure, you can have a light snack. After some time, the video capsule dissolves and is naturally eliminated from the body.

Ultrasound diagnostics

Ultrasound is prescribed for elderly patients with severe organ diseases, children, and women during lactation and pregnancy.

To prepare for the examination, it is enough to observe some dietary restrictions 3 days before the procedure and take mild laxatives the day before. Ultrasound is effective in diagnosing many pathologies: intestinal paresis after surgery, adhesions, tumors, Crohn's disease. The latest devices make it possible to conduct color Doppler mapping with high information capacity.

Magnetic resonance diagnostics

MRI is an analysis procedure by taking a series of images in a special scanner, which is a magnetic field. The method is quite accurate and helps detect many intestinal changes. To prepare, you only need to follow the restrictive recommendations the day before and take laxatives. Before the procedure, you will need to take a special contrast agent. Next, the person will need to remove all metal objects from himself and lie down on the scanner bed. The procedure requires absolute immobility, so the arms and legs are fixed with belts, and the body with bolsters. The intestinal examination itself takes about an hour.

So how do you check your intestines? Only the doctor can decide this issue. The method is always selected individually, taking into account the type of disease, age and condition of the human body. Modern methods of intestinal examination make it possible to detect many pathologies at the initial stages, when there are no disturbing symptoms, and to immediately begin therapy, which increases the effectiveness of treatment and maintains a satisfactory quality of life for a person.

Capsule endoscopy of the intestine is the newest, high-quality diagnostic method for diseases of the gastrointestinal tract. All you need is a small capsule with a camera.

The video capsule, which the patient must swallow, subsequently gives a complete picture of the intestinal mucosa, which is difficult to examine without the capsule. This examination method is the most reliable for diseases of the small intestine.

Description of the procedure

Capsule endoscopy of the intestines is one of the methods for examining the intestines. After swallowing the video capsule, it enters the rectum, but before that it goes through a certain path. She examines the lumen, walls and mucous membrane of the gastrointestinal tract, captures from 2 to 35 fps. The information is stored on a special recording device.

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Kinds

There are two types of capsules - small intestinal, which are used for examining the small intestine, and colonic, intended for examining the small and large intestine. To carry out a complete and high-quality diagnosis, you need to use a capsule that has two video cameras.

Video:

Advantages and disadvantages

The positive side of the procedure includes:

1. Painless – capsule endoscopy does not cause unusual sensations or discomfort.
2. Safety - the procedure does not harm the body, the capsule moves through the gastrointestinal tract under peristalsis. The video capsule is sterile and is used once, which completely eliminates the possibility of infection.
3. Comfort - during diagnosis, the patient is not limited in movement around the hospital, he goes about his business (reading, watching movies, talking with friends).
4. Information content – ​​diagnoses approximately 90% of different diseases th, which can be detected using gastroscopy. Capsule endoscopy is much more effective than radiography if you need to find the causes of hidden bleeding in the gastrointestinal tract.

There are few disadvantages, but they exist.

During capsule endoscopy, tissue particles cannot be removed for further analysis. The procedure does not imply any medical manipulations. Such manipulations are done only when carrying out.

The risk that the capsule will linger in the intestine cannot be ruled out, but this probability is very small. But there are ways to remove this capsule without surgery.

Indications for use

Capsule endoscopy is prescribed for suspected:

• polyps and tumors in the small intestine;
• gastrointestinal bleeding;
• weight loss;
• Crohn's disease, more details;
• abdominal pain, the causes of which are unknown;
• enteritis;
• celiac disease;
• chanemia;
• ulcerative colitis;
• preventive examination of the digestive system.

Capsule endoscopy is not performed for acute intestinal obstruction, swallowing disorders, active dysentery, or during pregnancy. Cannot be carried out at an age up to 16 years old and over 70 years old.

Preparation

2 days before capsule endoscopy, the patient needs to follow a slag-free diet. At lunch the day before the diagnosis, it is recommended to drink clear liquids.

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• On the day of endoscopy, you should refrain from eating until the capsule is swallowed;
• It is recommended not to smoke a day before the procedure;

Method of preparation with Fortrans:

• To cleanse the intestines 2 days before endoscopy in the evening you need to drink 1 liter of polyethylene glycol (1 sachet of Fortrans), and in the evening before the diagnosis drink 4 liters of polyethylene glycol (4 sachets of Fortrans).
• 1 packet of Fortrans is dissolved in 1 liter of water.
• You can add lemon juice for taste.

Intestinal endoscopy- This is an examination of the mucous membrane using a flexible probe equipped with a video camera, displaying an image on a monitor screen. There is no damage during examination; different parts of the digestive tract can be examined through the mouth or anus.

Depending on the department being examined, intestinal endoscopy is divided into several types:

Comparison table of endoscopic methods

Visual examination of the inner intestinal mucosa is the best method for diagnosing all diseases, but each method has its pros and cons.

What can endoscopic methods detect?

It is important that the image of the suspicious area can be enlarged to see the details. It is also possible to rotate the endoscopic probe inside the intestine to examine adjacent areas of interest, as well as to determine the extent of the lesion down to healthy tissue.

Contraindications: absolute and relative

There are no absolute contraindications for examination of the upper intestines or endoscopy, but it is recommended to postpone the examination in case of severe general diseases: intoxication, myocardial infarction and cerebral stroke, exacerbation of bronchial asthma. This procedure is not recommended for burns of the esophagus, aortic aneurysm, or multiple scars of the esophagus. However, if a disease of the digestive canal threatens the patient’s life, the study is performed in these conditions, but with extreme caution. Availability of an intensive care unit is necessary, and local and general anesthesia can be used during the study.

Studies in which equipment is inserted through the anus have a greater number of contraindications, but they are also assessed in the same way. The final decision is made by the doctor, focusing on the severity of the patient’s condition. The contraindications are:

If the patient’s condition allows, the diagnostic procedure is completed with therapeutic measures: infusion of medication, stopping bleeding, removal of a tumor or foreign body. This is easier for the patient to endure than abdominal surgery.

Preparation for endoscopic examinations

The point of preparation is to remove contents from the intestines as much as possible. The better the intestines are prepared, the more the doctor will see and the more accurately the diagnosis will be made.

Cleansing consists of two points: proper nutrition and cleansing itself with the help of enemas and laxatives.

2-3 days in advance, you need to stop taking activated carbon, iron supplements, lactofiltrum and De-Nol medication, if they were previously used.

Conducting surveys

The technique is simple, but requires excellent knowledge of anatomy.

Oral access

If the probe is inserted through the mouth, the mucous membrane is pre-treated with a local anesthetic. This is done to suppress cough and gag reflexes, as well as for greater patient comfort. A plastic mouthguard is inserted into the mouth to prevent involuntary movements. The examination is performed in the lateral position. The probe moves slowly to the depth that the equipment allows. The doctor examines all areas, records details, and, if necessary, selects (pinches off) a piece of living tissue for biopsy. After the inspection is completed, the equipment is removed and processed.

With access through the anus

The probe is inserted through the anus in a knee-elbow position or on the side. The procedure is painless, but unpleasant. In sensitive patients, anesthesia is used, often local. Additionally, the endoscope tube is lubricated with an anesthetic. A rigid tip is inserted into the rectum, and a flexible probe is inserted through it. The doctor has the ability to rotate the probe inside the intestine and record everything he sees in digital format. Biopsy and therapeutic procedures are available.

Recently, endoscopy of the lower intestine is increasingly performed in a state of therapeutic sleep, lasting no more than half an hour. This eliminates any possible discomfort.

Are there alternatives to endoscopic examinations?

By and large, there are none. No other research method provides such a complete picture of the disease, allowing us to see not only the structure of the intestine, but also its function.

A doctor who sees a living intestine immediately understands what disease he is dealing with. Visually determined:

• and other abbreviations;
• color and structure of the mucosa;
• normal and pathological discharge;
• various growths and contractions;
• tumors;
• boundaries of healthy tissues.

Endoscopy is the only method that allows you to see the organ directly. With all other methods, the image of the intestine is distorted and redundant data is mixed in.

In what cases is it necessary to undergo examinations?

You need to undergo endoscopy (even if you don’t want to) in the following conditions:

• the presence of blood in the stool;
• digestive and stool disorders;
• frequent constipation;
• constant heartburn and belching;
• flatulence;
• dramatic weight loss without dieting;
• intolerance to any type of food;
• discharge of pus or mucus from the anus;
• putrid odor from the mouth.

It is advisable for people over 45 years of age to undergo an endoscopic examination annually, especially if there has been a history of tumor formations in the family. Timely detection of tumors and their removal has saved thousands of lives, and this number is constantly growing.

When diagnosing diseases of the digestive system, it is often performed.

The procedure has become widespread today due to its ease of implementation and sufficient information content.

Using this method, it is possible to identify serious diseases of internal organs at an early stage of development. Capsule endoscopy is used to examine the small intestine.

Purpose of the procedure

An endoscope, as the main tool for examining the internal surfaces of the intestines and other organs, is a tube.

It is made from rubber, plastic or metal. Accordingly, endoscopes are flexible and rigid.

In accordance with the purpose, the following types of devices are produced:

• biopsy;
• operating rooms;
• viewing rooms

Biopsy endoscopy is performed when the attending physician needs to obtain a tissue sample from the inner walls of the intestine or other organ.

By its design, such an endoscope is a complex electronic-mechanical device.

The operating device is used to perform various surgical operations on the inner surface of the intestine. The viewing endoscope is used only to inspect these surfaces.

Based on the data obtained, the attending physician makes a final diagnosis. Doctors have a capsule endoscope in their toolkit for examining the body.

Outwardly, it looks like a vitamin capsule, which is how it got its name. A video camera is placed inside the capsule.

This is one of the latest developments in the field of medical technology. Capsule endoscopy allows you to obtain the most accurate information about the condition of the body.

The practice of intestinal endoscopy shows that the patient experiences pain during the procedure. Examination of the small intestine with a conventional endoscope is generally impossible.

In this case, the capsule technique is used. Today, this is the most progressive method for diagnosing diseases of the gastrointestinal tract.

Of particular note is the fact that the patient does not experience discomfort during the procedure.

The functionality of the endoscope is constantly expanding. The attending physician has the opportunity to diagnose diseases in a short time.

Indications for examination

According to current regulations, experts divide intestinal endoscopy into therapeutic and diagnostic. Capsule endoscopy is intended for diagnostic purposes.

The following symptoms are the reason for examination:

• discharge of mucus or pus from the anus;
• pain in the anal canal;
• changes in the process of defecation.

In addition to the listed signs, there are others that may also be a reason for intestinal endoscopy.

When choosing this method of examination, the attending physician must schedule the procedure and properly prepare the patient. This is a very important stage in diagnosis and treatment.

Intestinal endoscopy is carried out during a screening examination for the purpose of medical examination of the population.

This is necessary for the early detection of polyps in the rectum and signs of cancer. Diagnosis is mandatory for patients over 40 years of age who do not have pathological heredity.

People whose older relatives have suffered from malignant tumors in the intestines need to undergo endoscopy after the age of 25.

Treatment using an endoscope is prescribed for polyps and other neoplasms in the rectum. For the small intestine, other treatment methods are used.

Preparation and carrying out the procedure

Clinical practice shows that preparation for intestinal endoscopy is no less important than the procedure itself.

The fact is that the quality of preparatory procedures directly affects the reliability of the results obtained.

The main goal of preparation is to cleanse the large intestine of all contents. In certain situations, the condition of the small intestine does not affect the examination results.

Preparation for the procedure takes place in several stages. The first step is to eliminate foods that cause bloating from your diet three to four days before your due date.

At the second stage, a day before the endoscopy, the process of bowel cleansing begins. To choose the appropriate method, you need to consult your doctor.

You can use enemas and laxatives. Lunch should be light. You can drink tea for dinner before the examination day. On the day of the examination, you can only take liquid food in minimal quantities.

Almost always, patients fear that they will be hurt during endoscopy. To alleviate these concerns, the doctor may give the person an anesthetic or sedative.

Capsule endoscopy involves only a fasting day before the study.

Intestinal endoscopy is performed in a hospital setting. The attending physician and nurse must have appropriate experience and skills in performing this procedure.

In addition to obtaining the necessary data about the state of the body, it is important to prevent the patient from being in pain.

If during the examination the patient experiences pain, he must immediately report it.

Before the examination begins, the patient must be placed on his left side, so that he pulls his legs bent at the knees towards the chest.

Before inserting an endoscope into the anus, the doctor needs to examine the anus area, and only then begin the procedure.

Capsule endoscopy is performed to examine the small intestine. Unlike examination of the rectum, this does not hurt the patient.

An important feature of this procedure is that the patient does not have to be in the clinic. He swallows a capsule, which moves through the gastrointestinal tract and records the condition of the walls of the small intestine and other organs.

The information is transmitted to a special electronic device that is attached to the patient’s belt.

The study is completed after the capsule has come out naturally. Experts decipher the received data and draw appropriate conclusions.

Some nuances

Before conducting the study, the patient needs to know that intestinal endoscopy is a unique procedure, and for some it is not very pleasant.

However, it does not cause severe pain. It should be noted that, like other medical procedures, it can cause some complications.

If the doctor acts carelessly or the patient behaves restlessly, perforation of the rectum may occur.

Sometimes a patient has an allergic reaction to drugs used for anesthesia.

During the study, the doctor maintains contact with the patient and observes his reaction to the manipulations.

In some cases, endoscopy is performed under general anesthesia. An exception is the study of the small intestine.

The use of anesthesia or local anesthesia is determined by the patient's condition. Sedation is more often used - this is the name for the state of superficial sleep, which is caused by special medications.

The positive side of this state is that the patient is physically and emotionally relaxed, while maintaining the ability to maintain contact with the doctor.

It should be noted that sedation can cause allergies and cardiac dysfunction in the patient.

Every year the number of patients suffering from intestinal diseases continues to grow. The reasons for this are poor nutrition, non-compliance with work and rest schedules, a sedentary lifestyle and poor quality of drinking water. Intestinal endoscopy makes it possible to identify various pathologies at the initial stages, which, in turn, makes it possible to prescribe timely treatment.

For the purpose of early diagnosis, methods such as sigmoidoscopy and colonoscopy can be used. The first type of examination makes it possible to examine the rectum and distal sigmoid. Colonoscopy examines the large intestine, which includes the rectum, colon, and cecum, as well as the terminal portion of the small intestine.

Indications for intestinal endoscopy

Intestinal examination is indispensable for diagnosing benign and malignant neoplasms in the early stages. Endoscopy is also indicated if Crohn's disease and ulcerative colitis are suspected.

Preventive bowel examination is carried out for people aged 40-65 years, as well as for patients whose close relatives have suffered from colon cancer. The reason to contact a specialist is the appearance of the following symptoms:

• frequent abdominal pain;
• diarrhea or constipation;
• bloody and mucous discharge from the rectum;
• bloating;
• dizziness, feeling of weakness, weight loss.

Colon endoscopy can be used to remove foreign bodies from polyps and eliminate bleeding. It is also used to take tissue samples for further research.

Endoscopy of the rectum (large intestine)

The colon is examined using a special optical device. For colonoscopy, it is a flexible tube up to 1.5 meters long; for sigmoidoscopy, it is a plastic or steel device with a diameter of 2 cm and a length of up to 35 cm. Endoscopy of the rectum takes 20-30 minutes. Because it is considered unpleasant and may be painful for the patient, local anesthesia, general anesthesia, or sedation is sometimes used. Before the procedure, it is necessary to make preparations. It consists of following a special diet and cleansing the intestines.

Endoscopy of the small intestine

Examination of the small intestine using an endoscope is a rather complex procedure. This section is very long, and its lumen is much thinner than that of the colon. Colonoscopy allows you to see only the final segment of the small intestine. For more detailed diagnostics, capsule endoscopy is used in modern medicine.

You can get examined at the Open Clinic in Moscow. Endoscopy in our center is carried out using the latest equipment, which allows us to identify the slightest pathological changes in the body. Our clinic also offers the opportunity to perform endoscopy under general anesthesia.