When many people heard that they were going to have a colonoscopy, they immediately shook their heads like a rattle and were very resistant. However, it is recognized by the medical community as the “gold standard” for colorectal cancer screening, and it is the most effective and direct method for screening intestinal diseases.
Colonoscopy is an intuitive and accurate inspection method to observe colorectal lesions from the mucosal side of the intestinal lumen by inserting a colonoscope into the ileocecal region through the anus and following the “pipe” (circulating cavity), even into the terminal ileum. It can completely and clearly observe the entire intestinal tract, and take photos, videos, and tissue for pathological examination of suspicious parts. It is currently the best method for the diagnosis and treatment of colorectal diseases.
What are the types of colonoscopy
Colonoscopy is divided into ordinary colonoscopy and painless colonoscopy. There will be a little discomfort during ordinary colonoscopy, but most people can tolerate it. Those who cannot tolerate it or need treatment can choose painless colonoscopy. The so-called painless colonoscopy is a colonoscopy performed under anesthesia, which is conducive to the operation and can improve the comfort of the patient. For all patients who are going to undergo a painless colonoscopy, anesthesia assessment should be performed first to assess whether there is any contraindication to anesthesia.
The commonly used anesthetic agent for painless colonoscopy is propofol, and its advantages include fast concentration balance, short half-life, quick recovery of patients, complete recovery, and less residual effects. At the same time, all anesthesia for painless colonoscopy is implemented by anesthesiologists under ECG monitoring. After completing the painless colonoscopy, patients will receive continuous monitoring in the anesthesia recovery room until they are fully awake. Therefore, painless colonoscopy is very safe.
However, painless colonoscopy is not for everyone. Painless colonoscopy is not recommended for patients who have problems with anesthesia tolerance, severe heart, lung, kidney and other diseases, liver failure, severe abdominal adhesions, poor physical condition, and who are not suitable for painless colonoscopy after evaluation by an anesthesiologist. Adverse events that may occur in painless colonoscopy include pulmonary and cardiovascular adverse events, hypoxemia, arrhythmia, hypotension, etc. These adverse events may also occur in non-anesthetized colonoscopy, and there are reversible methods.
How does colonoscopy work
The patient needs to take medicine in advance to clean the bowel before proceeding to the colonoscopy. The doctor will pass a thin tube with a camera and a light source at the end into the rectum, colon and even the terminal ileum from the anus. The electronic colonoscope can obtain clear images of the rectum and colon mucosa through the miniature image sensor at the front of the mirror body. During the inspection process TCM practitioners may find lesions such as mucosal congestion, ulcers, polyps, diverticula, or tumors. If equipped with a special light and magnification system, the small changes in the colorectal mucosa can also be found and analyzed by observing the opening of the mucosal glands and the diseased blood vessels.
In general, if there is no abnormality in the whole colon, biopsy may not be necessary. Once suspicious lesions are found, such as polyps, ulcers, cancer, etc., doctors often take a biopsy for pathological analysis. In addition, many minimally invasive treatments can be performed under colonoscopy, such as polyp removal, submucosal dissection of early colorectal cancer and precancerous lesions, and hemostasis under colonoscopy.
Who needs colonoscopy
Colorectal cancer screening must first be “right seated”, depending on whether you belong to the general population, high-risk groups or genetic high-risk groups. The general population should begin screening for colorectal cancer at age 50. That said, anyone over the age of 50, regardless of gender, symptomatic or not, should have a colonoscopy with or without risk factors.
High-risk groups should be regularly screened for colorectal cancer from the age of 40, including:
1. Those with lower gastrointestinal symptoms such as blood in the stool, positive fecal occult blood, abnormal defecation such as chronic diarrhea or constipation, changes in defecation habits, and abdominal discomfort, and the diagnosis is unknown.
2. Imaging examination suspects intestinal lesions and needs further confirmation.
3. Abdominal masses, especially those in the lower abdomen need to be diagnosed clearly.
4. Unexplained low intestinal obstruction.
5. Those who need regular follow-up review after colorectal cancer surgery and colorectal polyp resection.
6. Family history of colorectal tumors.
7. Unexplained weight loss and anemia.
8. Endoscopic resection of colon polyps and early colon cancer.
How to prepare for colonoscopy
The preparation before colonoscopy is a university question, and many people need to “suffer” again because of insufficient preparation, and perform a bowel cleaning again. So what preparations do you need to make?
1. Fasting before colonoscopy
Food residues left in the intestine can affect the operation and examination results of colonoscopy. The doctor will ask to start dietary restrictions 1-2 days before the test. It is recommended to consume some clear liquid diet (clear soup, filtered juice, coffee, tea, soft drinks, etc.) or low-residue, low-fiber diet (porridge, noodles, tofu, toast, banana, pudding, apple, etc.); fasting Vegetables, meat, mushrooms, whole grains, watermelon, kiwi fruit, dragon fruit, tomato and other high dietary fiber, slag, and seed foods. You should completely fast from 6-8 o’clock the night before the examination. The specific fasting time must be in accordance with the doctor’s advice. It is also necessary to fast before the operation on the day of the examination.
2. Take bowel cleansers correctly
Many people know that they need to take “laxatives” before colonoscopy. This laxative is a bowel cleanser.
At present, the most widely used intestinal cleansing agent at home and abroad is polyethylene glycol electrolyte powder. It cleans the intestinal tract by oral administration of a large amount of liquid, which has no obvious effect on intestinal absorption and secretion, and does not cause water and electrolyte disturbance. safety. If the examination is carried out in the morning, the patient needs to take the bowel cleanser in a dose at 7-8 o’clock the night before and drink it within 2 hours; take a second box of bowel cleansing in the same way at 4-5 am on the day of the examination agent. If the colonoscopy is performed in the afternoon, the patient still needs to drink the bowel cleanser at 7-8 o’clock the night before, but the second box needs to be taken between 7-8 o’clock in the morning on the day of the examination. The specific method should strictly follow the doctor’s advice.
It is recommended to move around appropriately during taking the medicine, and rub the abdomen lightly to speed up the excretion. One hour after starting the drug, bowel movements are accelerated, and patients may feel bloated before defecation. Chewing gum can be relieved between taking laxatives.