Let you know about endoscopic examination - colonoscopy

Unit: Department of Gastroenterology, Shenzhen Shoukang Hospital Name: Chen Hongmei

Colonoscopy is also called electronic colonoscope. The device is mainly composed of a front-end video camera, a soft pipe, an operating handle and a main unit. During a colonoscopy, the doctor will slowly insert the front section of the colonoscope from the anus into the rectum, and then go back up until it reaches the ileocecal part or the end of the ileum, so as to effectively examine the entire large intestine. When using a colonoscopy, the doctor can clearly observe the rectum, colon, cecum, and terminal ileum in the intestine. If there are diseases and abnormal intestinal mucosa in the above locations, the doctor can take clear photos and describe the images in detail according to the location and nature of the lesion. If necessary, some tissues will be selected for pathological examination.

What is a colonoscopy?

The so-called colonoscopy is an electronic endoscope, which is mainly used in intestinal disease inspection and endoscopic surgical treatment. The device is about the thickness of a middle finger, and the curvature of the front end of the mirror body can reach 180° or more. The doctor uses the device to place it into the intestine through the patient's anus and reach the end of the small intestine. The actual situation of the patient's entire intestine can be clearly observed. Therefore, colonoscopy is a widely used and simple invasive examination method with a relatively high safety factor. Even if adverse reactions occur, they are within the controllable range.

Compared with other diseases, intestinal diseases have no obvious reactions in the early stages. Once symptoms appear, the disease is relatively serious. In particular, the high incidence of intestinal cancer is mainly concentrated around the age of 55. Therefore, doctors usually recommend that healthy people over 40 years old need to undergo regular colonoscopy examinations.

Since the factors affecting intestinal diseases are relatively numerous and complex, the general public should conduct regular intestinal examinations to ensure intestinal health. The following groups of people should pay special attention to intestinal health.

Groups with long-term smoking and drinking habits; groups with family history of colon polyps or colon cancer; groups of patients who have undergone cholecystectomy; groups of patients with chronic appendicitis or appendectomy; groups with long-term lack of exercise, unhealthy diet or high-fat and high-salt diet; groups with long-term constipation and diarrhea or changes in bowel habits for unknown reasons, abdominal pain, bloody stools, and excessive weight loss.

Advantages of colonoscopy

According to the latest global cancer statistics in 2020, colorectal cancer has become the third most common malignant tumor in humans, and its death toll ranks second. More than 80% of intestinal cancers are caused by the malignant transformation of colorectal polyps. Therefore, as long as we detect intestinal polyps in the early stage and remove them in time, the incidence of intestinal cancer can be greatly reduced. Therefore, if you want to effectively prevent and detect intestinal polyps, colonoscopy is one of the indispensable detection methods. This technology can not only effectively check the disease condition, but also remove the lesions, and fundamentally prevent the occurrence of diseases such as intestinal cancer. Because when the colonoscope enters the patient's intestine, it can clearly and intuitively observe the condition of the entire intestinal mucosa. Once an abnormality or unclear growth is found, the nature of the disease can be further clarified through electronic staining and magnification, and then consider what kind of surgical method to use for resection. In other words, colonoscopy is the gold standard for intestinal disease screening. Everyone should pay attention to this and perform colonoscopy in time.

Colonoscopy process

1. Preparation

Before the actual colonoscopy, the preparation stage is very important. The intestinal preparation directly affects the quality and effect of the colonoscopy. Therefore, before the colonoscopy, the patient should communicate with the doctor to determine the dosage and dosage form of the bowel cleansing medicine to be taken, as well as the date and time of the examination. The patient also needs to receive relevant dietary guidance for the colonoscopy. For example, the day before the colonoscopy, try to eat a semi-liquid diet with no or little residue, do not eat vegetables and fruits with skin or seeds. If it is initially determined that surgical treatment is required, the patient cannot use milk and dairy products the day before the operation to avoid abdominal distension after the operation.

On the day of the examination, the patient needs to take bowel cleansing medicine orally in the early morning. Usually, each packet of bowel cleansing medicine should be mixed with 1000 ml of warm boiled water, and a total of 2000 ml of bowel cleansing medicine needs to be drunk within one hour. If there is still fecal residue in the intestine after all the intestines are emptied, it is necessary to drink another 1000 ml of bowel cleansing medicine or directly perform enema cleaning until the intestinal discharge is clear water.

If the examination is scheduled in the afternoon, bowel preparation is required in the morning. Since colonoscopy is an invasive examination method, complications may occur in both the preparation and examination stages. Therefore, when making an appointment for a colonoscopy, the patient must clearly understand the types of possible complications and sign the relevant informed consent form. Extra attention should be paid to patients who suffer from heart disease, cardiopulmonary insufficiency, hypertension, colitis, peritonitis, mental illness or have undergone multiple abdominal surgeries. If any of the above conditions occur, an evaluation by the relevant department is required before the colonoscopy, and the colonoscopy may not be completed completely.

2. Check the process

During the colonoscopy, the patient should first lie on his left side with his knees flexed and extended. At this time, the doctor will slowly insert the colonoscope through the anus and observe whether the intestinal mucosa has any lesions according to the direction of the intestine. When the colonoscope turns a corner, the patient will feel abdominal pressure or bloating. The patient does not need to panic, but should try to stay calm, take a deep breath, and relax his body to facilitate a quick examination by the doctor.