Preparation for videocolonoscopy: toxin-free diet and purgation

Videocolonoscopy is a modern and efficient technique of endoscopic examination of colon and distal segment of the small intestine using a small camera on a flexible probe. Colonoscopy is often called videocolonoscopy, as fiber-optic or CCD cameras are often used for the examination, and the image is displayed on the monitor. 

The technique, apart from the detailed check-up, gives the possibility to perform treatment and diagnostic procedures (polyp removal, mucous membrane sampling for further examination, extraction of foreign bodies, etc.). 

Videocolonoscopy plays an important role in the modern medical science, so in some countries this technique is included in the mandatory program of screening examinations for the people who reached a certain age.

Usually, colonoscopy is performed for diagnostics of gastrointestinal organs.

Videocolonoscopy of the bowel allows for diagnosing of diverticulitis, inflammatory bowel diseases (Crohn’s disease, ulcerative colitis), polyps and colon cancer.

As cancerous tumors of the colon develop out of adenomatous proliferations of the mucous membrane, colon endoscopy in due time allows for revealing and eliminating the problem at the early stage in order to prevent the process advance.

During the colonoscopy procedure it is possible to extract a foreign body, to stop gastrointestinal hemorrhage, to get a tissue sample for a histopathological examination (videocolonoscopy with biopsy), to remove small polyps. For such cases an endoscopist has auxiliary medical devices, from endoscopic manipulators to complicated devices for the electric welding of tissues.

Colonoscopic screening for colon cancer is recommended for the people over 50. In this case the examination of the segmented intestine is performed on a scheduled basis, if a patient has no pathological signs.

There is a perception that colonoscopy is a very uncomfortable and painful procedure, that is why many people try to avoid it. Latest-generation videocolonoscopes, modern techniques of preparation for colonoscopy and the possibility of anesthesia in the process of the examination preclude pain feelings and make the procedure tolerable.

The day before the procedure a doctor informs a patient on how to prepare for the procedure. If for some reason (past history of painful examinations, history of bowel surgeries) the videocolonoscopy under anesthesia is required, a patient gets an intravenous injection of sedating medications just before the procedure. The medication is chosen depending on the general condition of the patient and his/her concomitant diseases. As a patient is in medication sleep during videocolonoscopy with sedating, an anesthesiologist monitors his/her state.

In most cases colonoscopy is performed without sedating medications. Recent studies has shown that music replay improves procedure tolerability.

A patient is lying on his/her left side with the legs bent at the knees and clutched to the abdomen. An anesthetic gel is commonly used to eliminate discomfort.

An endoscopist gently inserts a colonoscope. An endoscope is a flexible probe with a movable tip which makes its moving through the bowel easier.

The device has several channels: for tools, for gas supply, for lighting, etc. The gas is supplied into the intestinal lumen to straighten out its walls better and improve the visualization.

A special coloring material can be applied on the mucous membrane for the verification of suspicious regions through the colonoscope; it allows for excluding mistakes in certain cases and for determining the correct diagnosis. Modern videocolonoscopes are equipped with the computer that performs the digital processing of the image that, as a result, gives the possibility to objectivize the obtained results to the fullest extent.

In 95 % of cases it takes of about 10 minutes to bring a colonoscope through the whole colon. All the examination lasts on average 15–30 minutes.

When a doctor refers a patient to the examination, the former explains how to prepare for the bowel videocolonoscopy correctly. The indispensable condition for the colonoscopy is evacuation of fecal masses off the bowel. A patient has to adhere to the low-residue diet with low fiber content 2–3 days before the examination, and it is also recommended to increase fluid intake. 

A patient should perform the complete purgation of the large intestine a day before the colonoscopy.

In the last decades, purgatives (Fortrans, Endofalk, Lavacole, Moviprep) are used for this purposes. It is very important that the medication provides complete clearance of the intestinal mucosa. Residuals of any content in the bowel lumen will not allow an endoscopist to reveal a pathologic area that can result in late diagnostics of a severe disease.

In such cases the preparation for the colonoscopy is performed in hospital environment under the doctor’s control.

Article author: Vadim Elizarov

Publication date: 04.06.2020

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