Simultaneous colonoscopy and FGDS. How to prepare for a colonoscopy under anesthesia Preparation for FGDS and colonoscopy

Dear patients.
From March 1, the endoscopy room will cease operations due to the start of repair work and the installation of new equipment.
We apologize for the inconvenience caused.
Appointments with a gastroenterologist and ultrasound diagnostics are carried out at the address: st. Marata, house 78

Preparing for a colonoscopy

Three days before the test you must follow the following diet:

It is forbidden: meat, brown bread, fresh fruits and vegetables, greens, beans and peas, mushrooms, berries, seeds, nuts, jam with seeds, incl. small (currant and raspberry), grapes, kiwi.
Can: broth, boiled meat, fish, chicken, cheese, white bread, butter, cookies, compotes and jelly. If you suffer from constipation, you need to take the laxatives you use.
On the day of the study: complete fasting is necessary. You can drink any amount of liquid (tea, juices without pulp, mineral water without gas).

Preparation with Fortrans

One sachet of Fortrans dissolves in 1 liter cold water without gas. 1 liter of solution is drunk within an hour.

Colonoscopy is performed in morning hours:

15.00-19.00 - taking 4 liters of Fortrans (4 sachets per 4 liters of water)

Colonoscopy is performed in the afternoon:

17.00-19.00 - taking 2 liters of Fortrans (2 sachets per 2 liters of water)
7.00-9.00 the next day- take another 2 liters of Fortrans (2 sachets per 2 liters of water).

Preparation with Fleet (phospho-soda)

Colonoscopy is performed in the morning:

1. Day before the study:

Time 7.00 Instead of breakfast, drink one (at the rate of one glass of liquid - 250 ml) (or more) glass of liquid. After breakfast, dissolve the contents of the first bottle in half a glass of cool water. Drink the solution and wash it down with one glass of water.
Time 13.00 Instead of lunch, drink three glasses of liquid
Time 19.00 Instead of dinner, drink one (or more) glass of liquid. After dinner, dissolve the contents of the second bottle in half a glass of cool water. Drink the solution and wash it down with one glass of water.

Colonoscopy has been successfully used to detect diseases of the large intestine. But this procedure is painful, sometimes it is necessary to interrupt it ahead of schedule due to the fact that the patient is unable to endure it. IN Lately Preparing for a colonoscopy and performing it under anesthesia is becoming increasingly popular.

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Colonoscopy is a medical method for examining the condition and motor function of the large intestine and the last segment of the small intestine. This is done using a special flexible thin probe with a video camera on the tip that transmits an image to the monitor.

“Cold” light helps to examine the intestinal mucosa, eliminating tissue burns. The procedure is unpleasant and causes discomfort, so the decision to use anesthesia helps the doctor to conduct the examination well and the patient to endure it safely.

There is a certain circle of people who must have a colonoscopy under anesthesia:

Children under 12 years old. The unstable psyche of a child should not be traumatized by pain.
Patients with adhesions in the intestines. Such formations can remain after operations in this area, peritonitis, and serve as a complication of gynecological diseases. The colonoscope will have difficulty passing through the intestinal loops that are soldered together. A person will feel severe pain without anesthesia.
Patients with destructive processes in the large intestine. All manipulations in this area cause severe pain.
Persons with a low pain threshold. Such patients do not tolerate even mild pain well, and if the pain is significant, they may lose consciousness, and it is likely that vital organs will shut down. It is better to give such patients anesthesia immediately. It will also be mentally easier for them to prepare for a colonoscopy, since they will know that they will not feel pain.
Persons with mental disabilities.

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During the examination, the patient is placed on his left side and asked to bend his legs towards his stomach. The colonoscope tube is carefully inserted through the anus. The probe is advanced through the intestines, taking photographs. A special device supplies air, the intestine straightens, which allows the colonoscope to move easier.

Reasons for prescribing a colonoscopy

This survey is very informative. The proctologist will evaluate the patency of the intestine and its diameter. The functional abilities of the rectum and its activity are clearly visible during the study. From the photographs you can see the pattern of blood vessels, capillaries, and analyze the condition of the walls.

If the patient has hemorrhoids, then during colonoscopy the size of the inflamed node is determined, this will allow choosing a method for its removal. The procedure lasts from 10 to 25 minutes.

During colonoscopy you can:

identify polyps, tumors;
detect areas of inflammation and bleeding;
take tissue samples for further research;
remove polyp;
cauterize the ulcer;
identify diseases of the large intestine if signs are present (constipation, blood in the stool, low hemoglobin);

Data-lazy-type="image" data-src="https://meridianz.ru/wp-content/uploads/2017/03/podgotovka_k_kolonoskopii1.jpg" alt=" preparation for fibrocolonoscopy of the rectum" width="640" height="480"> !}

conduct colon cancer screening;
find out the cause of chronic diarrhea and rapid weight loss;
identify the causes of iron deficiency anemia.

Such an examination has great diagnostic value, but its use is limited due to pain. Even during the course, the study can be interrupted at any moment because the patient becomes ill or cannot bear it any longer. Anesthesia during the procedure helps solve this problem.

Important! After 45 years, everyone should undergo a colonoscopy for preventive purposes to exclude malignant neoplasms of the intestine. This should be taken especially seriously by people who have a family history of colon cancer or polyps.

There are different types of anesthesia

Anesthesia during colonoscopy allows you to get rid of all negative phenomena - the patient will not be in pain, the procedure time will be reduced, the doctor will be calm and focused on the procedure. The intestines will be relaxed, which will avoid injuries and other complications.

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Apply different types anesthesia, the choice depends on the patient and his condition. The table shows what advantages this or that type of pain relief has.

	Local anesthesia	General anesthesia	Sedation
What does it affect?	A numbing agent is applied to the tip of the colonoscope. The pain decreases and becomes dull, but sensitivity remains.	There is no pain, the procedure goes quickly, unnoticed by the patient, the doctor can conduct an examination without being distracted by persuading the patient to be patient a little longer.	This is a medicated, superficial sleep. The patient does not fall asleep, is half asleep, can talk, but does not feel pain or feels slight movements in the abdomen. Some medications wake you up quickly, while others wake you up a little later.
Advantages	There are no complications, as after general anesthesia, and there are practically no contraindications.	Provides 100% comfort, the patient does not remember anything, does not feel pain.	The patient is relaxed, does not feel anxiety or fear, hears speech addressed to him, and is able to react correctly, for example, turn to the other side. The breathing center is not suppressed, the person breathes on his own, without disturbances. If necessary, sedation can be converted to full general anesthesia.
Flaws	Not suitable for people with a low pain threshold.	Has many contraindications. Not for heart problems blood pressure, general weakness. There is also a risk of complications.	High price.

But not everyone can use anesthesia. During an interview with an anesthesiologist, the characteristics of the patient’s health condition are clarified in order to eliminate risk factors.

Contraindications for anesthesia:

heart failure;
mental illness;
neurological disorders;
acute period of lung pathologies, for example, bronchial asthma, chronic bronchitis;
pregnancy;
stroke;
acute infectious diseases of the respiratory tract.

In case of pathologies of the anal area, for example, anal fissures, hemorrhoids, proctologists decide on the procedure. Under certain conditions it is possible.

Important! If the patient diabetes, it is necessary to warn medical workers. In this case, a colonoscopy is done in the morning.

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Preparatory activities

In order for a colonoscopy to be successful, the intestines must be completely empty, because if it is filled with feces, the study will not give results and will have to be repeated. To prevent this from happening, you must follow certain rules.

No earlier than 3 months before the procedure, you must take tests for HIV, hepatitis B, and blood type. For a week, you need to ensure a slag-free diet, during which it is recommended to exclude foods high in fiber and poorly digestible foods from the diet. It can be:

crackers;
nuts;
pasta;
fruits, vegetables in any form;
bread, flour products;
juices with pulp.

5 days before the procedure, it is advisable not to take anti-diarrhea medications or products containing iron. You should not eat foods rich in fiber for 3 days.

Data-lazy-type="image" data-src="https://meridianz.ru/wp-content/uploads/2017/03/podgotovka_k_kolonoskopii21.jpg" alt="how to perform an intestinal colonoscopy correctly" width="640" height="480"> !}

The proctologist will recommend a special powder that has cleansing properties. For 1 day you cannot eat solid food, you should only drink clear drinks. On the last day, laxatives are taken, their use is discussed with a specialist. Already 8 hours before the colonoscopy, you must completely stop eating and drinking.

Important! Take painkillers medications Before a colonoscopy, you can’t do it without a doctor’s prescription. If you have a headache on the day of the procedure, or for some other reason you want to take an analgesic, you should inform the medical professionals about this.

Possible complications

After the colonoscopy, you are allowed to eat and drink as soon as you want. The presence of gases in the intestines and overcrowding may be felt. To get rid of this, you need to lie on your stomach for about two hours. If it doesn't help, you need to drink Activated carbon(8-10 pieces).

If the examination was carried out under general anesthesia, then it is advisable not to drive on this day. It is best to spend the rest of this day in bed, listening to your feelings.

Data-lazy-type="image" data-src="https://meridianz.ru/wp-content/uploads/2017/03/podgotovka_k_kolonoskopii5.jpg" alt=" colonoscopy under anesthesia" width="640" height="480"> !}

In general, the risk of complications during colonoscopy is low, since modern equipment is used, proctologists are highly qualified and have the necessary experience. But in some cases complications are possible:

bleeding at the site where material was taken for further examination or removal of the polyp;
intestinal infection;
wall perforation (through damage);
allergic reaction to the drug used;
individual intolerance to drugs.

Such an examination is carried out in an operating room, where there are all the means to provide emergency care. medical care under the circumstances. This allows us to hope that complications can be avoided or quickly eliminated.

The proctologist himself will decide which anesthesia to choose so that the result is positive and the consequences do not have a negative imprint. The patient must trust the doctors and carefully follow their recommendations.

Conclusion

Unfavorable environmental conditions, poor quality nutrition, and a sedentary lifestyle negatively affect human health, especially the digestive process. The intestines suffer the most.

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Neoplasms in the form of polyps in the large intestine are becoming more common; after 5-15 years they degenerate into malignant tumor. To prevent the occurrence of such terrible diseases, it is necessary to undergo preventive examinations.

Colonoscopy is an excellent diagnostic method, but few people agree to such a procedure because of its pain. The use of anesthesia helps the doctor and the patient, the examination ceases to be a scary phenomenon. Now you can undergo it once every 5 years, as it should be for prevention.

Good pain relief is ubiquitous. You can have a colonoscopy under anesthesia in Minsk, Krasnodar, Barnaul, Vladivostok and other cities. The main thing is to take care of your health. This should not be done by a doctor, but by the person himself.

Methods of endoscopic examination of organs gastrointestinal tract, colonoscopy and FGDS, over the years of use have proven themselves to be highly accurate and prompt. As a result of the examination, the medical specialist receives maximum information about the state of the gastrointestinal tract in a short period of time. This simplifies and speeds up the process of diagnosis and allows timely treatment of the disease.

The effectiveness of endoscopic diagnostics

The methods and methods for carrying out both procedures are similar. Colonoscopic examination and fibrogastroduodenoscopy (FGDS) are carried out by introducing a flexible tube (endoscope) equipped with a video camera into the internal organs. The image is transmitted to the monitor, and the gastroenterologist has the opportunity to assess in detail the state of the digestive system.

The differences between gastroscopy and fibrocolonoscopy (FCS) are as follows:

medical indications for the procedure;
method of inserting the endoscope (oral for FGDS, and rectal for FCS);
features of preparation for the examination.

The capabilities of endoscopic diagnostics make it possible to identify a number of diseases of the duodenum, stomach, large intestine and the final segment of the digestive system - the rectum. Colonoscopy allows you to determine the presence of polyps, ulcerative and tumor formations, inflammatory processes, cracks and hidden hemorrhoids inside the rectum, the presence of foreign objects.

Using fibrogastroduodenoscopy, FGDS diagnoses the presence of cancerous or benign tumors, erosive and ulcerative lesions, narrowing of the lumen (stenosis), protrusion of the walls (diverticula). The list continues with malfunction of the sphincters (muscular valves of the stomach), inflammatory diseases of the mucous membrane of the stomach and duodenum (gastritis and gastroduodenitis), reflux (reflux of gastric contents into the esophagus).

The great advantage of both endoscopic techniques is the ability to take biological material (biopsy) during the examination. laboratory research.

Combined diagnostics

There are often cases when, for medical reasons, a person needs to undergo both examinations. This may be a suspicion of multiple neoplasms in the gastrointestinal tract, inflammatory processes in several digestive organs at once.

Gastroscopy and FCS are associated with rather unpleasant sensations, so many people postpone examinations, exposing the body to the risk of complications. To alleviate the patient’s somatic condition and speed up the diagnosis process, in recent years, joint FGDS and colonoscopy have been practiced. In most of these cases, the examination is performed under general anesthesia.

The feasibility of carrying out combined diagnostics is assessed by the doctor. To do this, it is necessary to compare the presence of contraindications to fibrogastroduodenoscopy and fibrocolonoscopy, as well as individual indicators of anesthesia tolerance.

The need for anesthesia is considered on an individual basis.

Contraindications

FGDS is prohibited if a person has previously been diagnosed with the following diseases:

defective heart function (decompensation);
violation of coagulation (blood clotting);
pathologies in the middle parts of the chest cavity that prevent the introduction of an endoscope;
bronchial asthma in the relapse stage.

Relative contraindications:

psychopathic chronic diseases;
chronic diseases heart (ischemia, angina, arrhythmia);
colds, throat infections (sore throat, laryngitis, pharyngitis).

Colonoscopy is not performed in case of cardiac pathologies, peritonitis, perforation of the intestinal walls (perforation), in case of progressive rectal bleeding and during pregnancy (for women).

A little about preparation

To combine both procedures, the patient must prepare thoroughly. First of all, this concerns changing eating habits 3–4 days before the planned examination. It is necessary to lighten your diet by giving up fatty, heavy, fried foods and foods. Diet food will reduce the load on digestive tract, which will allow you to obtain optimal research results. It is imperative to avoid the consumption of carbonated and alcoholic drinks.

A combined examination requires double preparation. In addition to adjusting the diet, a 12-hour fast is required before the procedure. The same condition must be observed for the use of general anesthesia. An hour before diagnosis, avoid drinking liquids and smoking.

The day before, it is recommended to take laxatives (Fortrans is recommended for adults, for children it is better to use Dufolac). An alternative or additional measure to cleanse the intestines in people prone to chronic constipation is an enema. The stomach and intestines must be completely empty.

Additional information about anesthesia

Carrying out diagnostic measures under anesthesia is indicated in the following cases: the patient’s inability to overcome the gag reflex (for FGDS), unstable psycho-emotional behavior of the patient, adhesions in the large intestine and anus (for colonoscopy), childhood.

Intravenous anesthesia is more often used in adult patients

To use medicated sleep, you must undergo additional blood tests and an ECG. In addition, performing FGDS and FCS under anesthesia may be contraindicated in the following cases:

decompensated work of the heart muscle (heart failure);
chronic pathologies and infectious viral diseases of the respiratory system;
individual characteristics of the body do not allow the use of anesthesia.

Types of anesthesia:

general intravenous - the use of strong drugs to completely switch off the patient;
mask (inhalation) – introduction to a state of sleep through inhalation of anesthetics;
intravenous sedation is a superficial sleep in which mental reactions are blocked.

The latter type of anesthesia is the most preferable, since the patient is conscious and able to hear the doctor, and it is possible to increase the dose of anesthesia at any time if a complicated examination requires it. Endoscopic manipulations are performed sequentially, the dose of anesthesia is calculated for the total time of two examinations. The time interval for general diagnostics usually does not exceed 20–50 minutes. After the examination, the patient is under medical supervision for several hours to monitor the post-anesthesia state.

After the examination

As a rule, there are no serious complications from the use of anesthesia. The patient may experience weakness, dizziness, discomfort in the anus and throat area, inability to concentrate. After a short time, the uncomfortable symptoms go away on their own and do not require special therapy. If the condition is aggravated by pain in various parts of the gastrointestinal tract, fever, loss of consciousness, heavy rectal bleeding, difficulty breathing, this requires immediate contact with a medical specialist.

If there are any changes in your health after the procedure, you should immediately tell your doctor

The person undergoing the examination is given the following recommendations:

Do not eat for 2–3 hours after diagnosis. At the same time, the first meal should be small in volume and consist of light foods (soft low-fat cottage cheese, yogurt, boiled oatmeal).
For 2–5 days, adhere to the diet used during the preparatory period.
Avoid drinking alcohol and carbonated drinks for at least a week.
Limit coffee and chocolate.
Do not expose the body to physical activity, including postponing sports training;
Refrain from driving until the anesthetic substance is completely removed from the body.

Prerogative aspects of combined diagnostics under anesthesia

Performing an FGDS and colonoscopy simultaneously under anesthesia allows the doctor to analyze the condition of virtually the entire gastrointestinal tract at one time. This significantly increases the accuracy of the diagnosis and, as a result, the effectiveness of treatment. In addition, the prerogative is the patient’s comfortable condition during the examination, simultaneous preparation for two procedures at once, prompt diagnosis, minimal risk of mechanical damage internal organs, due to the immobility of the subject.

Disadvantages include the time span that diagnostics takes. Due to the use of anesthesia, the patient spends more time in the clinic than during a regular examination.

Despite the rather high cost, the joint diagnostic procedure under anesthesia is popular because it is safe, painless, and allows you to identify the entire “bouquet” of diseases in one examination session.

Endoscopy is a procedure that requires serious consideration and careful preparation. If you approach the preparation process in bad faith, the quality of the examination decreases, the procedure itself is delayed, and sometimes even becomes impossible. Each type of endoscopy, be it colonoscopy or FGDS, requires different preparation.

After forty years, people (both men and women) should undergo endoscopic examinations as a preventative measure in the following order - esophagogastroduodenoscopy once a year, colonoscopy once every four years.

Preparing for a colonoscopy

Preparation for colonoscopy in the 1st half of the day (9–14 hours) with MOVIPREP.

On the day of taking Moviprep (1 day before the colonoscopy) - all day long you are allowed to consume only clear liquids (broths, compotes, juices without pulp, tea, coffee, water) without restrictions, you can also eat jelly and drink jelly without berries, candies, sugar , honey

MOVIPREP® - start of administration at 17-18 pm on the eve of the test day. Preparation of the solution: dilute one bag marked A and one bag marked B in a small amount of water until the powder is completely dissolved and bring to a volume of 1 liter with water at room temperature. Prepare the 2nd liter of the drug in the same way.
Drink 1 liter of solution in glasses at intervals of 15 minutes. The solution can be drunk chilled, washed down with lemon juice, or drunk through a straw. After 1 liter of Moviprep, you must drink at least 1 liter of clear liquid (still water, compote without berries, juices without pulp (not red), tea, coffee without milk).

After stool appears, take the second liter of MOVIPREP® solution within one hour. After Moviprep, you must take at least 1 liter of clear liquid (still water, compote without berries, juices without pulp (not red), tea, coffee without milk). The night before the test, drink Espumisan (2 teaspoons of suspension per glass of water or 4 capsules).

Preparation for colonoscopy in the 2nd half of the day (after 14:00) with MOVIPREP:

B) Moviprep is divided into 2 portions.

2 days before the study, after dinner, take a laxative, regardless of the nature of the stool, to choose from: Duphalac 60 ml (prohibited for diabetes) or Castor oil 60 ml (2 bottles, taken warm, prohibited for cholelithiasis). At night, drink Espumisan (2 teaspoons of suspension per glass of water or 4 capsules).

On the day of taking Moviprep (1 day before the colonoscopy) - a light breakfast, after breakfast you are allowed to consume only clear liquids (broths, compotes, juices without pulp, tea, coffee, water) without restrictions, you can also eat jelly and drink jelly without berries, candies, sugar, honey.

MOVIPREP® - preparation of solution: dissolve one bag marked A and one bag marked B in a small amount of water until completely dissolved and add water to a volume of 1 liter. The resulting 1 liter of MOVIPREP® should be taken around 18-19 pm on the eve of the test day, drink the drug every 15 minutes, 1 glass (if desired, you can cool it, drink through a straw) for 1 hour.

After Moviprep, you must take at least 1 liter of clear liquid (still water, compote without berries, juices without pulp, tea, coffee without milk).

On the morning of the procedure, prepare a second liter of MOVIPREP solution and take it within one hour (1 glass every 15 minutes). After Moviprep, you must drink at least 1 liter of clear liquid (still water, compote without berries, juices without pulp, tea, coffee without milk).

The last dose of the drug should be completed no later than 5 hours before the start of the study.

Preparation for colonoscopy in the 1st half of the day (9–14 hours) with FORTRANS.

3-4 days before the test, a slag-free diet is prescribed, which excludes fiber from food (fruits and vegetables, nuts).

On the day of taking Fortrans (1 day before the colonoscopy) - all day long you are allowed to consume only clear liquids (broths, compotes, juices without pulp, tea, coffee, water) without restrictions, you can also eat jelly and drink jelly without berries, candies, sugar , honey

FORTRANS (4 packets): dilute each packet into 1 liter drinking water no gases. Water at room temperature. Take all 4 packets on the eve of the study from 17:00 to 21:00 (1 liter per hour). Drink glasses in one gulp at intervals of 15 minutes. Take 1.5–2 liters, wait for stool to appear, then continue. The solution can be drunk chilled, through a straw, with lemon juice. After taking Fortrans, drink Espumisan (2 teaspoons of suspension per glass of water or 4 capsules).

The entire evening before the test, walk and move more for better bowel movements.

Preparation for colonoscopy in the 2nd half of the day (after 14:00) with FORTRANS:

A) you can prepare according to option “1”, you can drink it in the morning no later than 4 hours before the colonoscopy.
B) Fortrans is divided into 2 portions.
3-4 days before the test, exclude fiber from food (fruits and vegetables, nuts).

On the day of taking Fortrans (1 day before the colonoscopy) - a light breakfast, after breakfast you are allowed to consume only clear liquids (broths, compotes, juices without pulp, tea, coffee, water) without restrictions, you can also eat jelly and drink jelly without berries, candies, sugar, honey.

FORTRANS (4 packets): dilute 2 packets per 2 liters of drinking water without gases. Water at room temperature. On the eve of the test, take 2 packets (2 liters) from 18:00 to 20:00 (1 liter per hour). Drink glasses in one gulp at intervals of 15 minutes. The solution can be drunk chilled, through a straw, with lemon juice.

The night before the test, drink Espumisan (2 teaspoons of suspension per glass of water or 4 capsules).

On the day of the study, dilute the remaining 2 packets of Fortrans into 2 liters of drinking water, take from 6 to 8 hours, and at the end of the dose - Espumisan.

The entire evening before the test and in the morning, walk and move more for better bowel movements.

Note: When performing a colonoscopy under anesthesia (sedation), you should neither drink nor eat on the day of the examination.

Preparation for FGDS (gastroscopy of the stomach)

When undergoing an FGDS procedure at the Only Clinic, you must abstain from any food and drink 6-8 hours before the examination.

Important: for diseases such as hypertension, coronary heart disease, diabetes mellitus, there are some features in preparation for endoscopic procedures Colonoscopy and FGDS under sedation:

Tablets medicines for ischemic heart disease, hypertension and others chronic diseases may be taken 2 hours before the examination and washed down with 100 ml of water.
In case of registration for endoscopic procedures in the first half of the day (before 12 o'clock) morning appointment hypoglycemic drugs must be excluded.
Patients taking long-acting insulin should discontinue the morning injection. You can take sweet water 2 hours before the examination, no more than 150 ml.
Patients who have been diagnosed with the above diseases are recommended to sign up for Colonoscopy and FGDS procedures under sedation in the morning.
If necessary and individual characteristics, the patient is provided with a free consultation with an anesthesiologist.

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First Moscow State Medical University named after I.M. Sechenov
National Medical and Surgical Center named after. N.I. Pirogov
Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology
Moscow Family Planning and Reproduction Center
Moscow State Medical and Dental University
Moscow Regional Research Clinical Institute named after. M. F. Vladimirsky
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