General information about a rektoromanoskopiya
This endoscopic research is conducted by means of the special device called the rektoskopy. It allows to give a visual assessment to an internal surface of intestines from back pass at distance of 30 cm. The device is similar to the tube hollow inside having small diameter it is made of metal and supplied with optics. Having entered the device into a rectum through an anus the proctologist (or the endoscopist) has an opportunity to examine intestinal mucous, having taken also part of sigmovidny department. The endoscopist by all means pays attention to elasticity, color, humidity, gloss and relief drawing, a skladchatost of a mucous membrane, draws conclusions about a condition of vessels, a tone and physical activity of the surveyed departments of intestines. If the new growth is suddenly noticed, the expert pinches off his small part then to carry out the histologic analysis.
When procedure is shown?
States at which it is expedient to make rektoromanoskopichesky inspection:
- Bleedings from an anus which can testify to various pathologies, for example, , external or internal , polyps or a cancer of a thick gut.
- At the severe pain exasperating the patient constantly or which is rolled incidentally in an anus zone. Such feelings can appear because of existence of gemorroidalny knots (not only external, but also internal) or oncological process in a rectum.
- The intensive expirations of pus or slime from an anus. Such can specify on proktit.
Due to growth of number of cases of detection of a cancer of rectum when the illness is already in full "heat" - on the third or even the fourth stage, the World Health Organization made the decision: to recommend carrying out a rektoroskopiya to people which age passed in forty years even if they have no complaints listed earlier and disturbing symptoms.
Whether preparation for procedure is necessary?
If intestines are clogged with kalovy masses, it will complicate introduction of a rektoskop to back pass, inspection it will be impossible to perform. Work of the endoscopist will become complicated if recently to the patient carried out and there is a residual barium. That inspection was productive, helped to establish the indisposition reasons, it is necessary to be prepared for it as appropriate. Even long before procedure the doctor has to explain to the patient that for survey intestinal mucous departments of intestines it will be necessary to resort to a rektoskop which should be entered through an anus. The proctologist specifies, whether there is no allergy at the patient, what medicines he uses, whether examinations of a gastrointestinal tract with X-ray contrast barium were conducted to it in the last seven days. Then the doctor will explain to the patient that on the eve of carrying out procedure (24-48 hours) he should keep to a diet, to clear the intestines. For this time vegetables and fruit are excluded from the use, is instructed - to drink more. In the day preceding procedure, the dinner should be passed, having replaced it with a cup of tea. Most of proctologists inclines to that it is necessary to appoint procedure to morning hours that it was made on an empty stomach. In some cases implementation of a cleaning enema for which it is necessary to use usual water and Esmarkh's mug can be recommended in 3 hours prior to arrival on procedure (or in the evening). InfoAdvisor.net warns that soap water does not need to be used for such purposes. Sometimes resort to cleaning of an intestinal path by means of laxatives. Among them – , to Normaza, Flit, Fortrans. The patient before procedure is warned that before introduction rektoskop will be greased that he moved ahead on a rectum therefore many have false desires on a defekation better. Even during the movement of the endoscope the gut stretches a little, it often causes gripes. To straighten intestinal mucous, in a gut air will move. If the patient feels that gases want to leave intestines, it should not it interfere. If there is a chronic inflammation in a rectum, in 20 minutes prior to introduction of a rektoskop it will be processed by solution of a mestnoanesteziruyushchy preparation.
Carrying out rektoromanoskopiya
Passes inspection in policlinic or a hospital, its duration – about 20 minutes. At first it is necessary to take off all clothes below a belt. Usually to the patient the disposable special shorts made for carrying out research are given. It is most convenient to carry out all manipulations on a high couch when the patient is in a knee and elbow pose. If the patient is on the left side, under his left hip enclose the roller or the small sizes a small pillow. The doctor carefully takes the right buttock aside, examines an anus. Further the palpation (inspection by means of the proctologist's fingers) an anus and area of a rectum follows. It is recommended to breathe these minutes through a mouth, quietly and deeply. After extraction of a finger the proctologist will note, whether there are excrements, allocations (purulent, mucous or bloody). The endoscope tube with the obturator inserted into it is greased with vaseline or gel, slowly entered on 5 cm into an anus. Then the obturator is replaced with an eyepiece then the device continues the slow movement on a rectum again. When it passes the anal valve, it is necessary to natuzhitsya as it occurs at depletion of intestines. That folds of a gut finished, there is an air supply to the intestinal device. If stir further survey fecal masses, the eyepiece will be taken out, and its place will replace the wadded tampon necessary for cleaning of an intestinal gleam. Stirring slime, blood is deleted, applying an electrosuction. If it is necessary to remove polipozny outgrowths, the coagulative loop is entered. When survey is complete, all samples of biomaterial are taken (from inflammatory sites or new growths), the device is gradually extended outside. Biomaterial is preserved in a special way, is located in necessary capacities. To avoid falling of arterial pressure, some minutes to the patient are better to lie down on a back. Some time after procedure intestines will leave gases. Mirsovetov warns that if the biopsy was made, in Calais in the first days blood streaks will be noticeable, you should not be frightened it.
Skillful actions of the endoscopist will not hurt the patient. The discomfort can arise, but it is connected by that during procedure in intestines there is an air. Pain if happens, the tolerant, not demanding introductions of anesthetics. Under anesthetic such inspection is done only to small children.
To whom is procedure contraindicated?
Proctologists consider a rektoroskopiya as the simple, almost not doing harm procedure if it is seen off by the expert possessing necessary skills and abilities. The list of absolute contraindications to this method is not present. But there are some situations when it is not necessary to begin it:
- The expressed narrowing of a gleam of anal pass.
- The strong bleedings bearing threat of life of the patient.
- The acute inflammations going in an abdominal cavity and the anal channel.
- The sharp paraproktit, existence of a sharp crack of an anus.
You should not be afraid of the described inspection though some discomfort during procedure is present. The carried-out rektoromanoskopiya allows to diagnose at early stages a number of pathological changes in a straight line and a sigmovidny gut (more precisely, one its third).