The colonoscopy (colonoscopy) - although a low-risk, but not particularly pleasant examination, on which the patient must be prepared carefully. Recent developments in imaging techniques now promise relief for the patients. However, a sufficient number of studies is still missing, for example, to scientifically secure virtual colonoscopy as a screening test.
What is a colonoscopy?
The colonoscopy (colon = the intestine, scopein = see), in which the inside of the rectum, the large intestine and the last part of the small intestine can be represented, is one of the most frequent investigations in the search for tumors of the colon. Colorectal cancer is the second most common cause of cancer death in Germany. Every year, more than 60, 000 new cases occur and around 30, 000 die from it. With timely detection, the disease is completely curable in almost all cases.
Since October 2002, the colonoscopy belongs as a check-up in the catalog of benefits of the health insurance companies. Thereafter, every patient from the age of 55 can undergo a colonoscopy as part of cancer screening. As a check-up, the colonoscopy can be taken twice every 10 years. However, few people voluntarily undergo this unpleasant and painful examination.
Preparation of a colonoscopy
Blood test: In the preparation phase of the procedure, a current blood picture is taken and the coagulation is examined. It may be necessary to discontinue or replace medications for a short time.
Colon cleansing: A prerequisite for a successful colonoscopy is a clear view of the intestinal mucosa. For this, the intestine must first be completely emptied. For the patient, this means dispensing with all dietary fibers and plant seeds, including whole grains, raw foods, bran, berry fruits, no later than 3 days before the examination. Iron supplements and aspirin should no longer be taken.
Almost two days before the examination, the diet is completely switched to liquid. Instead of rolls and coffee, only herbal tea, mineral water or clear broth are on the menu. The day before the colonoscopy, the intestine is emptied by a special laxative, which is taken three or four times, depending on the product. If the intestine is completely empty, only clear water should be drunk.
Colonoscopy: sedative necessary?
Whether a tranquilizer should be given or not, doctor and patient must clarify in the preliminary discussion. Some doctors generally recommend that the patient be immobilized during the examination, in other cases this aspect is addressed by the patient himself. Anyone who is always anxious about medical examinations should definitely discuss this point in the preliminary talk.
High blood pressure or heart failure are definitely a reason for immobilization. Since a few days pass between conversation and examination, relaxation exercises and meditations are also available to reduce any fears and tensions.
Just before the colonoscopy
Immediately before the examination, the patient receives a venous indwelling cannula. This approach may provide a tranquilizer or painkiller; In the rare case of a complication, emergency medications can be given without delay. In addition, before the procedure, the intestine is immobilized by means of medication, so that the natural intestinal movements do not interfere with the examination.
During the examination the patient lies on the left side. With the help of a lubricant, the colonoscope, a flexible tube about 12 mm thin, is advanced through the anus into the intestine. The colonoscope is flexible and can be controlled from the outside. In the head of the tube, a light source and a camera are integrated. The devices are usually equipped with a video camera, so that you can track the inner bowel image on the monitor.
Colonoscope as an instrument in colonoscopy
Attached are usually printer and video recording devices for documentation. During the examination air is pumped into the intestine, so that the empty intestine unfolds and all wall structures become well recognizable. A rinsing and suction at the end of the device additionally ensure good visibility. By adjusting wheels at the rear end of the coloscope, the front end can be bent in different directions. This makes it possible to determine the direction of the instrument when advancing and at the same time to look closely at the intestinal wall throughout its circumference.
At the same time, tissue samples can be taken for further examination through a working channel or any polyps (benign cancer precursors) that may be present can be removed immediately without the need for further intervention. This process is also referred to as interventional colonoscopy. As a rule, the procedure is performed in the morning and does not take longer than 30 minutes. A rest period after the procedure is just as natural as the subsequent ban on driving - especially when calming medicines have been administered.