Sigmoidoscopy is an endoscopic examination method that allows you to visually assess the condition of the anus (anus), as well as examine the rectal mucosa. In addition, the RRS examination makes it possible to examine the distal sigmoid colon.
Indications for conduction
This endoscopic manipulation is performed to detect intestinal diseases and treat them in a timely manner. As a rule, the RRS study is indicated for use in cases of suspected oncological pathologies, in the discharge of blood, mucus or pus from the intestines, in stool disorders, and chronic inflammatory processes in the rectal area. The indication for this examination is also hemorrhoids, a suspected prostate tumor in men or oncology of the pelvic organs in women. In addition, bowel RRS is used for preparation if other endoscopic procedures (eg, barium enema or colonoscopy) are needed. It is also carried out to detect ulcers and polyps with the possibility of taking material for microscopic examination.
Contraindications. Patient preparation
RRS rectal examination is not performed for profuse bleeding, if there ismenstruation in women, with acute inflammation of the anus or abdominal cavity, as well as with acute anal fissure, congenital or acquired narrowing of the lower intestines.
It should be noted that the most important condition in order to be able to examine the rectum endoscopically is the maximum cleansing of the intestine from the contents.
So, on the eve of this manipulation, it is recommended to adhere to a certain diet. Patients are forced to exclude from their diet fresh fruits, vegetables, black bread and legumes, cabbage in any form and other foods that lead to flatulence (increased flatulence in the intestines).
It should be remembered that in the evening before the examination by the proctologist and in the morning on the day of the examination, it is only allowed to drink a small amount of liquid (you can drink still water or weak tea with sugar).
Intestinal cleansing with enema
To prepare for sigmoidoscopy, in the evening before the examination, you need to do 2 cleansing enemas with an interval of 15 minutes. In the morning, this bowel cleansing should be repeated. If the examination of the proctologist is scheduled for the first half of the day, then breakfast is prohibited. If the sigmoidoscopy will be performed in the afternoon, then the patient is allowed a light breakfast, but before leaving the house, one more enema should be taken.
Let's take a closer look at how to properly clean the lower intestines, because without this RRS examination is impossible.
For holdingcleansing enema should prepare Esmarch's mug, petroleum jelly, a liter of water (its temperature should be no more than 20 ° C) and a tripod. The procedure is as follows:
• fill the system after checking the water temperature;
• hang Esmarch's mug on a tripod at a height of no more than 30 cm from the person who should cleanse the intestines;
• Lubricate the tip with Vaseline;
• we put the patient on the left side (the legs should be bent at the knees and slightly brought to the stomach);
• spread the buttocks and insert the tip into the anus 3 cm towards the navel and then 10 cm parallel to the spine;
• then open the faucet to let water flow into the intestines.
How to make a cleansing enema yourself?
To do this, you need to take a knee-elbow position in the bathroom, lean on your elbow, and insert the tip into the rectum with your free hand. This must be done slowly and very carefully. After that, you need to open the tap of Esmarch's mug and introduce water. If you feel pain, the fluid intake should be blocked and wait a little, breathing evenly and stroking the stomach.
It should be noted that it is imperative to control the amount of water injected (it should not exceed two liters). For better bowel cleansing, it is recommended to hold the liquid for at least 10 minutes. If possible, you can walk or lie on your stomach.
If you need to put 2 cleansing enemas at once, you can take a break of about 45 minutes between them. This is necessary in order to make sure that the washings from the first enema are drained.
At the request of the patient, you can use special microclysters (for example, "Mikrolaks"). They are used rectally. Pharmacological action is observed after 15 minutes.
Preparation for sigmoidoscopy without enemas
To do this, take the appropriate pharmacological preparations. The most commonly used is:
• "Fortrans". In the evening before the examination, the patient should drink 3 liters of water from 5 pm to 8 pm, in which 3 sachets of the indicated preparation must first be dissolved. Approximately one liter of solution should be consumed per hour. No breakfast in the morning.
• "Dufalak". On the eve of sigmoidoscopy, you need to drink 2 liters of water from 18 to 20 hours, dissolving 200 ml of the indicated syrup in it. Breakfast on the day of the examination is also prohibited.
• Fleet Phospho-soda. If the RRS examination is scheduled for the first half of the day, then in the morning before the procedure, instead of breakfast, you should drink a light liquid. This can be tea or coffee, pulp-free juice, or a non-carbonated soft drink. Then in 100 ml of cold water it is necessary to dissolve one sachet of the drug and drink the solution. At the same time, it should be washed down with 2 glasses of cold water. Instead of lunch, you need to consume at least 800 ml of light liquid, instead of dinner - another glass. After that, you need to drink another sachet of the drug in the same way as in the morning.
Features of sigmoidoscopy
The RRS procedure is performed strictly on an empty stomach. For examination, the patient must removeclothes below the waist and take a knee-elbow position on the couch. With severe pain in the anus, sigmoidoscopy is performed with local anesthesia. For this purpose, an ointment with dikain is used. A perianal block may be performed. If necessary, apply general anesthesia.
The doctor gradually introduces the rectoscope into the rectum and moves it forward, moderately supplying air, which allows you to straighten the intestinal folds and contributes to better visualization of the mucosa. Then the obturator is removed and, under visual control, the rectoscope is advanced to the sigmoid colon. After the examination, the tube is removed from the intestinal lumen in a circular motion, continuing the examination.
It should be noted that the RRS examination is completely safe, only if it is methodically incorrectly carried out, intestinal perforation may occur, which requires immediate surgical intervention.
Reviews on sigmoidoscopy
I must say right away that this examination is painless, but, of course, unpleasant. Some patients do not experience any discomfort at all, while others require at least local anesthesia. Often the determining factor that affects the attitude towards sigmoidoscopy is the fear of it.
To detect diseases such as cancer of the rectum or sigmoid colon, as well as ulcerative colitis or Crohn's disease, it is RRS examination that is used. Reviews of doctors about this procedure are positive, since it is important for the diagnosis of pain inabdomen, blood or other impurities in the stool, chronic constipation or diarrhea, and iron deficiency anemia of unknown etiology.
It should also be noted that sigmoidoscopy is recommended for all people over 55 years old for early detection of neoplasms in the intestine. With aggravated heredity, this procedure should be carried out annually.
