As you know, the intestine is the largest organ of the digestive system. Anatomically, it has several divisions. In the small intestine, absorption of nutrients from food occurs. In addition, there are produced enzymes that carry out the digestion of food. Water and vitamins are absorbed in the large intestine. There is also the formation of fecal masses. Numerous bowel diseases develop under the influence of various damaging agents. The most dangerous of them are surgical pathologies that require immediate assistance.
For the diagnosis of diseases, an examination of the intestines is needed. Ways to detect pathologies can be different. These include laboratory tests and instrumental diagnostics. The choice of method depends on the expected localization of the pathological focus.
Intestinal examination methods
An important step in making a diagnosis is an instrumental examination of the intestine. Ways to detect pathologiessubdivided into X-ray and endoscopic. The first are performed with suspicion of intestinal obstruction. Endoscopic diagnostic methods are prescribed to assess the condition of the mucous membrane of the organ. In some cases, both studies are shown.
The X-ray methods include intestinal irrigography. With its help, it is possible to assess the patency of the organ, its shape, the presence of gas in the abdominal cavity, pathological narrowing or expansion. Irrigography allows visualization of the large intestine.
Sometimes X-ray diagnostics are not enough to make a correct diagnosis. This requires fibrocolonoscopy (FCS). This method is widely used in elderly people with suspected cancer. It refers to endoscopic procedures. A sigmoidoscopy is performed to evaluate the sigmoid and rectum.
In addition to instrumental studies, laboratory diagnostics are carried out. It includes microscopy of feces, scraping for eggs of worms, analysis for occult blood.
Intestinal irrigography - what is it?
In a surgical hospital, an X-ray examination of the intestine is most often performed. After all, it allows you to identify acute pathological processes that require surgical intervention. Irrigography of the intestine - what is it and how is it performed? This method of diagnosis is carried out using an X-ray unit. Most often, preference is given to irrigography with contrast. Similar methodallows you to visualize not only the shape and location of the organ, but also its functional state.
Irrigrography is an X-ray examination, before which a contrast agent is injected into the intestinal cavity. Therefore, this method requires preparation. X-ray examination of the large intestine is performed after cleansing procedures. With some pathologies, it is not possible to empty the organ cavity. Nevertheless, an irrigography of the intestine must be carried out. This diagnostic procedure is characterized by high information content, speed of execution and painlessness.
Stages of irrigography
Intestinal irrigography is performed in 2 stages. The first is a plain x-ray of the lower abdomen. It is necessary for suspected surgical pathologies. During this study, the patient is in the supine position. If, after taking a survey picture, suspicions of a pathology of the large intestine remain, the diagnostic procedure is continued.
The second stage of the study is an x-ray with the use of a contrast agent. This procedure is called irrigography. Contrasting is necessary to improve visualization and the possibility of assessing the functions of the intestine (filling with substance, peristalsis). For the purpose of "staining" barium sulfate is used. This substance is injected into the cavity of the large intestine under X-ray control.
Indications forirrigography
The irrigography procedure is not performed as a screening, unlike an endoscopy. X-ray diagnostics is carried out only if serious diseases of the large intestine are suspected. There are a number of indications for performing irrigography. Among them:
- Suspicion of intestinal obstruction. In this case, contrasting is not carried out, since the introduction of barium sulfate can only aggravate the situation. In addition, the substance will not be able to fill the entire intestine due to the presence of an obstruction. In case of obstruction, the study is stopped after the first stage - plain radiography.
- Suspicion of a tumor. In some cases, with oncological pathologies, complete intestinal obstruction does not occur. However, if there is a tumor in the lumen of the organ, it compresses the stool, and can also be injured and bleed during the act of defecation. Bowel cancer can be suspected by complaints such as weakness, weight loss, fever to subfebrile numbers, pain in the lower abdomen, and constipation. If the tumor is localized in the left half of the intestine, there is a pathological admixture during defecation (blood, pus, mucus). The shape of the feces may change (in the form of ribbons).
- Suspicion of benign neoplasms - intestinal polyps.
- Ulcerative colitis (UC) is a chronic inflammatory process in the intestines.
- Crohn's disease. It is characterized by irreversible changes in the intestine, ulceration of its walls and the appearance of granulomatous growths. UC and Crohn's diseaserefer to facultative precancerous conditions.
Contraindications for irrigography
Despite the fact that intestinal irrigography is an informative and high-quality method of instrumental diagnostics, in some cases it cannot be performed. Contraindications include the following conditions:
- Pregnancy period.
- Suspicion of bowel perforation. In this case, such a research method is contraindicated due to the possibility of penetration of the contrast into the abdominal cavity. The release of barium sulfate from the intestine will only aggravate the prognosis of the disease.
- Acute cardiovascular failure, acute renal failure.
- Chronic pathologies in the stage of decompensation.
- Contrast medium intolerance. Some patients may develop immediate allergic reactions.
In these cases, other diagnostic procedures are performed instead of intestinal irrigography. If there are contraindications to all instrumental methods, examinations are based on the clinical symptoms of the disease.
Preparation for bowel examination
Preparation for irrigography is very important. After all, the result of the study depends on it. Preparation includes cleansing the large intestine from undigested food and feces. A few days before irrigography, the patient should follow a special diet, that is, exclude from the diet foods that lead to the accumulation of gases in the intestines. These include some vegetables (cabbage, carrots, beets, herbs) and fruits. Also, 2-3 days before the procedure, it is worth limiting the consumption of cereals (barley, oatmeal) and bread.
To empty the intestines, cleansing enemas are performed on the eve of the examination and immediately before it (in the morning). Laxatives are allowed. You can completely clean the colon with the help of the Fortrans medication. Diluted in 3 liters of water, the drug must be drunk from 6 pm on the eve of the procedure and in the morning. The last meal is allowed at lunch, dinner should be skipped. A light breakfast is recommended in the morning before the study.
Intestinal irrigography: how is the procedure performed?
The technique of the procedure is not complicated. The examination is painless and does not take much time. For these reasons, if serious diseases are suspected, intestinal irrigography is performed first. How is this research done? After performing a survey radiography, the patient lies on his left side, legs pressed to the stomach, and hands are behind the back. With the help of a special probe, from 1 to 2 liters of barium suspension is injected into the rectal cavity. At this time, the patient changes position on the couch several times to evenly distribute the contrast agent. As the bowel fills, several x-rays are taken. The last one is performed after the probe is withdrawn. To get a more accurate picture, the double contrast method is performed. For this purpose, after the procedure, air is injected into the rectum (using an irrigoscopy apparatus) andmore pictures are taken. Most often, this procedure is necessary for suspected benign neoplasms and cancer.
Interpretation of irrigography results
Intestinal irrigography is a method that allows you to evaluate: the shape, location and diameter of the organ. Thanks to contrasting, it is possible to obtain information about the extensibility and elasticity of tissues. When straightening the walls of the intestine (injection of air), even small neoplasms, ulcerative and hyperplastic processes can be visualized. In addition, during irrigography, the function of the internal sphincter, the Bauhinian damper, is evaluated. Pathological narrowing, anomalies, intestinal diverticula are visualized on x-ray images.
Features of irrigography for children
Irrigography for young children is performed under general anesthesia, despite the painlessness of the procedure. In some cases, before an x-ray examination, an ultrasound device sensor is installed in the intestinal cavity. Performing irrigography for school-age children does not differ from the "adult" procedure. However, it is necessary to pre-calculate the amount of contrast agent injected.
Possible complications of the procedure
Complications during the study are extremely rare. These include - peritonitis (when a contrast agent enters the abdominal cavity), allergic reactions to barium sulfate, intestinal embolism.
