Digestive problems can appear equally in an adult and a child. In most cases, the treatment of bowel diseases is time-consuming and can be quite complex, depending on the diagnosis. It is for the diagnosis that a biopsy may be required. This procedure is one of the diagnostic methods, so it should not cause any fear or apprehension.
What is a biopsy?
Translated from Greek, the word “biopsy” (consists of two parts) literally means “living, living tissue”, “examination”, that is, examination (examination) of a living, in the case of an intestinal biopsy - tissue.
This procedure involves taking a small piece of tissue, a sample for microscopic examination.
Biopsy is directly related toperforming other procedures for examination of the intestine, such as gastroscopy, colonoscopy, colposcopy, which are performed using a probe.
Purpose of this type of biopsy
The main purpose of an intestinal biopsy is to make an accurate diagnosis when other research methods were not so informative (even the use of the most modern equipment cannot guarantee the determination of the cause of a person's ailment).
It looks like this. During gastroscopy, polyp formations were detected, but their nature can only be determined by examining tissues under a microscope. A biopsy allows you to take tissue samples.
A piece of tissue taken during a biopsy is called a biopsy. Its laboratory study makes it possible to limit a malignant from a benign tumor, to determine the presence of an inflammatory process, etc.
What does a bowel biopsy show?
The technique allows to detect the following diseases:
- Cancer of the digestive system.
- Intestinal amyloidosis (protein metabolism disorder).
- Crohn's disease (chronic inflammation of the digestive tract with ulceration and scarring).
- Ulcerative colitis.
- Polypos.
- Gluten intolerance.
- Whipple disease (nutrient malabsorption).
- Autoimmune (non-specific inflammatory) diseases of the digestive system.
- Acanthocytosis (impaired absorption and transport of fats inas a result of erythrocyte pathology).
- Intestinal colitis (symptoms and treatment in adults vary by type, most commonly pseudomembranous and other types).
Types of biopsies
This procedure may vary depending on how the biopsy is taken:
- incisional - performed during an operation on the intestine, while excision of the tissue is done with a scalpel;
- excisional - for histological examination, the formation is completely removed, for example, the entire polyp or lymph node;
- puncture - to take a sample, a puncture is made with a special long needle;
- scarification - scrapings from the intestinal mucosa are taken for research;
- loop - a special loop is used to take the sample;
- endoscopic (or forceps) - tissue is taken with forceps during an endoscopic examination;
- trepanation - a piece of tissue is captured by a special tube with sharp cutting edges;
- aspiration - a piece of tissue is removed with an aspirator (electric suction).
When an inflammatory process is detected, a targeted biopsy of the intestinal mucosa can be prescribed, which allows you to determine the focus of inflammation. If there are suspicions of diseases and at the same time there are no external signs, an exploratory biopsy is performed. It involves the study of several tissue samples at once.
Rules of preparation for the procedure
Success of bowel biopsy (indications in this case may be different), itspainlessness and minimal risk of complications depends on compliance with the technology and correct preparation. The last step includes:
- abstinence from food 8-12 hours before the biopsy (one day before the procedure it is recommended to include only broth, juice and water in the diet);
- fish and meat broths on the bone, sweets, spicy seasonings);
- application of cleansing enemas or cleansing preparations, such as Fortrans or Endofalk (the scheme must be prescribed by a doctor).
Biopsy procedure
Biopsy is one of the methods for examining the human intestine. It requires the consent of the patient. Before the procedure itself, the patient is required to explain the course of the study, as well as possible consequences and complications. The doctor also indicates a possible reaction to the introduction of the endoscope, among which the most frequent are:
- heavy salivation (do not try to swallow saliva);
- vomiting;
- passing flatus.
How an intestinal biopsy is done depends on the area examined.
Features of small intestine biopsy
This procedure is performed in the following sequence:
- 30 minutes before the start of the procedure, the patient is given a sedative that allows him toto relax. The person during the procedure is conscious.
- The back of the throat is treated with an anesthetic, which reduces the risk of a gag reflex.
- After that, a mouthpiece is inserted into the growth, preventing accidental biting of the endoscope tube. Do not worry, this device does not interfere with breathing.
- The patient is turned over to the left side, after which the endoscope is inserted through the mouth. At the same time, the doctor strictly controls the course of the instrument and the place where it stops.
- Next, forceps are inserted through a special channel of the endoscope, with which they capture the biopsy. The latter is placed in a special sterile container filled with a solution, which is sent to the histological laboratory for the study of biopsy material.
- After taking the sample, the doctor removes the endoscope after making sure that there is no bleeding (they should not normally be) or perforations.
How long does a biopsy of the intestine, along with the main study, you can ask your doctor. Usually it is no more than 30 minutes. It can be unpleasant, but there is no pain syndrome.
Features of colon biopsy
In this case, a colonoscopy or sigmoidoscopy is performed. Do it like this:
- The patient is laid on his left side, while he must bend his legs to his stomach.
- Before the procedure itself, a person is given either sedatives or anesthesia. Before this, blood pressure is measuredpressure and pulse.
- After sedatives, lubricate the tip of the colonoscope with petroleum jelly, and then insert it into the anus. When the tool is moved, air is artificially pumped, which allows the tube to move more freely.
- When reaching the sigmoid colon, the person is turned over onto their back and then moved on.
- When the desired area is reached, a piece of tissue is removed using forceps. Then the instrument is removed (provided there is no bleeding or perforation).
In this case, the person may feel pain, so in most cases the procedure is performed under anesthesia.
Possible Complications
Complications of a biopsy are extremely rare. But still you need to be prepared for the possible:
- bleeding at the sampling site;
- perforation of the wall of the small or large intestine (a through hole in the wall with the release of contents into the abdominal cavity).
Intestinal biopsy: contraindications
Not everyone is shown this diagnostic technique. In this case, we speak of absolute and relative contraindications. Bowel biopsy not done if:
- severe infectious-toxic conditions such as sepsis, peritonitis;
- shock conditions;
- heart disease in the stage of sub- and decompensation;
- perforations (holes) in the wall of the digestive organs (this applies not only to the intestines, but also to the esophagus and stomach);
- gastrointestinalbleeding;
- mental abnormalities;
- intestinal stenosis (but only if the pathology is before the biopsy site);
- intestinal diverticulitis.
Also, this procedure is not performed after any surgical interventions on the organs of the abdomen and pelvis.
Relative contraindications are:
- predisposition to allergic reactions, especially to painkillers;
- acute infectious diseases, such as SARS, tonsillitis and others;
- gynecological diseases in women who are in the acute stage (in this case, the biopsy is postponed until the end of treatment for such diseases.)
When is a biopsy required?
Biopsy is not a mandatory research method in the presence of diseases of the digestive system. But in some cases, patient refusal can be life-threatening. It is mandatory to do a biopsy:
- if a tumor-like formation is detected (it may be indicated by the results of CT, MRI, colonoscopy or other studies);
- presence of multiple erosive and ulcerative processes in the small or large intestine;
- long-term inflammatory processes, the cause of which is not established;
- the presence of any symptoms indicating possible bowel diseases (this may be a change in the stool, the presence of blood in it, flatulence and other similar disorders), while the symptoms do not fit into the clinic of the most common diseases, which is whyadditional thorough examination required.
The main indications for biopsy of the small or large intestine (other than the above) are:
- narrowing of the intestinal lumen;
- chronic ulcerative colitis (colitis symptoms and treatment in adults may be uncomfortable);
- Crohn's disease (autoimmune, atypical inflammation of the intestinal wall);
- megacolon (giant colon and suspected Hirschsprung disease in a child);
- presence of rectal fistulas.
In most cases, the decision to perform a biopsy is made by a doctor during an examination such as an endoscopy or colonoscopy.
Baby biopsy
A child's biopsy is performed only in exceptional cases, in the presence of absolute indications. These are:
- suspicion of serious intestinal pathologies;
- unexplained bleeding that affects the general condition;
- extensive inflammation.
Biopsy requires careful preparation for the procedure, especially for children. You can entrust the procedure not just to a gastroenterologist, but to a doctor who is well acquainted with the anatomy of the child's body.
The material is taken under general anesthesia.
Preparing for a bowel biopsy involves:
- dieting (you need to exclude fatty, fried, smoked, s alty foods, milk and dairy products, sweets, pastries, carbonateddrinks) three days before manipulation;
- taking laxatives;
- cleansing enema (performed to remove stool that can make it difficult for an endoscope or colonoscope to pass through the bowel).
As a rule, the day before the study, the child is admitted to the hospital so that the small patient is under the supervision of medical workers and follows the protocol for preparing for manipulations (when the child is at home, whims and requests can leave parents indifferent, resulting in the effectiveness research will be low due to the presence of food debris in the intestinal lumen).
The process itself is no different from taking tissue samples from an adult, but the doctor moves the instrument according to the anatomy of the child.
Intestinal biopsy is a highly informative medical research method. The timely implementation of this manipulation allows you to determine the presence of serious pathologies at an early stage, which will play a decisive role in choosing a treatment strategy.
