Irrigation of the intestine: what it is, how it is done, preparation. Intestinal examination
As is known, the intestine is the largest organ of the digestive system. Anatomically, it is divided into several departments. In the small intestine, there is an absorption of nutrients supplied with food. In addition, enzymes that digest food are produced there. In the large intestine, water and vitamins are absorbed. There is also the formation of fecal masses. Under the influence of various damaging agents, numerous intestinal diseases develop. The most dangerous of them are considered surgical pathologies, in which immediate assistance is needed.
To diagnose diseases, you need an examination of the intestine. Methods for identifying pathologies can be different. These include laboratory research and instrumental diagnostics. The choice of method depends on the expected localization of the pathological focus.
Methods of examination of the intestine
An important stage in the diagnosis is an instrumental examination of the intestine. Methods of detecting pathologies are divided into radiological and endoscopic. The first are performed with a suspected intestinal obstruction. Endoscopic diagnostic methods are prescribed to assess the condition of the mucous membrane of the organ. In some cases, both are shown.
X-ray methods include irrigography of the intestine. With its help, you can assess the patency of the body, its shape, the presence of gas in the abdominal cavity, pathological constrictions or extensions. Irrigography allows you to visualize the large intestine.
Sometimes x-ray diagnosis is not enough to make the right diagnosis. At the same time it is necessary to conduct fibrocolonoscopy (FCC). This method is widely used in elderly people with suspected cancer. It refers to endoscopic procedures. To assess the sigmoid and rectum, a sigmoidoscopy is performed.
In addition to instrumental research, laboratory diagnostics is carried out. To it carry a microscopy of a feces, a scraping on eggs of worms, the analysis on the latent blood.
Irrigation of the intestine - what is it?
In a surgical hospital, most often an X-ray examination of the intestine. After all, it allows us to identify acute pathological processes that require surgical intervention. Irrigation 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 contrasting. This method allows you to visualize not only the shape and location of the organ, but also its functional state.
Irrigrography is an x-ray study, 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 purification procedures. With some pathologies, the cavity of the organ can not be emptied. Nevertheless, the irrigography of the intestine must be carried out. This diagnostic procedure is characterized by high informativeness, speed of execution and painlessness.
Stages of irrigography
Irrigography of the intestine is carried out in the 2 phase. The first is an overview radiography of the lower abdominal cavity. It is necessary for suspected surgical pathologies. When this test is performed, the patient is lying on his back. If, after the survey, suspicions of the pathology of the large intestine remain, the diagnostic procedure continues.
The second stage of the study is X-ray with contrast agent. This procedure is called irrigography. Contrasting is necessary to improve visualization and the possibility of evaluating bowel functions (substance filling, peristalsis). For the purpose of "staining" barium sulfate is used. This substance is introduced into the cavity of the large intestine under X-ray control.
Indications for the conduct of irrigography
Irrigography procedure is not performed as a screening, in contrast to endoscopy. X-ray diagnosis is carried out only if there are suspicions of serious diseases of the large intestine. 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 sulphate can only aggravate the situation. In addition, the substance can not fill the entire gut because of the presence of an obstacle. In case of obstruction, the study is discontinued after the first stage - the survey 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 squeezes the stool, and can also be injured and bleed during the act of defecation. To suspect intestinal cancer can be on such complaints as weakness, weight loss, fever to subfebrile figures, pain in the lower abdomen, constipation. If the tumor is localized in the left half of the intestine, a pathological impurity is observed during defecation (blood, pus, mucus). The shape of the feces can vary (in the form of ribbons).
- Suspicion of benign neoplasms - polyps of the intestine.
- Nonspecific ulcerative colitis (NNC) is a chronic inflammatory process in the intestine.
- Crohn's disease. It is characterized by irreversible changes in the intestine, ulceration of its walls and the appearance of granulomatous growths. NNC and Crohn's disease belong to facultative precancerous conditions.
Contraindications to the performance of irrigography
Despite the fact that irrigography of the intestine is an informative and qualitative method of instrumental diagnostics, in some cases it can not be carried out. Contraindications include the following conditions:
- Period of pregnancy.
- Suspicion of perforation of the intestine. In this case, a similar method of research is contraindicated because of 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 insufficiency of the cardiovascular system, arthritis.
- Chronic pathologies in the stage of decompensation.
- Intolerance to contrast medium. Some patients may develop allergic reactions of immediate type.
In these cases, other diagnostic procedures are performed instead of the intestinal irrigation. In the presence of contraindications to all instrumental methods of examination based on the clinical symptoms of the disease.
Preparation for intestinal examination
Preparation for irrigography is very important. After all, the result of research depends on this. Preparation includes cleaning the colon from undigested food and stool. A few days before the irrigography, the patient should observe a special diet, that is, to exclude from the diet products leading to the accumulation of gases in the intestine. They include some vegetables (cabbage, carrots, beets, greens) and fruits. Also for 2-3 days before the procedure, it is necessary to limit consumption of cereals (pearl barley, oatmeal) and bread.
To empty the bowels, cleansing enemas are performed on the eve of the examination and immediately before it (in the morning). Acceptance of laxatives. You can completely clean the large intestine with the help of the drug "Fortrans". Divorced in 3 liters of water, the drug should be drunk from 6 evenings before the procedure and in the morning. The last meal is allowed for lunch, you should skip dinner. In the morning, before a study, a light breakfast is recommended.
Irrigation of the intestine: how is the procedure performed?
The technique of the procedure is not complicated. The study is painless and does not take much time. For these reasons, if a serious disease is suspected, first of all the irrigography of the intestine is performed. How is this study conducted? After performing the survey radiography the patient lies on the left side, legs are pressed to the stomach, and the hands are behind the back. Using a special probe into the cavity of the rectum, enter from 1 to 2 liters of barium suspension. At this time, the patient several times changes position on the couch to evenly distribute the contrast medium. As the intestine is filled, several X-ray photographs are taken. The last one is executed after the probe is removed. To obtain a more accurate picture, a double contrast method is performed. For this purpose, after the procedure, air is injected into the rectum (with the aid of an apparatus for irrigoscopy) and a number of pictures are taken. Most often this procedure is necessary for suspected benign tumors and cancer.
Interpretation of the results of irrigography
Irrigation of the intestine - a method that allows you to assess: the shape, location and diameter of the organ. Due to contrasting, it is possible to obtain information about the extensibility and elasticity of tissues. When expanding the walls of the intestine (air pumping), one can visualize even small tumors, ulcers and hyperplastic processes. In addition, with irrigation, the function of the internal sphincter, the bauhinium valve, is assessed. X-ray photographs visualize pathological constrictions, anomalies, diverticula of the intestine.
Features of Irrigography for Children
Irrigography for young children is carried out under general anesthesia, despite the painlessness of the procedure. In some cases, before the X-ray examination, the ultrasound probe is installed in the intestinal cavity. The implementation of irrigography for schoolchildren does not differ from the "adult" procedure. Nevertheless, it is necessary to calculate the volume of the contrast medium administered in advance.
Possible complications of the procedure
Complications during the study are extremely rare. They include - peritonitis (when a contrast substance enters the abdominal cavity), allergic reactions to barium sulfate, embolism of the intestine.