What is the best way to have a colonoscopy with or without anesthesia?

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Colonoscopy is an invasive method for diagnosing diseases of the large intestine. The procedure is performed when you need to find the cause of bleeding and pain, helps to identify polyps, tumors, inflammation and other pathological changes in the walls of the intestine. This is the most informative method for diagnosing precancerous conditions and bowel cancer: according to recommendations Russian gastroenterologists, colonoscopy should be done for all people over 50 years old, even in the absence of complaints.

At the end of the last century, endoscopic examination of the intestine was performed under local anesthesia. Today, colonoscopy under anesthesia is available to patients. Let’s figure out what is the difference between these methods, and which option is better to choose.

Indications for the procedure

Endoscopic examination of the intestine is performed in such situations:

1. Diagnosis of diseases of the large intestine. With the help of special equipment, it is possible to examine in detail the mucous membrane and the lumen of the intestine.

2. Treatment of certain diseases. During colonoscopy, small polyps and tumors can be removed, bleeding can be stopped, and material can be taken for histological examination (biopsy).

Indications for colonoscopy are determined by a gastroenterologist or surgeon after a preliminary examination of the patient. For diagnostic purposes, the procedure is carried out in the presence of such conditions:

1. periodic or persistent pain in the umbilical region, lower and lateral parts of the abdomen;

2. signs of intestinal bleeding: blood in the stool, the release of scarlet blood during bowel movements or voluntarily;

3. mucus in the stool;

4. constipation, diarrhea (more than a week) or their alternation;

5. unreasonable weight loss.

Diagnostic colonoscopy is also carried out in dynamics – several months or years after the therapy. It allows you to evaluate the effectiveness of treatment and detect relapse in time.

Diagnostic colonoscopy is performed as a screening for healthy people when there are no signs of disease and no complaints. According to international guidelines for the prevention of colorectal cancerAll people over the age of 50 should be screened every 10 years. The purpose of diagnostics is to detect precancerous conditions and cancer at an early stage in time. People at high risk for bowel cancer are recommended to have a colonoscopy from the age of 45.

Indications for colonoscopy with or without anesthesia do not differ. Diagnostic and therapeutic goals will be the same, the difference is only in the features of the procedure.

Противопоказания

Any colonoscopy is not performed without prior preparation of the colon. The procedure is not performed even if during the examination the doctor cannot pass the intestines – for example, if there is a tumor or narrowing. Colonoscopy is stopped, further tactics are determined depending on the identified problem.

Colonoscopy with anesthesia is not performed for some serious diseases of the internal organs and the nervous system. This issue is resolved individually after a preliminary examination of the patient.

Preparing for a colonoscopy

Preparation for the procedure is different from how it will be carried out – under anesthesia or local anesthesia.

Without anesthesia

Good preparation of the large intestine is a key step in the diagnosis. The most important thing is to clear the intestine of feces so that the doctor can fully examine and, if necessary, take a biopsy. With poor-quality preparation, the intestinal lumen is closed by feces, and it is impossible to perform the procedure.

Preparation for a colonoscopy begins three days before the procedure. On the 1st and 2nd day, you need to follow a slag-free diet – eat only easily digestible food. The list of allowed and prohibited products is presented in the table.

On the third day of preparation (the day before the procedure), you can not eat solid food. It is allowed to drink an unlimited amount of liquid (clear broth, juice without pulp, green tea, still water).

On the eve of the colonoscopy, medication is also added. Laxatives are prescribed – as an option, Fortrans (2 liters). You should stop taking the drug no later than 4 hours before the procedure. When using Fortrans, an additional enema is not required.

On the day of the procedure, you can not eat or drink (except for the preparation for bowel preparation). It is allowed to take life-saving medications in consultation with the doctor.

Under anesthesia

The general principles of colon preparation are exactly the same as for colonoscopy without anesthesia. The goal is to clear the intestinal lumen and create favorable conditions for examination. But the use of anesthesia requires a more thorough examination before the procedure:

1. general clinical blood and urine tests;

2. biochemistry of blood;

3. blood type and Rh factor;

4. ECG;

5. therapist consultation.

During the examination, the doctor can identify chronic diseases and disorders in the functioning of internal organs. Some of them may be a contraindication for colonoscopy under anesthesia, others – a reason for a more thorough examination. Taking into account the identified pathology, the anesthesiologist will select the most gentle drug, which will reduce the risk of complications.

How is the procedure performed

The procedure is the same in both situations. The patient undresses below the waist, lies on the couch on the left side. If anesthesia is needed, the doctor injects the drug intravenously – and the patient falls asleep. He does not feel anything and wakes up when the whole procedure is completed.

Without anesthesia, the patient is conscious and experiences some discomfort during the procedure, often even pain. They are caused by the passage of the probe through the intestines. If the pain becomes unbearable, the procedure must be interrupted.

The length of the large intestine in an adult is about two meters. To ensure a good view during the examination, the intestines are filled with air. This is unpleasant: there is a spasm, there may be pain. Discomfort is also caused by the passage of the probe through the intestines, especially in places of physiological bends. Therefore, more and more colonoscopy is performed under general anesthesia. This is convenient for both the patient and the doctor: after all, it is easier for a sleeping person to conduct a full examination.

An alternative to anesthesia is medication sleep. The patient under the supervision of a physician takes sedatives. He remains conscious, but feels almost nothing. On the one hand, it is convenient – you can reduce the discomfort from the procedure without resorting to anesthesia. On the other hand, with a low pain threshold, the patient still feels all the stages of the examination, but at the same time cannot adequately respond to them – and the risk of complications increases.

The duration of a colonoscopy is 30 minutes without anesthesia and about 40-60 minutes with anesthesia. The doctor inserts the endoscope through the anus and gradually advances it into the lumen of the colon. It captures the rectum, colon and caecum, as well as the terminal part of the small intestine – the ileum. During the study, a gas is introduced, usually CO₂, less often air. Carbon dioxide is preferable – it is quickly absorbed, which means that the duration of painful sensations decreases.

During the examination, the doctor assesses the condition of the large intestine, reveals pathological formations – tumors, polyps, ulcers, diverticula, areas of narrowing, inflammatory changes. Based on these data, it is possible to make a diagnosis and determine the tactics of treatment.

Follow-up after colonoscopy

If the procedure was performed without anesthesia, immediately after its completion, the patient can return home. There are no lifestyle restrictions.

After colonoscopy under anesthesia, the patient is transferred to the ward, where he spends 2 hours. The doctor evaluates the general condition, determines the frequency of breathing and pulse, measures blood pressure. With good health, after two hours the patient returns home.

After a colonoscopy, regardless of the method of its implementation, bloating may persist for a day. This is a normal phenomenon: no treatment is required, outside the discomfort disappears on its own. But if abdominal pain appears, the general condition worsens, you should consult a doctor as soon as possible: complications may develop.

After a colonoscopy, you can eat and drink after 30 minutes. If the procedure was carried out under anesthesia, during the day you can not drive and operate any mechanisms.

Complications

Colonoscopy is an invasive procedure, so complications cannot be ruled out:

1. intestinal perforation;

2. pneumoperitoneum;

3. bleeding.

When using anesthesia, add:

1. disruption of the heart and lungs;

2. allergic reaction to the drug.

The use of modern technology, the high skill of the doctor and a thorough examination before the procedure can minimize the risks.

Conclusions

To sum up:

1. Colonoscopy is performed under anesthesia and without it. When using anesthesia, the patient remains unconscious throughout the procedure and does not feel anything. Without anesthesia, a colonoscopy can be uncomfortable and even painful.

2. Colonoscopy under anesthesia requires more thorough preparation and examination – some chronic diseases require a special approach to pain management.

3. The patient recovers faster after colonoscopy without anesthesia and can return to normal life within half an hour after the procedure. If anesthesia was used, the patient remains in the clinic for at least two hours.

4. The use of anesthesia is associated with the risk of complications. There may be an allergic reaction to the drug, a violation of the heart and lungs. The older the patient and the more chronic diseases he has, the higher the risk of an adverse outcome.

5. Colonoscopy is one of the most informative methods for diagnosing the colon. However, in some cases, it is impossible to carry out the procedure – for example, in case of chronic heart disease, the failure of previous attempts. An alternative may be capsule endoscopy. The patient simply swallows the video capsule, and the doctor receives information about the state of the intestine on the screen. This procedure compares favorably with other methods of examining the digestive tract, because it allows you to “look” even into the small intestine – a place inaccessible to other types of endoscopic diagnostics.

Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.