1. Form (filled out) for consent to medical intervention before the study (can be downloaded on the website)

2. All persons over 45 years of age and all those suffering from coronary artery disease or hypertension must have an ECG with a transcript (not more than 14 days old) - without an ECG, the study is not performed!

3. Have previous reports (copies) with you : endoscopy, x-ray of the gastrointestinal tract, epicrises from hospitals, information about operations performed on the gastrointestinal tract.

4. Referral from a general practitioner or gastroenterologist with the presumed diagnosis, objectives of the study, recommendations on the volume of biopsy material taken for histological examination and testing for HP.

5. Have a LARGE towel with you .

6. It is advisable to refrain from smoking on the day of the examination. 

The procedure is performed on an empty stomach . The last meal before the examination should take place the day before no later than 18.00 - light - 100 g of porridge, tea.

When performing the procedure in the first half of the day, it is recommended to exclude or postpone morning medications , which should be discussed with your doctor. It is allowed to take vital medications on the day of the test no later than 1.5-2 hours before the test. When taking tablets, you can take them with a sip of water.

It is recommended 1 day before the examination to take 2 teaspoons of ESPUMIZAN L emulsion 3 times a day and on the day of the examination in the morning - 2 teaspoons of ESPUMIZAN L emulsion with one sip of water.

Medicines for the treatment of diabetes mellitus can be taken half an hour after the examination, when you are already allowed to eat. You can take food with you.

In the presence of arterial hypertension, it is recommended to take a morning dose of the drug to lower blood pressure in the dosage prescribed by the attending physician. The study is contraindicated for blood pressure above 180 mm. rt. Art.

If the examination is scheduled for the afternoon (after 2 p.m.), then in the morning (at 7 a.m.) a light breakfast is allowed - plain yogurt or 100 g of porridge, sweet tea.

Allergy to any medications, especially LIDOCAINE;

If there is a tendency to increased bleeding with minor injuries or tooth extraction;

Does the patient take medications that affect blood clotting? Patients taking medications that affect blood clotting, such as Warfarin (Lavarin), Clopidogrel (Plavix, Trombex), Prasugrel (Efient) and other anticoagulants should inform your doctor about this.

Is there a replaced heart valve present?

Whether a pacemaker or defibrillator is installed;

The fact that the patient is pregnant;

The presence of chronic diseases of the lungs, heart, kidneys, liver, congenital bleeding disorders, diabetes mellitus, glaucoma, epilepsy, viral hepatitis, tuberculosis and other chronic infections;

Does the patient have removable dentures (false teeth).

Local anesthesia of the oropharynx is performed with solutions of anesthetic substances (we use 10% lidocaine aerosol) - in the absence of an allergy to this drug !

The insertion of modern thin flexible endoscopes is painless, but unpleasant. Anesthesia causes numbness of the oropharyngeal mucosa. There is a feeling of a “foreign” body, which goes away after 20-30 minutes.

1. Form (filled out) for consent to medical intervention before the study (can be downloaded on the website)

2. All persons over 45 years of age and all those suffering from coronary artery disease or hypertension must have an ECG with a transcript (not more than 14 days old) - without an ECG, the study is not performed!

3. Have previous reports (copies) with you - if available: EGDS, CS, X-ray of the gastrointestinal tract, epicrises from hospitals, information about operations performed on the gastrointestinal tract.

4. Referral from a general practitioner, surgeon or gastroenterologist with the presumed diagnosis, objectives of the study, recommendations on the volume of biopsy material taken for histological examination.

5. Have with you a LARGE BED sheet, personal hygiene items (toilet paper, pads, etc.)

COLONOSCOPY – WHY? TO WHOM? HOW?

This information will help you correctly understand the essence of colonoscopy - a medical intervention designed to diagnose colon disease at the earliest stage, assess the importance of endoscopic examination for your health, and also properly prepare for it.

COLONOSCOPY

Colonoscopy is a method of examining the colon from the inside, from its mucous membrane. 

The large intestine is the lower section of the gastrointestinal tract, in which there are three subsections - the rectum, colon and cecum.

Colonoscopy is performed after special preparation of the colon, by inserting an endoscope - a flexible thin device equipped with a light guide and a video camera - through the anus. Thanks to bright lighting and high resolution, a thorough examination of the lumen, walls and mucous membrane of the colon is ensured.

Indications for endoscopic examination of the colon are determined by a doctor: gastroenterologist, coloproctologist, therapist, surgeon, oncologist or the endoscopist himself. Typically, this intervention is aimed at identifying inflammatory changes, diverticula, colon polyps, as well as excluding cancerous lesions.

The main complaints are:

• signs of bleeding (discharge of scarlet blood, feces mixed with blood and clots, a significant decrease in hemoglobin levels), associated loss of consciousness, etc.
• presence of mucus in the stool
• loose stools lasting more than a week
• alternating constipation and diarrhea
• stomach ache
• frequent feeling of fullness and bloating
• weight loss
• unusual weakness

Colonoscopy should be carried out for the purpose of observation to assess the condition of the mucous membrane of the organ over time. In cases of polyps, or after their removal through an endoscope, after surgery for colon tumors, or in the presence of inflammatory diseases of the colon

The goal of screening is to detect a disease before symptoms appear .

The main task of screening colonoscopy is to identify polyps (adenomas), formations that do not manifest themselves until they increase in size and degenerate into cancer.

According to international recommendations for screening for colorectal cancer, a colonoscopy should be performed on every healthy person, starting at the age of 50 , and the study should be repeated (if there are no changes during the initial colonoscopy) every 10 years. However, in people with additional risk factors (such as polyps, tumors, inflammatory diseases of the colon in relatives), it is recommended to perform the first study as early as 45 years of age and, depending on the detected changes, conduct them at more frequent intervals.

Timely detection of polyps during colonoscopy allows their removal through an endoscope without resorting to a major operation involving the removal of part of the colon. If a malignant tumor is detected, early detection, before symptoms appear or spread, increases the chances of a complete cure.

For a more accurate diagnosis of the disease, it is possible to perform a biopsy during colonoscopy. A biopsy is the removal of fragments, small pieces, of colon tissue for subsequent examination of their structure under a microscope. A biopsy is performed using a thin instrument (forceps) through the endoscope channel; this procedure is painless.

Colonoscopy is also performed to treat diagnosed conditions, such as polyps, early forms of cancer, or a source of bleeding:

• identified polyps are removed using special instruments: an endoscopic loop or biopsy forceps. In early forms of cancer, a special technique for deeper tissue excision (endoscopic dissection of the submucosal layer) can be used, which is performed using special endoscopic knives;
• in case of bleeding, it is possible to eliminate the source of blood loss by injecting drugs through a needle, using electro- or argon plasma coagulation, or applying metal clips;

in case of strictures (narrowings or partial block of the lumen of the colon), a special balloon is passed through the endoscope channel, which is inflated in the narrowing until the lumen is completely straightened. In case of tumor narrowing, in some cases, it is possible to install a stent (prosthesis) to maintain the patency of the colon.

Previously, laxatives and cleansing enemas were prescribed to prepare the intestines for examination. Today there are ways to prepare the colon without having to do a single enema . But you need to take a drug that is not absorbed either in the stomach or intestines. As much as it comes in, so much comes out. At the same time, everything that is in the colon is washed out, and it is prepared perfectly, especially its right sections, which cannot be achieved with enemas. Therefore, we do not recommend preparing for colonoscopy with an enema to our patients.

But you will need to drink 4 liters, depending on your weight, digestive characteristics and the pathology suspected by the doctor. These 4 liters of the drug are not drunk immediately, but gradually, over several hours, and even in two stages.

Most or half in the evening, and a smaller part early in the morning on the day of the study. If the study is scheduled for tomorrow, then you can have your last meal today no later than 15-16 hours. This could be a light lunch. Allowed: clear soup, broth, no need to overeat on this day.

It is very important to follow a fiber-free diet and drink plenty of fluids for 3 days before the test day. No need to go hungry!!!

Below we will tell you in more detail how and what you can and cannot eat.

• Moviprep (UK),
• Fortrans (France),
• D-Forzhekt (Belarus),
• Forddrive (Belarus).

As a rule, the release form is powder. It is necessary to prepare from 2 to 4 liters of solution for preparation.

If you are preparing with Moviprep, then 2 liters of solution and 1.5-2 liters of drinking water are enough for you, and if you use other drugs, then 4 liters of solution.

Each sachet (or two, in the case of Moviprep) is dissolved in one liter of boiled or drinking water at room temperature. You can dissolve the entire volume at once, or gradually. This doesn't matter. Starting from 17-18 pm and until 21-22 pm, you drink two or three liters at a rate of one liter in one hour or an hour and a half. A glass in fifteen, twenty minutes. That is, not the entire volume at once, but gradually. The drug will begin to work, in most cases, within an hour or an hour and a half. You will want to go to the toilet. It is necessary that there is a toilet nearby, that is, it is better to cancel guests, visits or a visit to the theater that evening.

And usually by midnight that liter or two will be out. You will see how at first the water comes out cloudy, and then clearer and clearer, almost transparent by night. Sometimes there may be a delay in the effect of the drug for 2-3 hours. In this case, you should pause the preparation and wait for the amount you have already drunk to take effect. As a rule, you rest at night.

Early in the morning on the day of the study, you drink the remaining one or two liters of the drug, also one or two hours in advance, so that this liquid has time to come out at home, before you leave the house. The morning portion comes in easier and comes out faster.

In any case, the last sip of the prepared solution should be taken at least 3 hours before the scheduled time of colonoscopy .

Method 1. Preparation of 2 liters of solution : the drug Moviprep (2-step scheme: 1 liter in the evening + 1 liter in the morning)

On the eve of the study.

18.00 : Dissolve 2 bags - “sachets” A and B in 1 liter of drinking still water according to the instructions (1 bag contains 2 bags - “sachet” A and B)

19.00-20.00: drink 1 liter of solution, 1 glass every 15-20 minutes. Then drink 1 liter of permitted* liquid!

On the morning of the test: dilute and drink 1 liter of solution and 1 liter of approved* liquid in the same way.

Method 2. Preparation with 4 liters of solution : preparations D-Forzhekt, Fordrive, Fortrans (2-step scheme: 3 liters in the evening +1 liter in the morning)

On the eve of the study.

16:00 : Dissolve 3 sachets of the drug in 3 liters of drinking still water according to the instructions.

17:00-20:00: drink 3 liters of solution, 1 glass every 15-20 minutes.

On the morning of the test: dilute and drink 1 liter of solution in the same way (1 packet per 1 liter of water).

*Allowed clear liquids: water, juices without pulp (apple, light grape, birch), tea, clear non-carbonated drinks.

Important! On the morning of the examination day, the last glass of solution must be taken no later than 3 hours before the examination time! - for example, from 4 to 5 am, if the study is at 8.00.

1. The preparations should be stirred until all the powder has dissolved; store the solution in a cool place! The amount of solution cannot be reduced!!!

2. Patients who are overweight (more than 95 kg) and/or prone to constipation are advised to drink an additional 1 liter of preparation solution the evening before the test, and also take an additional laxative at night 2 days before the test .

Important!!! 3 days before the study - stop taking iron, bismuth (de-Nol, etc.), Almagel, activated carbon!

4. 1 day before the study : last meal no later than 12.00 (light breakfast and light lunch). Drink legal* clear liquids throughout the day.

5. If the bowel test is planned in the afternoon , the entire dose of bowel preparation can be taken in the morning of the test . Last glass of solution - 3 hours before the appointed time

6. Patients with colostomies are prepared according to the above scheme. Additionally, the rectal stump is cleansed with a microenema

The release form is powder.

The package contains 15 sachets, each of which is diluted individually in 200 ml of water. As a result, 5 sachets correspond to 1 liter of solution. 15 sachets - 3 liters of solution.

In terms of the amount of macrogol ( polyethylene glycol ) contained in Lavacol , 3 liters of Lavacol solution correspond to 3 liters of Fortrans solution (the “gold standard” of drugs for preparation for colonoscopy )

BUT!!! This is not enough for standard good and excellent preparation !

Therefore, taking into account the practical experience of using Lavacol in preparing patients for colonoscopy , we recommend taking 20 packets of Lavacol , i.e. purchase 1 box (15 packages) and 5 packages from another package .

The “ speed ” of using the drug is the same as when taking other drugs for preparation - 1 glass every 15-20 minutes - i.e. 1 liter in 1-1.5 hours.

And the dosage regimen is accordingly the same as when taking the drug Fortans and its analogues:

20 bags - 20 glasses of 200 ml of solution - equal to 4 liters of solution for preparation.

If taken in the 1st half of the day (before 15.00), then the drug is divided into evening and morning doses in the ratio of 15 + 5 or 10 + 10 packets, taking into account that the last glass of solution is drunk in the morning on the day of the study, 3-4 hours before the time of colonoscopy .

If taken after 15.00, then you can take all the sachets in the morning on the day of the study, taking into account that the last glass of solution is drunk 3-4 hours before the time of the study .

!!!It is mandatory to follow a diet for 3 days before colonoscopy without plant fiber, take Simethicone ( Espumizan , Bobotik , Comfortic or analogues) - 30 ml of the drug (usually 1 bottle) with the last portion of the solution .

1. intake of pure water up to 200 g (in small portions) 3 hours before the test.

2. for patients with diabetes, a light breakfast 3 hours before the test (100g porridge and sweet tea)

3. IT IS ALLOWED to take antihypertensive, cardiac, and antidiabetic medications - PRELIMINARY CONSULT WITH YOUR DOCTOR.

ADDITIONALLY FOR QUALITY PREPARATION AND REDUCING “UNPLEASANT” SENSATIONS DURING THE STUDY:

• It is recommended to take
• It is recommended to take
• During the preparation process, age-appropriate physical activity at home (bending, walking in place, exercises with a hula hoop) is desirable.

FIRST OF ALL, it is a medicine. You need to have the courage to take this drug.

When preparing in this way, you cannot eat solid food, but you can, and even need to, drink clear liquid. It is recommended to take this drug with water. Polyethylene glycol is not absorbed either in the stomach or intestines, it does not enter the bloodstream, it does not affect the heart or kidneys, it does not quench thirst, but it has a peculiar, salty-sweet taste. Not everyone says it's delicious. To eliminate this taste, after a glass of the drug, take a sip of any clear liquid:

• drinking water,
• mineral water without gas,
• clear juice without pulp - birch, apple, orange,
• green tea,
• weak black tea.

You can add lemon juice, drink chilled, and suck on Barberry lollipops.

Many patients took a lemon and added a few drops of lemon juice directly to the solution. By and large, how and in what time you take this amount of drug and preparation liquid does not play a special role. It is the volume that plays a role. Thanks to the volume of the solution drunk, everything that is in the lumen of the colon is washed out, and it cooks perfectly.

In addition, during the preparation process, it is advisable to exercise a little physical activity in the form of walking around the house, bending over, shallow squats, and exercises with a hula hoop. This contributes to a more thorough cleansing of the colon and, ultimately, a more efficient performance of the examination itself - colonoscopy.

(easily digestible, refined food containing almost no indigestible substances)

• Flour products and rice: white bread made from enriched refined premium flour, porridge (rice, oatmeal), muffins, biscuits, bagels (bagels) - without poppy seeds, simple crackers (without additives), vermicelli and noodles made from premium flour, including .h. white rice
• Meat: soups with low-fat meat broth; various, well-cooked dishes made from lean beef and veal; boiled chicken, also in the form of cutlets, meatballs, soufflé; egg
• Fish: dishes from cod, pike perch, perch, pike (low-fat fish)
• Dairy products: calcium-rich foods (low-fat cottage cheese, cheeses), natural yogurt (no additives!), no more than 2 glasses of skim milk
• Vegetables: vegetable broths, potatoes (without peel)
• Fruits and drinks: mousse, ½ banana, peach, melon. Tea, weak coffee, compotes, jelly and juices, preferably clear (without pulp, dried fruits, berries and grains!)
• Sweets: sugar, honey, jelly, syrup
• Possibly cooking, as well as consuming butter (butter, vegetable), mayonnaise, margarine in limited quantities.

• Flour products and cereals: all grain-containing products (whole grains, products containing crushed grains, nuts, poppy seeds, coconut flakes, etc.), brown bread, cereals (not included in the list of permitted), legumes, peas, lentils, etc. 
• Vegetables and fruits: all fresh and dried vegetables and fruits, cabbage in any form (both fresh and cooked), raisins and berries, especially with small seeds, all varieties of greens (parsley, dill, lettuce, cilantro, basil and etc.)
• Soups: cabbage soup and borscht, milk soups, cream soups, okroshka
• Meat, fish: fatty fish and meats, duck, goose, smoked meats, sausages, frankfurters
• Dairy products: yogurt containing fillers (fruit, muesli), pudding, cream, sour cream, ice cream, full-fat cottage cheese
• Seasonings and canned food: hot seasonings (horseradish, pepper, mustard, onion, vinegar, garlic), as well as all seasonings (sauces) with grains, herbs, pickles, canned food, salted and pickled mushrooms, seaweed
• Drinks: alcoholic drinks, kvass, sparkling water, prune drinks

Following dietary restrictions greatly influences the preparation process!

The time of a diagnostic study depends on many factors, such as the quality of preparation of the colon, the anatomical features of the organ, previous operations, as well as individual tolerance of the study. Also, the procedure time may increase due to additional (clarifying) interventions - diagnostic or therapeutic.

Colonoscopy begins in the left lateral decubitus position. During the examination, it is possible to change the position of the body - turn on your back or on your right side. The device is passed through the anus into the rectum and then into the colon and cecum, and the lower segment of the small intestine (terminal ileum) is also examined.

During the test, air or carbon dioxide (CO2) is injected into the intestinal lumen. The introduction of gases ensures straightening of the lumen and folds of the colon, clear visualization of the relief of the walls, mucous membrane, features of the vascular pattern, etc.

The colon is examined both when the device is inserted and when it is removed. In some cases, unpleasant pain may occur during a colonoscopy. Pain during a colonoscopy can be caused by a number of reasons. These include: previous operations on the abdominal cavity and the presence of adhesions, anatomical features of the large intestine: the presence of “sharp” bends and additional loops, elongation of the organ (dolichosigma, dolichocolon).

• The feeling of bloating may persist for some time
• You can drink and eat 30 minutes after the test
• if a biopsy was performed, physical activity should be avoided for 24 hours
• If unusual symptoms or any circumstances that worry you appear during the first hours and days after the test, contact the clinic where you had the test and inform your doctor! 

The endoscopic examination you are undergoing is an invasive instrumental intervention. The risk of complications is extremely low (no more than 0.4%). Endoscopists, when conducting research, try to do everything possible to avoid complications and reduce this percentage to zero.

Undesirable consequences that may occur during this procedure include:

• organ perforation
• pneumoperitoneum
• bleeding
• respiratory and cardiovascular disorder
• allergic reactions
• exacerbation of a chronic disease

If the above complications occur, hospitalization, emergency intensive, endoscopic and surgical treatment may be required.

Some of the most commonly diagnosed pathological changes in the colon are:

• Diverticula are small pouch-like protrusions in the wall of the colon.
• Polyps are neoplasms protruding above the mucous membrane. Polyps are usually benign tumors that have different sizes, shapes, bases and histological structures (hyperplastic or adenomatous).
• Cancer is a malignant tumor

Inflammatory diseases of the colon mucosa, for example: colitis - inflammation of the colon mucosa or Crohn's disease