Sigmoidoscopy is an endoscopic examination method that allows you to visually assess the condition of the anus (anus), as well as examine the rectal mucosa. In addition, RRS examination makes it possible to examine the distal sections of the sigmoid colon.
Indications for
This endoscopic manipulation is performed to detect intestinal diseases and treat them in a timely manner. As a rule, the RRS study is indicated for use in cases of suspected cancer, with the release of blood, mucus or pus from the intestines, with stool disorders, chronic inflammatory processes in the rectum. Indication for this examination is also hemorrhoids, a suspected prostate tumor in men or cancer of the pelvic organs in women. In addition, intestinal RRS is used for preparation if other endoscopic procedures are needed (e.g., irrigoscopy or colonoscopy). It is also carried out to identify ulcers and polyps with the possibility of taking material for microscopic examination.
Contraindications Patient preparation
An examination of the
rectum of the RRS is not carried out with profuse bleeding, with menstruation in women, with acute inflammation of the anus or abdominal cavity, as well as with acute anal fissure, congenital or acquired narrowing of the lower intestines.
It should be noted that the most important condition in order to be able to examine the rectum by the endoscopic method is the maximum cleansing of the intestines from the contents.
So, on the eve of this manipulation, it is recommended to adhere to a certain diet. Patients are forced to exclude from their diet fresh fruits, vegetables, brown bread and legumes, cabbage in any form, and other products that lead to flatulence (increased gas formation in the intestines).
It should be remembered that in the evening before the examination by a proctologist and in the morning on the day of the examination, only a small amount of liquid is allowed (you can drink still water or weak tea with sugar).
Cleansing the intestines with an enema
To prepare for sigmoidoscopy, in the evening before the examination, you need to do 2 cleansing enemas with an interval of 15 minutes. In the morning, this bowel cleansing should be repeated. If the examination of the proctologist is scheduled for the first half of the day, then breakfast is prohibited. If sigmoidoscopy will be performed in the afternoon, then the patient is allowed a light breakfast, but before leaving the house, another enema should be done.
Let us consider in more detail how to properly clean the lower intestines, since without this RRS examination is impossible.
To conduct a cleansing enema, Esmarch's mug, petroleum jelly, a liter of water (its temperature should be no more than 20 ° C) and a tripod should be prepared. The procedure is as follows:
• fill the system by first checking the temperature of the water;
• we hang Esmarch’s mug on a tripod at a height of not more than 30 cm from the person who should clear the intestines;
• lubricate the tip with petroleum jelly;
• we put the patient on the left side (legs should be bent at the knees and slightly brought to the stomach);
• part the buttocks and insert the tip into the anus 3 cm towards the navel, and then 10 cm parallel to the spine;
• then open the valve so that water enters the intestines.
How to make a cleansing enema yourself?
To do this, you need to take a knee-elbow position in the bathroom, lean on your elbow, and with your free hand insert the tip into the rectum. This should be done slowly and very carefully. After this, you must open the Esmarch mug tap and introduce water. If you feel pain, the fluid intake should be blocked and wait a few while breathing evenly and stroking the stomach.
It should be noted that it is necessary to control the amount of introduced water (it should not exceed two liters). For better bowel cleansing, it is recommended that you hold the fluid for at least 10 minutes. If you can, you can walk or lie on your stomach.
If you need to immediately put 2 cleansing enemas, between them you can take a break for about 45 minutes. This is necessary in order to make sure that the wash water is away from the first enema.
At the request of the patient, special microclysters can be used (for example, “Microlax”). They are used rectally. Pharmacological action is observed after 15 minutes.
Preparation for sigmoidoscopy without enemas
For this, appropriate pharmacological preparations are taken. Most commonly used are:
• Fortrans. In the evening before examination, the patient should drink from 17 to 20 hours 3 l of water in which 3 sachets of this drug must first be dissolved. Tentatively should be consumed per liter of solution per hour. Breakfast is not allowed in the morning.
• "Dufalac." On the eve of sigmoidoscopy, you need to drink 2 liters of water from 18 to 20 hours, dissolving 200 ml of the indicated syrup in it. Breakfast on the day of the examination is also prohibited.
• “Flit Phospho-Soda”. If the RRS examination is scheduled for the first half of the day, then in the morning before the procedure, instead of breakfast, you should drink a light liquid. It can be tea or coffee, juice without pulp or a non-carbonated soft drink. Then in 100 ml of cold water you need to dissolve one sachet of the drug and drink the solution. In this case, it should be washed down with 2 glasses of cold water. Instead of lunch, you need to drink at least 800 ml of light liquid, instead of dinner, another glass. After this, you need to drink another sachet of the drug in the same way as in the morning.
Features of sigmoidoscopy
The RRS procedure is performed strictly on an empty stomach. To undergo an examination, the patient should remove clothing below the waist and take a knee-elbow position on the couch. With severe pain in the anus, sigmoidoscopy is performed with local anesthesia. For this purpose, an ointment with dicain is used. Perianal blockade may be performed. If necessary, general anesthesia is used.
The doctor gradually inserts a rectoscope into the rectum and advances it forward, moderately supplying air, which allows you to straighten the folds of the intestine and contributes to a better visualization of the mucosa. Then the obturator is removed and, under the control of vision, the rectoscope is advanced to the sigmoid colon. After examination, the tube is removed from the intestinal lumen in a circular motion, continuing the examination.
It should be noted that RRS examination is completely safe, only with methodologically incorrect conduct can intestinal perforation occur , which requires immediate surgical intervention.
Reviews of sigmoidoscopy
It must be said right away that this examination is painless, but, of course, unpleasant. Some patients do not experience any discomfort at all, while others require at least local anesthesia. Often the determining factor that affects the attitude towards sigmoidoscopy is the fear of it.
To detect diseases such as cancer of the rectum or sigmoid colon, as well as ulcerative colitis or Crohn's disease, it is RRS examination that is used. The doctors' comments on this procedure are positive, since it is important for the diagnosis of abdominal pain, the detection of blood or other impurities in the feces, chronic constipation or diarrhea, as well as iron deficiency anemia, the etiology of which is unknown.
It should also be noted that sigmoidoscopy is recommended for all people after 55 years for early detection of neoplasms in the intestine. With burdened heredity, this procedure should be performed annually.