As you know, the intestine is the largest organ of the digestive system. Anatomically, it distinguishes several departments. In the small intestine, the absorption of beneficial substances that come with food occurs. In addition, enzymes that digest food are produced there. In the large intestine, water and vitamins are absorbed. There is the formation of feces. Under the influence of various damaging agents, numerous bowel diseases develop. The most dangerous of them are considered surgical pathologies, in which immediate assistance is needed.
To diagnose diseases, an examination of the intestine is necessary. Methods for identifying pathologies may be different. These include laboratory tests and instrumental diagnostics. The choice of method depends on the intended location of the pathological focus.
Intestinal Examination Methods
An important step in the diagnosis is an instrumental examination of the intestine. Methods for detecting pathologies are divided into radiological and endoscopic. The first are performed with suspected bowel obstruction. Endoscopic diagnostic methods are prescribed to assess the condition of the mucous membrane of the organ. In some cases, both studies are indicated.
X-ray methods include intestinal irrigography. With its help, you can evaluate the patency of the organ, its shape, the presence of gas in the abdominal cavity, pathological narrowing or expansion. Irrigography allows you to visualize the colon.
Sometimes an X-ray diagnosis is not enough to make a correct diagnosis. In this case, fibrocolonoscopy (FCC) is necessary. This method is widely used in elderly people with suspected cancer. It refers to endoscopic procedures. For sigmoid and rectum sigmoidoscopy, sigmoidoscopy is performed.
In addition to instrumental studies, laboratory diagnostics are carried out. It includes microscopy of feces, scraping on eggs of worms, analysis for occult blood.
Intestinal irrigography - what is it?
In a surgical hospital, an X-ray examination of the intestine is most often performed. After all, it allows you to identify acute pathological processes that require surgical intervention. Intestinal irrigography - what is it and how is it performed? This diagnostic method is carried out using an x-ray unit. Most often, irrigography with contrast is preferred. A similar method allows you to visualize not only the shape and location of the organ, but also its functional state.
Irrigrography is an X-ray examination, 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 cleansing procedures. With some pathologies, it is not possible to empty the organ cavity. Nevertheless, intestinal irrigography should be performed. This diagnostic procedure is characterized by high information content, speed of execution and painlessness.
Stages of irrigography
Intestinal irrigography is carried out in 2 stages. The first is a panoramic radiography of the lower abdomen. It is necessary for suspected surgical pathology. When performing this study, the patient is in a supine position. If after carrying out a survey picture, suspicions of a pathology of the large intestine remain, the diagnostic procedure is continued.
The second stage of the study is an x-ray using a contrast medium. It is this procedure that is called irrigography. Contrasting is necessary to improve visualization and the ability to evaluate bowel functions (substance filling, peristalsis). For the purpose of "staining" barium sulfate is used. This substance is injected into the cavity of the large intestine under radiological control.
Indications for irrigography
Irrigography procedure is not performed as a screening, unlike endoscopic examination. X-ray diagnostics are carried out only with suspicion of serious diseases of the large intestine. There are a number of indications for irrigography. Among them:
- Suspected intestinal obstruction. In this case, contrasting is not carried out, since the introduction of barium sulfate can only aggravate the situation. In addition, the substance will not be able to fill the entire intestine due to the presence of an obstacle. In case of obstruction, the study is terminated after the first stage - survey radiography.
- Tumor suspicion. In some cases, with oncological pathologies, complete bowel obstruction does not occur. However, if there is a tumor in the lumen of the organ, it compresses the stool, and can also be injured and bleed during the act of defecation. Bowel cancer can be suspected by complaints such as weakness, weight loss, fever to subfebrile numbers, pain in the lower abdomen, constipation. If the tumor is localized in the left half of the intestine, a pathological impurity is observed during bowel movements (blood, pus, mucus). The form of feces can change (in the form of tapes).
- Suspicion of benign neoplasms - intestinal polyps.
- Nonspecific ulcerative colitis (ULC) is a chronic inflammatory process in the intestines.
- Crohn's disease. It is characterized by irreversible changes in the intestine, ulceration of its walls and the appearance of granulomatous growths. UC and Crohn's disease are optional precancerous conditions.
Contraindications to performing irrigography
Despite the fact that intestinal irrigography is an informative and high-quality method of instrumental diagnostics, in some cases it cannot be carried out. Contraindications include the following conditions:
- Period of pregnancy.
- Suspected intestinal perforation. In this case, a similar research method is contraindicated because of the possibility of contrast penetration into the abdominal cavity. The output of barium sulfate from the intestine will only aggravate the prognosis of the disease.
- Acute cardiovascular failure, acute renal failure.
- Chronic pathologies in the stage of decompensation.
- Intolerance to a contrast medium. Some patients may develop immediate allergic reactions.
In these cases, other diagnostic procedures are performed instead of intestinal irrigography. If there are contraindications to all instrumental examination methods, they are based on the clinical symptoms of the disease.
Preparation for bowel examination
Preparation for irrigography is very important. After all, the result of the study depends on this. Preparation includes cleansing the colon of undigested food and feces. A few days before irrigography, the patient should follow a special diet, that is, exclude products from the diet that lead to an accumulation of gases in the intestine. These include some vegetables (cabbage, carrots, beets, greens) and fruits. Also, 2-3 days before the procedure, it is worth limiting the consumption of cereals (barley, oatmeal) and bread.
To empty the intestines, cleansing enemas are performed on the eve of the examination and immediately before it (in the morning). Laxative medications are allowed. You can completely clear the colon with the help of the Fortrans medication. Diluted in 3 liters of water, the drug must be drunk from 6 pm on the eve of the procedure and in the morning. The last meal is allowed at lunch, dinner should be skipped. In the morning, before exploring, a light breakfast is recommended.
Intestinal irrigography: 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 serious illness is suspected, intestinal irrigography is performed first. How is this study done? After performing a radiography, the patient lies on his left side, his legs are pressed to his stomach, and his hands are behind his back. Using a special probe, 1 to 2 liters of barium suspension is injected into the rectum cavity. At this time, the patient changes position several times on the couch to evenly distribute the contrast medium. As the intestines fill up, several x-rays are taken. The last of them is performed after the removal of the probe. To get a more accurate picture, the double contrast method is performed. To this end, after the procedure, air is injected into the rectum (using an irrigoscopy apparatus) and a number of shots are taken. Most often, this procedure is necessary for suspected benign neoplasms and cancer.
Interpretation of Irrigography Results
Intestinal irrigography is a method that allows you to evaluate: the shape, location and diameter of the organ. Thanks to contrasting, it is possible to obtain information on the extensibility and elasticity of tissues. When the intestinal walls are straightened (air injection), even small neoplasms, ulcerative and hyperplastic processes can be visualized. In addition, irrigography evaluates the function of the internal sphincter - the bauginium damper. On radiological images, pathological narrowing, abnormalities, intestinal diverticula are visualized.
Features of irrigography for children
Irrigography of young children is carried out under general anesthesia, despite the painlessness of the procedure. In some cases, before an X-ray examination, an ultrasound probe is installed in the intestinal cavity. Performing irrigography for children of school age does not differ from the "adult" procedure. Nevertheless, it is necessary to calculate in advance the amount of contrast medium administered.
Possible complications of the procedure
Complications during the study are extremely rare. These include - peritonitis (when a contrast agent enters the abdominal cavity), allergic reactions to barium sulfate, intestinal embolism.