Digestive problems can occur in an adult and a child alike. In most cases, treatment of intestinal diseases requires a lot of time, and it can be quite complicated, depending on the diagnosis. It is for the diagnosis and may require a biopsy. This procedure is one of the diagnostic methods, therefore, it should not cause either fear or concern.
What is a biopsy?
Translated from the Greek word “biopsy” (consists of two parts) literally means “living, living tissue”, “examination”, that is, examination (study) of living, in the case of an intestinal biopsy - tissue.
This procedure involves taking a small piece of tissue, a sample for microscopic examination.
A biopsy is directly related to other procedures for examining the intestine, such as gastroscopy, colonoscopy, colposcopy, which are performed using a probe.
The purpose of this type of biopsy
The main purpose of an intestinal biopsy is to make an accurate diagnosis when other research methods were not so informative (even using the most modern equipment cannot guarantee the determination of the cause of a person’s malaise).
It looks as follows. Gastroscopy revealed the formation of polyps, but their nature can only be determined by examining the tissues under a microscope. A biopsy allows you to take tissue samples.
A piece of tissue taken during a biopsy is called a biopsy. His laboratory study allows you to limit the malignant from a benign tumor, determine the presence of an inflammatory process, etc.
What does an intestinal biopsy show?
The technique allows to identify the following diseases:
- Digestive Cancer
- Intestinal amyloidosis (impaired protein metabolism).
- Crohn's disease (chronic inflammation of the digestive tract with the formation of ulcers and scars).
- Nonspecific ulcerative colitis.
- Polyposis.
- Gluten intolerance.
- Whipple's disease (malabsorption of nutrients).
- Autoimmune (non-specific inflammatory) diseases of the digestive system.
- Acanthocytosis (impaired absorption and transport of fats as a result of red blood cell pathology).
- Intestinal colitis (symptoms and treatment in adults depend on the species, most often it is pseudomembranous and other species).
Types of Biopsy
This procedure may differ in the method of obtaining the biopsy:
- incision - performed during surgery on the intestine, while excision of the tissue is done with a scalpel;
- excision - for histological examination, the formation is completely removed, for example, the entire polyp or lymph node;
- puncture - to take a sample a puncture is made with a special long needle;
- scarification - a scraping from the intestinal mucosa is taken for research;
- loopback - a special loop is used to take a sample;
- endoscopic (or forceps) - tissue is taken with forceps during endoscopic examination;
- trepanation - a tissue section is captured by a special tube with sharp cutting edges;
- aspiration - a piece of tissue is removed with an aspirator (electric suction pump).
If an inflammatory process is detected, a targeted biopsy of the intestinal mucosa can be prescribed, which allows you to determine the focus of inflammation. If there is a suspicion of disease and at the same time the absence of external signs, a search biopsy is performed. It involves the study of several tissue samples at once.
Rules for preparing for the procedure
The success of an intestinal biopsy (the indications in this case may be different), its painlessness and the minimum risk of complications depends on the observance of the technology and the correct preparation. The last stage includes:
- abstinence from food 8-12 hours before the biopsy (the day before the procedure, it is recommended to include only broth, juice and water in the diet);
- adhering to a non-slag diet 3 days before the procedure when carrying out a biopsy of the large intestine (rice, beans, semolina, white cabbage, garlic, sorrel, salad, eggs, dairy and sour-milk products, fatty meat and lard, fatty fish, fish and meat on the bone are prohibited broths, sweets, spicy seasonings);
- the use of cleansing enemas or cleansing agents, such as Fortrans or Endofalk (the doctor should prescribe the scheme).
Biopsy Procedure
A biopsy is one of the methods for examining the human intestines. It requires the consent of the patient. Before the procedure itself, the patient is required to explain the course of the study, as well as possible consequences and complications. The doctor also indicates a possible reaction to the introduction of an endoscope, among which the most common are:
- excessive salivation (do not try to swallow saliva);
- gagging;
- gas discharge.
How an intestinal biopsy is done depends on the department being investigated.
Features of a small intestine biopsy
This procedure is performed in the following sequence:
- 30 minutes before the start of the procedure, the patient is given a sedative, allowing him to relax. The person is conscious during the procedure.
- The back wall of the pharynx is treated with an anesthetic, which reduces the risk of a gag reflex.
- After that, a mouthpiece is inserted into the growth, preventing an accidental snack of the endoscope tube. You can not worry, this device does not interfere with breathing.
- The patient is turned on his left side, after which an endoscope is inserted through the mouth. In this case, the doctor strictly controls the progress of the instrument and the place of its stop.
- Then, through the special channel of the endoscope, forceps are introduced, which capture the biopsy. The latter is placed in a special sterile container filled with a solution, which is sent to a histological laboratory for examination of biopsy material.
- After taking the sample, the doctor, making sure that there is no bleeding (normally they should not be) or perforations, takes out the endoscope.
How long an intestinal biopsy is done along with the main study can be obtained from your doctor. Usually this is no more than 30 minutes. It can be unpleasant, but there is no pain.
Features of a colon biopsy
In this case, a colonoscopy or sigmoidoscopy is performed. Do this as follows:
- The patient is laid on his left side, while he must bend his legs to his stomach.
- Before the procedure itself, a person is given either sedatives or anesthesia. Before that, blood pressure and pulse are measured.
- After the action of sedatives, the tip of the colonoscope is lubricated with vaseline, and then introduced into the anus. When the tool moves, air is artificially forced, which allows the tube to move more freely.
- Upon reaching the sigmoid colon, a person is turned onto his back, and then move on.
- Upon reaching the desired site, a tissue site is removed using forceps. Then the tool is removed (provided there is no bleeding and perforation).
In this case, a person may feel pain, so in most cases the procedure is performed under general anesthesia.
Possible complications
Biopsy complications are extremely rare. But still you need to be prepared for the possible:
- bleeding at the site of sampling for research;
- perforation of the wall of the small or large intestine (through hole of the wall with the release of contents into the abdominal cavity).
Intestinal Biopsy: Contraindications
Not everyone is shown this diagnostic technique. In this case, they speak of absolute and relative contraindications. An intestinal biopsy is not done if:
- severe infectious toxic conditions, such as sepsis, peritonitis;
- shock conditions;
- heart disease in the stage of sub- and decompensation;
- perforation (holes) in the wall of the digestive system (this applies not only to the intestine, but also to the esophagus and stomach);
- gastrointestinal bleeding;
- mental disorders;
- intestinal stenosis (but only if the pathology is to the place of taking the biopsy);
- diverticulitis of the intestine.
Also, this procedure is not performed after any surgical interventions on the abdomen and pelvis.
Relative contraindications are:
- predisposition to allergic reactions, especially to painkillers;
- acute infectious diseases, for example, acute respiratory viral infections, tonsillitis, and the like;
- gynecological diseases in women who are in the acute stage (in this case, a biopsy is transferred until the end of treatment for such diseases.)
When is a biopsy required?
A biopsy is not a mandatory research method in the presence of diseases of the digestive system. But in some cases, a patient’s failure can be life threatening. A biopsy is mandatory:
- with a detected tumor formation (the presence of CT may be indicated by the results of CT, MRI, colonoscopy or other studies);
- the presence of multiple erosive and ulcerative processes in the small or large intestine;
- prolonged inflammatory processes, the cause of which has not been established;
- the presence of any symptoms indicating possible bowel diseases (this may be a change in stool, the presence of blood impurities in it, flatulence and other similar disorders), while the symptoms do not fit into the clinic of the most common diseases, which requires an additional thorough examination.
The main indications for a biopsy of the small or large intestine (in addition to the above) are:
- narrowing of the intestinal lumen;
- chronic ulcerative colitis of the intestines (symptoms and treatment in adults can be uncomfortable);
- Crohn's disease (autoimmune, atypical inflammation of the intestinal wall);
- megacolon (giant colon, as well as a suspected presence of Hirschsprung’s disease in a child);
- the presence of fistulas of the rectum.
In most cases, the doctor makes the decision to undergo a biopsy during studies such as endoscopy or colonoscopy.
Child's biopsy
In a child, a biopsy is performed only in exceptional cases, in the presence of absolute indications. These are:
- Suspected serious bowel disease
- unexplained bleeding that affects the general condition;
- extensive inflammatory processes.
A biopsy requires careful preparation for the procedure, in relation to children this is especially important. You can entrust the procedure not just to a specialist gastroenterologist, but to a doctor who is well acquainted with the anatomy of the child’s body.
The material is taken under general anesthesia.
Preparing for an intestinal biopsy involves:
- dieting (it is necessary to exclude fatty, fried, smoked, salty foods, milk and dairy products, sweets, pastries, carbonated drinks) three days before the manipulation;
- taking laxatives;
- cleansing enema (performed to remove stool, which can complicate the passage of an endoscope or colonoscope through the intestine).
As a rule, a day before the examination, the child is placed in a hospital so that the small patient is monitored by medical personnel and complies with the preparation protocol for manipulations (when the child is at home, the whims and requests may leave parents indifferent, as a result of which the research will be low for the presence of food debris in the intestinal lumen).
The process itself is no different from taking tissue samples from an adult, but the doctor moves the tool according to the characteristics of the anatomy of the child.
Intestinal biopsy is a method of medical research with high information content. The timely implementation of this manipulation allows us to determine the presence of serious pathologies in the early stages, which will play a decisive role in choosing a treatment strategy.