Colonoscopy is one of the most common bowel tests. However, due to the high invasiveness, morbidity and considerable cost of this method, many refuse to carry it out. Therefore, this article discusses other methods for examining the intestine, which can be an alternative to colonoscopy.
The importance of bowel examination
Unfortunately, malignant neoplasms of the intestine are becoming more common these days. In addition, the number of cancer cases is increasing not only among the elderly, as was previously thought. The incidence of young men and women has also increased.
The number of deaths due to colon cancer takes third place after neoplasms of the liver and lungs. The peak incidence occurs after the age of 45 years. And people who have reached the age of 55 are recommended to undergo a screening, that is, preventive, examination of the intestine once a year.
Although colonoscopy is the "gold standard" for diagnosing colon cancer, regular prophylactic use for large populations will cost the state or patient a lot. In addition, this examination method requires special preparation: setting an enema, diet, and also extremely unpleasant for the patient. And then the question again arises: is there an alternative to colonoscopy of the intestine? In this article you will find the answer.
Intestinal Examination Methods
You can highlight the following common methods for diagnosing intestinal diseases:
- irrigoscopy;
- capsular endoscopy;
- PET scan
- ultrasonography;
- hydrogen test;
- CT colonography (virtual colonoscopy).
The listed methods are not ideal and cannot fully become an alternative to colonoscopy. However, each of them has a number of advantages over the "gold standard" of diagnosis, which will be discussed later.
Irrigoscopy
This is an x-ray method for examining the large intestine with the preliminary introduction of contrast agents into it. With its help, you can evaluate both the structure and function of the intestine.
With a minimum dose of radiation, this method allows you to detect the presence of tumors, to analyze the folding of the mucous membrane. You can see the degree of patency of the intestinal canal, the presence of any obstacles to the evacuation of contrast. The method also allows you to evaluate the motor function of the intestine by determining the time of evacuation of the contrast medium.
An undoubted advantage is the painlessness of the procedure, and, as a consequence, the absence of the need for anesthesia.
Irrigoscopy is indicated in the following situations:
- prolonged constipation;
- feces mixed with blood, mucus or pus;
- chronic bloating;
- prolonged pain in the lower abdomen;
- bleeding during or after bowel movements.
Despite all its advantages, irrigoscopy cannot be an absolute alternative to colonoscopy. This is due to the fact that with the help of this X-ray method, although it is possible to see the presence of a neoplasm, one cannot take material for a biopsy and examine this tissue. Therefore, if a tumor is visualized on irrigoscopy, a colonoscopy with histological examination of the tissues will be the next step. However, as a screening method, it is more appropriate to do irrigoscopy.
Capsule endoscopy
Diagnosis of intestinal diseases using a capsule is an alternative to colonoscopy, one of the most modern methods for the study of the gastrointestinal tract (GIT). This method consists in a patient swallowing a small capsule with an integrated camera.
The undoubted advantage of this examination method is that with its help you can see the pathology of the most inaccessible section of the gastrointestinal tract - the small intestine. Capsular endoscopy also has a number of other advantages:
- painlessness - the patient does not experience any unpleasant sensations from the moment the capsule is swallowed and before it leaves the body;
- complete safety - the absence of contraindications and the sterility of the capsule relieve the patient of any risks;
- comfort for the patient during the entire procedure - while the capsule is in the patient’s body, he can safely move within the hospital;
- high information content is the best method for diagnosing bleeding from the gastrointestinal tract.
This method of examination of the intestine as an alternative to colonoscopy is shown in the following cases:
- low hemoglobin;
- suspected inflammatory process in the esophagus, stomach, or intestines;
- irritable bowel syndrome;
- monitoring the course of chronic inflammatory processes in the digestive tract;
- celiac disease - intolerance to cereal protein (gluten);
- suspicion of intestinal neoplasms;
- prolonged abdominal pain, the cause of which could not be determined using other diagnostic methods;
- prolonged violation of bowel movements (chronic constipation or diarrhea);
- progressive weight loss;
- impurities of blood in the stool.
Virtual colonoscopy
This is one of the modern alternatives to colonoscopy of the intestine, a type of computed tomography. Like irrigography, this diagnostic method belongs to the category of radiological. However, virtual colonoscopy is much more informative, and the radiation load on the patient is much less.
The essence of the method is to recreate a three-dimensional image of the intestinal tube, which is recorded after air is injected into the intestine, and the patient holds his breath.
The main advantages of this method:
- lack of invasiveness - the patient does not need to enter any instruments into the intestine;
- there is no need to anesthetize the patient or give him sedatives, since the procedure is gentle;
- the risk of intestinal damage is minimized, which cannot be said about classical colonoscopy.
Virtual colonoscopy is indicated in such situations:
- inflammatory processes in the intestines;
- ulceration of the mucous membrane of the stomach and duodenum;
- frequent gastrointestinal pathologies, the cause of which could not be determined by other examination methods.
- GI bleeding.
PET scan
This method of examination uses special radioactive pharmaceuticals that can accumulate in specific organs. It is with the help of how actively the organs absorb this substance, their functioning is evaluated.
PET scanning has received the most widespread use in monitoring the treatment of tumors, evaluating the blood supply to internal organs, and their functions.
When a patient has a bowel tumor, the use of this method is advisable to perform the following tasks:
- search for localization of metastases;
- tumor spread assessment;
- determination of tumor activity;
- determination of the stage of the tumor.
Thus, for a more detailed examination of the neoplasm, PET is an excellent alternative to colonoscopy.
Hydrogen test
This diagnostic method does not require invasive intervention in the patient's body. It is based on fixing the time of increasing the amount of hydrogen in different parts of the intestine. As you know, in the intestine there are a large number of bacteria that produce hydrogen. Thus, the sections of the intestinal tube with a high amount of this element are precisely the areas where the pathological process is localized.
This method can not be called a full-fledged alternative to the examination of colonoscopy due to its low information content, however, it can be used to diagnose such diseases:
- dysbiosis with the establishment of the exact cause;
- lactase deficiency;
- congenital intolerance to fructose.
Ultrasound scan
An intestine examination using ultrasound can be done in two ways: through the anterior abdominal wall (transabdominally) and through the rectum (endorectally).
Endorectal ultrasound is indicated in the following cases:
- chronic constipation;
- involuntary bowel movements;
- an admixture of blood in the feces;
- palpation of the tumor with a digital examination of the rectum;
- displacement of the intestinal tube was revealed during x-ray examination of the intestine.
Endorectal ultrasound examination, as an alternative to colonoscopy, is more informative than transabdominal. But this type of diagnosis is contraindicated in patients with rectal stenosis. The most optimal is the combination of these two ultrasound methods.
conclusions
Thus, when answering the question whether there is an alternative to colonoscopy, a definite answer cannot be given. Yes, in terms of prevention and regular examination, there really are alternatives. The presence of tumors can also be detected using non-invasive techniques such as capsule or virtual colonoscopy. But only classical colonoscopy with a biopsy allows you to establish what cells the tumor consists of, and this is one of the main criteria for determining treatment tactics.