Colon Cleansing Before Colonoscopy - Principles, Medications

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Bowel cleansing before colonoscopy

Colonoscopy is one of the methods of instrumental examination of the intestine, which allows timely detection and treatment of many serious pathologies. However, the accuracy of the study depends on how well the person prepared for the procedure. In this case, we are talking about cleansing the intestines. If you do not follow the recommendations for cleansing the organ before colonoscopy, then visualization diagnostics will be seriously difficult. As a result, the doctor may not notice some kind of inflammatory focus or growing neoplasm, or not get a complete picture of the disease.

Preparing for a colonoscopy involves cleansing the intestines, following a diet and fasting before the procedure. The correct psychological attitude is also important.

Content:

• Preparing for a colonoscopy
• Eating before colonoscopy
• Cleaning procedures before colonoscopy
• Types of colonoscopy laxatives

Preparing for a colonoscopy

The better a person prepares for a colonoscopy, the higher the information content of the study:

• 10 days before the procedure, you must stop taking iron preparations, from Activated carbon. It is also necessary to exclude blood thinners, which will avoid the development of bleeding.
• If the patient has an implanted artificial heart valve, then a course of antibacterial drugs is recommended before the colonoscopy. This is necessary to prevent the development of bacterial endocarditis.
• If the doctor permits, then before the colonoscopy, the patient can take an antispasmodic, for example, No-shpu.
• Doctors recommend refusing to take drugs from the NSAID group and drugs to stop diarrhea (Lopedium, Imodium, etc.).
• It is imperative to cleanse the intestines, as well as adhere to a diet. On the eve of the procedure, you must take a laxative (Fortrans, Lavacol, etc.).

Eating before colonoscopy

For 2-3 days before the upcoming procedure, the patient must adhere to a slag-free diet. Foods containing fiber should be excluded from the diet, as they can trigger fermentation processes in the intestines.

Diet before colonoscopy involves adherence to the following principles:

• It is necessary to adhere to the diet for a short period of time, since it is defective and unbalanced in composition.
• Be sure to drink enough water. Food products should provide the body with energy, vitamins and trace elements.
• From the menu, you need to exclude foods that are difficult to digest, or are capable of provoking fermentation processes in the intestines. Therefore, fatty and sinewy meat, sausage, refractory fats, smoked meats, marinades are removed from the diet. Do not eat fresh vegetables, mushrooms and herbs. The ban includes cereals, bran bread and rye flour, seeds and nuts, milk and dairy products, and alcoholic beverages.
• The diet is based on broths, diet meats, soups and cereals.
• Drink at least 1.5 liters of water per day.
• Products are steamed or cooked. Frying is prohibited.
• Spicy and salty dishes are removed from the menu.
• They eat food in small portions, but often.
• They switch to liquid meals 24 hours before the procedure. These can be soups, tea with honey, juices diluted with water, yoghurts and kefir.

Foods that can be eaten:

• Poultry, veal, beef, fish and rabbit meat.
• Dairy products.
• Boiled buckwheat and rice.
• Low-fat cheeses and cottage cheese.
• White bread, biscuit biscuits.
• Green tea with honey without sugar.
• Juice diluted with water and compote.

The following products should be excluded from the menu:

• Barley and millet.
• Lettuce leaves, paprika, cabbage, beets and carrots.
• Beans and peas.
• Raspberries and gooseberries.
• Dried fruits and nuts.
• Oranges, apples, tangerines, grapes, apricots, bananas and peaches.
• Rye bread.
• Sweets.
• Sparkling drinks, coffee and milk.

An example of a menu to follow three days before colonoscopy:

• Breakfast: boiled rice and tea.
• Snack: low-fat kefir.
• Lunch: soup with vegetables and compote.
• Snack: low-fat cheese.
• Dinner: boiled fish, rice and a glass of tea.

An example of a menu to follow 2 days before colonoscopy:

• Breakfast: cottage cheese with a low percentage of fat.
• Snack: two crackers with tea.
• Lunch: broth with a small piece of meat, steamed cabbage.
• Snack: fermented baked milk.
• Dinner: boiled buckwheat and tea.

The day before the colonoscopy, the last meal should take place no later than 2 pm.

Cleaning procedures before colonoscopy

An obligatory step in preparing for a colonoscopy is the process of cleansing the intestines. It is carried out with an enema or with drugs. The enema is put on the eve of the study at least 2 times. Then 2 more times it is placed before the procedure itself.

In one approach, about 1.5 liters of water are injected into the intestines. To make the cleansing process mild, you can take a laxative 12 hours before the colonoscopy.

If the patient has rectal cracks or other organ pathologies, then it is forbidden to give him an enema. In this case, the administration of drugs aimed at gentle bowel cleansing is indicated.

Types of colonoscopy laxatives

Laxatives are used to cleanse the intestines. They come to the rescue in cases where the enema is contraindicated.

Fortrans

This drug is specially designed for the preparation of patients before surgery and examination of the digestive system.

Fortrans is an osmotic laxative used to treat chronic constipation and preoperative bowel cleansing.

• Ingredients: salts (sodium and potassium), macrogol, soda, additive E 945.
• Pharmacological parameters. The drug is not absorbed into the blood, is not absorbed in the digestive tract. The effect occurs after 1-1.5 hours after ingestion. Taking the next dose will cut this time in half.
• Form and dosage. The drug is released in powder form, which is in sachets. Before taking 1 packet is dissolved in a liter of water. For every 20 kg of weight, you must take 1 sachet. The entire final volume is divided into 2 equal parts. The first half is drunk in the evening before the upcoming procedure, and the second half in the morning, 4 hours before the study.
• Contraindications. You can not take the drug for people with heart failure, persons under the age of majority, patients with cancerous lesions of the digestive system.
• Undesirable manifestations: vomiting.

The drug is produced in France. The cost of packaging is 450 rubles.

Lavacol

This drug is an analogue of Fortrans. It is produced by the Moscow Pharmaceutical Factory. The price for a package of a medicinal product is 200 rubles.

• Ingredients: macrogol, sodium sulfate, potassium chloride, sodium chloride and sodium bicarbonate.
• Pharmacological parameters. The drug has a laxative effect. Macrogol, after entering the intestine, retains water molecules, due to which the contents of the organ are quickly evacuated outside. Sodium and potassium salts prevent the development of electrolyte disturbances in the body.
• Form and dosage. The drug is produced in powder form, for every 5 kg of weight, one sachet of the drug is taken, which is diluted in a glass of warm water. If you add a little syrup to the solution, the taste of the drug will significantly improve. Take a glass of solution every 15-30 minutes.
• Contraindications: heart failure, intestinal obstruction, perforation of the gastric or intestinal walls, ulcers and erosion of the stomach or intestines, stomach stenosis, kidney disease.
• Undesirable manifestations: nausea and vomiting, abdominal discomfort.

Moviprep

Moviprep is one of the most well-studied and widely used macrogol-based drugs worldwide. It appeared in Russia 2 years ago. Its effectiveness has been confirmed by many clinical studies that have been conducted in Europe, America and Japan. For 10 years of its existence on the pharmaceutical market, Moviprep has earned only positive reviews from specialists.

Compared to similar medicines, Moviprep has the following advantages:

• For high-quality bowel cleansing, you need to drink 2 times less solution, that is, not 4, but 2 liters.
• The drug does not cause nausea and vomiting. Has a pleasant lemon flavor.
• Composition. Sachet A: macrogol, sodium sulfate, sodium chloride, potassium chloride, aspartame, lemon flavor, acesulfame potassium. Sachet B: ascorbic acid, sodium ascorbate.
• Pharmacological parameters. The drug causes mild diarrhea, which allows you to effectively cleanse the intestines.
• Form and dosage. The drug is taken orally. Dissolve sachets A and B in a small amount of water, and then bring its volume to 1 liter. Thus, you need to prepare another portion of the solution. As a result, you should get 2 liters of finished liquid. It can be drunk 1 time (in the morning or in the evening before the cleansing procedure), or divided into 2 doses (one liter is taken in the evening, and the second part of the drink in the morning). The entire volume of the solution should be drunk within 1-2 hours, divided into equal portions. You should also supplement the volumes of liquid with juice without pulp, tea or coffee without milk in the amount of 1 liter. Two hours before the colonoscopy, they stop drinking water.
• Contraindications: gastroparesis, intestinal obstruction, perforation of the walls of the stomach and intestines, phenylketonuria, ulcerative colitis, Crohn's disease, toxic megacolon, age under 18 years of age, lack of consciousness, hypersensitivity to the components of the drug.
• Undesirable manifestations: anaphylaxis, headaches, convulsions, dizziness, increased pressure, abdominal pain, nausea, vomiting, flatulence, itchy skin and rashes, thirst, chills, malaise, changes in the blood picture.

The cost of the drug is 598-688 rubles.

Endofalk

It is a laxative drug, the main active ingredient in which is macrogol. He is prescribed to cleanse the intestines before the upcoming colonoscopy.

• Ingredients: macrogol, sodium and potassium chloride, sodium bicarbonate.
• Pharmacological parameters: the drug has a carminative effect, is not absorbed in the body, comes out unchanged.
• Form and dosage. The drug is in powder form. Before taking it, it must be dissolved in water (1 sachet of powder requires 0.5 liters of water). To cleanse the intestines, you need 3.5-4 liters of solution. The entire volume of the drug should be consumed in 4-5 hours.
• Contraindications: dysphagia, stomach stenosis, ulcerative colitis, intestinal obstruction.
• Adverse manifestations: disturbances in the work of the heart, nausea, vomiting, allergic reactions.

The drug is produced by an Italian pharmaceutical company. Its cost is 500-600 rubles.

Pikoprep

Pikoprep is a new drug used to cleanse the intestines. Sodium picosulfate, included in its composition, causes the walls of the organ to contract, pushing the feces outward. Magnesium citrate absorbs water and softens intestinal contents.

• Ingredients: citric acid, magnesium oxide, sodium picosulfate, potassium bicarbonate, sodium saccharinate dihydrate, orange flavor additive. This supplement includes ascorbic acid, xanthine gum, dry orange extract and lactose. The drug is in powder form. The powder itself is white, and the solution prepared from it may have a yellowish tint and an orange smell.
• Pharmacological parameters. This drug belongs to the group of laxative solutions.
• Form and dosage. One sachet of the drug must be dissolved in 150 ml of water. The first portion of the solution is taken before dinner, washed down with 5 glasses of water, 0.25 l each. The next dose is taken at bedtime with 3 glasses of water.
• Contraindications: dehydration, peptic ulcer of the gastrointestinal tract, heart and vascular diseases, pregnancy, colitis, intestinal obstruction, kidney disease, pregnancy, age under 9 years old, lactose intolerance, rehabilitation period after surgery.
• Undesirable manifestations: allergic reactions, headache, nausea and vomiting, diarrhea, abdominal pain.

The cost of the drug is 770 rubles.

Fleet Phospho-Soda

Ingredients: sodium hydrogen phosphate dodecahydrate, sodium dihydrogen phosphate dihydrate, sodium benzoate, glycerol, alcohol, sodium saccharin, lemon and ginger oil, water, citric acid.

Pharmacological parameters. The drug belongs to laxatives, retains and accumulates water in the intestine, which causes its contraction and promotes rapid emptying.

Form and dosage:

• Morning appointment. At 7 o'clock in the morning, instead of breakfast, drink a glass of water and the first dose of the drug (45 ml of the drug is diluted in half a glass of water). This solution is washed down with another glass of water. At lunchtime, instead of eating, drink 3 glasses of water. Instead of supper, take another glass of water. After dinner, take the next dose of the solution, diluted in half a glass of water. Drink the medicine with a glass of cool water. You also need to drink fluids before midnight.
• Evening appointment. At one o'clock in the afternoon, you can eat light food. At seven in the evening they drink water. After dinner, take the first dose of the drug with a glass of water. During the evening, you need to drink another 3 glasses of liquid.
• On the day of the appointment. At seven in the morning they don't eat, they drink a glass of water. After breakfast, take the next dose of the drug with another glass of water.

Contraindications: individual intolerance to the components of the drug, intestinal obstruction, nausea, vomiting, abdominal pain, inflammatory diseases of the gastrointestinal tract and violation of the integrity of their walls, renal failure, age under 15 years, pregnancy and lactation.

Adverse manifestations: nausea, vomiting, abdominal pain, flatulence, dizziness, headache, allergic rashes, dehydration.

The cost of the drug is 1606-2152 rubles per package

Duphalac

• Ingredients: water and lactulose.
• Pharmacological parameters: enhances intestinal peristalsis, accelerates metabolism. A small amount of the drug is absorbed into the bloodstream.
• Form and dosage. The drug is produced in the form of a syrup, which is packaged in bottles of 200 and 500 ml. The dose is determined by the doctor; during treatment, the prescribed drinking regimen must be observed.
• Contraindications: diabetes mellitus, appendicitis, lactulose intolerance.
• Adverse manifestations: flatulence, vomiting, dizziness, increased weakness.

The drug is produced in Holland and costs 475 rubles.

Dinolak

• Ingredients: lactulose, simethicone.
• Pharmacological parameters. The drug enhances intestinal peristalsis, accelerates metabolism, neutralizes gases. It is not absorbed in the body, excreted unchanged.
• Form and dosage. The drug is available in the form of a suspension. The doctor selects the dose on an individual basis.
• Contraindications: intestinal obstruction, individual intolerance to lactulose.
• Undesirable manifestations: heart failure, headache, increased fatigue.

The drug is produced in Russia. The cost of the drug is 500 rubles.

Lactulose-based drugs act more slowly than macrogol drugs.

Colonoscopy will allow you to get reliable results only if the person follows all the doctor's recommendations regarding bowel cleansing and dieting. Most often, the procedure takes place without complications. However, with an increase in body temperature, with developing intestinal bleeding or vomiting, you need to seek medical help as soon as possible.

The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon

Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"