Фиброколоноскопия кишечника – один из методов диагностики, который способствует оценке состояния кишечного отдела. Это безопасное эндоскопическое исследование, при осуществлении которого оптический зонд погружают внутрь полости изучаемого органа с последующими изучением:
- Состояния слизистых оболочек.
- Вероятности присоединения кишечных инфекций, сопровождающегося воспалительным процессом.
- Метод также позволяет диагностировать кишечную непроходимость, новообразования, нарушения всасывания.
Для проведения необходимых манипуляций врач используют специальную длинную трубку – фиброколоноскоп, к которой присоединена камера и осветительные приборы. Трубочка очень гибкая, что позволяет прибору с камерой проходить даже в узких, труднодоступных местах кишечного тракта.
Показания и противопоказания к процедуре
Осуществление ФКС рекомендовано по следующим показаниям:
- Жалобы на нарушения нормального функционирования ЖКТ, которые могут указывать на синдром раздраженного кишечника: тяжесть в животе, боль, нарушения стула, метеоризм (избыточное газообразование).
- Подозрение на непроходимость кишечника.
- Подозрение на внутреннее кровотечение, оказание экстренной помощи.
- Резкие колебания массы тела (уменьшение веса без явной причины).
- Выявление или исключение новообразований.
- Болезнь Крона.
- Проглатывание инородного предмета.
- Выявление слизистых и кровяных примесей в каловых массах.
- Показания к проведению гистологических анализов.
Важно! Фиброколоноскопия рекомендована пациентам, которым показано локальное оперативное вмешательство. В процессе осмотра врач может удалить полип. Подобные новообразования выявляют у 3-5% пациентов в ходе профилактического осмотра.
ФКС кишечника — безопасная процедура, однако необходимо учитывать возможные противопоказания к ее проведению. Диагностическое исследование не рекомендовано пациентам со следующим:
- Нарушения сердечного ритма.
- Легочная и сердечная недостаточность в выраженной форме.
- Язвенные колиты в фазе обострения.
- Атеросклероз.
- Нарушения целостности стенок кишечника.
- Спаечная болезнь брюшной полости.
- Аневризма аорты.
- Перитонит.
- Инфаркт (в острой форме).
- Недавно перенесенный инсульт, оперативные вмешательства в области желудочно-кишечного тракта.
- Колиты (молниеносная форма).
От проведения ФКС также рекомендовано воздерживаться при остром течении воспалительного процесса в прямой кишке, перитоните, нарушениях свертываемости крови, тромбозах, гипертонии III степени.
Подготовка в ФКС
В процессе подготовки к ФКС необходимо придерживаться ряда рекомендаций, которые позволят достичь наиболее точных результатов. Каждому из пациентов врач дает индивидуальные рекомендации, однако некоторые правила являются общими для всех.
Диета | В процессе подготовки к колонофиброскопии важно пересмотреть рацион и внести в него определенные коррективы. Рекомендовано ввести в рацион: |
- Каши на воде без сливочного масла.
- Нежирный бульон.
- Хлебобулочные изделия с небольшим количеством сахара.
- Клетчатку.
Диету необходимо соблюдать на протяжении 3-5 дней до проведения процедуры.
- Жаренная и жирная пища.
- Молочная продукция.
- Острые и пряные блюда.
- Бобовые.
- Пациентам назначают 2 клизмы.
- На первом этапе вводят 1 литр воды, спустя 60 минут – еще 1.
- Подобная процедура также рекомендована утром, в день проведения ФКС.
Использование слабительных препаратов:
- Врач может рекомендовать использование Дюфалака, Фортранса либо Магнезии.
- Дозировку рассчитывают индивидуально для каждого пациента, учитывая массу тела.
- Слабительные средства начинают использовать за 24 часа до фиброколоноскопии, в обеденное время суток.
- Пациенту показан прием легкой пищи в 12:00. Последний прием раствора слабительного препарата – 18:00.
Как проходит фиброскопия?
Процедура проходит в несколько основных этапов. Врач должен предварительно объяснить пациенту, каким образом будет проходить ФКС, чтобы избежать психоэмоциональных нарушений в процессе диагностики.
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Проведение первичной диагностики может занять до получаса. Если же ФКС будет проводиться во 2 или 3 раз, процесс проходит намного быстрее. Если будут выявлены полипы, их незамедлительно удалят. Пациент при этом не чувствует дискомфорта или болевых ощущений, и продолжительность манипуляций может увеличиться до 35 минут.
Отличия колоноскопии от фиброскопии
Колоноскопия и фиброскопия – похожие процедуры в современной медицине, основной целью которых является получение информации о состоянии внутренних органов при помощи наименее инвазивных методов. Перечень показаний, противопоказаний, рекомендаций относительно подготовки у обеих процедур аналогичен. При этом существует определенная разница между данными методами исследования:
- Фиброскопия – более современная методика, которую врачи используют чаще при обследовании пациентов.
- Фиброколоноскоп отличается более сложным строением, позволяет получить более развернутую информацию о состоянии внутренних органов.
- Колоноскопический прибор является тонкой резиновой трубкой, а в процессе создания фиброскопа используют сверхпрочные оптические волокна.
- Колоноскоп отличается меньшей гибкостью.
- Обе процедуры информативны и удобны для обследования больного.
Важно! Использование более современной техники позволяет свести к минимуму вероятность возникновения нежелательных реакций и дискомфортных ощущений.
Восстановительный период после ФКС – что делать?
На протяжении периода восстановления после ФКС также необходимо соблюдать указания врача для того, чтобы избежать развития осложнений.
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Стоимость процедуры
Стоимость ФКС составляет от 5 000 до 7 000 руб. и зависит от ряда факторов:
- Клиника, которая осуществляет проведение ФКС: государственная, частная.
- Тип стационара: круглосуточный, дневной.
- Экстренный или плановый тип проведения исследования.
- Какой препарат был использован для оказания обезболивающего эффекта.
- Квалификация специалиста-диагноста, который проводит ФКС.
- Какая аппаратура была использована.
- Наличие дополнительного сервиса.
Важно! Цена на ФКС, которую осуществляют в амбулаторных условиях в дневном стационаре, будет ниже, чем при необходимости проведения исследования в ночное время суток.
Отзывы пациентов
Отзывы пациентов о фиброколоноскопии кишечника преимущественно положительные. Ряд пациентов рекомендуют ФКС в качестве средства для профилактики и своевременного выявления болезней органов ЖКТ, другие указывают, что подобный вид диагностики – один из наиболее информативных. Проходить ФКС рекомендуют с использованием анестезирующих препаратов, седации либо внутривенного наркоза. В противном случае можно испытать психологический и физический дискомфорт, боль, пока врач будет исследовать органы ЖКТ.
Согласно отзывам, перед началом ФКС необходимо задать все уточняющие вопросу врачу, спросить про ОМС, алгоритм проведения видеоколоноскопии. Врач также остается на связи, пока будет длиться процесс. Делаться ФКС будет не менее 20 минут, в процессе врач будет обследовать толстый кишечник. Подготавливаться необходимо особо тщательно, чтобы получить максимально четкие и достоверные результаты при расшифровке. Предпочтение необходимо отдавать хорошим клиникам с высококвалифицированными специалистами.
девочки, привет всем! Все, закончились мои мучения по сдаче анализов, вчера сходила проверила желудок, 2 минутки потерпела, попыталась выплюнуть трубку и все, короче не страшно.
Боялась я фиброколоноскопии (ФКС), да так боялась, что 3 раза просила заведующую её отменить, но врач была непреклонна, или ирригоскопия (ИКС- это исследование рентгеном прямой кишки) или ФКС.
ИКС мне не подходит, т.к. после нее нельзя некоторое время беременеть, а мне надо сразу))) ну и там надо попасть не меньше чем за неделю до месячных и не менее недели после. Иначе, как сказал мне врач, облучим тебе все, вообще родить не сможешь никогда.
Начитавшись в интернете, как все это ужасно, больно, как люди орали на всю больницу, я пипец как боялась.
голодать и очищать организм начала со вторника, чтоб не было шлаков. ела куриный бульон, грудку, пила кефирчик. слабость была, но зато вставая на весы я радовалась ))
Вчера, часиков с 5 я начала пить специальный раствор Фортранс. Для того, чтоб очистить кишечник. На мои 57 кг его надо было выпить 4 литра с интервалом в 15 минут стакан. Ну и как сказано в инструкции, гладить живот, делать самомассаж. Ну и как рекомендация в инструкции -вечер дома провести.
Вместо самомассажа- я делала генеральную уборку, благо муж был в командировке, так что я чередовала горшок и мытье полов весь вечер. На вкус фортранс-терпимо, правда на 3 литре тянет выплюнуть его в лицо тому, кто его придумал. По вкусу похоже на сладко-соленую воду. я туда и апельсин добавляла, и лимон, тогда ощущение, что пьешь жидкое мыло, слегка соловато-сладкое.
Кушать с ним параллельно нельзя, можно только пить, да и пить не получается, считайте 4 литра за вечер в себя залить бяки и почувствовать жажду невозможно.
В общем отлично я расслабилась. Цели достигла- должна была выходить прозрачная светло-желтенькая водичка, и больше ничего, если вы понимаете о чем я. )
На утро, я выпила кружку чая с медом и поехала в ГКБ №3. Пришла, в гастроэнтерологию, мне выдали спец. шорты -трусы для колоноскопии, легла на простынку на левый бок, медсестра и врач были довольно молодыми и аккуратными, меня порадовало, что они обе были девушки, а не мужчины. В общем, исследование длилось минут 20, неприятно было в паре мест, когда кишечник делал изгиб, тянуло живот и я покрикивала, старалась абстрагироваться и дышать, дышать, дышать, думать о дыхании, закрыла рукой глаза, думала я сплю, короче главное- отвлечь свой мозг от ощущений, что в тебе 3 метра трубка, микроскоп и твой кишечник на экране))
периодически мены переворачивали то на один бок то на другой, немного натерли попу, местами я чувствовала трубку и в животе, и под ребром, почти под грудью, но в целом не было таких моментов, чтоб я прям орала, все было аккуратно, и повторюсь практически безболезненно.
Потом все быстро достали, дали чуток полежать и отпустили домой. Кишечник здоров, я счастлива. в понедельник ложусь на операцию .
Надеюсь, кому-нибудь мой пост поможет. Врача моего звали Елена Александровна, фамилию я не запомнила. Дело было в ГКБ №3. Рекомендую, если кому понадобится.
п.с. хорошо что делали без наркоза. смысла нет выкидывать на это деньги. Возможно, если бы брали биопсию, то было бы больнее, но её не брали.
ну и ещё из плюсов, я похудела на 2 кг., и очистила организм от шлаков и токсинов.
Одним из самых информативных и относительно недорогих методов первичной диагностики заболеваний нижнего отдела пищеварительного тракта является колоноскопия. Благодаря данной процедуре, позволяющей оценить состояние слизистой оболочки на всем протяжении прямой и толстой кишки, перед специалистами открылись широкие возможности для принятия корректных врачебных решений.
Виды колоноскопии
Это эндоскопическое исследование с применением фиброколоноскопа (гибкого оптического зонда, предназначенного для введения в прямую кишку). Он оснащен микроскопической видеокамерой и источником холодного света, исключающим ожог слизистой оболочки. Фиброколоноскоп передает на экран монитора многократно увеличенное изображение, позволяющее детально рассмотреть внутреннюю стенку кишечника.
Ультразвуковая эндоскопия является более совершенным методом диагностики, назначаемым в том случае, когда при проведении традиционного обследования был выявлен новообразовательный процесс. Данная процедура, предусматривающая использование прикрепленного к эндоскопу УЗ-датчика, позволяет определить глубину прорастания опухоли и уточнить ее распространенность и тканевую специфичность.
Такая эндоскопия является прогрессивным методом диагностики, позволяющим получать детальное изображение и выявлять проблемы, пропущенные при проведении КТ или МРТ. Она проводится при помощи видеокапсулы. Пациент проглатывает капсулу, которая после попадания в ЖКТ продвигается по нему и передает изображение на принимающее устройство. При помощи камеры-пилюли, естественным путем покидающей организм, обнаруживаются полипы, источники кровотечения, доброкачественные и злокачественные опухоли.
Виртуальная фиброколоноскопия – это разновидность компьютерной томографии, посредством которой воссоздается трехмерное изображение толстой кишки. С ее помощью выявляются полипы и выступающие в просвет кишечника доброкачественные и злокачественные новообразования. У такой колоноскопии цена выше, чем у других методов диагностики.
Видеоколоноскопия
В наших клиниках обследование проводится с помощью цифровой видеоэндоскопической системы PENTAX EPK-1000 (Япония). Для проведения диагностики используется аппарат PENTAX EG-2490K. Преимуществом использования инструмента является то, что изображение врач видит на мониторе уже во время проведения процедуры. На дистальной части прибора имеется ПЗС-матрица, преобразующая оптическое изображение в электронные сигналы и передающая их на обработку в процессор. После этого полученная картинка выводится на экране.
В клиниках IMMA мы уделяем большое внимание безопасности пациентов. Для очищения аппарата мы используем стерилизационную машину BANDEQ CYW-100N (Южная Корея). Она обеспечивает полный цикл проверки на герметичность, дезинфекции, промывки, стерилизации и сушки гастроскопического оборудования. Это тотальное уничтожение инфекций и вирусов!
Показания
Проведение колоноскопии может преследовать как диагностическую, так и терапевтическую цель. Эндоскопия назначается в ситуациях, когда имеется:
- локализованная/разлитая боль в области прямой или толстой кишки;
- патологические выделения из анального отверстия (слизь, кровь, гной);
- нарушения стула (запоры, сменяющиеся диареей);
- патологии нижних отделов кишечника, выявленные в ходе рентгенодиагностики;
- боли в заднем проходе;
- железодефицитная анемия, беспричинная потеря веса;
- присутствие инородного тела в просвете прямой кишки;
- кишечная непроходимость;
- язвенный колит;
- болезнь Крона;
- необходимость обнаружения источника кишечного кровотечения;
- эндоскопическое удаление полипов или опухолей;
- необходимость забора биопсийного материала.
Противопоказания
Все существующие противопоказания к проведению колоноскопии кишечника условно подразделяются на абсолютные и относительные. Список абсолютных ограничений включает в себя:
- тяжелые формы ишемического и язвенного колита;
- сердечную/легочную недостаточность;
- инфаркт миокарда;
- шоковые состояния;
- перитонит;
- острые инфекционные заболевания.
К относительным ограничениям для проведения эндоскопии относят следующие.
- Недостаточная подготовка к колоноскопии кишечника;
- острая кишечная кровопотеря;
- беременность;
- менструация;
- состояние пациента, требующее строгого постельного режима.
При наличии кардиостимулятора, искусственного сердечного клапана, сахарного диабета, глаукомы и пониженной свертываемости крови эндоскопия проводится только в случае крайней необходимости.
Подготовка
Для получения максимально информативных результатов обследования требуется проведение специальной подготовки к колоноскопии. Цель предварительного этапа – полное очищение кишечника. Алгоритм подготовки к фиброколоноскопии (ФКС) под седацией или без него одинаков. Он включает в себя 2 основных этапа. К первому относят соблюдение диеты перед колоноскопией (исключение из рациона продуктов, вызывающих брожение и газообразование). Ко второй – освобождение толстой кишки от каловых масс (медикаментозным или механическим очищением с использованием слабительных средств или растворов для клизм). Подробнее о подготовке (диете и очищении) Вам расскажет врач на консультации.
Проведение процедуры
Эндоскопия кишечника – это достаточно неприятная процедура, в отдельных случаях вызывающая выраженные болевые ощущения. Поэтому в современной клинической практике применяются три метода, позволяющих облегчить состояние пациента во время исследования:
- седация (медикаментозный сон);
- местная анестезия;
- общий наркоз (пациент пребывает в глубоком сне).
Подготовка к процедуре колоноскопии с местной анестезией предусматривает смазывание наконечника фиброколоноскопа обезболивающим составом, снижающим неприятные ощущения. При проведении колоноскопии под седацией пациента при помощи специального снотворного препарата вводят в поверхностный медикаментозный сон. Детям до 12 лет, людям с низким болевым порогом и пациентам с массивными спаечными и деструктивными процессами при отсутствии противопоказаний рекомендуется проводить колоноскопию под наркозом.
Колоноскопия с использованием наркоза проводится одинаково у женщин, мужчин и детей. Пациента укладывают на левый бок с подтянутыми к груди коленями. Далее по жеданию пациента выполняется анестезия (услуга доступна в клиниках в Куркино, Коммунарке, Марьино). Непосредственно при обследовании в задний проход вводится колоноскоп. Его постепенно продвигают при умеренной подаче воздуха, расширяющего просвет и расправляющего складки слизистой оболочки. В момент преодоления изгибов для облегчения продвижения наконечника пациента могут переместить с бока на спину. В среднем длительность колоноскопии составляет 30 минут. При необходимости забора биопсийного материала время увеличивается.
Результаты
После того как пациенту сделали колоноскопию, сразу же подготавливаются результаты в печатном формате. При необходимости забора биопсийной ткани для последующего проведения гистологического исследования бланк анализа передают лечащему врачу через несколько дней.
Медицинские клиники IММА, предоставляющих полный комплекс лечебно-диагностических услуг, предлагают выполнить колоноскопию с использованием анестезии или пройти платное исследование с применением медикаментозного сна. Выбор варианта анестезии осуществляет врач. Если Вы желаете записаться на консультацию, уточнить правила подготовки и диеты, а также стоимость эндоскопии тонкого кишечника, мы предлагаем связаться с нашими специалистами по контактным телефонам в Москве.
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