These preparations should be made before colonoscopy.

Colorectal cancer is one of the most common malignant tumors in digestive system. Globally, the incidence and mortality of colorectal cancer rank third and fourth respectively in malignant tumors, and the incidence and mortality in China are also rising, which seriously threatens the physical and mental health of all mankind.

As a simple, intuitive and minimally invasive examination method, colonoscopy plays a key role in screening, early diagnosis and treatment and comprehensive prevention of colorectal cancer and precancerous lesions.

Studies have shown that colonoscopy screening can significantly reduce the incidence of colorectal cancer by 48%, and high-quality colonoscopy is an effective means to prevent colorectal cancer.

Is your intestine clean?

With the improvement of people's health awareness, colonoscopy is becoming more and more popular. The key to the success of colonoscopy is whether the colon is dry or not.

Failure of intestinal preparation will lead to incomplete observation of colon, reduce the detection rate of colorectal lesions, the success rate of cecal intubation, prolong the operation time of endoscope and increase the incidence of complications.

Inadequate intestinal preparation accounts for a quarter of colonoscopy, which obviously affects the quality of colonoscopy.

Factors affecting intestinal cleanliness

Own factor

old age

fat

Chronic constipation

History of pelvic and abdominal surgery

Chronic diseases such as hypertension and diabetes.

Intestinal preparation factor

Diet preparation

Types of intestinal cleaners

Administration method of intestine-clearing agent

Administration time of intestine-clearing agent

Use of defoamer

Diet preparation

Two days before the inspection to the night before the inspection.

Chronic constipation patients

Low-fiber diet for 3 days before examination

Liquid food before inspection 1 day

Take laxatives three days in advance.

Choose the right intestinal cleaner.

An ideal intestine-clearing agent:

Fast, safe, high cleanliness, no damage to intestinal mucosa, good patient tolerance and economical price.

Traditional laxatives

right

Polyethylene glycol electrolyte

Scientific taking method of intestinal cleaner

Single dose and high dose PEG(4L)

Single dose and high dose PEG(4L) is a scheme approved by FDA.

However, a large number of studies have proved that 4 lpge regimen has higher quality of intestinal preparation than single administration.

For colonoscopy in the afternoon, ASGE and ESGE suggest taking full dose PEG regimen on the same day.

Take a large dose of FEG(4L) in several times.

Taking 2LPEG at night before examination and on the day of examination respectively has higher quality of intestinal preparation than taking 4LPEG at night before examination 1 day.

Taking it in batches can improve the detection rate of adenoma and the compliance and tolerance of patients, and reduce the occurrence of complications such as abdominal discomfort and vomiting. Therefore, it is generally recommended to take 4L in batches at home and abroad.

Low dose polyethylene glycol (2L)

The guide of China recommends 2PEG, which is different from the 4LPEG scheme recommended by European and American countries. It may be because compared with westerners, China has smaller body shape, lower weight and different eating habits, so it can't tolerate 4LPEG well.

Chronic constipation patients

It is necessary to appropriately increase the dosage of PEG or start taking laxatives 2-3 days in advance.

Appropriate interval time

The time interval between the last administration of intestinal preparation and the start of colonoscopy affects the quality of intestinal cleaning.

Every time the interval between the last drug preparation and the start of colonoscopy increases 1 hour, the chance of the right colon achieving good or excellent cleanliness decreases 10%.

When the time interval is 3-5h, the preparation quality of each segment of colon is the best.

At the interval of 7h, the quality of intestinal preparation decreased obviously.

Combined use of defoamer

The application of defoamer combined with PEG in intestinal preparation before colonoscopy can effectively reduce the bubbles in intestinal cavity, improve the definition of endoscopic visual field and shorten the operation time, which is of great significance to the quality control of colonoscopy.

How to clean the intestines before colonoscopy,

Do you know everything?

Department profile

The endoscopic room of Shanghai Tongren Hospital is a standardized and efficient medical team, focusing on the endoscopic diagnosis and treatment of early gastrointestinal tumors, biliary diseases and gastric varices complicated with portal hypertension. Capsule endoscope, magnetically controlled capsule gastroscope, electronic enteroscopy, magnifying endoscope, electronic staining endoscope (NBI/FICE/BLI), ultrasonic endoscope, fine needle puncture under the guidance of ultrasonic endoscope, diagnosis and treatment of biliary tract diseases under duodenoscope, endoscopic submucosal dissection, endoscopic submucosal excavation, endoscopic full-thickness gastrectomy, oral endoscopic sphincterotomy, etc. , responsible for more than 70% of digestive endoscopy in Changning District.

Contributed by: Zhang Haiqin in the endoscopy room.