Those who have already come across this procedure are looking for a way to check the intestines without a colonoscopy, since not only the procedure itself is quite unpleasant, but the preparatory stage before it takes a lot of time and effort. No one denies its effectiveness and efficiency, indispensability in terms of obtaining information, but a person has a desire to do without unpleasant sensations, especially if he knows about the availability of alternative methods. Modern research methods really offer other options for obtaining the necessary information, which allows in some cases to replace them with colonoscopy.
About the procedure and explainability of the desire to replace it
Colonoscopy of the intestine is carried out by inserting a flexible tube with instruments and a camera at the end into the colon. When viewed from the walls of the intestine, along the way, noticed polyps and fecal stones can be removed. Warning that the procedure is generally quite tolerant, the proctologist does not tell the whole truth, but in some cases prescribes sedatives. This method is not applicable in the case of liver, pulmonary, heart failure, with peritonitis and colitis, violation of blood coagulation and acute intestinal infections.
In addition to the aesthetic ugliness of the procedure, there is also a preparatory period in which the patient spends 24 hours before the examination in the toilet or near it. This is due to both the liquid diet prescribed before the study and the laxatives and enemas prescribed for bowel cleansing. If alternative methods can be dispensed with, patients prefer them. Colonoscopy is performed only in cases where the doctor needs complete and objective information.
Alternative research methods
In addition to colonoscopy, there are 7 instrumental methods for diagnosing the condition of the intestine. The only thing they are inferior to colonoscopic examination is that in the case of detection of negative phenomena in the intestine, it is impossible to take tissue from a problematic formation for analysis. Other methods for examining the intestine do not allow this, and if this kind of pathology is detected, you will have to return to the intestine with special devices at the end. Proctologist examination is carried out by the following methods:
- virtual colonoscopy,
- CT scan,
- magnetic resonance imaging (MRI),
- barium irrigoscopy,
- positron emission tomography (PET),
- capsular endoscopy.
Computed tomography is similar to an X-ray image, but instead of a single image, the tomograph takes them in layers, performing a gradual production of images in large numbers. Computed tomographic examination of the intestine without a colonoscopy can by no means always reveal cancer in the initial stage, which is always within the power of the proven method. For such a study, a contrast solution is drunk or an injection of the same substance is made. The procedure lasts much longer than the X-ray examination, and all this time the patient should lie motionless on the table.
Virtual tomography works using a program that processes CT results and can detect polyps larger than 1 cm, but this method of research is not available at every medical center, and early diagnosis with its use is excluded. And if polyps are found, they will still have to be deleted.
MRI is based on the use of magnets and radio waves, the energy of which is directed to the body, and then returned in the form of reflected pulses. This method is based on the introduction of a drug with gadolinium, which behaves differently in sick and healthy tissues, allowing you to identify polyps based on the decoding of the template in a detailed image using a computer program. This bowel examination is contraindicated in people with kidney disease.
PET uses for research a radioactive sugar - fluorodeoxyglucose. The test allows you to explore the area around the abnormality, the condition of the lymph nodes and surrounding organs if the cancer is already diagnosed, but does not give tangible evidence for immediate diagnosis. For complete information, the doctor must see a preliminary CT scan.
Ultrasound is rarely used, since it can only be used to determine the stage of cancer germination or a sufficiently large tumor. It is used most often as endorectal ultrasound for examination of the rectum, using a special sensor inserted into the immediate examination area.
Capsule endoscopy is applicable for the study of veins, muscle membrane and intestinal mucosa and is performed by swallowing a special capsule that takes pictures and transfers them to a recording device. This is a modern technology using wireless cameras - not widespread and quite expensive.
Irrigoscopy is an X-ray examination using a barium enema. The method is old and proven, but in the era of the spread of computer methods - outgoing, since there are few radiologists who can skillfully decrypt pictures.
The answer to the question of how to check the intestines for oncology without colonoscopy when considering each of these methods separately seems to be difficult today. Even if polyps can be detected at a later stage, their removal will again return to an unpleasant procedure.
Non-instrumental research methods
Gastrointestinal diseases of a less serious etiology caused by malnutrition, but giving fairly serious symptoms that give rise to unreasonable suspicions, can, according to gastroenterologists, be examined using non-instrumental methods. In such cases, palpation, listening and tapping, as well as visual examination of the external signs of the abdomen are considered priority. In some cases, the disease is determined by bloating, flatness, symmetry or asymmetry of the abdomen, the location of pain sensation, determined by pressure, the nature of these pain sensations - acute, cutting, stitching or dull.
A preliminary and fairly accurate diagnosis can be made on the basis of decades-old medical history collection methods, especially if they are supported by laboratory biochemical tests in the form of blood, urine and feces, as well as samples of the liver and pancreas. If the cause of pain is the gut, then a proctologist is connected to the examination, examining it using the anal-finger method. On palpation, the walls of the anus, their flexibility and elasticity, the mucous layer and the level of mobility are checked. This research method is carried out on a gynecological chair reclining, or in the knee-elbow position. During this procedure, an anesthetic solution or spray may be needed, the doctor may ask the patient to push or relax to assess the condition of the intestine.
Sound choices based on information
Today, there are a number of alternative methods that can be used to replace colonoscopy, which is especially objected to by those who have never undergone it, starting from the already slightly outdated and infrequently used sigmoidoscopy and irrigoscopy, superseded by the latest computer technologies, and even based on the latest technologies methods of computer diagnostics and endoscopy using wireless cameras. Each of the analyzed methods has unconditional positive and the same negative sides.
Some of them are applicable only in a narrow specialization, some are undesirable because of the contrast agents used, but in either case, the patient still has to go through the colonoscope, because this is the only way to fully diagnose and take samples at the same time. for analysis and immediately remove minor unpleasant phenomena. In the process of diagnosis using colonoscopy, you can immediately free the intestines from fecal stones, polyps and other benign growths, that is, clean the intestinal passages, the activity of which is hampered by these benign formations, significantly improving the functionality of a complex area. This examination is also indispensable in the field of early diagnosis of cancer, which makes it possible to treat at an early stage and successfully cure a troubling ailment.
Colonoscopy - what is it?
The essence of colonoscopy is to check the intestinal lining with a probe through the rectum.
This instrument has a camera and a small flashlight. With the help of them, the doctor can assess the condition of the organ from the inside. The procedure lasts about half an hour.
After conducting it, it is possible to identify the following pathologies:
- infectious diseases, inflammations,
- diverticulums (specific neoplasms on the intestinal mucosa),
- swelling of large veins.
This procedure helps with a biopsy (tissue sample for examination). Preparation for this procedure should also be serious.
It is important to follow a special diet at least a week before the procedure. This includes the use of easily digestible food - potatoes, wheat noodles, light soups, rice.
It is forbidden to eat mushrooms, granola, cucumbers, onions, lettuce and wholemeal bread.
It is necessary to cleanse the intestines in the evening and in the morning before the procedure. For cleaning, both an enema and special preparations, such as Dufalac, are used.
Colonoscopy of the intestine can not be performed with diseases such as:
- liver or pulmonary failure,
- heart failure,
- bleeding disorders
- acute intestinal infections.
If it is possible to do with alternative methods, then the subject is prescribed them, and a colonoscopy is performed only if a complete and clear picture of the entire organ is needed. Fecal stones and polyps can also be removed during this unpleasant procedure.
Also, sedatives may be prescribed to the patient before the examination.
Is it possible to replace colonoscopy
No non-invasive method can provide a diagnosis of such small formations that are detected by this procedure. Refusing to study does not make sense, because the biopsy material is taken using the same colonoscope. If formations are identified, their removal or thorough examination will be required.
To reduce the patient’s discomfort, the procedure is performed under local anesthesia, and, if indicated, under anesthesia.
It is better to overcome the psychological barrier and obtain reliable information during one procedure than to undergo several, albeit painless, studies. Coloproctologists recommend resorting to non-invasive methods if there are contraindications to this method of visual inspection of the intestinal walls.
Non-invasive bowel examination
These methods have their advantages, the main one is painlessness. But they do not provide the accuracy for which colonoscopy is famous. When assigning a bowel check for oncology, you need to know what research methods are used. The following visualization methods are available:
- virtual colonoscopy,
- Ultrasound scan
The first method is volume reconstruction, obtained by computer and magnetic resonance scanning. It does not cause pain, but it is impossible to see small outgrowths or ulcerations on the mucosa with its help. Ultrasound diagnostics is one of the safest methods, it takes a little time, is comfortable for the patient, requires a minimum of preparation and does not have absolute contraindications, but is only suitable for the diagnosis of large formations. Small polyps, ulcers, inflammation will go unnoticed.
Thus, ultrasound is a more informative procedure for examining other organs.
With computed tomography, the coloproctologist receives a series of layered images of the colon and sigmoid colon. This procedure takes at least half an hour. She is painless. Examination is done using a contrast agent. The procedure is carried out in a special room, so people suffering from claustrophobia will not be able to transfer it. A contraindication to such testing is an allergy to a contrast medium, pregnancy, some pathologies (CRF, severe forms of diabetes, myeloma and thyroid ailments). The device has weight restrictions. Overweight patients will have to choose a different diagnostic method.
The positron emission tomography method, or PET, is based on the use of radioactive sugar. The cells of a cancerous tumor absorb it more intensively than healthy tissues. The procedure takes about half an hour, 60 minutes before the start of the examination, the patient takes sugar.
This method is not used for the initial diagnosis of polyps and early stages of cancer. But it can be used to clarify the diagnosis made by CT. PET allows you to assess the degree of damage to nearby tissues and lymph nodes. It has almost the same contraindications as computed tomography.
Neither CT nor PET can replace the use of a colonoscope.
As a replacement for colonoscopy, MRI with contrast (gadolinium) is sometimes used. This procedure is famous for the higher quality of the resulting visual display of soft tissues (up to 10 times), while there is no radiation load on the body. But a number of devices have the same limitations as CT devices (they are closed and the table is limited in weight). The procedure lasts about an hour.
A working device produces unpleasant clicks that can scare children and cause a migraine attack in those patients who are prone to them. MRI has contraindications. This is an allergy to gedolinium, the patient’s presence of an Ilizarov apparatus and large metal implants, some types of pacemakers, electronic devices in the middle ear and hemostatic clips of cerebral vessels.
MRI is an informative method, but even it is not able to completely replace colonoscopy.
Minimally invasive colonoscopy replacement methods
Some of these methods have been used for many years and are not particularly pleasant, others are promising and gentle, but even they will not replace the uncomfortable colonoscopy procedure. These include:
- capsular endoscopy,
- irrigoscopy with barium or air,
- endorectal ultrasound diagnosis.
The colon or sigmoid colon can be studied using a method that has enviable prospects - this is an electronic tablet (video tablet). This method of capsular endoscopy is considered the most sparing and at the same time the most expensive. After the patient swallowed the electronic device, after some time the device begins to take pictures.
The doctor receives photos of the mucous membrane of the investigated area. But he should use only the obtained images, while colonoscopy is an online method. That is, a specialist, in the event that some site seems suspicious to him, can examine him more carefully.
Irrigoscopy is a tried and tested method for years, but also not too pleasant.. It comes down to setting an enema with barium or to straightening the intestines by pumping air, after which an x-ray is taken. This method also has contraindications (pregnancy, allergy to barium, etc.). It requires a lot of experience to decrypt a picture and is insensitive to small polyps. The method is good when you want to see the location of the intestines in the abdominal cavity. It perfectly reveals lengthening of the sigmoid colon (dolichosigma) and inversion of the intestines.
Rectal cancer is confirmed by endorectal ultrasound. In this procedure, the sensor is inserted into the rectum through the anus. This research method is commonly used to verify the diagnosis of an oncological process in the rectum. It is needed to determine which surrounding tissues and lymph nodes affected the process.
Typically, these methods are used as preliminary diagnostic methods or in addition to colonoscopy (and another selected study). As independent tests, they are insufficient.
- examination and questioning of the patient,
- general blood test,
- blood test for tumor markers,
- analysis of feces for occult blood.
A change in the color of the skin, its thinning, hair loss, exfoliation of the nails, which is accompanied by strong weight loss and a change in stool (the presence of mucus, blood impurities, constipation or diarrhea) - all this is evidence of problems with the intestines. Hidden blood in the stool can talk about erosive-ulcerative processes, and positive tumor markers - about the development of the tumor.
This information is for guidance only.. The research method should be chosen by a specialist in accordance with his observations and experience. Today, colonoscopy remains one of the most informative ways to diagnose pathologies of the colon and sigmoid colon.
When you need to check the intestines
Alimentary canal pathologies are accompanied by:
- prolonged nausea and vomiting,
- unexplained weight loss
- lack of appetite,
- disorders of the stool.
Life with a feeling of constant discomfort and pain turns into a nightmare. You will need the help of a gastroenterologist who needs information to select adequate therapy.
In recent years, colorectal cancer has significantly “rejuvenated”. He is dangerous in that at the initial stages of development, when the chances of recovery are still high, he does not show himself. Symptoms appear in the terminal phase when the prognosis is already disappointing.
Malignant neoplasms in the lower digestive canal can be avoided if intestinal polyps are identified and treated in a timely manner as the main cause of their occurrence.
Elena Malysheva, in the program "Live Healthy", talks about the main ways to diagnose intestines.
How to check the intestines in a hospital
A detailed examination is prescribed after identifying the main symptom, namely, latent blood in the feces.
Laboratory diagnostics include:
- General analysis of capillary blood taken on an empty stomach. It allows to detect the inflammatory process in the intestine, a violation of its suction function, disorders, helminth infections, bleeding, neoplasms. These diseases are characterized by low hemoglobin and high ESR.
- For biochemical analysis, venous blood is required. With its help, urea, C-reactive and total protein are detected, which determine helminthic infestations, acute infections, cancer, bleeding.
- Research on tumor markers, which are judged by the decay particles of degenerated cells. Exceeding the norm does not always indicate a malignant neoplasm. A preliminary diagnosis confirms or refutes additional research.
- A general urine test reveals dehydration and impaired absorption. Biomaterial is collected in the morning.
- Coprogram. This is the name of the study of feces for intestinal diseases and the presence of parasites. 2 days before the analysis, tomatoes, beets and other products containing pigments are excluded from the diet.
- Hidden blood is determined by its traces in the feces, for example, using the fecal immunochemical test carried out at home.
- Determination of pathological microbes with suspected acute or chronic infections. Using a special loop, the doctor selects a smear from the rectum for further bacterial growth. Microscopic examination reveals the type of pathogens, their sensitivity to various antibiotics to select the most effective therapy.
- Analysis of dysbiosis is carried out by sowing feces on the flora and counting the number of coli, lacto and bifidobacteria, as well as hydrogen and other tests.
The method of checking the condition of the abdominal organs, the presence of seals, the degree of pain.
Initially, an indicative palpation is performed to determine body temperature, muscle tone. The norm is considered a condition when there is no pain when feeling, the organs are mobile, the abdominal cavity is soft. Muscle tension indicates the location of the disease.
Swelling and swelling are detected by deep palpation. In the presence of neoplasms, one can determine their size, localization, shape and density. Healthy organs make no sound.
The method is used to study the anal canal. It is carried out with the index finger using anesthetic ointment according to the strictly prescribed rules and order of examination. In 90% of cases, it is possible to make an accurate diagnosis.
A method of instrumental diagnostics, with which you can check any part of the large intestine. For this purpose, a device equipped with a miniature video camera is used, which is inserted through the anus. When examining the inner walls of the lower sections of the digestive canal up to the appendix, inflammation, ulceration, tumors or polyposis are detected.
New models of endoscopes provide a piece of tissue for more thorough examination and removal of small formations. Previously, such actions were performed only during the operation.
The procedure for checking the intestines through the ass is contraindicated in acute forms of respiratory and cardiovascular failure, ischemic colitis, inflammation of the peritoneum, and violation of the integrity of the intestines.
Preparation for a colonoscopy includes a 3-day diet, taking laxatives on the eve of manipulation. Sometimes it is performed under general anesthesia. Soreness depends on the level of medical equipment and the qualifications of doctors.
The intestines can be checked without colonoscopy using a number of techniques, including the non-traumatic x-ray method using barium sulfate. Compared to CT (computed tomography), it is more sparing in terms of radiation exposure. Contrast is administered by enema or orally. On the monitor, you can see the nature of the folds of the intestinal wall, study cicatricial narrowing and congenital defects of the digestive canal.
In the shaded areas reveal:
- foreign bodies.
The method is indicated if colonoscopy is not possible or its results are in doubt.
The duration of the procedure is 15-45 minutes. Proper execution eliminates complications. Irrigoscopy is possible both in a specialized center, clinic, and in a hospital equipped with appropriate equipment and reinforced by the skill of a radiologist.
A painless diagnostic method that allows you to check a section of the large intestine 30 cm long from the anus. Before the manipulation, a digital examination of the anus is performed to identify contraindications, which include:
- acute hemorrhoids
- anal fissures
- inflammation in the lower digestive canal.
Inspection of the intestine begins with an assessment of the condition of the mucosa, its color, the presence of erosion and ulceration, swelling, the severity of folds in the walls of the anus and rectum.
A safe diagnostic measure that allows you to examine the intestines for diseases, including in pregnant women and children. It is carried out through the abdominal wall or rectally with a catheter inserted into the rectum.
The second method helps in the diagnosis of complex neoplasms on the outer layer of the anal canal, "invisible" during colonoscopy. It is carried out with a full bladder, which pushes the loops of the small intestine.
A special diet, enema, and the use of Fortrans cleanse the intestines, including the gases that interfere with the study. As a contrast, a special liquid is used.
The study requires a capsule with a video camera that is swallowed by the patient. Information is recorded on a special medium. After its analysis, the doctor selects a treatment regimen. Preparation consists in following a diet and fasting on the eve of manipulation. The price of the procedure can reach 30,000 rubles.
Magnetic resonance imaging
Diagnostic method used in various fields of medicine, including in the field of gastroenterology. When examining the digestive canal, MRI is an auxiliary procedure, since there are problems with the visualization of layered loops of the large intestine. The test is painless and does not require special preparation.
Detection of an inflammatory or malignant process using MRI is not a basis for diagnosis. A colonoscopy will be required with the study of each centimeter of the mucosa with the possibility of a biopsy and therapeutic measures:
- Cauterization of damaged vessels.
- Elimination of intestinal inversion.
- Removal of polyps.
The method is uninformative at the initial stage of the disease. But when examining seriously ill and pregnant women, it is the only available.
The abbreviated name is FGDS. It is a progressive and highly informative method of instrumental diagnostics. It provides visualization of the mucous membrane of the esophagus, stomach and duodenum, pH measurement, drug administration, stopping bleeding, removing polyps, collecting biomaterial for microscopic examination and detection of Helicobacter pillory.
On the eve of the procedure lasting 5-10 minutes, thorough preparation is carried out. You can do it under local anesthesia with lidocaine, which relieves discomfort in the throat.
FGDS is shown to all adults after 40 years of age in order to be checked at an early stage for the oncological degeneration of the digestive canal organs.
The arsenal of bowel tests is wide. Accurate timely diagnosis is a condition for successful recovery.
MRI and MR colonography
MRI is considered a good alternative to colonoscopy, but is significantly superior in cost. Therefore, it is prescribed as an additional research method in special cases.
It is also possible to attribute MR colonography to this. This procedure involves the introduction into the intestine of 2 liters of liquid with a contrast agent. And using a special apparatus, the state of the organ looks in three-dimensional display. The duration of the procedure is about an hour.
Contrast can cause kidney complications. Therefore, patients with renal failure are not allowed to be examined by this method, or in extreme cases, when all the pros and cons are weighed.
People with fear of enclosed spaces should also not use this method.
CT can also be considered an alternative technique. But it has its drawbacks - small neoplasms are difficult to assess from the information provided.
The advantages of this technology include the fact that when it is carried out, the mucous membranes are not damaged, tissues with high density are released, it is possible to assess the pathology contours and the condition of nearby organs.
This is displayed as a three-dimensional image of the anatomical structure of the organ in good quality.
Ultrasound can be used instead of colonoscopy in some cases. This examination is a registration of sound waves that are reflected from tissue boundaries that differ in structure and density.
This study allows us to assess the area of damage to the organ by a tumor. It is also possible to see nodes with a diameter of 0.5 to 2 cm.
Often an invasive examination of the intestine is prevented not only by the fear of patients, but also by a number of contraindications to the procedure. Therefore, an alternative examination may be prescribed by a specialist.
Non-invasive diagnostic methods allow you to identify:
- benign or malignant tumor formations,
- cracks and polyps of the mucous membrane,
- diverticulums of the rectum.
These diagnostic procedures have their advantages. First of all, these are painless manipulations that are well tolerated by patients and give a clear picture of intestinal damage.
- However, non-invasive examination methods do not provide the opportunity to take material for a biopsy for histological examination.
- When detecting small tumor formations, the malignancy or benignness of the pathological process is not always determined.
- The final diagnosis in complex cases of bowel disease and suspected malignancy is always confirmed by histology. Sometimes a patient has to undergo an examination twice, since only invasive examination methods allow you to visually examine and take material for a biopsy from problem areas of the organ.
Non-invasive diagnostic methods
Currently, the doctors' arsenal has a sufficient number of various instrumental non-invasive methods for examining the intestine. They allow you to identify pathology promptly and with high accuracy even when the clinical manifestations of the disease are absent or very insignificant. Such techniques include:
Virtual colonoscopy or colonography – multispiral computed tomography of the intestine is an analogue of computed tomography. Diagnostics is carried out by rotating the tomograph around the patient when an inspection and fixation of a certain section of the intestine with the surrounding tissues in the section occurs.
According to indications, diagnostics can be carried out with a contrast medium (barium) to determine the malignancy of the process.
Magnetic resonance imaging is the safest and most effective diagnostic procedure for identifying the nature and localization of the pathological process not only in the intestine, but also in the surrounding tissues. The principle of diagnosis is based on contrasting the walls of the organ.
The patient before the procedure consumes up to one and a half liters of a solution of sorbitol or mannitol and a contrast agent is accumulated intravenously accumulating in the walls of the colon. The measures taken contribute to intestinal distension, which leads to high-quality images that make it possible to clearly determine the presence of a pathological process.
The procedure is performed while lying on your stomach and lasts about an hour.
PET (positron emission tomography)
The method is based on the ability of a pathological formation in the intestine to accumulate a radioactive chemical administered intravenously. Most often, this element accumulates in tissues with an increased metabolism, that is, in malignant formations.The radiation that is emitted by this pathological process is recorded by a special device.
As a rule, a PET study is supplemented by a CT scan, since this method only displays the location of labeled atoms, so the result of a PET scan is combined with CT images.
Which method will be most suitable
When examining the intestines to determine the pathological process, primarily oncology, it is impossible to give an unambiguous answer about the advantage of a particular non-invasive diagnostic method. In each case, an individual approach is carried out taking into account:
- general condition of the patient
- time of illness
- certain contraindications.
The decision on the appointment of the examination and the choice of method is made by the doctor. But colonoscopy is by far the most informative way of examination, especially in the early stages of the development of the disease. It allows you to visually recognize a pathological lesion in the intestine, the size of which does not exceed 1 mm, and take the material for a biopsy.
The final diagnosis, made after the conclusion of the histological examination, makes it possible to determine further tactics in the treatment of the revealed intestinal pathology.
Intestinal Inspection Methods
Intestinal examination methods without colonoscopy can reveal various diseases, but most of them cannot be used for biopsy. Therefore, if there is a suspicion of oncology after all the replacement procedures, it may be necessary to use just such a diagnostic method.
How can I check the colon without a colonoscopy?
Endoscopic examination method - a capsule with a mini-video camera is placed in the investigated organs. The preparatory phase is the cleansing of the stomach and intestines. The patient is given an endocapsule, he swallows it. Due to the natural contractions of the walls of the digestive tract, it moves down.
A special apparatus is installed on the body of the subject and fixes the location of the camera and its signals. Then the computer decrypts the data, and the doctor interprets it. The capsule exits through the rectum when visiting the toilet.
Disadvantages: not all cities can conduct such an examination, it is carried out for a fee, there is a risk that the capsule will remain in the stomach and it will have to be pulled out using tools.
Allows you to evaluate the reflex ability of the anus and its condition. Preparation for the procedure is standard. During the examination, the patient may be in a knee-elbow position, lying on his side or sitting on a gynecological chair.
The doctor puts on gloves, lubricates the fingers with petroleum jelly, inserts the index into the rectum and feels its walls. The study can be carried out using the index finger, index and middle, as well as using a second hand located on the lower abdomen.
The advantage of this method is that it does not require additional tools and equipment, and direct contact with the walls of the intestine allows the doctor to accurately assess their condition and check the rectum without colonoscopy. The disadvantage is a small area of examination, therefore, digital research is only a preliminary stage of diagnosis.