How does the initial appointment with a proctologist go? Preparing for a proctological examination
For some reason, there is an opinion in society that all problems associated with the rectum and anus are shameful. This is completely wrong! There is nothing shameful about diseases of this part of the body. Diseases of the anus disrupt a person's quality of life - problems with bowel movements, pain, and so on. And the first time patients turn to a doctor is when it is no longer possible to endure. Who is a proctologist, and what diseases are within his area of responsibility? How to properly prepare for an appointment with a doctor?
A visit to a proctologist has nothing shameful in it!
Proctology is a field of medicine that deals with the study and treatment of diseases of the large intestine and pararectal area. The area of responsibility of a proctologist includes the following diseases:
At the appointment, the doctor will make a diagnosis, determine the stage of the disease and give appropriate recommendations. You should definitely and immediately consult a doctor if the following symptoms occur:
- Impaired bowel movements - constipation
- Blood, pus or
How is a proctological examination performed?
No matter how embarrassing and sickening your soul may be, you will have to undergo a number of procedures in the doctor’s office. It is important to understand that it is not trying to cause you discomfort or mental suffering! It is important for the doctor to carefully examine the patient and make the correct diagnosis. What happens in the proctologist's office:
- Visual inspection of the anal area and surrounding area. This will allow you to assess the severity of hemorrhoids, fistula, the degree of intestinal prolapse or the condition of the anal fissure.
- Finger examination – this stage will have to be patient! The doctor will treat the edges of the anus and hands with a special anesthetic. This will relieve discomfort. This study will allow you to assess the condition of the anal muscles, detect neoplasms, and assess the condition of internal hemorrhoids. In addition, digital examination allows us to identify contraindications for endoscopic examination rectum.
- – endoscopic procedure, allowing you to assess the condition internal walls rectum at a distance of 10 cm. During the procedure, a smear is taken and, if necessary, a biopsy is performed. Anoscopy allows for therapeutic manipulations - coagulation of hemorrhoids, administration of medications.
How to properly prepare for a visit to a proctologist?
A proctologist is a doctor of all things, whom you should not be ashamed of.
Any trip to the doctor requires compliance with the rules of preparation for the visit. Even when planning a trip to the therapist to measure your blood pressure, you need to at least brush your teeth and comb your hair. Visiting specialists requires a more thorough approach. Before you come to see a proctologist, you will have to empty the intestines of the contents. This is done in two ways:
- Mechanical colon lavage using an enema
- Using special
If the patient suffers from severe pain, then it is better not to cleanse the intestines on your own. The doctor will conduct an initial and manual rectal examination and prescribe painkillers and anti-inflammatory drugs. After the pain is relieved, the proctologist will conduct the necessary instrumental examination.
Enema. Methodology of the procedure
The colon cleansing procedure is carried out 3-4 hours before the expected visit to the doctor. The patient will have to do 2 cleansing enemas. The break between procedures is 45 minutes. The water temperature should be pleasantly warm – 36–37 degrees. If you go to a morning appointment, then it is advisable to carry out cleansing procedures before bedtime. If the appointment is scheduled for evening time, then the enema can be done after the morning toilet.
So, instruments and materials:
- Exmarch mug - a container resembling a heating pad with a hose, tip and clamp
- Warm water
- Oilcloth so as not to stain the trestle bed or bed
The volume of the Exmarch mug is from 1.5 to 2 liters. The tip on the hose can be glass or plastic about 10 cm long. The latter is more preferable. If you have a device with a glass tube, be sure to check it - there should be no chips or sharp edges. Before the procedure, thoroughly wash the tip with soap.
Check the clamp on the hose. It doesn’t matter if this part is broken or lost! It can be easily replaced with a regular clothespin. Everything is ready! Let's start cleansing the body:
- Lie on your left side, bend your legs
- Raise Exmarch's mug to a height of 1–1.5 m
- Release the air from the hose and nozzle
- Lubricate the tip with Vaseline or any liquid neutral oil
- Spread the buttocks and gently rotate the tip into the rectum and open the clamp
- Within 5–10 minutes, the entire contents of the Exmarch mug will enter the intestines
- During the procedure it is possible painful sensations due to stretching of the intestinal walls
- Quickly go to the toilet and enjoy the process of cleansing the body
- After 40 minutes, repeat the procedure
- If for some reason this method is not suitable, then you can perform an enema in the knee-elbow position.
Laxatives in preparation for a visit to the doctor
You need to properly prepare for a visit to a proctologist
If a democratic enema is for some reason impossible or the patient does not like the procedure, then you can turn to laxatives. Doctors recommend using either Microlax microenemas or sachets
How to use Microlax?
The drug is a capsule with a viscous solution white. The product contains sodium citrate, sodium lauryl sulfoacetate and sorbitol. The volume of one tube is 5 ml. Microlax is combination drugs. Its action is based on softening feces and increasing the volume of fluid in the intestines. The body cleansing process will begin in 15 minutes.
The drug is approved for use in children under 1 year of age and older, pregnant and lactating women. There is only one contraindication for this drug - individual intolerance to Microlax. How to administer the drug? It's simple:
- Open the tube
- Squeeze a drop of product onto the tip
- Insert the tip of the tube to its full length (for babies under 1 year of age, the tip is inserted halfway)
- Inject the drug and remove the tip
- After 15 minutes we enjoy the process of defecation
- The cleaning procedure with Microlax should be carried out 3 hours before your appointment with a proctologist.
The drug "Fortrans"
It is easier to prevent a disease than to treat it!
This medicine is used orally. That is, you drink a laxative solution and there is no need to torture your butt with an enema. Comfortable? Yes, but expensive, tasteless and long. And there are also a number of contraindications! Basics active substance in the preparation - macrogol 4000 - has an osmotic effect. The package contains 4 sachets for preparing the solution. But in pharmacies they sell sachets individually. So for a patient weighing up to 80 kg, it is enough to purchase 2 sachets; if more than 80 kg, then you will have to drink 3 packets of laxatives.
Each packet should be dissolved in 1 liter of water. So, if the patient weighs 100 kg, then you will have to take 3 liters of solution. Preparation for the visit begins 12 hours in advance. That is, if you plan to take it in the morning, then you need to start drinking the solution in the evening of the previous day. Every 15 minutes you should drink 1 glass of solution. Thus, 2 liters of Fortrans will have to be drunk in 2 hours, 3 liters in 3 hours. After 1 hour, cleansing of the body begins and ends 2 hours after taking the last portion. Contraindications to taking Fortrans:
- Serious condition of the patient
- Intestinal obstruction or suspicion of this condition
- rectum of any etiology
- Inflammatory processes on the mucous membrane of the rectum and intestines in general
- Age up to 15 years
- Pregnancy is a relative contraindication. The question of taking this drug is decided by the attending physician
- Individual intolerance to the components of the drug
- Kidney diseases
Attention! Don't prolong the procedure! You’re supposed to drink 2 packets in 2 hours – so that’s what you need to do! And not 1 sachet in the evening, but 2 in the morning! The expected effect will not be achieved.
It may even have the opposite effect. Water will not leave the intestines, but it will not be absorbed and absorbed due to the drug dissolved in it. And the intestines will not be cleansed, and your belly will be full of water.
Diet before visiting a proctologist
Doctors do not impose any restrictions on the patient’s diet. It is recommended not to eat peas, beans, cabbage in any form - anything that causes increased gas formation. The day before the visit, it is advisable to eat light, dietary food. There are no restrictions on drinks, but it is advisable not to drink juices with pulp. On the eve of the visit, a light breakfast is indicated if the appointment is scheduled for the morning. At any other time - 1.5 hours before your visit to the doctor.
In any case, it is up to you and your doctor to decide how to cleanse the intestines. – cheap and cheerful, but unpleasant. But going to the toilet after an enema is a one-time thing! Medicines for colon cleansing it is expensive, possibly tasteless and unpleasant. And the process is lengthy, and in the case of Fortrans there is an additional load on the kidneys and the entire body.
The doctor will tell you in the video how to prepare for an examination with a proctologist:
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If you are planning an appointment with a proctologist, then it is advisable to prepare accordingly for the examination, oYou need to look at the rectum when it is cleared of contents.
There are two main ways to prepare the intestine for manipulation:
- laxative drugs (FLIT phospho-soda, FORTRANS)
- cleansing enemas (up to clean water)
It is better to come to an appointment with a proctologist on an empty stomach. Those who do not tolerate hunger well or are suffering diabetes mellitus, can have a light snack before the visit. You should not eat foods that can cause excess gas and loose stools: fruits, dairy products, carbonated drinks, etc.
Also don't forget to bring yours outpatient card, results of previous examinations and other medical documents.
If the consultation with a proctologist is urgent, i.e. If you have an exacerbation of hemorrhoids, anal fissure and the exacerbation is accompanied by severe pain in the anus, bleeding, then there is no need to prepare for an examination. IN further specialist, after the initial examination, will determine the need for examination. Do not injure the sore areas again. The doctor will carefully conduct the examination without this preparation. If necessary, you will be prescribed therapy to relieve an exacerbation or pain syndrome, and after that you will undergo the necessary instrumental examinations.
Features of the examination at the On Line Clinic
The examination includes:
- Anoscopy (examination of the rectum to a depth of 10 cm)
- Rectoscopy (examination of the rectum to a depth of 20 cm)
- Digital examination of the anal area.
- Detailed consultation with a doctor with a diagnosis and prescription of a course of treatment (if necessary).
The examination is carried out in a comfortable position (on a couch, lying on your left side) using an anesthetic (lidocaine) gel, which avoids discomfort.
A complete proctological examination lasts about 30-40 minutes.
Disposable instruments are used, and anoscopy is performed under video control.
Treatment can be started already at the initial appointment.
Preparation using FORTRANS.
Preparation is carried out on the eve of the study.At the same time, there is no need to follow a slag-free diet, as well as to perform cleansing enemas.
It is advisable to start taking Fortrans 1.5 - 2 hours after meals.You can no longer eat after you start taking the drug.
2 packets of Fortrans powder are diluted in 2 liters of water and taken from 17 to 19 hours.Dissolve the contents of each package in 1 liter of high-quality drinking water room temperature (to dissolve the drug it is convenient to use a 1.5-l plastic bottle from under mineral water).In 1 hour you need to drink 1 liter of solution, a glass over 15 minutes in small sips.The approximate duration of action of the laxative is 18-21 hours.
3 packages must be purchased for those patients who have large sizes bodies, constipation, adhesive disease abdominal cavity, previously identified lengthening or prolapse of the colon (during the passage of barium through the intestines, irrigation or colonoscopy).
Approximately 1.5-2 hours after taking the first liter of FORTRANS solution, loose stools will appear, which is a natural consequence of taking this drug. Loose stool will periodically appear several more times until approximately 21.00 - 22.00. After this, as a rule, the urge stops, and the preparation is considered complete.
If nausea occurs after drinking the solutionYou can bite a slice of lemon. It is also recommended to drink the drug chilled, which reduces discomfort.
Preparation using FLIT phospho-soda.
The term "liquid" includes water, solids-free soups, fruit juices without pulp, tea and coffee, clear carbonated and non-carbonated soft drinks
Preparation with enemas.
IN general case before initial examination The patient puts two cleansing enemas (up to clean water) of 1.5-2 liters each approximately 3-4 hours before the appointment, with a break between them of approximately 45 minutes, the water temperature is about 37 degrees. Also, you should not eat foods that cause flatulence the day before. If you have an appointment in the evening, but there is no way to prepare during the day, then a cleansing enema can be given after the morning bowel movement.
During the examination in the afternoon (approximately 15-17 hours): light breakfast, no lunch. Cleansing enemas (Esmarch mug) are done at 12, 13, 14 o'clock.
When examined in the morning: light dinner, light breakfast. The night before, 1-2 cleansing enemas (before clean water), 1 cleansing enema in the morning 1-1.5 hours before the visit.
Technique for performing a cleansing enema.
To cleanse and prepare the intestine for research, the so-called Esmarch mug is used (patients often call it a “hot water bottle” because of its external similarity). The enema is administered in a lying position on the left side with legs bent and pulled up to the stomach. It is advisable to prepare a basin and oilcloth (towel) in case you cannot hold water. 1-1.5 liters of warm (room temperature) water is poured into Esmarch's mug, after which it rises up to a height of 1-1.5 meters. The enema can be held in a raised state by one of your relatives, or, if you are doing the procedure without assistants, you can hang it up (for this, as a rule, there is a special hole in the enema). After this, the tip is lowered down into the basin, the tap is opened (if there is no tap, it can be replaced with a clothespin) and air and a small amount of water are released, after which the tap is closed. The tip is lubricated with Vaseline and inserted into anus, the tap opens, after which liquid under pressure enters the rectum. After removing the tip, wash it with soap under running water. warm water and boil.
Happy preparation!
Enema
The purpose of preparing for an initial consultation with a coloproctologist is to cleanse the intestines of contents.
In all other cases, including bleeding from the anus, preparation is mandatory, as it will allow the doctor to conduct a more informative examination.
If you still do not have the opportunity to prepare, do not be upset - the diagnosis of many proctological diseases does not require special training intestines (hemorrhoids, anal fissure, acute paraproctitis, condylomas, etc.) and during the initial visit, the doctor, if necessary, will prescribe additional diagnostic procedures for you.
The day before (1-2 days) before the visit to the proctologist, it is necessary to follow a “slag-free” diet; you should not eat fresh fruits and vegetables, as well as foods that cause increased gas formation in the intestines (cabbage, legumes, grapes, apples and flour), in some In cases you can take 3-4 crushed tablets activated carbon.
There are the following most optimal ways colon cleansing before examination by a proctologist:
The best and perhaps most famous way is a simple and reliable way cleansing the intestines using cleansing enemas.
If a visit to the proctologist is planned for the second half of the day, you can limit yourself to two enemas immediately after the morning bowel movement. Before taking it, it is advisable to limit food intake to a minimum (for example, a sandwich, tea, coffee, chocolate, cookies).
The enema is administered in a lying position on the left side with legs bent and pulled up to the stomach. It is advisable to prepare a basin and oilcloth (towel) in case you cannot hold water. 1-1.5 liters of warm (room temperature) water is poured into Esmarch's mug, after which it rises to a height of 1-1.5 meters. The water temperature is about 25-28 degrees. Colder water greatly enhances motor activity intestines, and can cause unpleasant pain. The enema can be held in a raised state by one of your relatives, or, if you are doing the procedure without assistants, you can hang it up (for this, as a rule, there is a special hole in the enema). After this, the tip is lowered down into the basin, the tap is opened (if there is no tap, it can be replaced with a clothespin) and air and a small amount of water are released, after which the tap is closed. The tip is lubricated with Vaseline and inserted into the anus, the tap is opened, after which the liquid under pressure enters the rectum. After removing the tip, it is advisable to lie down in the same position for a while (5-10 minutes), and then you can go to the toilet. With proper preparation, the water should come out without any admixture of feces. After use, wash the tip with soap under running warm water and boil.
If you have difficulty administering cleansing enemas, there is alternative way preparation for examination by a proctologist.
The package contains 4 tubes. With the help of this drug it is easy to clean the rectum, which is sufficient both for a full examination and sigmoidoscopy, and for preparing the intestine before surgery. To prepare the intestine for examination, 2-3 tubes are enough. After administration of the drug, emptying usually occurs within 5-20 minutes. 10-15 minutes after the first emptying, you can enter the contents of the 2nd tube. If after the introduction of the 2nd microenema there is no emptying, then you should not be upset - this means you managed to prepare the first time and there is no content in the intestine. If after two microenemas you have doubts about the cleanliness of the intestine, you can administer it a third time.
Latest answers by direction
Asked by: Oksana
Hello. A colonoscopy with phosphosoda was prescribed. At 12:40 pm. On what schedule should I take the drug?
Answer: Svyatovets Sergey Sergeevich
Hello Oksana! The drug is taken according to the instructions:
You should start taking Fleet Phospho-soda on the day before your scheduled procedure.
If your appointment is scheduled before noon, you must follow the instructions for a morning appointment. If your appointment is scheduled for the afternoon, follow the instructions for an afternoon appointment.
Morning appointment
Day before the procedure
7:00 Instead of breakfast, drink at least one glass (or more) of “light liquid” or water.
The term “light liquid” includes water, solids-free soups, fruit juices without pulp, tea and coffee, and clear carbonated and non-carbonated soft drinks.
First dose of the drug: taken immediately after breakfast. For the logo, you need to dissolve the contents of one bottle (45 ml) in half a glass (120 ml) cold water. Drink the solution and wash it down with one (or more) glass (240 ml) of cold water.
13:00 Instead of lunch, you should drink at least three glasses (720 ml) of "light liquid" or water, if you wish, you can drink more liquid.
19:00 Instead of dinner, drink at least one glass of “light liquid” or water. If desired, you can drink more liquid.
Second dose of the drug: taken immediately after dinner. Dissolve the contents of the second bottle (45 ml) in half a glass (120 ml) of cold water.
Drink the solution and wash it down with one glass (240 ml) of cold water. If desired, you can drink more liquid.
If necessary, you can drink “light liquids” and water until midnight.
Day appointment
Day before the procedure
13:00 During lunch you can have a light snack. After lunch, you should not eat any solid food.
19:00 Instead of dinner, drink one glass of “light liquid” or water. If desired, you can drink more liquid.
First dose of the drug: taken immediately after dinner. Dissolve the contents of one bottle (45 ml) in half a glass (120 ml) of cold water. Drink the solution and wash it down with one glass (240 ml) of cold water. If desired, you can drink more liquid.
During the evening you need to drink at least three glasses of “light liquid” or water.
Day of procedure
7:00 Instead of breakfast, drink one glass of “light liquid” or water. If desired, you can drink more liquid.
Second dose of the drug: taken immediately after breakfast. Dissolve the contents of the second bottle (45 ml) in half a glass (120 ml) of cold water.
Drink the solution and wash it down with one glass (240 ml) of cold water. Water and “light liquids” can be consumed until 8:00.
Usually this drug causes stool within half an hour to 6 hours.
Most proctological diseases require correct diagnosis and prescribing treatment for such a delicate procedure as rectoscopy. It consists of examining the rectum and taking necessary materials for tests. Since the procedure is quite delicate, in order to avoid discomfort and the need for repeated visits, you should take care of preparing for this visit in advance. Moreover, this will also reduce the reception time.
A couple of days before your scheduled visit to the doctor, it is recommended to eliminate solid foods from your diet. And the day before the examination, it is advisable to stop taking foods that cause increased gas formation. These include: beans, peas, bread, potatoes, radishes, cabbage, cucumbers, peppers, melon, prunes, cherries, pears, figs, corn, onions, plums, fermented milk products, as well as all fried, fatty, smoked and spicy foods . You should not drink carbonated drinks. If it was not possible to avoid eating junk food, you should take three tablets of activated carbon, after crushing them. It is better to go to the appointment on an empty stomach. A drug such as Fortrans can help in cleansing the intestines. This medicine in powder form is freely sold in pharmacies. The dosage is calculated at the rate of 1 sachet per 25 kg of person’s weight. The contents of each package are dissolved in one liter of warm water. The resulting solution should be consumed in small sips over an hour. Its taste is not very pleasant, so you can wash the solution down with light juice, such as apple juice. The urge to defecate will begin approximately 3-4 hours after drinking the solution and continue for the same amount of time. Therefore, it is advisable not to plan anything during this time.
Postponing a visit to the proctologist, especially because of embarrassment, is extremely undesirable, since a timely examination will help to avoid problems and even more unpleasant sensations in the future.
A visit to any doctor is an event for which everyone prepares with special care and excitement. What can we say about how confident you need to be at an appointment with a proctologist. Preparing the intestines before visiting a doctor is necessary so that the doctor can conduct a high-quality external examination of the delicate area and an internal examination of the rectum, including instrumental ones.
Specifics of the work of a proctologist
This specialist examines and treats problems in the lower colon (sigmoid, rectum, and anal area). Modern methods diagnostics can detect many diseases on early stages, this is especially relevant for oncology. Timely treatment will avoid the transition of the process to chronic stage, the development of complications and will preserve the intestines in full.
A proctologist identifies and treats diseases such as:
- haemorrhoids;
- anal fissures;
- inflammatory diseases of the colon;
- ulcerative colitis;
- polyps;
- intestinal obstruction;
- rectal cancer.
The doctor himself tells how an examination by a proctologist goes:
An appointment with a proctologist is as follows:
- a conversation with a doctor to collect anamnesis (information) about the disease and the patient’s life in general;
- external examination and palpation (palpation) of the anal area externally and internally;
- anoscopy – at a depth of up to 10 cm;
- sigmoidoscopy - examination of the deeper parts of the rectum and sigmoid colon for the purpose of detecting polyps, ulcers, erosions, and neoplasms.
The patient in the proctologist’s office lies on his side, on his back with his legs apart or in a knee-elbow position; the doctor uses special drugs(sprays, gels), the entire visit takes about half an hour.
An appointment with a proctologist is a safe event. The only condition is that before the examination you need to be well prepared, both mentally and physically.
The exception is in emergency cases - severe pain or profuse bleeding. In these situations, no preparation is carried out; such patients are subject to immediate examination and examination.
In all other cases, it is necessary to pre-prepare the intestines.
How to prepare for an examination
A visit to a proctologist should not cause any discomfort in the patient. Main - positive attitude and a desire to solve an emerging health problem: To go to a clinic or hospital, preparation is necessary:
- Set yourself in a positive mood.
- Following a diet - you need to prepare two days before going to the doctor. It is better to exclude from your diet foods that cause increased gas formation (legumes, carbonated drinks, raw vegetables, whole milk, rye bread, kvass). Seasonings, spicy, salty foods that irritate the intestines are not recommended. The day before you can only eat liquid food.
- Cleanse the intestines.
To cleanse the intestines, choose one of two methods:
Proctologists and patients love the drug microlax. It has a convenient form of packaging in the form of a syringe with a ready-made solution; one microenema is used for a single use. To cleanse the intestines, do 2 or 3 such microenemas; there is no need to prepare anything else. The result of the drug microlax occurs two hours after use.
To choose the most appropriate method of preparing for a proctological appointment, it is advisable to use the recommendations of the doctor himself, taking into account the existing complaints and the patient’s health condition.
A positive attitude and proper preparatory measures are the key to a successful visit to the proctologist.