- Laboratory testing methods
- Instrumental diagnostic methods
- Related videos
The incidence of bowel diseases is increasing year by year. Early diagnosis can successfully treat the emerged pathology and prevent the development of dangerous complications. In this regard, many are worried about how to check the intestines.
At the moment, there is a large number of diagnostic techniques that allow a painless and high-quality examination of all departments of this body. The prevalence of intestinal pathologies is explained by the intense rhythm of the life of modern man. Stressful situations, improper diet, sedentary lifestyle - all this leads to disruption in the work of the entire gastrointestinal tract.
About the problems in the intestine can say the following symptoms: belching, heartburn, nausea, vomiting, abdominal pain, flatulence, stool change, the appearance of blood and mucus in the stool, anemia. Sometimes an examination of the intestine can be assigned to identify the cause of permanent malaise, weakness, deterioration of appetite, and weight loss against a background of adequate nutrition.
The organ check begins with a patient examination, finger examination and anoscopy. Already at this stage, the doctor may have enough information to make a diagnosis. In some cases, additional research will be required, for example, sigmoidoscopy, colonoscopy and radiography. In this article, we will highlight informative methods for examining the intestine. Let's talk about the techniques used for various pathologies.
Laboratory methods of examination
If the doctor suspected the development of intestinal pathologies, the examination begins with a blood test, urine and feces. The results of such studies will confirm or disprove the presence of pathological processes in the body.
A general blood test is prescribed for suspected inflammatory and infectious processes, bleeding, parasitic lesions, and also oncology. Collection of biological material is carried out exclusively sterile instrumentation. In adults, blood is taken from the ring finger, and in young children - from the thumb of the foot.
Capillary blood surrenders in the morning to an empty stomach
Bowel diseases affect the changes in blood counts, namely:
- erythrocytes and hemoglobin. Anemia can indicate the development of internal bleeding;
- lymphocytes. These cells reflect the level of activity of the immune system. In infectious and oncological processes, the level of lymphocytes can both increase( lymphocytosis) and decrease( lymphocytopenia);
- monocytes. An increase in the number of these cells indicates the development of an infectious lesion;
- eosinophils. An increase in this indicator( eosinophilia) most often indicates helminthic invasions. But also it can speak about the presence of malignant neoplasms. The decrease in the number of eosinophils is usually observed in the postoperative period, as well as at the initial stages of the infectious process;
- sedimentation rate of erythrocytes( ESR).An increase in this indicator may indicate inflammatory and infectious processes.
Now let's talk about biochemical research. To carry out the analysis, you will need venous blood, which is also taken in the morning on an empty stomach. Biochemical research includes the following indicators:
- total protein. A decrease in its concentration may indicate problems with the functional activity of the intestine, including those caused by neoplastic processes and bleeding;
- C-reactive protein. This parameter helps in diagnosing acute infectious, oncological and parasitic processes;
- urea. With the syndrome of impaired intestinal absorption, there is a decrease in the concentration of urea in the blood.
Also blood can be tested for oncomarkers. The essence of this analysis is to identify the products of the disintegration of cancer cells. For this purpose, the venous blood is taken on an empty stomach. The presence of oncomarkers is allowed in the body of a healthy person within certain limits.
Consider the types of oncomarkers:
- CA - 19 - 9. An increase in this indicator does not always indicate an oncology. To confirm the diagnosis will have to conduct a number of additional studies. A genetic racial feature affects the presence of this parameter. So, in people of Caucasian nationality, even with oncology, the oncomarker CA-19-9 is absent;
- REA.Not available in adults. The oncomarker is produced by the cells of the digestive tract of the fetus during the gestational period;
- СА - 242. High parameters of this parameter allow to reveal at early stages malignant formations of thick and rectum;
- СА-72 - 4. It is assigned for detection of tumor lesions of the large intestine;
- Tu M2-RK.Gives information about the development of tumors, metastases and the occurrence of relapses.
Another method of investigation is the blood test. It helps to identify food intolerance. With the help of a blood test, you can identify which foods are not perceived by the intestine. Hemotest helps to establish the processes of digestion by eliminating some foods.
In stools, various microorganisms, particles of undigested food, epithelium, pigments can be found. With the help of these indicators, the lab technician can detect pathological processes in some areas of the intestine.
The basis for carrying out the program are diseases of the stomach and duodenum, defeat of the thick and small intestine, problems in the work of the liver, gall bladder, pancreas, tumor and infectious processes, helminthic invasion, control of the treatment. The study does not require special training, but patients should remember some of the rules of
. If you take medications that contain bismuth and iron, they must be discarded. It is forbidden to use laxatives, rectal suppositories, and also to do enemas. When carrying out the X-ray with the coloring substance, the coprogram is done no earlier than in seven to ten days. This is explained by the fact that barium can change the properties of the stool.
Coprogram helps to identify dysbacteriosis - change in the quantitative and qualitative composition of the microflora
Two days before the analysis, you will have to give up some products, namely tomatoes, pastas, tomato juice, beets. It is better to temporarily exclude from the diet all vegetables and fruits that have dyeing properties. For three days should stop taking antibacterial drugs, as well as drugs that affect the motor function of the intestine. The basis of the diet should be vegetables, fruits, cereals, sour-milk products. It is better to give up fatty, fried, hot, smoked, pickled.
Before emptying the intestine, a toilet of external genitalia should be performed. The urine should not enter the container with the biomaterial. The collected sample should be delivered to the laboratory as early as possible. If necessary, store feces in the refrigerator, but no more than eight hours.
The coprogram includes macroscopic and microscopic examination of feces. Initially, the laboratory assesses the appearance of feces, density, staining, the presence of a specific odor. Microscopic analysis allows you to assess the ability of the intestines to digest food. The doctor can identify the following elements:
- Protein. Normally, he should not be present. Its presence may indicate inflammatory processes. The protein is found in ulcers, polyps and cancer.
- Blood. Detects the biological fluid in internal bleeding. This can be caused by tumors, polyps, ulcers, helminths. The altered blood indicates a lesion of the upper parts, unchanged - the lower ones, and the hidden one is characteristic for tumors.
- Steril. The increase in this pigment indicates the presence of hemolytic anemia. A decrease in stercobilin may indicate an obstruction of the bile ducts.
- Mucus. Performs a protective function, so its appearance indicates inflammatory processes in infections.
- Iodophilic flora appears with dysbacteriosis.
- Detritus. A decrease in the number of this indicator indicates a violation of the digestive process;
- Neutral fat. An increase in their level may indicate a violation of the production of biliary secretion and absorption in the intestine.
- Muscle fibers. The appearance of these elements in an unchanged form may indicate pancreatic pathologies.
- Soaps. An increase in its quantity is usually observed with digestive deficiency of the stomach, duodenum and small intestine;
- Leukocytes. Normally not present. Their appearance indicates the development of colitis.
Also in the coprogram you can identify other elements, for example, fatty acids, vegetable fiber, ammonia, connective tissue fibers, pathogenic microorganisms.
Instrumental diagnostic methods
In this case, the collection of information about the intestine is carried out with the help of special technical devices. They help to determine not only the nature and localization of the pathological process, but in some cases even take biological material and remove the formations. More information about the morphological diagnosis of the stomach and intestines can be found in the book by Aruin LI.
Colonoscopy is a method of examination that tests the colon. Diagnosis is carried out using a long flexible probe, to which a video camera is attached. During the study, a specialist can see the patient's intestines from the inside. The attached video camera allows you to take pictures and videos. Initially, the colonoscope is placed in the anus and gradually moves the probe deeper along the bowel.
Doctors can prescribe a colonoscopy for chronic anemia and a sharp weight loss
The study allows you to study the condition of the mucous membrane in detail, evaluate the work of the organ, including the motor function. The specialist has the opportunity to consider inflammatory processes and neoplasms. Colonoscopy combines not only diagnostic, but also therapeutic measures. For example, if a polyp is found, the doctor can remove it immediately. Also during the study, you can take a sample of biomaterial for histological analysis.
During a colonoscopy, a doctor can stop bleeding, dissect spikes, remove a foreign object, expand the lumen of the organ. Experts recommend a large intestine examination in the following cases:
- for persons over 50 years of colonoscopy is recommended for preventive purposes;
- hereditary predisposition to polypoles;
- is a diagnosed oncology with the next of kin.
A doctor may be sent to a colonoscopy in the presence of certain patient complaints, for example, the appearance of blood in the stool.
This symptom can indicate not only the presence of hemorrhoids or anal fissures, but also more serious pathologies: tumors, Crohn's disease, ulcerative colitis.
Pus and mucus in feces is another reason for colonoscopy. Painful sensations in the abdomen, arising after eating, before the act of defecation, with movements, inclinations can be an indicator of disruptions in the work of the intestine. Constant constipation is a prerequisite for the appearance of pathological changes in the work of the digestive tract.
Stool disorder may be a symptom of already existing pathologies, which can be detected with endoscopic examination. Another reason for colonoscopy is the alternation of constipation and diarrhea. These signs may be present in irritable bowel syndrome, colitis and oncological pathologies.
The procedure is performed on an outpatient basis. For this purpose, a special cabinet is equipped. The patient lies on the left side, while the legs are pressed to the stomach. The anorectal zone is treated with an antiseptic. For the best passage of the probe through the intestine, the initial department is lubricated with a special substance. During the procedure, patients sometimes feel bursting, pressure and moderate pain.
To spread the mucous folds, the intestine is filled with air. At this point, there may be spasmodic pains and swelling. Colonoscopy requires special training. The effectiveness of the procedure depends on the patient's conscious attitude. To remove stool and parts of semi-digested food from the intestinal walls the evening before the patient should drink Fortran.
For the preparation of a medicinal solution, the dry powder is diluted with boiled water. Three days before the test, products that promote enhanced gas production should be excluded from the diet:
- white cabbage;
- whole milk;
- is fatty and fried;
- fresh baking;
- vegetables and fruits.
It is important to refuse from gas-forming products on the eve of the
procedure. Also, you should stop using coffee, alcohol and any beverages that have coloring properties. On the eve of the patient should not have dinner, the last meal should be no later than 14.00.There are contraindications to the colonoscopy:
- disease of the clotting system;
- acute infections;
- exacerbation of inflammatory processes;
- massive bleeding;
- high temperature;
- severe cardiac pathology.
Recently, the virtual colonoscopy is gaining in popularity. Computer tomography allows you to recreate a three-dimensional image of the intestine. Air is bled through the tube in the rectum and the abdominal cavity is scanned. Unlike the classical version, visual colonoscopy has several advantages:
- there is no need to use endoscopic instruments;
- possibility of holding patients with diseases of coagulation system and cardiac pathologies;
- gentle and comfortable procedure;
- there is no need for anesthesia.
Despite the fact that colonoscopy is an effective method of diagnosis, it is not always possible to carry it out because of existing contraindications. In such cases, alternative methods are used, for example, anoscopy, sigmoidoscopy, irrigoscopy, capsular endoscopy.
The essence of the study is to use a wireless camera, which the patient must swallow as a tablet. It makes thousands of pictures that are transferred to a recording device. The technique allows you to explore hard-to-reach departments that can not be reached with standard instrumental methods.
Capsular endoscopy provides complete information on the mucosa and the venous wall of the digestive tract. The procedure is carried out in large centers, as expensive imported equipment is used for its implementation.
Capsular endoscopy allows to examine the small intestine without colonoscopy
The procedure allows to study the condition of the lower part of the sigmoid and rectum. Recto-manoscope allows not only to study the internal state of the organ, but also to carry out certain procedures, for example, removal of polyps, moxibustion, removal of a foreign body.
During the procedure the patient occupies the knee-elbow position. After a finger examination of the rectum, the device is inserted into the anus. The procedure takes no more than five to ten minutes and in most cases is well tolerated by patients.
So, early diagnosis of the intestine allows you to identify dangerous pathologies and successfully deal with them. Laboratory and instrumental diagnostic methods are used to assess the state of the intestinal tract. Based on the results obtained, the doctor conducts a differential analysis and diagnoses.