Colon and Rectal Diagnostic Examination (9)
Ano ang Colonoscopy?
Ang colonoscopy ay isang panloob na pagsusuri ng malaking bituka at tumbong, gamit ang isang instrumentong tinatawag na colonoscope.
Paano isinagawa ang pagsusuri?
Ang colonoscope ay may kalakip na isang maliit na kamerang nakakabit sa isang nababaluktot na tubo. Hindi tulad ng sigmoidoscopy na ang naaabot lamang ay ang ikatlong ibabang bahagi ng malaking bituka, ang colonoscopy ay nagsusuri ng buong kahabaan ng colon.
Ang pasyente ay mahihiga nang patagilid sa kaliwang bahagi at ang mga tuhod ay ititiklop patungo sa dibdib. Pagkatapos mabigyan ng gamot na pampakalma at pang-alis ng kirot, ang colonoscope ay padadaanin sa puwitan. Ito ay dahan-dahan at maingat na ipapasok sa bukana ng malaking bituka at kung minsan ay pinaaabot sa pinakamababang bahagi ng maliit na bituka.
Nagpapakawala ng hangin ang scope upang mas maging malinaw ang pagtingin sa loob ng bituka. May kasama ring panghigop (suction) ang instrumento upang maalis ang mga dumi at tubig. Mas malinaw sa paningin ng nagsusuri kung ang scope ay papalabas kung kaya’t kalimitang mas masusing eksaminasyon ang ginagawa sa ganitong pagkakataon. Gamit ang colonoscope, maaaring kumuha ng tissue samples sa pamamagitan ng maliliit na biopsy forceps. Maaaring magtanggal ng mga polyps gamit ang electrocautery snares. Pwede ring kumuha ng litrato at magsagawa ng laser therapy.
Paano maghanda para sa pagsusuri?
Kailangang ganap na linisin ang bituka. Ang manggagamot ay magbibigay ng mga tagubilin para sa pagsasagawa nito. Ito ay maaaring kumbinasyon ng mga labatiba (enema); hindi pagkain ng solid food sa loob ng 2 o 3 araw bago ang pagsusuri; at paggamit ng laxatives. Karaniwang ipapatigil ang pag-inom ng aspirin, ibuprofen, naproxen, o iba pang mga gamot na nagpapalabnaw ng dugo ilang araw bago ang colonoscopy.
Hihilingin din ang pag-inom ng maraming malinaw na likido(liquids) sa loob ng 1-3 araw bago ang procedure. Ang mga halimbawa ng malinaw na likido ay:
* Kape o tsaa na walang gatas o creamer
* Bouillon o sabaw na walang taba o mantika
* Dyelatin (gelatin)
* Sports drink
* Sinalang katas ng prutas (strained fruit juices)
* Tubig
Maliban na lang kung ipagbawal ng doktor, regular na inumin ang anumang resetang gamot. Itigil ang paggamit ng iron supplements ilang linggo bago ang test, maliban din kung sabihin ng doktor na ipagpatuloy. Ang iron ay maaaring magpaitim ng dumi na magpapalabo ng view sa loob ng bituka. Maghanap ng makakasama sa pag-uwi. Maaaring makaramdam ng pagkahilo at hindi makapagmaneho pagkatapos ng pagsusuri.
Ano ang mararamdaman?
Ang mga gamot na pampakalma at pangkirot ay nakapagpapa-relax at nagpapa-antok. Maraming pasyente ang hindi maka-alalang sila ay nag-colonoscopy. Bago ang pagsusuri, ang doktor ay nagsasagawa ng rectal exam upang makatiyak na walang mga pangunahing pagbabara (blockages) sa loob ng puwit. Maaring makaramdam na parang madudumi habang ang daliri o ang colonoscope ay ipinapasok sa loob ng puwit.
Maaari makaramdam ng presyon habang ang scope ay gumagalaw sa loob ng bituka. Maaari ring makaranas ng bahagyang pagkirot at kabag habang nagpapakawala ng hangin ang colonoscope o habang ito ay itinutulak papaloob. Ang pag-utot ay kailangan at dapat na asahan.
Maaari makaginhawa ang pagsasagawa ng mabagal at malalim na paghinga. Ito ay makakatulong din upang ma-relax ang abdominal muscles. Patuloy ding magkakaroon ng bahagyang pagkirot at kabag matapos ang procedure. Madadalas din ang pag-utot. Ang pagka-antok ay lilipas pagkaraan ng ilang oras. Dahil sa pagkakahimbing maaring walang maalala ang pasyente sa natapos na procedure.
Bakit isinagawa ang pagsusuri?
Ang colonoscopy ay maaaring gamitin para sa mga sumusunod na kadahilanan:
* Pagsakit ng tiyan, pagbabago sa regular na pagdumi, o pagbaba ng timbang
* Abnormal na pagbabago (tulad ng polyps) na nakita sa sigmoidoscopy o x-ray test (CT scan o barium enema)
* Anemya dahil sa kakulangan sa iron (karaniwan kapag walang ibang dahilan ang nahanap)
* Dugo sa dumi, o ma-itim na dumi
* follow-up sa isang nakaraang karamdaman, tulad ng polyps o colon kanser
* Inflammatory bowel disease (ulcerative colitis and Crohn's disease)
* Screening para sa colorectal kanser
* Kumunsulta sa espesyalista upang talakayin ang colonoscopy.
2nd Floor, Podium Building, The Medical City,
Ortigas Avenue, Pasig City, Metro Manila
Tel No. (632) 9881000 or (632) 6356789 ext. 7789
www.colonandrectalspecialists.com , www.crsi.com.ph
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Clinic Hours: Mondays to Saturdays – 8:00 AM to 5:00 PM except Wednesdays
Ang Mga Espesiyalista
Manuel Francisco T. Roxas, M.D.
Robert L. Chang, M.D.
Catherine S. Co, M.D.
Carlo C. Cajucom, M.D.
Marc Paul J. Lopez, M.D.
Dione P. Sacdalan, M.D.
A colonoscopy is an internal examination of the colon (large intestine) and rectum, using a long, flexible, tubular instrument called a colonoscope.
The colonoscope has a small camera attached to a flexible tube. Unlike sigmoidoscopy, which can only reach the lower third of the colon, colonoscopy examines the entire length of the colon.
The patient will lie on his left side with knees drawn up toward the chest. After administering a sedative and pain reliever, the colonoscope is inserted through the anus. It is gently moved into the beginning of the large bowel and sometimes into the lowest part of the small intestine. Air will be inserted through the scope to provide a better view. Suction may be used to remove fluid or stool. Tissue samples may be taken with tiny biopsy forceps inserted through the scope. Polyps may be removed with electrocautery snares, and photographs may be taken.
Examination for Common Anorectal Conditions
Common anorectal conditions are usually examined using digital rectal exam. A doctor inserts a lubricated, gloved finger into the rectum to feel for abnormal lumps or areas. Then, a lubricated instrument (anoscope) is placed a few inches into the rectum. This is to view the anus, anal canal, and lower rectum.
Sexually Transmitted Anorectal Disease Examination
Diagnosis for sexually transmitted anorectal diseases has become more difficult in recent years owing to the complexity of pathogens. Diagnosis and treatment has become even more challenging in the HIV+ patient population. Some common sexually transmitted anorectal infections are gonorrhea, chlamydia, syphilis, herpes simplex virus, and cytomegalovirus.
The specialist usually begins with a thorough history of the patient. This is accompanied by a focused physical examination. Laboratory studies (serological, bacteriological or pathological with tissue biopsy and examination) confirm the diagnosis.
Proctosigmoidoscopy / Flexible Sigmoidoscopy
A sigmoidoscopy is an examination that allows the doctor to look inside the rectum and lower (sigmoid) colon for polyps using a narrow, lighted tube called a sigmoidoscope. If any polyps are found during the exam, they can be removed in a procedure called a polypectomy. A sigmoidoscopy is recommended every three to five years.
Endorectal and Endoanal Ultrasonography (UTZ)
Endorectal Ultrasound is a special ultrasound technique in which a transducer is directly inserted through the anus and into the patient's rectum. The sound wave echoes detected by the transducer are converted by a computer into an image. It is one of the most useful diagnostic tools for diseases of the anal and rectal regions of the body, especially for cancer screening and staging.
Diagnostic and Therapeutic Colonoscopy with Multi-band Intensity
A colonoscopy is an internal examination of the colon (large intestine) and rectum, using a long, flexible, tubular instrument called a colonoscope.
The colonoscope has a small camera attached to a flexible tube. Unlike sigmoidoscopy, which can only reach the lower third of the colon, colonoscopy examines the entire length of the colon.
The patient will lie on his left side with knees drawn up toward the chest. After administering a sedative and pain reliever, the colonoscope is inserted through the anus. It is gently moved into the beginning of the large bowel and sometimes into the lowest part of the small intestine. Air will be inserted through the scope to provide a better view. Suction may be used to remove fluid or stool. Tissue samples may be taken with tiny biopsy forceps inserted through the scope. Polyps may be removed with electrocautery snares, and photographs may be taken.
Fecal Occult Blood Examination using the latest immunological-based test.
This test should be performed every year to check for tiny amounts of blood in the stool. FOBT involves placing a small amount of stool on a test pack. New FOBT uses the latest immunological-based test which does not require fasting and diet preparations. In concert with an FOBT, a flexible sigmoidoscopy should be done every 3 years. A positive FOBT should warrant a complete colonoscopy.
Diagnostic and Therapeutic Colonoscopy with Multi-band Intensity
A colonoscopy is an internal examination of the colon (large intestine) and rectum, using a long, flexible, tubular instrument called a colonoscope.
The colonoscope has a small camera attached to a flexible tube. Unlike sigmoidoscopy, which can only reach the lower third of the colon, colonoscopy examines the entire length of the colon.
The patient will lie on his left side with knees drawn up toward the chest. After administering a sedative and pain reliever, the colonoscope is inserted through the anus. It is gently moved into the beginning of the large bowel and sometimes into the lowest part of the small intestine. Air will be inserted through the scope to provide a better view. Suction may be used to remove fluid or stool. Tissue samples may be taken with tiny biopsy forceps inserted through the scope. Polyps may be removed with electrocautery snares, and photographs may be taken.