结肠镜检查

定义

A colonoscopy is an exam that views the inside of the colon (large intestine) and rectum, 使用一种叫做结肠镜的工具.

The colonoscope has a small camera attached to a flexible tube that can reach the entire length of the colon.

选择的名字

Colon 癌症 - colonoscopy; 结肠直肠癌 - colonoscopy; 结肠镜检查 - screening; Colon 息肉 - colonoscopy; Ulcerative colitis - colonoscopy; 克罗恩病 - colonoscopy; Diverticulitis - colonoscopy; Diarrhea - colonoscopy; 贫血 - colonoscopy; Blood in stool - colonoscopy

如何执行测试

结肠镜检查 is done most often in a procedure room at your doctor's office. It can also be done in the outpatient department of a hospital or medical center.

• You will be asked to change out of your street clothes and wear a hospital gown for the procedure.
• 你可能会得到 将药物注入静脉(IV)来帮助你放松. 你应该不会感到任何疼痛. You may be awake during the test and may even be able to speak. 你可能什么都不记得了.
• You lie on your left side with your knees drawn up toward your chest.
• 镜通过肛门轻轻插入. It is carefully moved into the lowest part of the large intestine. The scope is slowly advanced as far as the lowest part of the small intestine.
• Air is inserted through the scope to provide a better view. 吸力可用来清除液体或粪便.
• The doctor gets a better view as the scope is moved back out. So, a more careful exam is done while the scope is being pulled back.
• 组织样本(biopsy) or 息肉 may be removed using tiny tools inserted through the scope. Photos may be taken using the camera at the end of the scope. 如果需要，程序，例如 激光疗法，也完成了.

如何准备考试

Your bowel needs to be completely empty and clean for the exam. A problem in your large intestine that needs to be treated may be missed if your intestines are not cleaned out.

Your health care provider will give you the steps for cleansing your bowel. 这被称为肠道准备. 步骤可能包括:

• 使用灌肠剂
• Not eating solid foods for 1 to 3 days before the test
• 服用泻药

You need to drink plenty of clear liquids for 1 to 3 days before the test. 透明液体的例子有:

• 清咖啡或茶
• 无脂清汤或肉汤
• 明胶
• 不添加色素的运动饮料
• 过滤果汁
• Water

你可能会被告知停止服用阿司匹林, 布洛芬, 甲氧萘丙酸, or other blood-thinning medicines for several days before the test. Keep taking your other medicines unless your doctor tells you otherwise.

You will need to stop taking iron pills or liquids a few days before the test, unless your provider tells you it is OK to continue. 铁会使你的大便变黑. This makes it harder for the doctor to view inside your bowel.

考试的感觉如何

The medicines will make you sleepy so that you may not feel any discomfort or have any memory of the test.

当瞄准镜向内移动时，您可能会感到压力. You may feel brief cramping and gas pains as air is inserted or the scope advances. 放屁是必要的，也是意料之中的.

考试后，你可能会有轻微的症状 腹部绞痛 然后放很多气体. 你可能还会感到胃胀、恶心. 这些感觉很快就会消失.

You should be able to go home about one hour after the test. You must plan to have someone take you home after the test because you will be woozy and unable to drive. The providers will not let you leave until someone arrives to help you.

当你回家的时候，跟着我 指令 从手术中恢复过来. 这些可能包括:

• 多喝液体. 吃一顿健康的饭来恢复你的能量.
• You should be able to return to your regular activities the next day.
• 避免开车, 操作机器, 喝酒, and making important decisions for at least 24 hours after the test.

为什么要进行测试

结肠镜检查的原因如下:

• 腹部疼痛排便改变或体重减轻
• 发现的异常变化(息肉) 乙状结肠镜检查 或x光测试(CT扫描 or 钡灌肠)
• 贫血 due to low iron (usually when no other cause has been found)
• 大便带血或黑色的柏油大便
• 对过去发现的后续调查，例如 息肉 or 结肠癌
• 炎症性肠病(溃疡性结肠炎 and 克罗恩病)
• 结直肠癌筛查

正常的结果

正常表现为肠道组织健康.

异常结果意味着什么

Abnormal test results may mean any of the following:

• Abnormal pouches on the lining of the intestines, called 憩室病
• 出血部位
• 结肠或直肠的癌症
• 结肠炎 (肿胀和发炎的肠道)由于 克罗恩病, 溃疡性结肠炎感染或血液流动不足
• 一种叫做 息肉 on the lining of your colon (which can be removed through the colonoscope during the exam)

Risks

Risks of colonoscopy may include any of the following:

• Heavy or ongoing bleeding from biopsy or removal of 息肉
• Hole or tear in the wall of the colon that requires surgery to repair
• 需要抗生素治疗的感染(非常罕见)
• Reaction to the medicine you are given to relax, causing breathing problems or low blood pressure

参考文献

Garber JJ, Chung DC，编辑. 结肠息肉和息肉综合征. 见:Feldman M, Friedman LS, Brandt LJ编. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11日艾德. Philadelphia, PA: Elsevier; 2021:chap 126.

李建军，李建军，李建军，等. 结肠直肠癌. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff临床肿瘤学. 6日艾德. Philadelphia, PA: Elsevier; 2020:chap 74.

国家癌症研究所网站. Colorectal Cancer Prevention (PDQ) - Health Professional Version. www.癌症.gov /类型/结直肠/ hp / colorectal-prevention-pdq. 更新于2022年4月21日. 2023年2月28日发布.

帕特尔SG，梅FP，安德森JC，等. Updates on age to start and stop colorectal 癌症 screening: recommendations from the U.S. 结直肠癌多社会工作组. 胃肠病学. 2022;162(1):285-299. PMID: 34794816 pubmed.ncbi.nlm.nih.gov / 34794816 /.

Shaukat A, Kahi CJ, Burke CA, Rabeneck L, Sauer BG, Rex DK. ACG clinical guidelines: colorectal 癌症 screening 2021. 我是胃肠醇吗. 2021;116(3):458-479.  PMID: 33657038 pubmed.ncbi.nlm.nih.gov / 33657038 /.

美国预防服务工作组网站. 最终建议声明. 结直肠癌:筛检. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-癌症-screening. 2021年5月18日发布. 于2023年3月28日发布.