X-ray method of examination of the large intestine. X-ray examination of the colon

- This is a comprehensive study that allows you to evaluate its motor and evacuation function, as well as to identify defects in its structure (ulcer, tumor). An important advantage of this method is low cost, ease of preparation and the ability to assess the condition of the intestine in real time (fluoroscopy) and at the same time take pictures.

An x-ray of the intestine is used to diagnose such conditions (diseases):

The necessity and expediency of using this method is determined by the doctor: therapist or gastroenterologist. Various variations of this technique can be used:

• examination of the condition of the small intestine;
• examination of the condition of the small intestine ();
• combination of these two components.

Bowel loops are poorly visualized even with modern X-ray equipment. To correctly assess the condition of the intestine, contrast is used. In most cases, barium sulfate is used - a white liquid with a characteristic aftertaste. When conducting irrigoscopy, double contrasting is used - barium sulfate and an inert gas (or gas-air mixture) are introduced.

Indications

Conducting this study in a group of diseases included in the concept, as well as bleeding of any localization, is contraindicated. If the barium mixture enters the bloodstream or leaks into the abdominal cavity, the patient's condition worsens and can lead to death in the absence of emergency medical care.

Preparation for the procedure

The informativeness of the results of an x-ray of the intestine is determined by how well the patient prepared for the procedure. If the preparation is done incorrectly or insufficiently carefully, then it will be difficult or completely impossible to assess the condition and functionality of the intestine. The doctor must describe in detail all the stages of preparation, focusing on their multiplicity and duration.

The components of proper preparation for examining the small and large intestines are the same.

Diet

2-3-4 days before the X-ray of the intestine, the patient should refuse products that are slowly digested, provoke metabolism and fermentation processes in the intestine. These include:

• all legumes (peas, cabbage, beans);
• champignons and all other mushrooms;
• flour and confectionery products;
• rice, pasta, potatoes;
• some types of fruits (grapes, peaches, nectarines, pears);
• all types of carbonated drinks (alcoholic and non-alcoholic);
• bread (rye and "Borodinsky").

It is important not to make exceptions, telling yourself that a small amount will not significantly hurt. Such deviations from the diet will lead to poor quality of preparation and a decrease in the information content of the procedure.

The last meal before the bowel x-ray should be the night before. On the day of the study, even a light breakfast is undesirable.

Enema

An unpleasant, but absolutely necessary procedure. If it is not done, then the accumulated feces will interfere with the distribution of the contrast agent.

It is advisable to hold a high the day before the study. This will require the help of another person. Liquid is poured into a special bag, from which it is introduced through a hose into the patient's intestines through the anus. The patient stands in a knee-elbow position. 1-1.5 liters of cool water is poured. After that, the patient feels the urge to defecate: softened feces are excreted along with the liquid. If necessary, the procedure is repeated 2 or even 3 times.

An enema is also required in the morning on the day of the study.

Laxatives

For a complete bowel cleansing, apply:

• Bisacodyl;
• White charcoal or traditional activated charcoal;
• Lactulose.

The drugs should be used 2-3 days before the expected date of the bowel x-ray. The possibility of replacing an enema with a laxative should be clarified with your doctor.

There is a technique for quickly cleansing the intestines using a session. For this, it is necessary to have a special room in the medical institution, so that immediately after the session the patient gets an x-ray of the intestine.

The order of the x-ray of the intestine

The research technique depends on which part of the intestine is being examined: the small or large intestine. The contrast agent is administered in various ways. In any case, the examination takes about an hour. Before starting, the patient must undress, remove all metal jewelry.

Examination of the small intestine

The already dressed patient performs the following actions:

1. Drinks about 500 ml of contrast (barium mixture); the characteristic calcareous taste can provoke vomiting, so you need to drink slowly.
2. The patient sits for about half an hour, waiting for the contrast agent to reach the beginning of the small intestine.
3. In a standing position or lying on your back (depending on the specific situation), an x-ray is taken.
4. In total, the shooting is carried out 8 times, the final picture - after emptying the intestines.

Perhaps the doctor considers it necessary to evaluate the motor function of the intestine in dynamics, for which the patient will stand motionless in front of the screen.

Colon examination

The contrast agent does not enter the small intestine, as it is injected through the anus. Irrigoscopy is preceded by an examination of the anus and rectum using an optical cable.

During the introduction of the contrast mixture, the patient lies on his side: the leg from above is bent at the knee and pressed to the stomach. Unpleasant sensations and the desire to immediately empty the intestines must be restrained. To reduce discomfort, the health worker monitors the slow filling of the intestines.

The multiplicity of shooting is determined individually. It may be necessary to change the position of the patient's body to obtain different images.

Contraindications to the procedure

Contraindications to the use of intestinal x-rays are divided into relative (with time they can be eliminated) and absolute (they do not disappear, a choice of another research method is required).

The effect of x-rays on the body is negligible, especially if no other studies using x-rays have been conducted in the near future.

Possible Complications

The probability of their occurrence is small. When conducting an x-ray of the intestine, it is possible:

• allergic reaction to the contrast agent;
• problems with bowel movements (constipation);
• involuntary leakage of contrast agent through the anus.

Only an allergic reaction poses a danger to a person, everything else is an annoying nuisance.

The large intestine is the final part of the digestive tract. In this section of the intestine, absorption and formation of feces takes place, which will then be removed from the body. In addition, the large intestine is responsible for the absorption of vitamins and electrolytes from food. This part of the digestive tract is prone to a variety of diseases - the appearance of tumors, inflammatory processes, impaired absorption of nutrients and peristalsis (motor and contractile activity of muscle tissue in the walls of the intestine, which contributes to the promotion of its contents). Why are such pathologies dangerous? They directly affect the general condition of a person, and some of them (to a greater extent this applies to oncology) are extremely dangerous to life and health if they are not identified and treated in time. One of the methods for diagnosing diseases of this part of the gastrointestinal tract is x-ray of the large intestine.

How does the human large intestine work, for which its examination is prescribed

The main stages of digestion associated with the primary processing and digestion of incoming food occur in the stomach and small intestine. However, after the transition of the food bolus to the section of the large intestine, the process of its processing does not end - it is the large intestine that is responsible for the further intake of the remaining useful substances into the blood from the processed food.

Anatomically, the department is represented by the blind, colon, sigmoid and rectum. The colon, in turn, has three subdivisions - ascending, transverse and descending. The rectum has a wider part - the so-called ampulla of the rectum, and a tapering section, located closer to the anus - the anus. Visually, the large intestine looks like a loop, the shape of which is similar to a square with an open contour. On average, its diameter reaches 6-6.5 centimeters, and its length is about two meters.

The large intestine contains a wide range of beneficial bacteria. Its special flora contributes to the further processing of the food bolus, and its transformation into fecal mass. What is useful that remains in the contents of the food bolus at the stage of its presence in the thick section, the bacteria process and convert into vitamins, sugars and amino acids. Further, they are absorbed by the mucous walls of the intestine, from where useful substances enter the bloodstream.

Leftover food that can no longer be digested accumulates in the large intestine in order to be expelled from the body during bowel movements.

The large intestine, as part of a well-functioning mechanism, performs its functions in conjunction with the rest of the digestive tract, therefore, in a healthy person, food passes a continuous path from the oral cavity to the rectum, through which the body leaves what is left of this food after processing.

And what happens if pathological changes appear in the large intestine? The patient feels characteristic symptoms, deterioration of health, weight loss, abdominal pain and other ailments. In such cases, it is necessary to prescribe diagnostic procedures, in particular, X-rays of the large intestine.

What diseases can affect the large intestine

Most often, in patients with problems in the work of the large intestine, they find:

• ulcerative colitis;
• colon cancer and polyps;
• Crohn's disease;
• ischemic and pseudomembranous colitis;
• irritable bowel syndrome;
• wall diverticula;
• congenital anomalies.

Ulcerative colitis

Pathology is a chronic condition of an organ when its internal mucosa becomes edematous, inflamed, changes its color from normal beige-pink to bright red, and loses its integrity due to small ulcerative formations. These ulcers do not heal well and bleed. A disease with a long course and without adequate treatment can provoke the appearance of polyps and neoplasms.

Oncology, polyps, neoplasms

Tumors in the large intestine are quite common in patients. Colon cancer is one of the four most common types of cancer in the world. Polyps and tumors in this part of the body are most dangerous because their appearance is almost asymptomatic, and in the early stages they can only be detected by accident. The consequences of oncological and neoplastic processes in the colon can be the most severe, up to death.

Crohn's disease

The disease is characterized by a general inflammatory process in the digestive tract, which also covers the large intestine, and not only the inner shell of the walls, but also the middle one with the outer one, as well as the lymphatic vessels located nearby. The disease is difficult to diagnose, its manifestations take the form of symptoms of a dozen other pathologies, and its complications are extraintestinal in nature - lesions of large joints, the appearance of ulcers in the oral cavity, vision problems.

Ischemic and pseudomembranous colitis

In ischemic colitis, the degenerative process affects the vascular system that feeds the intestinal walls. Ischemia is characterized by local inflammation and ulceration of the mucous layer of the wall, the gradual development of intestinal obstruction.

Pseudomembranous colitis develops due to the significant multiplication of one of the varieties of intestinal bacteria - clostridia. Usually, the intestinal flora is self-regulating - each type of bacteria controls the growth and development of all the others. With prolonged use of antibiotics, laxatives or cytostatics, some bacterial species are destroyed, and, accordingly, the reproduction of others is increased.

Clostridia in the course of their life activity produce toxins that negatively affect the intestinal membranes, which is why fibrinous plaques called pseudomembranes form on them.

irritable bowel syndrome

The main cause of IBS is considered to be a violation of intestinal motility, however, the disease can also be secondary, that is, it can occur against the background of other diseases of the gastrointestinal tract. In the intestines, discomfort is constantly felt, the localization and symptoms of which are quite difficult to determine accurately.

Diverticula and diverticulitis

Diverticula in the walls of the large intestine look like sacs. In fact, they represent a stretching of the wall, in which a “pocket” is formed, protruding towards the abdominal cavity. The course of the process without complications can, in the worst case, cause constipation or a feeling of heaviness in the abdomen. However, if the contents of the intestine stagnate in the cavity, against the background of the presence of dysbacteriosis in the intestine, diverticulitis can develop - an acute inflammation with characteristic symptoms that are dangerous for a person.

Congenital structural disorders

Such disorders include elongation of the sigmoid colon (dolichosigma), as well as hypertrophy of the colon in any of the departments, or in a specific segment. Pathologies are characterized by disorders of intestinal processes, constipation, flatulence. In severe cases, intoxication with feces may occur, which cannot leave the body in time.

Radiography of the large intestine: irrigoscopy and irrigography

X-ray examination of the intestine is widely used as a method of diagnosing its condition using x-rays. Since the organ examined in this way is hollow, the implementation of the procedure is informative only with the use of a contrast agent.

Irrigoscopy and irrigography - such names for X-ray of the large intestine are found in the medical literature. As for the differences between these categories, there are several points of view on this matter. One of them says that X-ray of the large intestine can be correctly called both irrigoscopy and irrigography, that is, these are similar concepts without any differences.

According to another theory, irrigography involves fixing the image obtained by X-ray irradiation on a special film, while irrigoscopy allows you to display the picture on the monitor of the device for monitoring the large intestine in real time. There are no differences in terms of technique or methods of preparation.

Irrigoscopy itself can be of two types - it depends on the method of contrasting:

• classical barium enema involves the introduction of a contrast agent in a liquid state;
• irrigoscopy with double contrast: in this case, the patient is first injected with a liquid contrast that envelops the walls of the intestine, after which gas or air is gradually supplied into the intestinal cavity.

Indications and contraindications for irrigoscopy

The list of reasons why a doctor may send a patient for examination of the condition of the large intestine includes characteristic pathologies that affect this section of the gastrointestinal tract. Usually people come to the doctor for an appointment with typical symptoms:

• violation of the stool (disorder or constipation, if they are of a long-term nature);
• flatulence;
• bleeding from the anus;
• pain, feeling of heaviness in the abdomen;
• the presence of blood in the stool.

However, the symptoms themselves are not the basis for the appointment of barium enema. The doctor conducts a survey and examination of the patient, sends him to take a variety of tests, issues a referral for an ultrasound scan of the abdominal organs. Having received all the results, then the doctor decides whether it is necessary to conduct an x-ray of the large intestine with contrast.

The indication for the appointment of the procedure, most often, is the suspicion of the presence of a certain ailment or condition, if the results of preliminary tests and examinations do not allow an accurate diagnosis and determine the etiology of the process. The doctor directs the patient for x-rays, suspecting:

• the presence of tumors and polyps;
• gastric and intestinal bleeding with a tendency to relapse;
• Crohn's disease;
• intestinal obstruction of any nature;
• diverticulitis;
• dolichosigma;
• Hirschsprung's disease (congenital anomaly);
• the presence of foreign bodies;
• ulcerative, ischemic, pseudomembranous colitis;
• various inflammatory processes in the intestines.

Pain syndromes in the anus, anus, abdominal cavity, excessive organ mobility, prolonged and painful constipation, and systematic bowel disorder are also indications for irrigography.

When should a patient not be given a procedure? Doctors name among the contraindications of irrigography such factors:

• rapidly progressive ulcerative colitis;
• the presence of pregnancy;
• toxic megacolon;
• colitis with severe course;
• the presence of allergies or intolerance to the contrast agent;
• cardiovascular diseases, hypertension;
• early postoperative period, if the intervention took place in the abdominal cavity.

How to prepare for a colon x-ray

The procedure is practically not carried out without special preparation: in this case, its results simply will not be of value, since, firstly, fecal masses will remain in the intestines, distorting the picture, and secondly, the contrast agent will not be able to fully distribute throughout the organ.

Therefore, before the procedure, the patient must take care of cleansing the large intestine.

Preparation includes adherence to dietary restrictions, mechanical and medical cleansing measures. Two to three days before the scheduled date of the X-ray, it is forbidden to use:

• raw vegetables: cabbage;
• millet, pearl barley and oatmeal;
• black bread;
• and other legumes;
• alcohol and carbonated drinks;
• fried or grilled foods.

On the eve of the procedure, before going to bed, you should take a laxative, which the doctor will prescribe. Before this, a cleansing enema is recommended. Be sure to do an enema in the morning on the day of the procedure.

Irrigoscopy for adults and children: technique

The diagnostic procedure can be carried out only in the conditions of a medical institution, in some cases - with the placement of the patient in a hospital. The doctor makes every effort to ensure that the examination is carried out as quickly and safely as possible for the patient.

Initially, the radiologist needs to take several survey pictures, while the patient will need to alternately assume a lying and standing position.

The patient lies on the couch in the position on the left side. Through the anus and rectum, with the help of a special contrast enema, he is injected with a contrast agent.

For this purpose, two types of contrasts are used in medicine:

• a preparation with barium, in which the main substance is barium sulfate, and the auxiliary substances are tannin, sodium citrate, gelatin or cellulose;
• sodium amidotrizoate - it contains more expensive drugs like Urographin or Verographin.

The second type of drugs is mainly used to examine newborns, or for patients of any age with suspected perforation of the intestinal wall.

The process itself is divided into several phases. The first of them is the phase of weak filling, when the contrast gradually envelops all the folds of the mucosa, visualizing them well. This is followed by a phase of tight filling - during it, the intestine is completely filled with contrast, which makes it possible to assess the thickness of the lumen, shape, location, contours, the presence of foreign bodies, places of narrowing and expansion. By how quickly the contrast is excreted by the intestines, the doctor can draw conclusions about the elasticity of the walls and intestinal motility.

In the process, the physician will need about 500 milliliters of the solution. If you have a double contrast procedure, you will need a little less fluid. Gas or air is introduced into the cavity in order to give a clearer view of the wall thickness and mucosal folds, and better visualize the organ. This phase is called the double contrast phase.

After the introduction of the substance, when the rectum and sigmoid colon are filled with contrast, the patient is transferred to the back, and then to the right side. The doctor captures a series of images at different filling phases. Further, if necessary, the doctor gently introduces air into the intestine, and takes a few more pictures, already with double contrast.

The patient is now emptying his bowels. When all the contrast has left the organs, the doctor takes the last picture of the abdominal cavity without contrast.

The mechanism for implementing barium enema for children is no different. For small patients, if possible, they try to prescribe alternative methods of examination, since preparation requires considerable time and effort, and the procedure itself is not pleasant, although it is painless. Children of primary school age may be prescribed irrigography under general anesthesia.

When performing irrigography on a patient, the doctor may encounter some difficulties. With poor preparation, there may be feces in the intestines, visible in the pictures. If the sphincter is weak, the patient will experience contrast incontinence. In addition, the contrast agent can be unevenly distributed throughout the large intestine, which makes it difficult to analyze the resulting images.

The danger for the patient is the situation when the pathologically altered intestinal wall is perforated due to the introduction of contrast. In each case, the radiologist is responsible for deciding whether or not to carry out the procedure further. If necessary, the doctor stops the examination at any stage and proceeds to provide emergency medical care to the subject.

Possible risks and consequences of the procedure

Doctors refer irrigography to types of examination that are safe for humans. Provided that all preparation requirements are met, if the doctor has a sufficient level of qualification, usually the patient does not have any problems after an X-ray of the large intestine with contrast. However, there are exceptions, for example, when perforation of the affected intestinal wall occurs due to injected contrast, or when the contrast agent enters the abdominal cavity.

In some cases, the subject after diagnosis feels weakness, drowsiness and dizziness. These symptoms are not dangerous and pass quickly.

If, after the procedure, the patient systematically notices an increase in body temperature, intestinal disorders, blood coming out of the anus, nausea, vomiting and abdominal pain, he must definitely visit the attending physician.

Examination of the large intestine using barium preparations and X-ray irradiation is a reliable way to detect diverticulosis, rectal cancer, dolichosigma, the presence of foreign bodies, and other pathologies, diseases, and functional disorders. In addition to the fact that, thanks to the results of irrigoscopy, the doctor can make a primary or confirm an existing diagnosis, the procedure also allows you to establish the existence of grounds for surgical intervention.

Speciality: infectious disease specialist, gastroenterologist, pulmonologist.

General experience: 35 years .

Education:1975-1982, 1MMI, San-Gig, highest qualification, infectious diseases doctor.

Science degree: doctor of the highest category, candidate of medical sciences.

X-ray of the colon (irrigoscopy) is an imaging diagnostic method that allows you to identify various diseases, pathological conditions and violations of the physiological functions of the large intestine. This method is effectively used in the practice of gastroenterologists. This type of study, as a rule, is carried out using a contrast agent, namely, an aqueous suspension of barium.

This approach allows you to visualize well the contours and structure of the intestine and get maximum information about various disorders and pathological changes.

There are two methods for conducting this type of research, which have some differences, as well as different tasks and goals:

• the standard technique of barium enema, which allows to detect only some large anomalies of the large intestine;
• a procedure with double contrasting, namely, when the intestines are filled with a radiopaque substance, followed by the introduction of air into the colon, which makes it possible to identify smaller defects.

Contraindications and indications

Examination of the large intestine is a necessary procedure for certain pathological conditions and disorders in the gastrointestinal tract. The study may reveal:

• colon polyps;
• neoplasms of various origins (both malignant and benign);
• the presence of foreign bodies;
• diverticula;
• conditions that provoke disruption of the intestines, and consequently - a violation of the stool;
• colitis of various etiologies;
• activity of bowel contractions, etc.

Among the contraindications, it should be especially noted the presence of perforation of the large intestine, in which the study is absolutely impossible to carry out because of the risk of getting a radiopaque substance outside the large intestine. This type of study is also not recommended for pregnant and lactating women, as well as children under the age of 14, but these contraindications are more likely to apply to fluoroscopy in general, and not to barium enema in particular.

Preparation for the procedure and the course of the study

This type of research requires special preparation from the patient. A few days before the scheduled visit to the clinic, you should refrain from taking food products that contribute to the formation of toxins and gases, namely: legumes, cabbage and other vegetables and fruits, regardless of how they are processed and prepared.

In the evening before the procedure, doctors recommend that the patient refrain from eating and cleanse the intestines with the help of drugs specially designed for this or a cleansing enema. Another cleansing enema is done directly on the day of the x-ray of the colon.

To conduct a study under the strict supervision of a specialist, a radiopaque substance, an aqueous suspension of barium sulfate, is administered orally or through the rectum to the patient. As this contrast medium begins to pass through the patient's intestines, the doctor will be able to assess the general condition of the esophagus and its functions. After that, with the help of a special apparatus, pictures of a survey or sighting character can be taken. During the study, pictures of different segments of the intestine from different positions can be taken, which will make it possible to compile a single picture.

The next stage of the study is carried out after the removal of radiopaque from the intestine, which allows visualizing the relief of the mucous membrane lining the large intestine, as well as the presence of pathological changes in it. The double contrast method is used if the patient is suspected of having neoplasms of various etiologies. It is worth noting that the results of such a study are not so informative and additional studies may be required to identify the nature and localization of pathological tissue growth.

With this method of research and diagnosis, the exposure of the patient is much less than with other studies. Some side effects can be observed in connection with the use of a radiopaque substance, but such cases are rare.

An x-ray of the intestine is a non-invasive technique that is used to assess the condition of the mucous membrane and the motor functions of the internal organ. The study is the most informative and does not cause the development of complications. For X-ray diagnostics, modern equipment is used, which allows you to get a clear image of the internal organs and make the correct diagnosis.

An x-ray of the intestine is prescribed for the purpose of differential diagnosis when the following symptoms appear:

• violation of the digestive processes, expressed in the form of constipation or diarrhea and accompanied by concomitant diseases such as anal fissures, hemorrhoids, dehydration, etc.;
• a sharp decrease in body weight that occurs for no apparent reason;
• changes in the consistency, color and smell of the stool, which is a sign of a large number of diseases;
• pain syndrome in the abdomen, dyspepsia (nausea, vomiting);
• the presence of blood, mucus and purulent inclusions in the feces after defecation.

Video "Indications for X-ray of the intestine" on the VISUS-1 channel.

What does an x-ray show?

It makes it possible to conduct a full assessment of the functionality of the intestine and to identify the nature of the interaction with other organs located in the peritoneum.

An x-ray of the intestine is an informative diagnostic procedure that:

• will show the diameter, shape of the lumen and the location of the small and large intestine;
• establishes the ability to stretch and the level of elasticity;
• evaluate the characteristics of the motor functions of the internal organ and the area of ​​​​inflammation;
• will determine the presence of developmental anomalies, polyps, tumors, ulcerated areas and diverticula.

Is an x-ray of the intestine harmful, and how often can it be done?

If the recommendations for the procedure are followed, minimal harm is caused to the body. The rays do not accumulate in tissues and structures, thanks to the strict control of the radiation intensity. The intensity does not exceed generally accepted norms. The device directs radiation exactly to the area that needs to be examined.

An X-ray of the intestine is not recommended for preventive purposes more than twice a year, since it is associated with radiation exposure to the body. If the diagnosis is prescribed by the attending physician, the procedure should be carried out as prescribed.

There is concern only when using a contrast agent - barium. It can cause allergic reactions and constipation. If you follow the advice of a specialist conducting diagnostics, then the development of undesirable consequences can be avoided.

Contraindications and restrictions

• ulcerative colitis of a destructive type;
• individual intolerance to barium;
• the presence of through wounds in the intestinal area;
• congenital enlargement of the internal organ;
• heart failure and palpitations.

Pregnancy is an absolute contraindication. In case of obesity, it is also unacceptable to undergo the procedure, since the equipment is designed for 110-150 kg.

Are X-rays given to children?

The diagnostic procedure can be performed on a child from 3 years old. This is due to the fact that only at this age does it finish forming, and the intestinal microflora becomes stronger. Preparatory measures and radiation can cause digestive disorders at an earlier age. The negative impact of x-rays is possible on bone growth zones.

In childhood, an x-ray of the intestine is prescribed for frequent colic, suspected obstruction and adhesions. Preparation and the procedure itself is carried out, as in adults: a microclyster with a contrast agent is introduced.

Methods of x-ray examination of the intestine

Diagnostic research is divided into two types:

1. X-ray - photographing a specific area of ​​​​the body with printing pictures on film. In this case, it is possible to make a video recording.
2. X-ray. Processing of the internal organ in real time through a special screen. Using the equipment, you can take several pictures for display on the monitor.

with barium

An x-ray of the intestine using a contrast agent is called an irrigoscopy.

Contrast is used to:

• obtaining an accurate outline of images;
• checking the patency of the rectum;
• determining the nature of the functioning of the intestine.

To date, it is carried out 87% more often than without it.

Colon examination

Barium is mixed with warm water (3 liters) and slowly injected with a special device into the intestine.

Pictures are taken in different projections:

• on the stomach;
• on the side;
• on the back.

An x-ray of the colon can cause complications. That is why it is recommended to carefully monitor your health in order to take therapeutic measures in time.

Examination of the small intestine

The patient takes a special solution orally and after 4-7 hours comes to the clinic for diagnosis. With an uneven distribution of the contrast agent, the specialist conducts a light massage of the abdominal cavity, which allows you to correct the situation.

The duration of the procedure is 30-60 minutes. The conclusion is made on the basis of how the contrast is distributed in the intestinal area: the presence of gaps, obstruction.

When is a bowel x-ray done without barium?

A diagnostic procedure without barium is performed for suspected intestinal obstruction. There is no need to use a contrast agent only if the specialist knows exactly in which part of the intestine the pathological process is localized.

Preparing for an x-ray

To obtain more accurate results of an x-ray of the intestine, it is necessary to prepare for the procedure, following the recommendations of a specialist. Preparation includes following a special diet.

Without fail, before the procedure, it is necessary to carry out cleansing the intestines.

Diet

• black bread;
• whole milk;
• legumes;
• fruits and vegetables.

Purgation

The day before the procedure, you should take laxatives prescribed by your doctor, which will help cleanse the intestines from the accumulation of feces. 2-3 hours before the x-ray of the intestine, it is imperative to do a cleansing enema.

Channel VISUS-1 presents "Preparation for X-ray of the intestine."

How is the procedure and how long does it take

An X-ray of the intestine is done in an office equipped with all the necessary equipment and protective equipment.

Patients are under the strict supervision of a specialist who follows a certain sequence of actions during the examination:

1. The subject takes off his clothes with metal fasteners, jewelry and lies down on the couch.
2. With the help of special belts, the specialist fixes the limbs in order to immobilize.
3. The table is set in a vertical position and a primary image is taken.
4. The patient is injected with a contrast agent, after which images are taken in various projections.
5. The study is carried out until the barium fills the entire area of ​​​​the small intestine.

In the study of the large intestine, double contrast can be used: with the help of barium and air, which is pumped inside using the Bobrov apparatus. As barium and air are distributed, the specialist takes pictures in various projections.

Interpretation of results

The interpretation of the received data is carried out by a specialized specialist - a radiologist. It takes no more than half an hour to receive the results of the study. Normally, the images should show a mottled image.

In the presence of flakes, we are talking about the development of:

• lymphosarcomas;
• lymphogranulomatosis;
• malabsorption syndrome.

polyps

An x-ray examination of the intestine can reveal polyps. The formations are localized on the mucous membrane and do not cause much harm. Despite this, they must be identified and removed without fail, which eliminates the likelihood of developing malignant degeneration.

Signs of intestinal obstruction on x-ray

Intestinal obstruction has peculiar signs: pain in the abdomen and vomiting. At the same time, intestinal peristalsis is also disturbed. The radiograph shows small bowel obstruction in the form of stopping the movement of a contrast agent or air to other departments.

Intestinal dyskinesia

The disorder may be asymptomatic, and detected during an X-ray for the first time. Intestinal dyskinesia is accompanied by insufficiency, that is, functional disorders.

X-ray signs of hypomotor dyskinesia are a weakening of peristalsis and intestinal tone. This is fraught with a slowdown in metabolic processes and contributes to weight gain. As complications, the development of intestinal obstruction should be distinguished.

An x-ray of the intestine is one of the most informative diagnostic methods that allows you to diagnose tumors, polyps, ulcers and other pathologies of an important organ. To date, modern devices are used that reduce the likelihood of complications to a minimum and ensure maximum safety of the procedure. X-ray examination is used in many diseases of the gastrointestinal tract that occur with similar symptoms, as it facilitates the correct diagnosis and allows you to decide on a further method of treatment.

The essence of the procedure is the use of special equipment that passes a dose of radiation that is safe for health through the patient's body. X-rays give an image of the organ under study on a special picture, which allows you to determine its contours, shape, size and see pathological changes. Modern equipment used in the course of the study accurately directs the radiation flux and allows you to adjust its intensity, which eliminates the possibility of irradiating neighboring organs.

When examining the intestines, several x-ray techniques are used:

• X-ray of the small intestine is carried out using a contrast agent (barium solution), which the patient drinks before the procedure.
• An x-ray of the large intestine is performed by irrigoscopy (when a contrast agent is injected into the rectum) or using the double contrast method (when an inert gas or air under pressure is injected into the colon along with a contrast agent).

In addition, the method of irrigography is used. The difference of this procedure is that the image of the colon filled with a contrast agent is displayed not on the picture, but directly on the monitor screen.

When is an intestinal x-ray ordered?

A referral to an x-ray of the intestine is given by a therapist, gastroenterologist or oncologist in the presence of complaints such as:

• rapid weight loss;
• the appearance of frequent loose stools with a change in its color (tarry, black stools);
• pain in the abdominal region;
• chronic constipation caused by a violation of the motor and evacuation function of the large intestine;
• the appearance in the feces of mucus, pus or blood.

Indications for the appointment of an x-ray examination are suspicions of such pathologies as a tumor process, developmental anomalies, Crohn's disease, the development of a chronic inflammatory process (enteritis or colitis), the presence of polyps, diverticula.

The following conditions are contraindications to the procedure:

• pregnancy;
• intestinal perforation;
• severe or unconscious state of the patient;
• ulcerative colitis;
• toxic megacolon;
• severe form of heart failure, tachycardia;
• intestinal obstruction;
• internal bleeding;
• severe abdominal pain.

In addition, a recent bowel biopsy procedure is a contraindication to X-ray examination. During it, colon tissue is taken, so the introduction of a contrast agent can provoke inflammation.

What does the procedure show?

An x-ray examination allows you to determine the location, shape and diameter of the lumen of the colon, the degree of its elasticity and ability to stretch, as well as assess the appearance and motor functions of the intestine. Irridoscopy helps to see pathological narrowings and areas of obstruction in the intestine, to identify developmental anomalies, the presence of ulcerative defects, polyps, diverticula or tumors.

The use of a contrast agent - barium for x-ray of the intestine ensures the correct diagnosis with a minimal risk of injury to its membranes. This substance does not cause allergic reactions and is not absorbed into the blood. Such an examination allows you to carefully examine the condition of the intestine on the monitor screen, and, if necessary, take targeted pictures of pathological areas, which are then carefully studied by a specialist.

Preparation

Prior to X-ray examination, preliminary preparation is necessary. Three days before the procedure, foods that cause increased gas formation and fermentation in the intestine are excluded from the diet:

• legumes,
• cabbage,
• raw vegetables with coarse fiber,
• black bread,
• whole milk,
• fat meat,
• carbonated drinks

A complete list of prohibited foods can be obtained from your doctor. If there is constipation, it is necessary to take laxatives (Duphalac) and drink more fluids. 24 hours before the study, it is recommended to completely refuse to take solid food. You can drink tea, fruit juices (without pulp), broths.

Good to know!

Bowel cleansing before x-rays must be done in the evening, on the eve of the procedure. To do this, you need to drink a laxative and make two cleansing enemas with an interval of 2 hours. On the day of the study, 1-2 more enemas are given before the procedure.

If you do not tolerate the enema procedure, you can clean the intestines in another way. To do this, you should take special preparations (Fortans, Bisacodyl), designed to prepare the intestines for diagnostic procedures. Fortans are available in powder, which should be dissolved in water and taken strictly according to the instructions. Bisacodyl is produced in tablets and suppositories. An approximate scheme for taking Bisacodyl for bowel cleansing is as follows:

1. the day before the study, take 2 tablets of Bisacodyl during breakfast;
2. after three hours, drink any laxative;
3. after another three hours, they again take Bisacodyl in the same dose;
4. Bisacodyl candle is used in the evening (you can’t eat);
5. in the morning, before the study, a suppository with a laxative effect is once again used.

More detailed instructions for preparing for the study will be given by the attending physician. Additionally, it should be noted that before the procedure it is recommended to stop smoking, and a week before the proposed study - from drinking alcohol.

How is an intestinal x-ray done?

X-ray examination is performed on an empty stomach. Before starting the procedure, the patient must remove outer clothing, glasses, all metal objects (rings, chains) and put on a hospital gown.

X-ray of the small intestine is carried out in several stages. At the beginning of the procedure, the patient is given to drink a barium suspension in a volume of 500 ml. The contrast medium looks like a milkshake, but has a characteristic calcareous taste.

If the procedure for examining the intestines with double contrasting is carried out, then the patient drinks the barium solution through a special tube into which the device additionally supplies air or an inert gas. After that, it is necessary to wait a certain time (at least 2 hours) for the contrast agent to reach the sections of the small intestine. As the small intestine fills with barium, the specialist takes pictures every 45 minutes in different body positions (sitting, standing, lying on his side). The last picture is taken after a bowel movement.

The departments of the small intestine after being filled with barium, the specialist examines for about 30 minutes on the monitor screen. Due to the promotion of the contrast agent and the condition of its mucosa. With a low degree of fullness with a contrast agent, the relief of the inner surface of the intestine is assessed, with a strong filling - contours, shape, size, functioning, and the presence of abnormal changes (inflamed areas, tumors, ulcers) is determined.

If the passage of barium is disturbed, then the doctor tries to distribute it evenly by pressing on the abdominal wall. Already by the way the contrast agent is distributed in the intestinal lumen, an experienced specialist can judge a particular pathology. So, if barium deposits in flakes, this indicates a violation of the absorption function. And uneven filling of the lumen with a contrast agent indicates the presence of a tumor process.

Double contrast

The use of double contrast improves the quality of the images, since the supplied air helps to straighten the walls of the intestine. But the injection of air causes a certain discomfort in the patient and is accompanied by a feeling of fullness. To eliminate discomfort, it is recommended to take deep breaths. The study is completed after the contrast agent reaches the caecum (appendix).

At the end of the procedure, the doctor assesses the patient's condition and recommends taking laxatives, as barium can cause constipation. If, after deciphering the images, it turns out that there are no serious pathologies, the doctor allows you to lead a normal lifestyle and adhere to a proper diet. The patient is warned that for 2-3 days after the procedure, the feces will have a white tint.

X-ray of the large intestine is carried out using the method of irrigoscopy. Before starting the study, a sigmoidoscopy procedure is performed, that is, the lower parts of the rectum (to a depth of 30-40 cm) are examined with a special device - a sigmoidoscope. After that, the tip of a special apparatus is inserted into the rectum, through which 1.5-2 liters of barium solutions are pumped. The procedure is carried out under X-ray control.

Procedure

The contrast agent is applied very slowly and carefully so as not to damage the intestinal mucosa. During the procedure, the patient is asked to change the position of the body, roll over from side to side in order to take panoramic or targeted pictures. The doctor must ensure that the barium suspension does not leak out, otherwise further research will lose its information content and it makes no sense to continue it. After the contrast agent has reached the caecum, a final review is taken and the patient can empty their bowels.

When conducting a double contrast study, a large volume of barium is immediately pumped into the intestine so that it completely covers the mucous membrane. After that, they begin to pump air, which straightens the folds of the colon and helps to study its relief. It is this type of diagnosis that is most informative if a tumor process or the presence of polyps and diverticulum is suspected, as it allows you to examine and evaluate the structure of the inner surface of the intestinal mucosa in all details.

At the end of the procedure, the doctor will recommend drinking more fluids and may prescribe a laxative, which will speed up the evacuation of residual contrast material from the intestines. Within a few days after the procedure, discoloration of the stool is noted. Particular attention is paid to the patient's condition, since the occurrence of pain, constipation or bloating may indicate undesirable complications.

Is there any discomfort?

An x-ray of the intestine is a rather unpleasant procedure that not everyone tolerates well. Some patients endure discomfort (associated with the filling of the intestines with contrast agent), spasms, and a feeling of fullness when air is injected with double contrast. Patients with hypersensitivity of the digestive tract receptors feel much worse. In this case, the doctor tries to explain each action and supports the patient by explaining to him when to hold his breath or take a deep breath to reduce discomfort.

In order to perform targeted images, the patient is asked to change body position during the procedure. In this case, the assistant must hold the tip of the tube through which the contrast medium is supplied in a certain position in order to prevent its leakage.

Now they have begun to produce more modern equipment, equipped with a special rotating stand, on which the person being examined is placed. It rotates and can take a certain position at different angles, which facilitates the procedure and eliminates the need to change the position of the body by the patient.