X-ray (x-ray) of the large intestine (irrigoscopy with irrigography)

Intestinal irrigoscopy - what is it?

Irrigoscopy is an X-ray examination of the colon with the introduction of a contrast agent (barium sulfate). The procedure visualizes the intestinal lumen, allows you to assess the condition of its inner lining, the elasticity of the walls, and the functioning of the valves.

The main advantages of irrigoscopy:

high information content with relative ease of implementation;
painlessness;
minimal number of contraindications - the procedure is prescribed to patients of any age;
relative safety, allowing you to be examined several times.

Irrigoscopy is prescribed for suspected diverticulitis, polyps, neoplasms and a number of other pathologies of the colon.

What diseases can affect the large intestine?

Most often, patients with problems with the large intestine 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 mucous membrane becomes swollen, 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. If the disease lasts for a long time and without adequate treatment, it can provoke the appearance of polyps and neoplasms.

Oncology, polyps, neoplasms

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

Crohn's disease

The disease is characterized by a general inflammatory process in the digestive tract, which also covers the large intestine, not only the inner lining of the walls, but also the middle and outer lining, 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 - damage to 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 supplies the intestinal walls. Ischemia is characterized by local inflammation and ulceration of the mucous layer of the wall, and the gradual development of intestinal obstruction.

Pseudomembranous colitis develops due to a significant proliferation of one of the types of intestinal bacteria - clostridia. Typically, the intestinal flora carries out self-regulation - each type of bacteria controls the growth and development of all the others. With long-term use of antibiotics, laxatives or cytostatics, some bacterial species are destroyed, and, accordingly, others increase in proliferation.

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

Irritable bowel syndrome

The main cause of IBS is considered to be impaired intestinal motility, but the disease can also be secondary, that is, it can occur against the background of other diseases of the gastrointestinal tract. There is a constant feeling of discomfort in the intestines, the localization and symptoms of which are quite difficult to accurately determine.

Diverticula and diverticulitis

Diverticula in the walls of the large intestine look like pouches. In essence, they represent a stretching of the wall, which creates a “pocket” that protrudes towards the abdominal cavity. The process without complications can, in the worst case, cause constipation or a feeling of heaviness in the abdomen. However, if intestinal contents stagnate in the cavity, against the background of dysbiosis in the intestines, diverticulitis can develop - acute inflammation with characteristic symptoms that are dangerous for humans.

Congenital structural defects

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, and flatulence. In severe cases, intoxication may occur with feces that cannot leave the body in time.

In what cases is irrigoscopy performed?

The doctor refers the patient to irrigoscopy if the following complaints are present:

abdominal pain of various types: acute, aching, nagging, occurring after eating;
violation of bowel movements: constipation or diarrhea;
the appearance of blood in the stool: stool becomes black and liquid;
anemia, general weakness, often accompanied by weight loss.

Absolute contraindications to the procedure are colonic edema, pseudomembranous colitis and a recent biopsy. In this case, other examinations are prescribed: for example, colonoscopy. Women of childbearing age are recommended to undergo the procedure within 10 days after the end of menstruation.

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 affecting this section of the gastrointestinal tract. Usually people see a doctor with typical symptoms:

bowel dysfunction (disorder or constipation, if long-term);
flatulence;
bleeding from the anus;
pain, a feeling of heaviness in the abdomen;
the presence of blood in the stool.

However, the symptoms themselves are not grounds for prescribing irrigoscopy. The doctor conducts a survey and examination of the patient, directs him to undergo various tests, and issues a referral for an ultrasound of the abdominal organs. Having received all the results, the doctor then decides whether an X-ray of the large intestine with contrast is necessary.

The indication for prescribing a procedure, most often, is the suspicion of the presence of a certain illness or condition, if the results of preliminary tests and examinations do not allow an accurate diagnosis and determination of the etiology of the process. The doctor refers the patient to an x-ray, suspecting:

How is intestinal irrigoscopy performed?

The patient is asked to take a certain position on the couch, after which the radiologist uses an X-ray machine to take survey pictures (irrigograms). Then the patient is given a contrast agent, barium sulfate, using an enema. During the administration of contrast, the specialist can take several more targeted photographs.

After the barium has completely filled the intestinal lumen, another general irrigogram is performed, showing the diameter of the internal intestinal cavity and its shape. As soon as the picture is taken, the enema is removed and the patient is asked to empty the gastrointestinal tract, and a new general picture is taken.

In some cases, a radiologist performs irrigoscopy with double contrast: after emptying the gastrointestinal tract, the intestines are filled with air, which straightens the folds of the intestine and allows you to study in detail the structure of its walls.

Do dates weaken or strengthen the intestines?

Constipation is the absence of stool for 3 days, whereas normally the intestines should be emptied 1-2 times a day.

Constipation can occur once. For example, as a result of the influence of stress on the body. It can also be systematic. In the latter case, stool disorder occurs due to errors in nutrition. Fatty foods, flour products, rice, semolina and even some fruits and vegetables slow down the activity of the intestinal muscles and strengthen them. To avoid this unpleasant condition, you need to eat foods rich in coarse fibers. This is the majority of plant foods.

Dates are among the leaders in plant fiber content.

In them they are represented by fiber. Once in the digestive tract, it is not subject to the action of the enzyme system and is evacuated unchanged into the intestines. Here it increases the volume of feces, puts pressure on the intestinal walls and enhances peristalsis. Due to this, the work of the intestines is activated, which promotes the removal of its contents. Fiber coats feces and facilitates their passage through the digestive tract.

Along with bowel movements, waste and toxins that poison our body are removed. Thus, dried fruits help cleanse our body of harmful substances. One of the many beneficial effects of this fruit is its ability to suppress the activity of pathogenic bacteria in the intestines. This causes the growth of its own, beneficial microflora and normalizes digestive processes.

Thus, dates can be safely called a natural laxative. They act delicately. They do not cause discomfort in the form of a feeling of bloating and abdominal pain, like many pharmaceutical laxatives. And they don't take you by surprise.

How much barium is infused during irrigoscopy?

The contrast agent for irrigoscopy is barium sulfate. It is administered as a solution through the anus using an enema. The mixture is pre-prepared by junior medical personnel: 400 grams of barium sulfate is mixed with 2 liters of water. Then the composition is heated to 33-35℃. During the procedure, the entire volume of suspension (2 liters) is used. Barium sulfate is practically insoluble in water, is not absorbed in the intestines and therefore has no effect on the body.

How should I prepare for the procedure?

The effectiveness of irrigoscopy is largely determined by the quality of preliminary bowel cleansing. In order to remove background that could introduce an error, the intestines must be thoroughly cleaned of food debris. Immediately before the procedure, this problem is solved by 3 main methods: drug cleansing, enemas and colon hydrotherapy.

In addition to cleansing procedures, it is necessary to ensure preliminary bowel preparation before conducting research. 3-4 days before irrigoscopy, a diet is established excluding food that takes a long time to process, as well as food that can cause excessive feces, fermentation and flatulence in the intestines. It is necessary to completely remove the following products from the diet: pearl barley, millet and oatmeal; beets, carrots, cabbage, fresh herbs, garlic, onions; legumes; fresh apples, plums, peaches, apricots, citrus fruits; black bread. It is recommended to provide a menu based on protein dishes: lean meat and fish, eggs, semolina porridge. White bread is consumed in small quantities.

1 day before the procedure, you should switch only to liquid nutrition: broths (not fatty), jelly, compote, tea. It is necessary to increase the drinking regime, consuming at least 2.5 liters of liquid per day. It is recommended to skip dinner immediately before the test. The day before, laxatives are prescribed: magnesium sulfate or citrate, castor oil, etc.

On the day of the procedure, a complete cleansing of the intestines is carried out. For this purpose, the drug Fortrans is used.

On the day of the procedure, a complete cleansing of the intestines is carried out. Currently, a drug approach is most often used for this purpose. Fortrans is considered the most popular drug. In this case, an aqueous solution of the drug is prepared, which is taken in a total volume of 3 liters, 200-20 ml every 15-20 minutes. Solution concentration: 1 sachet per 1 liter of water. The relaxing effect begins after 1-1.5 hours, and the effect finally stops after 4-6 hours. In addition to Fortrans, Duphalac and Fleet Phospho-soda are used.

How is intestinal irrigography performed in children?

Irrigoscopy is prescribed to children from the age of three, since at this age they develop a stable intestinal microflora, and it is also easier to explain to the child what is required of him. The procedure is painless and safe - the barium suspension is removed from the body in a short period of time, and the dose of X-ray radiation is minimal.

The procedure is performed in exactly the same way as for an adult patient. If necessary, the radiologist helps the child take the required body position.

You can undergo irrigoscopy at a medical office.

How to prepare?

Preparation begins a couple of days before the procedure, since it is necessary to carefully prepare for the examination.

This procedure can only be carried out after complete cleansing of the large intestine, otherwise the results will be distorted and a repeat study will be necessary.

Correct results will be obtained in patients who, a few days before the examination, stopped consuming fruits and vegetables, as well as foods that cause gas; increased the amount of clean water drunk in the absence of contraindications; started taking laxatives and rinsing procedures, and also started taking sorbents.

This study, due to the safety of the method, is carried out in both adults and children.

, but, nevertheless, there are still contraindications: acute diverticulum, severe colitis, approximately six months after a biopsy of the colon mucosa, the postoperative period after operations in the pelvis and abdominal cavity, excessive mobility of the organ, dystonia, dyskinesia, malignant and benign tumor processes, injuries and lesions of the intestine, pregnancy and lactation, cerebral edema, coma, fever, period of infectious diseases, foreign bodies, wall perforation, cardiovascular failure, tuberculosis.

Coffee and intestines

After one cup of espresso a day, it is difficult to say whether coffee strengthens or weakens the stool, the intestines do not react to the small amount of active substances in the drink, of which there are about 3,000. If you increase the dosage, then you can feel changes in the body’s functioning - diarrhea may begin, or vice versa - constipation.

Several studies have been conducted on this matter to find out what the statistics are on the effects of caffeine on the gastrointestinal tract. It was initially thought that increased peristalsis was a side effect of caffeine. It turned out that this is not entirely true, because caffeine is present in other drinks, but the effect of coffee as a laxative is several times stronger.

Coffee can be used as a laxative for weight loss.

This is especially true with a protein diet, since protein takes longer to digest in the body and causes constipation. There is a warning regarding the protein diet and coffee: these two factors put a lot of strain on the digestive system and the body as a whole, so the creators of the diet recommend drinking 3 times more water per day than with a normal diet.

This is due to the diuretic effect of caffeine and the increased content of nitrogenous substances in the blood after digestion of protein foods. It is necessary to restore the water-salt balance and at the same time help the kidneys remove uric acid from the tissues. Otherwise, you can develop gout - the deposition of uric acid salts in the joints, severe pain and swelling, which can only be eliminated with diet and water.

Interpretation of results

The data obtained is deciphered by a specialized specialist - a radiologist. It takes no more than half an hour to obtain the results of the study. Normally, the pictures should have a speckled image.

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

lymphosarcoma;
lymphogranulomatosis;
malabsorption syndrome.

Polyps

An X-ray examination of the intestines 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, which eliminates the possibility of developing malignant degeneration.

Signs of intestinal obstruction on x-ray

Intestinal obstruction has peculiar symptoms: pain in the abdomen and vomiting. In this case, intestinal motility is also impaired. The x-ray shows small intestinal obstruction in the form of a stop in the movement of contrast agent or air to other parts.

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 include weakened peristalsis and intestinal tone. This is fraught with a slowdown in metabolic processes and contributes to weight gain. The development of intestinal obstruction should be highlighted as complications.

What does a colon x-ray show?

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

X-ray of the intestines is an informative diagnostic procedure that:

will show the diameter, shape of the lumen and location of the small and large intestine;
will establish stretchability and elasticity level;
will 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.