Colonoscopy and sigmoidoscopy: what is the difference, which is better?
Numerous varieties of endoscopic examinations of the colon give the proctologist a possibility, depending on the momentary state of health, to choose the best of them. The most commonly used methods are colonoscopy and sigmoidoscopy.
First, both techniques are not good and meet the standard of «price-quality». For the patient they are more affordable than, for example, virtual or videocolonoscopy. The doctor makes the choice between them based on goals set for the survey, need for speed holding and a number of other reasons. So the difference between a colonoscopy from a sigmoidoscopy? Why and when coloproctologist chooses one of them?
The penetration depth and the difference of opportunities
The answer to the question: «Sigmoidoscopy or colonoscopy,what’s the difference?» – is that the endoscopes, which conducted the survey, have differences in the device, and therefore different functionality.
Sigmoidoscopy is performed using different types of rectoscopes. Common models, for example, Sartaeva consist of different length and diameter barrels with metal tip – tube-beak. The length of the barrel allows you to visually inspect the walls of the lower portion of the colon at a distance of 20-30 cm from the anus. For lighting use led fibre optic illuminator. thanks to its tool device is only suitable for diagnostic examination of the two lower parts of large intestine – the rectum and the distal (lower) part of the sigmoid colon.
In case needs urgent diagnosis in intensive care or in the operating room for examination of the rectum applies anoscope tool such as gynecological mirrors.
For emergency inspection of other parts of large intestine, in most cases, uses a laparoscope, getting to the problem «directly» – puncture through the abdomen.
«Traditional» colonoscopy is performed with the help of colonoscopes. A completely different configuration, not instruments and apparatus, proctologist provides the following features:
- taking a close look at a magnified image of the surface of the walls of all departments of the colon;
- if necessary, rinse off any blood, mucus and feces in the right place;
- to seize upon detection of a foreign object;
- to perform the polypectomy is an operation to remove polyps;
- take required quantity of samples of biological material for laboratory analyses;
- take photographs or video of the problem areas.
However, the latest models of modern rectoscopes differ from traditional colonoscopes only the length and material of the tool tube, so in the ads of private clinics can be found service – videomicroscopy. When performing this survey, the coloproctologist available all of the above functionality colonoscopy, but to execute them is possible only on 30-cm distance from the anus. The basic cost of diagnostic videomicroscopy a third more expensive than the usual sigmoidoscopy, and 2-4 times cheaper than a diagnostic examination with colonoscopy.
Motivation proctologist when choosing the type of diagnosis
Colonoscopy or sigmoidoscopy which is better? Posing such a question is not correct. With the same success you can ask: «Which is better, scooter or racing bike?». When choosing the type of examination the doctor is based on logic and certain rules. In this case, the expert must justify a specific purpose, to voice their suspicions and assumptions.
If the proctologist had full confidence in the localization of the problem area in the rectal area, it will be assigned the diagnostic sigmoidoscopy. In doubtful cases, or suspected multiple localization of the pathology(s) will immediately be asked to examine all the departments of the colon using colonoscopy.
Naturally, if the primary rektoromanoskopii examination of the distal sigmoid colon will be identified the affected areas, located on the border of opportunity proctoscope, proctologist must prescribe a colonoscopy.
In some cases, an experienced and attentive personnel, assigning sigmoidoscopy, can offer to bring an additional amount of money. For what?
If in the course of the diagnostic examination will be detected polyps or suspicious growths, with the help of a colonoscope, it is possible to immediately perform the polypectomy and/or biopsy for histological analysis. This «efficiency» will free you from repeat 3-4 day uncindery diet and bowel cleansing enemas and laxatives drugs.
The right choice type of examination for postoperative control remains with the specialist. So do not be surprised if the operation was performed to the distal sigmoid colon, several surveys were conducted with the help of a proctoscope, but the next inspection will be requested to do a colonoscopy. So not everything is in order and it is possible that pathology is not only back, but also changed its localization.
As a preventive measure sigmoidoscopy are shown to undergo 1 time in 5 years, all persons over 50 years of age, no aggravated information in history. But regular preventive colonoscopy necessary after 35-40 years, in which family history has cases kollateralny cancer.
Is there any difference in the procedures of preparation for the examinations?
It would seem that the rules of preparations for the research must be significantly different, but they are absolutely identical. Sigmoidoscopy and colonoscopy require prior compliance with special regime of diet food with the exception of indigestible, fiber-rich foods and also those foods and beverages that reinforce the processes of fermentation. Both methods need a bowel cleanse cleansing high enemas or laxatives special medications, for example, fleet Phospho-Soda.
For colonoscopy this training is logical, but why a sigmoidoscopy, you cannot do one enema, made directly before the examination? The fact that the intestine is quite difficult to launder from the build-up of feces. With this task single enema can not cope.
Another important condition of training for which you need to follow a special diet and mechanical cleaning of the intestine walls, it is the maximum release from the stool at all. So putting the enema and began the procedure of sigmoidoscopy, without complying with the above rules, the physician will be deprived of the opportunity to inspect the sigmoid colon or to interrupt the examination at all as peristalsis «do their dirty work».
Different the research?
Both procedures are uncomfortable. However, the patient should know in advance, and mentally prepare for the fact that sigmoidoscopy is held in the initial position – standing on my knees, focus on the forearm. Colonoscopy well the examinee lying on his side, pulling your knees to your stomach, and sometimes the doctor may ask the patient to roll over on your back and raise to the side knees bent.
Time spent on the survey with the help of a rectoscope is approximately 4 times less than with colonoscopy. However, this is only possible in ideal conditions. At almost the speed of carrying out these delicate procedures influence not only the experience and qualifications of the doctor-diagnostician. In some cases, colonoscopy may take the minimum time is 10-15 minutes, and sigmoidoscopy be delayed up to 20 minutes. Why? You must make allowances for the individual sensitive characteristics of the patient, proper training, the real clinical picture of the physiological state of the intestinal wall – the multiplicity, severity and number of varieties existing pathological changes.
In conclusion, I should add that absolute contraindications for colonoscopy rektoromanoskopii and the same, cardiac and pulmonary insufficiency, bleeding hemorrhoids, pathology blood clotting.