HIGH QUALITY PREPARATION TO COLONOSPCOPY IS A KEY TO EXACT DIAGNOSTICS

Abstract

Colonoscopy is the golden standard for the colon visualization. The precancerous changes in the large intestine include adenomatous polyps, serrated lesions and changes in the mucosa associated with dysplasia (in patients with inflammatory bowel disease). Because of the flattened nature of the identification of serratic entities is complocated, and the localization in the right departments requires a thorough bowel preparation. Apparently, unrecognized serratic flat adenomas serve as a primary source for the development of «interval cancer». One of the most important indicators of quality of colonoscopy are good and excellent quality of bowel preparation, completeness of the examination, time of extraction of the endoscope is not less than 6–10 min, the detection rate of adenomas, which is about 15–30%. Insufficient quality of preparation for colonoscopy is directly connected with a high frequency of missed adenomas and the likelihood of «interval cancer.» Among the predictors of lack of preparation the use of narcotic drugs and tricyclic antidepressants, the presence of diabetes, obesity, arterial hypertension, liver cirrhosis, constipation, incomplete adherence to the patient instructions are noted. The degree of purification of various segments of the colon is often assessed using the 9-point Boston Bowel Preparation Scale, BBPS. The standard of preparation today is the use of a solution of polyethylene glycol (PEG). But currently Russian and international experts recommend using a two-stage (split) regime of PEG solution 2l + 2l. PEG doesn’t interfere with ingestion processes and is not absorbed in the intestine. A split-regime of PEG 2l + 2l demonstrates a high effectiveness and significantly better tolerance by patients due to which it’s a standard of preparation to colonoscopy recommended by professional unions.