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Colonoscopy, Hematochezia, Cachexia, Anastomosis
1. Colonoscopy
Hematochezia
Cachexia
Anastomosis
By Hana Jakubickova
2. Colonoscopy
Introduction
Endoscopic examination of the whole colon
with a camera on a flexible tube passed
through the anus
Allows the doctor to look at the inner lining
of large intestine (colon and rectum)
Could be used to look at the lower part of
the small intestine
3. Colonoscopy
Introduction (Cont.)
Helps find ulcers, colon polyps, tumors, and
areas of inflammation
During a colonoscopy, tissues samples could be
collected
Abnormal growths can be taken out
Colonoscopy could be used as screening test to check for cancer
or precancerous growths in the colon or rectum.
6. Indications for Colonoscopy
Blood in the stool or rectal bleeding
Dark or black stools
Unexplained changes in bowel habits, chronic
diarrhea
Iron deficiency anemia
Sudden, unexplained weight loss
Abnormal results from a stool test or a barium
enema test
7. Indications for Colonoscopy (Cont.)
Inflammatory bowel disease (IBD)
Crohn disease
Ulcerative colitis
Long-term, unexplained belly pain
Screening for colorectal cancer
- people with no risk factors at age 50
- people with a family history of colon cancer
at age 40, or 10 years before the age that the
relative got cancer
8. Preparation for Colonoscopy
One to three days prior :
- a low fiber or clear-fluid liquid only diet
- don’t drink orange juice, prune juice, and
milk (contain fiber)
- don’t consume liquids and foods the are
dyed red, orange, purple, or brown (no grape
juice, fruit punch, cherry Jell-O, or grape
popsicles)
- cola and black coffee are usually allowed
9. Preparation for Colonoscopy (Cont.)
The day before the colonoscopy:
- laxative tablet, laxative solution (Nulytely,
Golytely)
- if indicated stop taking aspirin, aspirin-like
products, and blood thinners
stop drinking clear liquids 6 to 8 hours prior
30 to 60 minutes before the test:
- you may be given enema
11. Colonoscopy
Procedure
Patient is undress and changed into an
examination gown
Vital signs are check and monitored
Intravenous line is put in place (sedation and
pain medication is given through IV line)
Patient is positioned on his/her left side with the
knees up to the belly
12. Colonoscopy
Procedure (Cont.)
The doctor
- checks the anus for potential blockage (with a
lubricated gloved finger)
- gently puts lubricated colonoscope into the anus
and moves it slowly through the rectum and
colon
- inflates the large intestine with carbon dioxide
gas for a better view
13. Colonoscopy
Procedure (Cont.)
The doctor
- may ask the patient to move periodically so
the scope can be adjusted for better viewing
- slowly withdraws the scope once it reaches
the opening to the small intestine
- again examines the lining of the large intestine
- removes polyps or performs biopsy if
necessary
14. Polyp Removal
Polyp is A sterile solution A portion of The polyp
identified is injected under the polyp is is fully
the polyp to lift it now removed removed
away from deeper
tissues
15. Colonoscopy
Recovery
The test usually takes 30 to 60 minutes.
After test:
- patient is watched for 1 to 2 hours
- could go home when fully awake
- may not drive or operate machinery for 12 hours
- should drink a lot of fluid
- may have bloating or cramps
16. Hematochezia
Is the passage of bright red (or maroon) bloody
stools from the rectum
Is also called bright red blood per rectum
(BRBPR)
Is usually from the lower gastrointestinal tract
(the colon or rectum) or from hemorrhoids
It is distinguished from melena, which is stool with blood that has
been altered by the gut flora and appears black, smelly, and tarry
(sticky). Melena usually signifies bleeding from the upper
gastrointestinal tract)
18. Hematochezia
Causes
Adults
- hemorrhoids - enlarged, painful veins in the
rectum
- diverticulosis - condition where pockets
(pouches) form in the colon
- colorectal cancer
- large polyp
19. Hematochezia
Causes (Cont.)
Adolescents and young adults
- ulcerative colitis – a type of inflammatory bowel
disease that causes inflammation and sores
(ulcers) in the lining of the large intestine;
usually affects the lower section (sigmoid colon)
and the rectum
20. Hematochezia
Causes (Cont.)
Newborns
- result of swallowed maternal blood at the time of
delivery
- initial symptom of necrotizing enterocolitis -
acquired disease, primarily of preterm or sick
neonates, characterized by mucosal or even
deeper intestinal necrosis
21. Cachexia
Is physical wasting with loss of weight, fat, and
muscle mass caused by disease
Occurs in people who are eating enough, but
cannot absorb nutrients
Is not the same as anorexia (lack of appetite) or
starvation (a healthy person’s body can adjust
starvation by slowing down its use of nutrients,
but in a cachectic patient, the body does not
make this adjustment)
23. Cachexia
Causes
Cancer (end-stage cancer – cancer cachexia)
AIDS (acquired immunodeficiency syndrome)
COPD (chronic obstructive pulmonary disease)
CHF (congestive heart failure)
Tuberculosis
Drug addiction
Some severe cases of schizophrenia (vesanic
cachexia)
24. Cachexia
Treatment
Additional caloric supplementation does not
relieve cachexia.
Corticosteroids
Cannabinoids
Progestogens
25. Anastomosis
A surgical connection between two structures
(usually tubular structures), such as blood vessels
or loops
of intestine
29. Anastomosis
Phases of healing:
Lag phase (day 0-4)
- Acute inflammatory responses occur
- Anastomosis has no intrinsic strength
Fibroplasia phase (day 3-14)
- Fibroblasts proliferate
- Immature collagen is laid down
30. Anastomosis
(Cont.)
Phases of healing:
Maturation phase (beyond 10 days)
- Collagen is remodeled
- Strength of anastomosis is increased
31. Sources:
Wikipedia, the free encyclopedia (Last modified June 25, 2009). Colonoscopy.
Retrieved July 4, 2009, from http://en.wikipedia.org/wiki/Colonoscopy
WebMD. Monica Rhodes (August 11, 2008). Colorectal Cancer Health Center
Colonoscopy. Retrieved July 4, 2009, from
http://www.webmd.com/colorectal-cancer/colonoscopy-16695
Wikipedia, the free encyclopedia (Last modified June 15, 2009). Hematochezia.
Retrieved July 4, 2009, from http://en.wikipedia.org/wiki/Hematochezia
Wikipedia, the free encyclopedia (Last modified July 3, 2009). Cachexia. Retrieved
July 4, 2009, from http://en.wikipedia.org/wiki/Cachexia
32. Sources (Cont.):
MedicineNet.com (Last editorial review November 10, 2004). Definition of
Cachexia. Retrieved July 4, 2009, from
http://www.medterms.com/script/main/art.asp?articlekey=11065
Surgical-tutor.org.uk, a free on-line resource (Last updated April 21, 2009).
Intestinal and Vascular Anastomoses. Retrieved July 4, 2009, from
http://www.surgical-tutor.org.uk/default-home.htm?core/preop1/anastomoses.htm
MedinePlus (Updated July 25, 2007). Medical Encyclopedia: Anastomosis. Retrieved
July 4, 2009, from
http://www.nlm.nih.gov/medlineplus/print/ency/article/002231.htm