The document discusses various topics related to colonoscopy and the gastrointestinal system. It provides information on colonoscopy procedures, preparation, and potential findings. It also defines and describes hematochezia (bloody stool), cachexia (wasting syndrome), and anastomosis (surgical connection of tubular structures).

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.

4. Anatomy of the Colon

5. Colonoscopy vs. Sigmoidoscopy

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

10. Colonoscopy
Procedure

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)

17. Hematochezia

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)

22. Cachexia
Cachexia involves increased tissue metabolism.
Protein synthesis is decreased and degradation is
increased.

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

26. Anastomotic Techniques
 Conventional methods
- hand-sewn
- stapled
 Novel techniques
- compression rings
- tissue glues
A compression ring

27. Anastomosis
Anastomoses can be
fashioned in these ways:
 End-to-end
 End-to-side
 Side-to-side
End-to-end anastomosis End-to-side anastomosis

28. Small Intestine Anastomosis

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