Coloproctology and Colonoscopy

An extensive and accurate patient history is the basis of the search for the causes of digestive disorders and medical complaints on the part of our patients. The aim is to establish whether the issue is a blockage to the passage such as constipation, slow transit constipation or outlet constipation, or diarrhoea.

Changes in the bacterial populations and the distribution of bacteria in the intestine (disruption to the symbiosis) lead to an increased extent to the production of gas in the intestine and to changes in the passage. Disruptions to the mucous membrane in the intestine cause damage to the immune system. The reasons for changes to the intestinal wall (e.g. polyps) and inflammations must be clarified. These can all cause discomfort to the stomach and interfere with intestinal health.

Another major problem is anal continence disorders. A large number of possible causes need to be looked into for this, and the most gentle and most effective treatment for the patient found.

Conservative therapy

When the causes of the problems are identified, the digestive tract can, for example, be supported using targeted adaptation of the diet. Since 70% of the immune system is located in the large intestine, this intestinal defence can be strengthened, for example by stabilising the mucous lining of the intestinal wall and optimising the bacterial distribution and bacteria populations. The use of prebiotics and probiotics also contributes to this, as does the administration of orthomolecular medications for support.

Colonoscopy

The colonoscopy is an important, gentle examination in coloproctology. Colonoscopy is the most effective examination for diagnosing the entire large intestine, for the early recognition of cancer, for tumour aftercare after cancer operations and for treatment (e.g. polypectomy).

With a single examination, three different measures can be carried out:

1.

an accurate assessment of the inner layer of the intestine through enlarged, colour images.

2.

if there is any uncertainty, tissue samples can be taken from the mucous membrane and sent to the pathologists for testing.

3.

treatment for polyps, for example, involving their complete removal

 

Flexible endoscopy - the "gentle" colonoscopy*

What does "gentle colonoscopy" mean?

I have been carrying out colonoscopies without the use of anaesthetic for more than three years.

As a replacement for this, I use tried and tested laughing gas, in addition to drugs to relax the intestine (administered via venous access). During the first phase of the examination, patients inhale a mixture of 50% oxygen and 50% laughing gas. This leads to a saturation of the oxygen content in the blood and to a dampening of the sensation of pain, which in turn leads to an increase in pain tolerance. Patients are awake during the examination, so they are able to take part in the examination, get to known their beautiful intestine from the inside and talk to the examiner and ask questions. The effect of the gas wears off after five minutes, so patients do not require a recovery period.

In a "gentle colonoscopy", the examination has to be carried out very carefully, with only very limited strain being put on the organism. This all benefits the person undergoing the examination, hence "gentle colonoscopy".

Colonoscopy is the most effective examination for diagnosing the entire large intestine, for the early recognition of cancer, for tumour aftercare after cancer operations and for treatment (e.g. polypectomy). In this examination, the inside of the intestine is viewed in colour and in an enlarged manner, and is assessed. If any abnormalities are identified, small forceps are used to take a pain-free sample in the same procedure. This is then tested by the pathology department. If polyps are found, these are removed, retrieved and sent to the pathologists for testing in the same procedure using a high frequency technique. The removal of polyps is also pain-free. However, the risk of complications when removing polyps is greater.

One examination for three possible uses: diagnosis, confirming a diagnosis and treatment

The most significant complications to the endoscopic removal of polyps is bleeding and secondary bleeding, and the perforation of the intestinal wall.

There is secondary bleeding in less than 2% of polypectomies (polyps removal). For larger polyps, secondary bleeding is more frequency (approximately 5-7%). Perforations are even rarer and occur in less than 1% of all polypectomies. However, the removal of larger polyps increases the rate of perforation to 1-2%.