What to do before visiting a proctologist and what to expect from a doctor

• What to expect from your first consultation?
• What should you do before your appointment?
• How to cleanse the rectum
• Recommended diet before visiting a proctologist

If you are concerned about pain in the rectum and anus, then you need to make an appointment with a proctologist. Unfortunately, many people put off visiting the doctor because of embarrassment and lack of understanding of what awaits them at the appointment. But without an examination, it is almost impossible to make a correct diagnosis, and, therefore, prescribe effective treatment. In order for everything to go without complications, you need proper preparation for visiting a proctologist.

Pharmacology

The drug is a laxative. Intended for rectal use. The composition contains several active components that enhance each other’s effect on the human body, helping to soften stool and facilitate the process of defecation.

Sorbitol helps increase the amount of fluid entering the intestinal lumen, which increases the volume of stool and softens it. As a result, the process of defecation is greatly facilitated.

Sodium citrate helps displace fluid from stool.

As a result, water is displaced from the stool and the amount of fluid entering the intestines increases, which significantly facilitates the process of defecation in people who suffer from hemorrhoids and constipation.

The effect of the drug is observed within 5-10 minutes from the moment of using the microenema. But the effect of the drug may depend on the patient’s personal characteristics.

Information on pharmacodynamics is not available.

Recommended diet before visiting a proctologist

The day before a visit to the doctor, exclude fatty, fried, heavy fish and meat dishes, and mushrooms from the diet. It is advisable to eat vegetable soups, cereals, white meat chicken or turkey, a lot of vegetables and fruits, which stimulate peristalsis as they contain a lot of fiber.

You should not eat foods that cause gas formation in the intestines and flatulence: legumes, potatoes, cabbage, carbonated drinks, black and whole grain bread. It is necessary to completely eliminate alcohol, because it has a bad effect on the condition of the gastrointestinal tract.

On the day of your appointment, you should not eat for several hours before the proctological examination. If you go to the doctor in the first half of the day, it is better not to eat in the evening. If the reception is late in the evening, a light breakfast is allowed. You can drink water, fruit juices without sugar and pulp until your appointment.

If the reception takes place in the first half of the day, then there is no need to have breakfast. If in the second case and the patient cannot remain without food for a long time, then you can allow yourself a light breakfast of foods that do not cause gas formation.

It is recommended to take slippers, a diaper and toilet paper with you.

How to use Microlax

The medicine is used rectally. Before giving an enema, you need to wash your hands well and thoroughly clean the area around the anus. The seal must be broken off immediately before insertion. After removing the seal, you need to press on the tube so that the solution comes out. After this, the tip is inserted into the anus and the entire contents of the tube are squeezed out. You need to take out the enema with the walls of the tube compressed.

From the age of 3, the tip must be inserted completely. For younger children, half will be enough. One enema will be enough for a one-time dose.

The frequency of use and dosage can only be determined by a specialist, taking into account the individual characteristics of the patient.

Many people wonder about the emergence of addiction. Doctors say that you should not take the medicine for a long time. If a person has chronic constipation, then it is worth making an appointment with a doctor to undergo an examination and prescribe further treatment.

It is not recommended to take the medicine in parallel with alcoholic beverages.

Reviews about the drug are in most cases positive. In 95% of cases, the treatment takes place without any adverse reactions or discomfort. Parents note that Microlax has a much better and more effective effect on young children than other medications.

What to expect from your first consultation with a proctologist

The first appointment is a consultation and visual examination. The doctor collects anamnesis and reads the medical documentation. The examination can be carried out on a couch or in a special chair. The doctor may perform a digital examination of the rectum. It can be performed after anesthesia with ointment or gel, but this is only required in 5% of cases, because all manipulations are absolutely painless. During a digital examination, the condition of the skin in the anal area, mucous membrane, sphincter contractility, and whether there are hemorrhoids or other neoplasms are assessed.

The specialist begins the appointment with a conversation, studying the medical history and tests (if available). But the matter is not limited to conversations alone - the doctor conducts a visual examination of the perineum and anus, as well as a digital examination. If necessary, anoscopy and sigmoidoscopy are performed, for which special devices are used.

In order for the doctor to get a true picture of what is happening to the body, the patient needs to prepare in advance.

Kolosovsky Yaroslav Viktorovich

surgeon, mammologist, oncologist, phlebologist

A timely visit to a proctologist is incredibly important for the patient, since in many cases contacting a doctor immediately after the onset of symptoms allows you to save life and health. Many diseases of the rectum are very dangerous. About 33% of all outpatients are treated for hemorrhoids, which are often complicated by bleeding. 5% of patients are diagnosed with colorectal cancer during an appointment with a proctologist, and the earlier it is detected, the greater the chance of successfully curing the pathology.

Proctological diseases are becoming more common today due to physical inactivity, a sedentary lifestyle and poor nutrition. Impaired defecation, pain in the projection of the rectum, discharge from the anus - all these symptoms are reasons to consult a doctor as soon as possible, because any disease is easier to treat at an early stage, and the prognosis for it becomes much better.

Analogs

To date, no drugs have been developed that could be classified as analogues of the active component. But there are analogues that are similar in the principle of influence and the list of indications for use. These products include glycerin suppositories, which can be given to adults and children from infancy. The cost of many analogues is lower.

Analogs based on the principle of action also include Glycerin and Norgalax. These drugs also have a laxative effect and are used rectally. Glycerin is also available in solution form for topical and external use.

Preparation for inspection

Dear patient!

If you are planning an appointment with a proctologist, then it is advisable to prepare accordingly for the examination, that is, give a cleansing enema.

Let us immediately make a reservation that if you have severe pain (it hurts to give yourself an enema) or bleeding, then you do not need to give an enema before the initial medical examination. Do not injure the sore areas again. The doctor will carefully conduct the examination without this preparation. If necessary, you will be prescribed therapy to relieve exacerbation or pain, and after that you will undergo the necessary instrumental examinations.

In general, before the initial examination, the patient gives two cleansing enemas of 1.5-2 liters each, approximately 3-4 hours before the appointment, with a break between them of approximately 45 minutes, the water temperature is about 37 degrees. Also, you should not eat foods that cause flatulence the day before. If you have an appointment in the evening, but there is no way to prepare during the day, then a cleansing enema can be given after the morning bowel movement.

Now let's talk about how to give an enema correctly.

Cleansing enema

An important condition for high-quality diagnostics is thorough cleansing of the intestine from contents. An Esmarch mug is used to perform a cleansing enema. It can be bought at almost any pharmacy. An Esmarch mug is a reservoir (glass, enamel or rubber) with a capacity of 1.5-2 liters. At the bottom of the mug there is a nipple onto which a thick-walled rubber tube is placed. For a rubber reservoir, the tube is its direct continuation. The length of the tube is about 1.5 m, the diameter is 1 cm. The tube ends with a removable tip (glass, plastic) 8-10 cm long. The tip must be intact, with smooth edges. It is preferable to use plastic tips, since a glass tip with a chipped edge can seriously injure the intestine. After use, the tip is washed well with soap under running warm water and boiled. Next to the tip on the tube there is a tap that regulates the flow of fluid into the intestines. If there is no tap, it can be replaced with a clothespin, clamp, etc.

For enemas, use only water from a proven source (one that is safe to drink). For children, it is better to use only boiled water. The water temperature is about 37-38 degrees. Colder water significantly increases intestinal motility and causes unpleasant pain. Using water with a temperature of more than 40 degrees for an enema is dangerous to health.

So, let's look at ways to give an enema.

1st method

Lie on the bed close to the edge on your left side with your legs bent and pulled towards your stomach. Place an oilcloth (plastic film) under your buttocks, and lower the free edge of it into a bucket in case you cannot hold water. Pour 1-1.5 liters of water at room temperature into Esmarch's mug, lift it up to a height of 1-1.5 m and lower the tip down to release a small amount of water and along with it air from the tube. Fill the tube (drain some liquid from the tube), then, without lowering the mug, close the valve on the rubber tube. Check if the tip is broken, lubricate it with Vaseline (soap, vegetable oil) and, spreading the buttocks, insert the tip into the anus with light rotational movements. The first 3-4 cm, insert the tip towards the navel, then another 5-8 cm - parallel to the tailbone. If there are obstacles and the tube rests against the intestinal wall or hard feces, remove it 1-2 cm and open the tap. Pressurized water will enter the large intestine. Almost immediately there will be a feeling of “fullness” in the intestines and an urge to stool. At these moments, you need to reduce the flow rate of liquid from the mug by closing the tap on the tube or squeezing it. Gentle circular stroking of the abdomen will help reduce discomfort.

If the tip is clogged with feces, it should be removed, cleaned and reinserted. If your rectum is filled with stool, try flushing it out with a stream of water. Esmarch's mug does not need to be completely emptied. Leaving a little water at the bottom to prevent air from entering the intestines, close the valve that regulates the flow of liquid and remove the tip.

Place a pre-prepared pad (cloth, repeatedly folded toilet paper, etc.) on the perineum, which must be pressed between the legs.

2nd method (“according to Hegar”)

Get on all fours in the bathroom (knee-elbow position), leaning on one elbow, and insert the tip into the rectum with your other hand.

The tip must be inserted slowly and carefully, especially with hemorrhoids. Having inserted the tip, lower your head and shoulders lower and begin to breathe deeply, but not often, with your stomach, “sucking in air through your mouth or nose.” If not all the water has entered, and you already feel pain in the intestines, turn off the tap on the hose and breathe deeply.

When the water in the mug runs out, remove the tip and place a pre-prepared pad on the anus.

It is advisable to hold the water for 10 minutes. To do this, lie on your back and breathe deeply. Soothe the pain and feeling of fullness in the abdomen with stroking. If possible, walk around with the water injected or lie on your stomach. When administering a cleansing enema, you need to ensure that no more than 1.5-2 liters of liquid are administered at a time. If it is necessary to give two enemas in a row, you should maintain an interval of 45 minutes to 1 hour between them, making sure that the rinsing water from the first enema has completely drained.

Cleansing enema substitute

If you have difficulty administering an enema, there is an excellent alternative - the drug Microlax.

Microlax is a ready-made saline laxative solution in microenemas of 5 ml for single rectal administration, 4 pcs. packaged. The laxative effect of using this drug occurs 5-20 minutes after administration.

To prepare the intestine for examination, it is enough to use 2 microenemas. As a rule, emptying occurs 15-20 minutes after rectal administration of the 1st microenema; after emptying, the 2nd microenema is administered. If after the introduction of the 2nd microenema there is no bowel movement, then you managed to prepare for the first one.

Microlax acts gently, without irritating the intestines and without causing systemic side effects. Considering the safety of Microlax, it is recommended for adults and children, as well as for pregnant and lactating women.

Rules for using Microlax:

1. Break off the seal on the tip of the tube;

2. To facilitate the administration process, you need to lightly press the tube so that a drop of the drug lubricates the tip of the enema;

3. Insert the tip of the microenema into the rectum;

4. Squeezing the tube, squeeze out its entire contents;

5. Remove the tip while continuing to lightly squeeze the tube.

How to properly administer microenemas to adults and children?

The drug Microlax® is used rectally (inside the rectum), in the form of microenemas. It is available in convenient tubes - each containing 5 ml of solution - the optimal dose to cope with constipation.

The tip of the tube is also very convenient. It is of such a length that it can be completely inserted into the rectum of an adult or a child over 3 years old, as a result, the medicine will get to the right place and immediately begin to act.

For children under 3 years of age, the tip is inserted halfway. For convenience, there is a special mark on it.

Reviews from doctors about the procedure

Performing a cleansing enema is what doctors advise for long-term constipation. Of course, you will have to spend a little time figuring out how to give an enema yourself, but the result will be worth it.

Vladimir Pavlovich Kiriyenko, proctologist: “Timely lavage of the intestines quickly improves the condition of patients - there is no point in dragging on to the point of fainting. In addition, when performing manipulations at home, either independently or with the help of calling a doctor, patients do not experience such embarrassment as in the hospital.”

Doctors remind us of the importance of consulting with a professional: the patient does not always know that he has contraindications to the procedure.

According to surgeon A. Markovskaya: “The main obstacle to independent intestinal lavage is ignorance of the optimal volume and temperature of the administered fluid. It is very easy to harm yourself, so avoid self-medication as much as possible. Moreover, nowadays it is very easy to call a specialist to your home.”

Patient reviews

Patients themselves also often write on forums about their experience of using enemas - some use regular water enemas, some buy special ones with a solution (for example, Enema), while others call a specialist and choose the optimal composition of the liquid with him.

Maria, 25 years old, had her bowel lavaged before going for an endoscopy: “It’s the hardest thing to cleanse yourself properly, you’re always afraid of doing something wrong. She called the nurse and was even surprised that the enema was administered without discomfort. Fast and no problems, I recommend.”

Andrey D. shared another experience, a little less pleasant: “I had to give an enema before a visit to the proctologist, but for me it was the first experience of such a procedure - as a result, a lot of unpleasant sensations and damage to the mucous membrane. The doctor said that coming “unprepared” is not critical, it’s better not to harm the body and ask a specialist for help.”

Christina N. says: “For a couple of years now, my grandmother has been bedridden and moves little—hence the problems with stool. Recently we tried to give an enema with the help of a nurse, the result was excellent, I calmly emptied after half an hour. It’s a good method, and there’s no need to poison an elderly person with laxatives, she already has a lot of pills.”

From their impressions it is clear: constipation cannot always be prevented, because it appears from stress, from travel, and from unusual cuisine. An enema is a simple and affordable way to cleanse the intestines, so there are a lot of positive reviews.

Analogues and substitutes

There are no analogues of Microlax that are completely identical in composition. When choosing substitutes, preference is given to those products that help quickly solve the problem, this mainly applies to rectal suppositories. Instead of Microlax, you can use suppositories:

• Glycerin;
• Glycelax;
• Bisacodyl;
• Sea buckthorn.

Glycelax and glycerin suppositories are suitable for relieving constipation in infants. Starting from three months.

Microclysters-substitutes for Microlax

Not all of the microclyster analogues listed above can be used to relieve constipation in children. Therefore, before purchasing them, you need to carefully study the indications and contraindications for the chosen product.

Benefits of an enema

Laxatives intended for oral use begin to act after at least 4-5 hours. In contrast, rectal placement of Microlax leads to defecation almost immediately, which accordingly quickly improves well-being and allows you to eliminate discomfort in the shortest possible time. But this is not the only advantage of Microlax. Other advantages of the drug include:

• no toxic effects on internal organs;
• the possibility of using microenemas in any trimester of pregnancy;
• no age restrictions - the drug is suitable for eliminating constipation in infants and young children;
• a small number of contraindications;
• Convenience of administering an enema - a thin and semi-rigid applicator allows you to insert it into the anus correctly and quickly

Microlax is not addictive and can be used periodically for occasional constipation. Short courses of daily use of the drug are also permitted, but it must be borne in mind that in order to fully restore intestinal function, it may be necessary to take other medications.

Microlax is also convenient because each container contains a single dose, so there is no need to determine the amount of the drug.

Microlax does not interact with systemic medications. This is due to the fact that the components of the drug act only at the intestinal level and do not enter the blood. When using other drugs intended for rectal administration at the same time, you must wait until you have emptied before administering them. All components of Microlax are excreted along with the feces. After which you can safely insert suppositories with anti-inflammatory, regenerating or analgesic properties.