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How to do an enema in hospitals before surgery or examination

An enema before surgery is often necessary. But why do doctors prescribe such an unpleasant and frightening procedure for many people? Before any planned operation, the patient must be prepared. The preparation includes many different activities. Artificial bowel cleansing is necessary to ensure that no complications arise during and after surgery.


During anesthesia, all the patient's muscles relax. Relaxation of the sphincter can lead to involuntary bowel movements. In addition to impaired muscle function, full intestinal loops also make the surgeon's job more difficult. Especially when the operation is performed in the intestinal region or stomach.

Therefore, patients should not eat before surgery. Anesthesia causes vomiting in some people. Food masses entering the respiratory tract can cause suffocation or other complications. But this does not mean that patients should fast before surgery. Strict restrictions on food weaken the body as a whole, which negatively affects subsequent rehabilitation.

It is not recommended to take laxatives for several days before surgery. The loss of nutrients and microelements is also harmful. Therefore, it is better to do an enema. It should be noted that performing a cleansing enema in the correct way does not cause any discomfort.

After surgery, patients tend to experience constipation. This phenomenon is due to the fact that patients eat and move little. In the first hours after surgery, it is forbidden to even drink liquid. All this leads to the patient experiencing difficulty defecating during the recovery period. Due to the fact that peristalsis does not work properly, gases accumulate and this causes pain.

Read also:  Performing cleansing, siphon and medicinal enemas.

Colon cleansing in a medical facility

In hospitals, an enema is given to prepare for subsequent medical procedures and as a preventive action against the infectious process. Before carrying out the manipulations, the patient and the doctor determine how the enema procedure will take place. A suitable option is selected, the purpose of which is to free the intestines from fecal matter.

Typically, an enema and cleansing solution are used to remove contents from the organ. The manipulation is carried out at home and in a hospital setting. The first option is applicable for those who are shy and cannot concentrate on the procedure.

An enema administered at the clinic before surgery looks like this:

  • The patient is in the hospital. The first cleansing is carried out. This occurs 16 or 12 hours before surgery. As a rule, it is carried out in the evening before bedtime.
  • Liquid in a volume of up to two liters is injected into the colon. For the procedure, boiled water is taken, slightly heated to 37 degrees.
  • The second enema is given in the morning.

To carry out the manipulations, special equipment is used - an Esmarch mug. This is a container that holds up to three liters of water, with a rubber hose and tip. A clamp is installed that allows you to adjust the required volume of water.

Type of enema and use

Removing contents from the intestinal canal is necessary not only for surgery and examination. There are various cases when cleanliness in the organ is required.

Types of enema procedures used in hospitals:

  • Cleansing. Remove constipation, dirt, and stagnant feces for further action.
  • Medicinal. The procedure takes effect immediately after complete cleansing of the organ. They are used when it is necessary to deliver a drug into the body. Perhaps the person’s condition does not allow the medicine to be administered in another way. Since the intestinal walls quickly absorb liquid, there is confidence that the medicinal drug will enter the bloodstream and begin to act.
  • Nutritious. There is a need to provide nutrients to a weakened person or when swallowing functions are impaired.
  • Diagnostic. Used when contrast needs to be introduced. As a rule, a contrast agent is administered during an X-ray examination. The resulting photos clearly show problem areas of the intestine, making it possible to identify pathological formations.

The siphon enema procedure is known. Its use is justified if there is no result from other procedures or if it is necessary to prepare the patient for surgery within a short period of time.

Technology for performing enema in a hospital for adults:

  1. Esmarch's mug is being prepared. Pour the solution into the container in the required quantity. The medical solution should not exceed a temperature of 22 degrees. The clamp is removed and the air leaves the tube. Water poured out, close the clamp. The mug is located at a height of one meter.
  2. For easy entry, use a tip lubricated with Vaseline.
  3. A sheet and oilcloth are placed on the couch so that dirt gets there during the procedure.
  4. The patient assumes the fetal position on the left side.
  5. The nurse performs further actions independently. Inserts the tip into the anus and advances in stages to a depth of 15 centimeters. The process is unpleasant, but if the tip is sufficiently greased, it is tolerable.
  6. The clamp opens and the liquid pours inside.
  7. It is advisable not to drain the water completely so that there is no air inside.
  8. The tip is carefully pulled out and the equipment is put away.
  9. A person lies down for 10 minutes and goes to the toilet.

The cleansing procedure for a child is performed in the following way:

  • Mom is spreading a diaper on the couch.
  • Lubricate the tip of Esmarch's mug with Vaseline. If the baby needs help, use a bulb or syringe, and also lubricate with Vaseline. Spread the buttocks and pour the required amount into the colon.

Try to hold the water in yourself for 3 minutes. Then the baby has a desire to go to the toilet.

Solutions for manipulations

When a patient is afraid of giving an enema, the doctor has the right to prescribe a medication that performs the function of relaxation. Use does not harm the human body.

A drug for cleansing by oral administration is indicated if stopping points are noted in the rectal canals: hemorrhoids, tumor formations, cracks.

The pharmaceutical industry produces drugs in different forms:

  • Pills.
  • Syrup.
  • Powder. This type is available for intravenous administration and intramuscular procedures.
  • Ready solutions.

Each medicine performs its intended function: stimulates motor activity, increases feces in size with the help of retained fluid.

If the patient is ready to perform enema procedures, for each type of manipulation an individual type of liquid injected is provided:

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  • The medicinal treatment uses various decoctions of medicinal herbs: chamomile, wormwood, celandine.
  • Nutritious. Involves the introduction of nutrients into the body. Typically, this is a solution containing 5 percent glucose and sodium chloride. Hydrogen peroxide is also used to destroy viruses and bacteria.
  • The laxative contains the necessary substances. An enema is given to help cope with prolonged absence of bowel movements. Has a laxative effect. The solution is prepared using an isothermal suspension of sodium chloride.

Before surgery

It is often necessary to administer an enema before emergency surgery. It is advisable to perform these manipulations before general anesthesia. When anesthesia begins to affect the body, complete relaxation of the muscular system is provoked. This also applies to the lower intestine. Spontaneous excretion of feces occurs. An enema before surgery will reduce the risk of infection of the surgical wound when surgery is performed on the intestine. A clogged large intestine can become an obstacle to reaching the diseased organ; cleaning before surgery is recommended.

Often after surgery, patients complain of a prolonged absence of bowel movements. For the first time after surgery, physical activity is prohibited for patients, the intestines do not develop, and constipation occurs. The amount of gases inside increases, flatulence occurs.

Operations requiring bowel cleansing:

  • Surgery on the organs of the digestive system.
  • Before emergency surgery.
  • Planned surgery.
  • Women who have started labor.
  • Preparing for a caesarean section.

Cleansing enema. Technique performed in a hospital

  • Esmarch's mug needs to be filled with water, 1.5-2 liters (temperature 18-22 degrees). Air is released from the system and a clamp is applied. The mug is suspended on a tripod at a level of one to one and a half meters above the couch with the patient.
  • A sterile tip is placed on the end of the rubber tube and lubricated with Vaseline.
  • An oilcloth is placed on the couch under the patient.
  • The patient lies on his left side, bends his knees.
  • The medical worker puts on sterile disposable gloves, spreads the patient's buttocks with his hands and carefully inserts the tip into the rectum with a slight rotational movement to a depth of three to four centimeters towards the navel. Then, using the same movements, turn the tube up to 8-10 centimeters towards the tailbone.
  • The clamp on the rubber tube is removed, and water (1-2 liters) is gradually poured into the rectum.
  • To prevent air from entering the intestines, a little water is left at the bottom of the mug.
  • Before removing the tip, a clamp is applied to the tube.
  • The tip is removed with a slight rotational movement in the reverse order (from the tailbone to the navel).
  • The patient needs to retain water for ten minutes. To do this, he lies on his back and breathes deeply.
  • After the procedure, the used tips are soaked in a special solution.

Is it possible to carry out these manipulations at home? Yes, but you need to remember one thing. A cleansing enema should be performed in a hospital or at home after consultation with a doctor. The technique for executing the algorithm is as follows:

First, you need to ask the patient whether he has stool after a cleansing enema. If the patient is in a hospital and is on bed rest, a cleansing enema is given in the room, behind a screen. After water has been introduced into the intestines, a bedpan is placed under the patient. When the intestines have completely emptied, the patient is washed. If it is difficult for the patient to turn on his side, then the enema is given when he lies on his back with his knees bent and legs apart. A basin is placed on the edge of the couch in case the patient cannot retain water. If a medical professional discovers a hemorrhoidal node when inserting the tip, then the tip must be carefully inserted so as not to injure the nodes.

Tips for first timers

There are many people who suffer from a fear of enema procedures, considering them dangerous and painful. The danger of an enema lies in its frequent use. It is recommended to use forced bowel cleansing no more than once every 3 days and no longer than 3 weeks. The restriction is set because nutrients, minerals, and beneficial bacteria are washed out.

When studying the question of whether it is painful or not, it should be said that if recommendations, instructions are followed and there are no contraindications, the manipulation is considered painless. To ensure a smooth insertion of the tip with the tube, lubricate the tip and anus with Vaseline or other fat.

How is the patient prepared for surgery?

Most often, the patient is necessarily admitted to the hospital to undergo preparatory procedures, including cleansing the rectum. Many people wonder why they do an enema before the operation, but the answer is very simple, because it is the complete cleansing of the intestines that makes it possible to facilitate the process. surgical procedures.

A laxative can also be used as a cleansing drug, but today there are quite a lot of them, so it is worth describing several of the most popular laxatives that have a positive effect on the functioning of the intestines and help start the bowel movement process.

Quite well-known means for cleansing the intestines are Duphalac, Fortrans, Bisacodyl and Lavacol; in addition, folk ingredients that have a remarkable laxative effect can be used, for example, it can be castor oil or tincture of senna herb.

https://youtube.com/watch?v=iOPa9pePrQk

Contraindications

Despite the indicated safety of enema procedures, contraindications should be taken into account.

Flushing the intestinal tract allows you to remove dirt, waste, and toxins from the canals. With frequent washing, beneficial microorganisms are also removed along with harmful substances, and the local microflora is completely washed out. Mineral components also leave: for example, calcium. As a result of calcium leaving the body, arrhythmia and other difficulties with the cardiac system develop.

In what cases will an enema cause negative reactions:

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  • The presence of purulent diseases inside.
  • Ulcers, fissures, neoplasms in the anus and large intestine.
  • Development of purulent infection inside. It occurs when the integrity of the intestine, in particular the appendix, is compromised, and the contents, along with pus, reach the surface of other organs.
  • Inflammation of the appendix of the cecum - appendicitis.
  • Internal bleeding that opens in the stomach or intestinal tract.
  • Hemorrhoids provoke bleeding.
  • Frequent prolapse of the intestine into the anus.

An enema before surgery provides preliminary removal of intestinal contents. A simple procedure helps prevent complications and makes the surgeon’s work easier. Cleansing is necessary during interventions on the abdominal organs: the gastrointestinal tract, urological and gynecological operations, and the use of laparoscopy techniques.

Artificial stool retention helps eliminate complications of the early postoperative period for any disease, relieves the patient from straining, and ensures wound healing. In hospitals, nursing staff are responsible for the correct implementation of instructions for preparing for surgery.

Therapeutic enema

Therapeutic enema makes it possible to act directly on the intestinal mucosa if it is impossible to take medications orally. The main condition for its successful implementation is the preliminary elimination of feces using cleansing manipulation.

The volume of a medicinal enema, as a rule, does not exceed 50-100 ml. It is desirable that the liquid temperature is about +40…+42ºС. This will ensure good absorption of medicinal substances into the intestinal mucosa. Microclysters are performed using a special canister or Janet syringe with the patient lying on his side with his knees bent. The tip should be lubricated with Vaseline, spread the buttocks and insert it into the rectum to a depth of 10-12 cm. The contents of the enema should be squeezed out slowly so that the liquid has time to be absorbed and does not lead to a reflex contraction of the intestines.

The medicinal composition determines the therapeutic effect of microenemas and can be resorptive or local.

Microenemas are usually used for local effect. Solutions based on medicinal herbs and oil extracts have an anti-inflammatory effect on the intestinal mucosa, relieve pain, relieve itching and burning.

Using microenemas, you can administer not only herbal remedies, but also medications: painkillers, narcotics, sedatives. This feature is sometimes used before surgical interventions.

There is no need to worry or worry before performing an enema. If all staging rules are followed, the procedure will be quick and painless.

An enema before surgery provides preliminary removal of intestinal contents. A simple procedure helps prevent complications and makes the surgeon’s work easier. Cleansing is necessary during interventions on the abdominal organs: the gastrointestinal tract, urological and gynecological operations, and the use of laparoscopy techniques.

Artificial stool retention helps eliminate complications of the early postoperative period for any disease, relieves the patient from straining, and ensures wound healing. In hospitals, nursing staff are responsible for the correct implementation of instructions for preparing for surgery.

Why is an enema done before surgery?

The intestines of an adult with a normal diet contain up to 8 kg of feces. They contain waste secretions, bacteria, and toxins. Normal digestion is accompanied by gas formation, swelling and collapse of intestinal loops, contraction of the muscle layer in the form of waves of peristalsis. Even at rest, the intestines form wave-like movements. A patient with constipation may experience fecal blockages, sudden dilatation, and swelling of the loops of the small and large intestines.

Let us imagine the position of the operating surgeon when opening the abdominal cavity. The doctor tries to minimize the incision and choose the best access to the intended intervention site. When the intestines are clogged, immediately after opening the peritoneum, a nearby swollen loop crawls out into the wound on its own. It is difficult to put it back, the rest of the intestine makes it difficult to find the pathology and assess the severity of the lesion.

  • The risk of traumatic damage to the mesentery, blood vessels, disruption of the integrity of the intestinal wall, and nerve fibers increases sharply.
  • With the laparoscopic approach, the view of the operating area is reduced.
  • The constant threat of feces entering the abdominal cavity and severe peritonitis requires preliminary maximum cleaning of the intestines and removal of gases.

If the patient is to be operated on under general anesthesia, this means not only pain relief, but also complete muscle relaxation. To limit the entrance “gate” of infection through an open wound, complete atony is required. But the loss of contractility of the anal sphincters causes arbitrary leakage of urine and feces and violates the sterility of materials and linen. Due to the same relaxation of the esophagus, stomach contents can enter the airway, so anesthesiologists insert a suction tube.

Why an enema is needed in a trauma department becomes clear when considering the technical features. Surgical interventions on bones make it difficult to maintain high tone in muscle groups that hold a limb or joint in an incorrect position. The problem of relaxation is also fraught with the release of feces. An enema is necessary for emergency and planned operations.

Before birth, when contractions begin, the baby's path should be free of infection. But pushing is accompanied by defecation. Therefore, midwives first give a cleansing enema to women sent to the delivery room.

Important! During gynecological operations (including abortion), the doctor needs a palpable feeling of the density of the uterus. Intestinal fecal stones and spasmed muscles do not provide opportunities and interfere with forced diagnosis.

For 2-3 days after the operation (sometimes more), complete rest and artificial absence of bowel movements, provided by an enema, are required. Meals are reduced, only liquid meals are allowed. Pre-cleaning helps prevent post-operative complications. To combat constipation, stimulation is used on the fifth day if stool does not appear on its own. By this time, the wound begins to heal, and the danger of sutures coming apart from straining disappears.

Is an enema required before childbirth?

Quite recently, upon admission to the maternity hospital, a woman in labor was required to have an enema.

There was an opinion that an empty intestine reduced the risk of contamination during pushing and removed unnecessary support for the baby's head, which, passing through the pelvis, also encountered a mass of hard feces.

The embarrassing moment for all women was also excluded when, during pushing, they released feces.

Today, with the availability of a mass of disposable napkins of varying quality, it is noted that there is no need to be afraid of blocking the birth canal when a woman in labor has had spontaneous bowel movements in the last 24 hours.

During an internal examination of a woman in labor, the gynecologist does not feel the presence of hard feces.

If bowel movement occurs during childbirth, then disposable sterile pads are immediately thrown away along with the feces, and fresh pads protect the newborn from infection.

Doctors are confident that the risk of infection is much higher when performing an enema.

Types of enemas to prepare for surgery

Most often, cleansing enemas are required in preparation for surgery. They allow you to remove feces and gases from the large intestine. Usually boiled water at room temperature and an Esmarch mug are used. Volume for an adult - 2 liters, for a child - 0.5 (babies under one year old from 50 to 150 ml).

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Siphon procedure is a type of purification using a funnel, high-level oscillation and reduction of liquid introduced under pressure with passive release of the contents. Washing is done until clean effluent water is obtained.

Less commonly, for depleted and weakened patients in cases of repeated surgery, therapeutic and nutritional enemas are required. Administration of drugs through the rectum is used under conditions of inability to swallow or damage to the upper parts of the digestive tract. In order to improve absorption through the intestinal wall, a cleansing enema must first be given. The volume is 50–100 ml, the temperature is slightly above the body (40–42 degrees). Rubber syringes, ready-made microenemas, a catheter and Zhanne syringes are used. The method is used for administering local anesthetic drugs before short operations and painful dressings.

Important! Nutrient enemas are given by drip solutions with protein and fat mixtures, ready-made preparations for parenteral infusion. Concentrated glucose provides a weakened patient with energy, proteins help speed up healing in the postoperative period.

Features of nutrition and drinking regime

Another feature of the preparatory stage before fibrocolonoscopy is adherence to a slag-free diet (how fibrocolonoscopy differs from colonoscopy, read more here). This diet is prescribed 3-4 days before the procedure.

https://www.youtube.com/watch?v=StgFOqs6P84

A slag-free diet before colonoscopy allows you to soften stool, eliminate constipation and fecal retention in the intestinal tract.

Prohibited foods on a slag-free diet are:

  • fresh fruits and vegetables;
  • rice, legumes;
  • fresh berries;
  • confectionery and flour products;
  • any greens;
  • smoked meats, pickles, hot and spices.

During therapeutic nutrition, any low-fat fermented milk products, vegetable broths and unsaturated meat soups are considered preferable.

Recommended drinks include jelly (they satisfy hunger), unsweetened dried fruit compotes, green tea, and clean water. Coffee, complex cocktails, and berry fruit drinks should be avoided.

For desserts, any jellies are suitable. Bread can be replaced with crackers, biscuits or crackers.

If we compare an enema with a medicated cleansing, then drugs for preparing the intestines for colonoscopy are more popular. Enema cleansing is suitable for almost all patients, but it is rarely possible to carry out a high-quality procedure on your own.

How is an enema done before surgery, and how to prepare for it?

To successfully cleanse the intestines before a planned operation, it is recommended to follow a diet for a week. With the help of a balanced diet, it is necessary to prevent increased gas formation, fermentation, and stagnation of feces. The following products should be avoided:

  • fried, fatty and smoked foods;
  • pickles and marinades;
  • lard, fatty cottage cheese, sour cream;
  • confectionery;
  • alcohol, carbonated drinks;
  • fast food;
  • fresh vegetables and fruits, juices.

These products negatively affect the consequences of the operation:

  • digest slowly;
  • require the absorption of a significant amount of energy;
  • promote increased gas formation.
  • low-fat fermented milk products (cottage cheese, kefir, yogurt);
  • meat and fish non-rich soups;
  • boiled meat, steam cutlets;
  • porridge;
  • stewed vegetables and fruits.

Important! Hospitals allocate treatment rooms for preoperative hygiene in their structure. The patient comes into it, or he is brought on a gurney if independent movement is impossible. An experienced nurse performs the procedure. If necessary, a nurse helps her.

For a cleansing enema, boiled water is prepared, an Esmarch mug is prepared, and the tips are sterilized. The manipulation algorithm requires sequential actions:

  • the patient lies on a couch covered with oilcloth on his left side, it is better for him to bend his right leg at the knee;
  • the mug hose is closed with a tap or clamp;
  • pour 2 liters of water at a temperature of about 30 degrees;
  • hang the container on a tripod or the nurse supports it with her hands;
  • open the tap slightly and release air until water appears;
  • the tip is lubricated with Vaseline;
  • the patient is asked to lift the upper buttock and slowly insert the tip into the anus 7-10 cm;
  • Raise the mug to arm's length and open the tap.

The liquid gradually enters and fills the intestines. By squeezing the rubber hose, you can regulate the speed of water flow. After the container is empty, the tap is turned off and the tip is removed from the anus. The patient is recommended to turn over on his right side, back, be patient and hold the water for up to 10 minutes. Then defecation occurs.

For enhanced cleaning during intestinal surgery, a siphon enema is prescribed. It differs from the usual one by using a funnel and a hose. The tip is inserted to a depth of 20 cm. The volume of liquid is initially 2 liters. When the bottom of the funnel remains low, it is lowered into the basin to drain the intestinal contents through the tube. Then pour the liquid again and repeat the steps several times until clean water comes out. After an effective siphon, the patient needs to rest for 1.5-2 hours.

The preparation scheme includes 2 stages of cleansing:

  • the first enema should be done the evening before the operation (12-16 hours before);
  • the second - at 6 am on the day of intervention.

Not as scary as it seems.

I want to share my experience about this operation.

At the moment I am in the hospital, a day after the operation.

Diagnosis: 1st degree infertility, polycystic disease of both ovaries. (pregnancy does not occur for 4 years, menstruation is only with the help of hormones), insulin is increased, while taking the pills, chronic hepatosis, uterine infantilism.

What tablets I take: duphoston 10 mg/2 times a day, 1/4 metipred, glucophage 1000 twice a day.

I’ll start with where I had the operation, the operation was carried out in the Kamchatka Regional Hospital, in the gynecological department, the doctor was good). The operation is free.

What to take with you to the hospital:

  • towel
  • razor (or shave smooth at home)
  • toothpaste, brush, soap
  • several rolls of toilet paper
  • the pills you are taking
  • 1.5 liters of non-carbonated water
  • nightie (no need for pants, it’s not comfortable on the stomach with seams)
  • robe
  • pads (3 drops, after surgery)
  • fruits, baby puree, non-sweet compote is possible
  • phone, charger
  • all tests, directions, fresh ultrasound.
  • policy, passport, SNILS
  • slippers
  • bags for outerwear and street shoes
  • spoon, mug
  • comb

That's what I needed, the rest is up to you.

On 06/22/16 I was admitted to the hospital, went into the department, the gynecologist asked me what I was sick with as a child, what was bothering me (at that moment my right side was bothering me), then she sat me on a chair, checked me, felt me, and sent me away. referral to the hospital queue. Then I came back to her, signed the papers with the nurse, and went to my room. My blood was taken that day. Then I was invited to an enema, I’ll tell you in more detail so that no one would be afraid, otherwise they are often more afraid of an enema than an operation.

you go into the bathroom, there is a couch, there is a toilet just behind the wall, the nurse tells you to lie on your left side, with your head to the wall, takes something like a dropper out of the bag, and inserts it into the anus (without pain), then water is poured into you in the intestines, grumbling, seething, it seems to you that you are ready to go to the toilet, but no, after that the nurse says you need to walk for another 2 minutes, but if you can’t bear it, then go with a calm soul, you need to take with you:

towel (for drying)

soap (to wash after)

toilet paper (to cover the toilet)

Phone or magazine (while you’re sitting, so you don’t get bored)

that's all, the enema is not scary and does not hurt.

The enema was given at 17:00. Until 17:00 I just lay on the bed and waited for the anesthesiologist, after the enema, 30 minutes later he came. He also asked me about illnesses, asked me to open my mouth and move my lower jaw forward. He said that before bed he would give me the tranquilizer phenazepam, and in the morning before the operation. And he told me what general anesthesia is.

About tomorrow, lunch, dinner.

You can safely eat at lunch before the enema, but after lunch you can no longer eat, only drink water.

In the morning, they also do an enema; before the operation, you can’t drink or eat; if you give a pill, then either put it under your tongue or swallow it without water.

Here comes day X 06/23/2016 at 9:00 am I was already sitting on the crib, in my compression stockings, in a robe (without panties, and a nightie), I also need to remove all the metal and lenses.

They put me on a gurney, took off all my clothes, gave me a cap to remove my hair, and covered me with a sheet, wheeled me into the operating room, the anastasiologist complimented me and said that I looked good :))) they put me on a table with gynecological footrests. They put a thing on my right hand to measure pressure, a bag on top, and a rag on top of the bag, they also put two covers on my legs, they inserted an IV into my left hand, and they put something like a clothespin on my finger, and they started injecting anesthesia, I don’t remember anything else. .

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At 12 o'clock they were already taking me to the ward, I remember that I had not yet recovered much from the anesthesia and was sobbing, they transferred me to my bed, I cried for another 10 minutes, for an unknown reason. The entire lower abdomen, ovaries, and uterus ached. A tube with drainage was sticking out of the right side (drainage is a bag for draining pus and other unnecessary things from a wound).

After that, I slept until 20:00, woke up to drink and write SMS. The first trip to the toilet was up to the wall, but when I went back, my head began to spin very badly. But I reached the ward.

In the evening they gave me a fluconazole tablet and injected me with painkillers. Slept poorly, woke up to neighbors snoring

It is now June 24, 2016, and I feel good. In the morning they took the temperature, gave me a painkilling injection, and allowed me to wash myself. Now my lower abdomen is feeling a little tight, I'll have to bandage it soon.

I have been working towards this for a long time, I hope this will help, and my husband and I will be happy parents. Thank you all, write comments, I will answer everyone :)

Contraindications to the procedure

Enemas are not given if the proposed operation does not exclude or is performed for:

  • gastrointestinal bleeding;
  • internal purulent complications;
  • exacerbation of ulcerative and inflammatory diseases of the stomach or intestines;
  • suspicion of the disintegration of a malignant tumor;
  • cracks and prolapse of the rectum;
  • intestinal rupture;
  • thromboembolism of mesenteric vessels;
  • repeated surgical intervention (for the first - in the last 5 days).

Important! The question of postponing the operation and enema to a later date is decided at elevated temperatures, menstruation in women, against the background of the patient developing general weakness of unknown origin.

Other methods of bowel cleansing before surgery

To cleanse the large and small intestines before a planned operation, the doctor prescribes effective laxatives instead of enemas. They are recommended to be taken at home before hospitalization.

  1. Rectal suppositories - with bisacodyl, glycerin. They, irritating the nerve endings of the rectal canal, stimulate peristalsis. Stool appears after 30-60 minutes. Bisacodyl is less damaging to the mucous membrane. Recommended once a day.
  2. Microlax - administered as a microenema several hours before surgery.
  3. Tablet drugs (Senade, Bisacodyl) are prescribed 2 tablets per day for regular bowel movements.
  4. Powders with macrogol (Relaxan, Tranzipeg) - retain water, increase volume and soften stool, prescribed in the morning and evening before surgery. A good effect is produced by drinking a solution of magnesia (10-30 g).
  5. Duphalac - a product with lactulose, has an advantage over others - it does not disturb the intestinal bacterial flora.

It is impossible to cleanse the intestines before surgery without the advice of a doctor. The presence of pathology and certain indications for intervention suggest features for a particular case. Unreasonable enema can cause harm.

An enema before surgery is often necessary. But why do doctors prescribe such an unpleasant and frightening procedure for many people? Before any planned operation, the patient must be prepared. The preparation includes many different activities. Artificial bowel cleansing is necessary to ensure that no complications arise during and after surgery.

During anesthesia, all the patient's muscles relax. Relaxation of the sphincter can lead to involuntary bowel movements. In addition to impaired muscle function, full intestinal loops also make the surgeon's job more difficult. Especially when the operation is performed in the intestinal region or stomach.

Therefore, patients should not eat before surgery. Anesthesia causes vomiting in some people. Food masses entering the respiratory tract can cause suffocation or other complications. But this does not mean that patients should fast before surgery. Strict restrictions on food weaken the body as a whole, which negatively affects subsequent rehabilitation.

Colon cleansing before hemorrhoid surgery

Preparation for hemorrhoid surgery begins in advance and is carried out strictly on the recommendation of a coloproctologist. The quality of the preoperative stage affects the outcome of treatment and the possibility of complications. The necessary measures include a medical examination, a special diet before surgery to remove hemorrhoids, bowel cleansing, and, if necessary, medications are prescribed. The doctor who will carry out the treatment will explain how to prepare correctly and for how long it takes to treat hemorrhoids. This largely depends on the severity of the lumps and the method of surgical intervention: for example, laser and surgery require different intensity of preparatory measures.

Before removing hemorrhoids, the patient must be examined. This is especially true for people who have chronic diseases. During the period of their exacerbation, no surgical interventions are performed. If any pathology is detected in the active phase, it is necessary to carry out a course of treatment so that the disease goes into stable remission.

It is important to exclude sluggish infectious processes and normalize cardiac and respiratory activity.

A week before surgery, bowel cleansing is required. For this purpose, a special diet, enemas, and laxatives are used. The doctor will tell you about this in detail at your appointment, and will also recommend the necessary medications for existing intestinal dysfunction.

7 days before surgery, you must begin to strictly adhere to your diet. On the eve of surgery it is recommended:

  • last meal – 12 hours before surgery;
  • before visiting the doctor, take a shower or bath, put on clean underwear;
  • carry out cleansing enemas, following the recommendations, and, if necessary, take laxatives.

It is important to stop taking anticoagulants, antiplatelet agents, and NSAIDs a few days before surgery. For a positive psychological attitude, it is better not to read negative reviews from patients, but to trust the doctor.

Preliminary examination before surgery should begin with a visit to the therapist. After the examination, the doctor will decide whether to conduct additional examinations, in addition to the mandatory ones, which are carried out before any surgical treatment. If necessary, consultations with narrow specialists will be scheduled.

Goals of the preparatory stage:

  • identify contraindications to surgery;
  • prepare the intestines for surgical procedures and the body for anesthesia;
  • to prevent infectious complications and bleeding that may occur in the postoperative period.

Before surgery, it is necessary to do laboratory blood tests:

  • general clinical;
  • biochemical;
  • coagulogram;
  • sugar;
  • group and Rh factor;
  • markers of viral hepatitis;
  • for syphilis and HIV.

A general urine test is given.

Functional examinations required:

  • ECG;
  • radiography of the OGK or FLG;
  • Ultrasound of the abdominal organs.

Separately, as prescribed by the proctologist, an intestinal examination is carried out to clarify the stage of hemorrhoids and the severity of the disease. After digital examination and anoscopy, the proctologist prescribes one or more functional studies, including endoscopic and x-ray studies. The most informative are:

Each technique has disadvantages and advantages. If there is no suspicion of a tumor or total damage to the intestinal wall, sigmoidoscopy is usually performed. The reason for irrigoscopy is damage to the intestinal wall, identified neoplasms, and diverticula.

In recent years, more gentle cleansing methods than the use of enemas have been used to prepare for surgical treatment. For this purpose, drugs based on macrogol are successfully used. This is a polymer that retains the solution in the intestinal lumen. It activates peristalsis and promotes rapid evacuation of feces.

Medicines are taken according to a special regimen. Thanks to such drugs, the intestines are cleared of feces gently and quickly.

Medication preparation for surgery to remove hemorrhoids includes:

  • sorbents that bind and remove waste;
  • laxatives on the eve of the prescribed day of treatment.

If the patient suffers from chronic constipation, laxatives or enemas are taken to cleanse the intestines.

Of the laxative medications, it is preferable to use:

Fortrans is the most effective drug currently available. It is easy to use. Prescribed more often than other known drugs. Available in dosed powders, it significantly increases peristalsis, normalizes evacuation, and prevents the removal of electrolytes.

The required amount of the drug is taken in portions at the rate of: 1 packet - per 15 kg of person’s weight. If the patient's weight is 70 kg, the required number of sachets is 5 (rounded up). The contents of 1 package are diluted in 1 liter of clean water, the solution is drunk in small sips of 1 glass over 1 hour.

After taking the medicine, nausea appears and vomiting is possible due to the unpleasant taste. To reduce discomfort, it is recommended to take a slice of lemon.

Defecation occurs an hour after taking the first dose of medicine. Bowel movement continues for 3 hours.

Most of the drug is drunk in the evening before the test (4 glasses over 4 hours). The remaining packet is diluted on the morning of the operation, the solution is taken 4 hours before the operation.

Fortrans cannot be used without a doctor's prescription, since there are serious contraindications to its use:

  • intestinal obstruction;
  • Crohn's disease;
  • pregnancy and lactation;
  • pain of different localization in the abdomen;
  • dehydration.

Active cleansing of feces after taking Fortrans leads to the development of dysbacteriosis. This is due to the simultaneous removal of beneficial microorganisms. Therefore, subsequently you need to take a course of probiotics. In addition to dysbacteriosis, urticaria, swelling, and heaviness in the abdomen may appear.

Duphalac is a highly effective lactulose-based medicine. Due to safety, it is prescribed for pregnant and lactating women. If necessary, it can also be used by newborns. Patients find it more comfortable and prefer it because of its pleasant taste. It has fewer contraindications. The drug is available in the form of syrup, so it tastes very sweet and is contraindicated in diabetes mellitus. It is a probiotic because it promotes the growth of beneficial bacteria.

It is recommended to start using this medication 4 days before surgery. You need to drink 45 ml in the morning at the same time. At the same time, you must adhere to a slag-free diet all days and drink up to 2 liters of pure water without gas per day, unless there are contraindications from the heart and kidneys. On the eve of the appointed date, according to the instructions, 200 ml of Duphalac is diluted in 2 liters of water. The prepared solution is consumed within 3 hours in small portions. In between, you can drink tea, juice without pulp, low-fat broth. Stool appears within 60 minutes, defecation lasts 3 hours. A positive result is the release of clear water from the intestines.

In addition to diabetes mellitus, the drug is contraindicated in cases of lactulose intolerance and hepatic encephalopathy.

Microlax is available in the form of an enema and is easy to use. It is rarely used as an independent remedy for bowel cleansing before surgery. Used as an aid to improve the quality of cleaning. The medicine has no contraindications and acts very quickly: the effect is observed after 15 minutes. Side effects are extremely rare: abdominal discomfort, allergic rashes, and a burning sensation in the anus may occur.

The choice of drug is made by the doctor based on the general well-being of the patient and the existing concomitant pathology.

In addition to laxatives, medications are prescribed that reduce flatulence:

  • activated carbon in adequate dosage;
  • Espumisan.

Espumisan belongs to the group of antifoam agents. Used to reduce bloating in any pathological condition. The main active ingredient is simethicone. It is not absorbed into the systemic circulation and is excreted unchanged in the feces. The drug prevents the formation of gas bubbles in the mucus, destroys newly formed ones, and thereby promotes the removal of gas to the outside or its entry into the blood. Used during meals or immediately after meals, 2 capsules 3-5 times a day. The doctor may increase the dosage.

Activated carbon is an adsorbent with high surface activity. Reduces gas formation well. Dosage - 250 mg, an adult needs to take 4 tablets 4 times a day, maximum dosage - 8 g.

In order for the surgical intervention to proceed without complications, it is necessary to first prepare the intestines and free them from feces.

In the absence of contraindications, high cleansing enemas are performed the night before and on the day of the study. For these purposes, it is better to use Esmarch's mug. It is convenient for independent use, its volume allows you to prepare the intestines for surgery both with existing diarrhea (0.5 liters of water is required) and with constipation (1.5 liters of water).

Warm boiled or purified water is poured into it. The procedure is repeated 2-3 times. The interval between cleansing is 5-10 minutes. If even after the third procedure it is not possible to achieve the release of clean water from the intestines, another 1 or 2 enemas are performed. You should try to keep the injected water in the intestinal lumen for at least 10 minutes, which is the negative side of the therapeutic manipulation - not everyone can withstand it.

Contraindications are the presence of cracks and other damage to the mucous membrane. In this case, the doctor selects laxatives.

Any operation, and especially on the intestines, is stressful for the body. When preparing, it is necessary to exclude additional irritation factors so as not to provoke constipation or diarrhea. Particular attention is paid to nutrition before surgery. The condition of the digestive tract largely depends on it. Intestinal dysfunction complicates the course of the disease and worsens the condition of varicose nodes. Appointed:

  • slag-free diet - low-calorie foods that reduce the formation of feces;
  • with the exception of coarse plant fiber to prevent flatulence and treat dysfunction in the form of constipation or diarrhea.

Products that irritate the mucous membranes, lead to stool problems, flatulence and aggravate hemorrhoids are prohibited.

The following dishes and foods can cause constipation:

  • rich fatty broths;
  • dishes made from semolina and rice;
  • pasta;
  • slimy soups and jelly;
  • strong tea.

The following have an irritating effect on the intestinal mucosa:

  • raw vegetables;
  • spicy, fatty, fried;
  • pork, lamb, duck meat;
  • sweets.
  • fruits (apples, bananas);
  • berries (raspberries, gooseberries);
  • grapes and raisins;
  • parsley;
  • soft white bread, pastries.

Frequent and fractional meals are used - food should be taken 5-6 times a day in small portions, and up to 2 liters of clean water should be drunk daily.

The first preparatory stage before intestinal surgery is a strict slag-free diet, eating by the hour. Restrictions on certain foods are necessary for all patients. This does not depend on concomitant diseases, frequency or consistency of stool.

Dietary nutrition is introduced a week before surgery. Products that enhance:

  • gas formation and fermentation;
  • formation of a large amount of feces.
  • lard, sausages, fried meat;
  • legumes;
  • porridge (buckwheat, pearl barley, millet);
  • milk, hard cheeses;
  • unprocessed vegetables;
  • fruits with seeds, berries;
  • sweet yeast products, black bread;
  • greenery;
  • spices, salt;
  • alcohol-containing and sweet carbonated drinks.

Food should be low-fat and light. Allowed:

  • unrich broths;
  • dairy products;
  • boiled or baked potatoes;
  • homemade juices without pulp;
  • biscuits.

All dishes are prepared liquid, without large pieces, transparent. Sugar, honey and butter are limited or completely eliminated.

Since any surgery requires a clean bowel, you should limit your diet a week before surgery. To do this, exclude harmful foods, alcohol, carbonated drinks, spicy, fatty, fried foods. During these days, fermented milk products are useful and will improve digestion.

At the preparatory stage, the passage of feces is facilitated: the amount of food is sharply limited, and its consistency changes. It becomes liquid or mushy. These days, if the patient suffers from chronic constipation, you can use cleansing enemas. For internal hemorrhoids, the use of an enema is not suitable for everyone. In this case, it is recommended to take a laxative. This will help get rid of feces and prevent toxins from being absorbed from them.

For a person who sharply limits the food load, without prior gradual preparation and cleansing of the intestines, the body will perceive the refusal of habitual food as a hunger strike. Therefore, compensatory and protective mechanisms will begin to turn on.

If a person gradually limits certain foods and their quantities in his diet, he will not develop psychological problems. Fasting therapy for hemorrhoids leads to faster healing of cracks, if any, and a reduction in hemorrhoidal cones. Energy is not spent on processing food, but goes towards healing the pathological process.

If the patient begins to fast without preparation, there remains a high probability of failure. The patient will begin to eat any food, including those harmful to the intestines. The body will not be able to cope with the heavy load after several days of not eating, which can be fatal.

Therefore, you need to come out of fasting gradually. It is necessary to do this gradually, to prepare for expanding the menu. If severe weakness, fatigue, or a sharp deterioration in general condition occurs, you must immediately stop the fasting process. In this case, there will be no effect from this treatment, or complications will occur.

There are contraindications to fasting:

  • diabetes;
  • cardiac dysfunction;
  • severe renal and liver failure;
  • infections;
  • hypothermia;
  • malignant tumors.

In the process of restricting nutrition, it is necessary to cleanse the intestines with the help of laxatives or enemas, since intestinal motility sharply decreases with a small intake of food, stagnation occurs, toxins are absorbed, and constipation worsens.

After the operation, complete fasting is also prescribed for 24 hours to avoid the formation of feces. You are allowed to drink water in small quantities. In the future, the diet expands.

When creating a menu for a week or longer, tables of prohibited and permitted foods for hemorrhoids are used. The basis is diet No. 4 according to Pevzner. Caloric intake is calculated - 240 kcal/day.

You can use the following sample menu before surgery as a basis.

  1. Brynza. Weak unsweetened tea.
  2. Kefir. Yesterday's bread.
  3. Soup with vegetables. Boiled chicken. Cucumber. Decoction of dried fruits.
  4. Cheese casserole. Ryazhenka.
  5. Kiwi.
  1. 2 egg omelette. Soft cheese. Drink made from chicory.
  2. Low-fat cottage cheese with sugar. Baked apple.
  3. Fish soup. Steamed meatballs. Beet salad. Compote of dried apricots.
  4. Kefir. Stewed cabbage with carrots.
  5. Steam cutlet, wheat porridge, weakly brewed tea.
  1. Millet porridge cooked in water. Bread and butter. Coffee without milk.
  2. The vinaigrette.
  3. Borscht with beef broth. Salad. Juice without pulp.
  4. Biscuits. Dried fruits compote.
  5. Boiled liver. Vegetable stew. Tea.
  6. Prunes soaked in boiling water.

Before the operation, the patient must be examined to clarify the stage of the disease, identify contraindications, and select a specific method of surgical treatment. Therefore, some diagnostic studies, at the discretion of the doctor, are carried out in a clinic. They are part of the preparation for the operation.

At the preparation stage, the following is carried out on an outpatient basis in a polyclinic setting:

Complaints, anamnesis, and results of preliminary laboratory tests are preliminarily studied. An external examination reveals inflammation, cracks, erosions, and ulcers. External cones are examined, their size and condition are assessed.

To identify pathological discharge, relief and thickening of the walls, tone of the anal sphincter, pain, a rectal-manual examination is performed. The presence of internal nodes and their size can be determined in this way only when they have reached large sizes and protrude into the lumen of the rectum. In other cases, upon palpation, the nodes contract, “go” into the intestinal wall, and it is not possible to accurately understand their size. This study makes it possible to detect large tumors.

Digital examination allows palpation to detect changes in the prostate gland in men and the uterus in women due to their anatomical location. The manipulation is carried out with the index finger. The doctor uses medical gloves and Vaseline. The patient is in a knee-elbow position or on his side with his legs pulled up to his stomach.

Anoscopy is the simplest endoscopic examination of the rectum. It is carried out on an outpatient basis, at the first visit to the proctologist, after a digital examination. It is carried out using a special optical device with a 1 cm tube and backlight. It is necessary to determine any changes in the mucosa and neoplasms in the intestines, including hemorrhoids, diverticula, polyps and other neoplasms. Using the device, you can take biopsy material.

During sigmoidoscopy, a more in-depth study is carried out: the instrument tube is inserted to a depth of up to 25 cm, and not only the rectum, but also the sigmoid colon is examined. This method involves removal, coagulation, tissue sampling for biopsy, and locally administered medications.

The preparation plan for the operation includes a conversation with the anesthesiologist. The doctor finds out the allergy history, what medications the patient is constantly taking, and tests are carried out if necessary. Based on the results and taking into account the chosen operation, the anesthesiologist decides under what anesthesia the operation will be performed.

Before the operation, dentures and jewelry are removed.

Surgery is an effective treatment for hemorrhoids. In many cases, it allows you to get rid of the disease forever. The result depends on timely consultation with a doctor and proper preparation.

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The average person's intestinal tract contains an average of 3-8 kg of feces. These masses contain various bacteria, waste and all kinds of inclusions.

The entry of fecal particles into various systems of the body outside the intestines is fraught with

development of sepsis and intoxication. Therefore, bowel cleansing before surgery on the gastrointestinal tract is a necessary procedure.

Cleansing of the gastrointestinal tract is required to prevent the development of an infectious process, and for the convenience of the operation itself.

In the clinic, before the operation, the doctor advises the patient about the upcoming procedure and recommends a suitable method for cleaning the intestines from feces.

An enema is one of the simplest and most commonly used methods for removing feces. The procedure can be carried out either independently by the patient at home or by medical personnel in a medical facility.

With the help of an enema, cleansing in the hospital is carried out as follows:

  • In the evening, 12-16 hours before surgery, the first enema is given.
  • 1.5-2 liters of warm boiled water is injected into the lower part of the large intestine.
  • The second procedure is performed in the morning on the day of surgery.

Some patients have a negative attitude towards giving an enema. They can be replaced by a medicine to cleanse the intestines.

Laxative drugs are easy to use and safe for health. Such products are especially in demand for patients who have any pathologies in the rectum and anus: hemorrhoids, polyps, fissures, etc.

Depending on the mechanism of action, there are drugs that stimulate peristalsis, increase the volume of feces and dilute feces.

It is worth considering that the dosage of the medicine should only be determined by a specialist, taking into account the individual health characteristics of the patient and the nature of the upcoming operation.

The drug is produced by the pharmacological industry in the form of a powder for oral use. The product is sold in packages containing 4 sachets with the medicine. One portion of the medication should be dissolved in a liter of warm water.

The active substance of Fortrans does not enter the bloodstream from the stomach and does not affect other systems of the human body. The drug is excreted from the intestines with feces in the same form as it entered the gastrointestinal tract. Fortrans has a powerful laxative effect due to the active substance – macrogol. Once in the digestive tract, it swells and increases the volume of intestinal contents and stimulates peristalsis.

The drug is recommended for use before colonoscopy, irrigoscopy, MRI with the use of a contrast agent and various surgical interventions.

The product helps remove feces from all parts of the colon.

Duphalac is a lactulose-based laxative. Available in the form of a viscous yellowish syrup, ready for use. Duphalac is available in syrup form. To prepare for surgery, it is recommended to use about 100-150 ml of the drug .
In most cases, doctors prescribe Duphalac as an adjuvant in combination with a cleansing enema. The product stimulates peristalsis and softens feces, facilitating their easy removal. Duphalac has a hyperosmotic effect and helps increase the contents of the large intestine.

Solution for oral use with osmotic action. Available in 45 ml bottles.

The product is a saline laxative that increases the content of the intestinal lumen and softens feces. It should be taken for 2 days before surgery, immediately after breakfast.

While using Fleet Phospho-soda, you need to increase the amount of fluid you consume and follow a special diet prescribed by your doctor.

In some cases, removing feces from the rectum alone is not enough. Some operations require complete cleansing of the intestines from feces. In this case, resort to hardware action.

The procedure must be carried out by a specialist with constant monitoring of the patient’s condition.

If such a procedure is necessary, then bowel cleansing is carried out in a sanatorium or clinic.

There are also organizations that provide a similar service at the patient’s home, but it is not recommended to use it.

The fact is that during hardware bowel cleansing, the patient may experience weakness, nausea and general discomfort caused by a decrease in blood pressure.

Therefore, during hardware cleaning, it is necessary to have equipment in the immediate vicinity to provide emergency medical care.

The procedure for cleansing the intestines in a clinical setting is called colon hydrotherapy or colonics:

  • Cleansing is carried out using a special apparatus.
  • A hose is inserted into the patient’s rectum, through which clean water or herbal infusion is supplied in portions to the digestive tract.
  • The device for hydrocolotherapy is designed in such a way that the waste liquid is removed into a special reservoir.
  • The manipulation continues for about 20-40 minutes.

The main advantage of the procedure is that it allows you to remove feces from all parts of the intestinal tract and minimize the risk of infection during surgery.

Clearing the digestive tract and intestines of feces is an important part of preparing for surgery.

The procedure can be carried out using pharmacological drugs, an enema or hardware techniques.

The most appropriate method of cleaning is determined by the doctor, based on the specifics of the upcoming surgical intervention and the individual health characteristics of the patient.

Yulia, Volgograd: “They suggested doing colonics before surgery on the small intestine. I was very doubtful and worried, but it turned out that everything was happening very delicately. The conditions are comfortable, all materials are disposable. The process is unpleasant, but there is no painful sensation. But afterwards you feel clean and light. And the doctor praised me after the operation for having a clean intestine.”

Irma, Perm: “Before the operation, I took a laxative for quick cleansing. It works effectively, and you don’t need to go for an enema in the morning. But the taste is unpleasant, and drinking a whole liter of solution at a time is very difficult.”

Ilya, Ryazan: “I had polyps removed from my intestines. I took Fortrans. Very convenient, no awkward procedures in the enema room. I am glad that the doctor recommended this remedy to me.”

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Preparation for surgery to remove hemorrhoids must be strictly carried out according to the recommendations of the attending proctologist. The quality of the preparatory stage for surgical treatment of hemorrhoidal disease affects not only the effectiveness of the technique, but also significantly reduces the risk of postoperative complications.

We suggest considering what and when radical methods of treating hemorrhoids are used, as well as how to prepare for them.

Surgery to remove hemorrhoids is mainly performed in the later stages of the disease, as well as in case of complications.

Direct indications for radical surgical treatment of hemorrhoids are the following conditions:

  • massive hemorrhoidal bleeding, which can lead to anemia;
  • constant loss of hemorrhoidal cones, which causes chronic inflammation of the tissues of the anus;
  • high risk of anorectal thrombosis and strangulation of hemorrhoidal cones;
  • anorectal thrombosis;
  • third stage of hemorrhoids (with large hemorrhoidal cones);
  • fourth stage of hemorrhoids;
  • combined hemorrhoids;
  • ineffectiveness of conservative treatment methods;
  • ineffectiveness of previously performed minimally invasive surgical techniques.

Massive rectal bleeding causes anemia, which entails a deterioration in the patient’s general condition in the form of general weakness, chronic fatigue, pale skin, and shortness of breath.

The constant presence of prolapsed nodes in the anus poses a danger in terms of the attachment of pathogenic microorganisms, which will lead to purulent complications of hemorrhoids.

Also, with advanced hemorrhoids, caustic mucus is released from the rectal canal, which irritates the skin of the perianal area, which brings a lot of suffering to the patient, since the anus is very itchy.

In addition, hemorrhoids of the third and fourth stages are manifested by severe pain, and ointments, suppositories and tablets no longer bring relief, so patients themselves express a desire to get rid of their problem as quickly as possible.

The importance of preparation also lies in identifying conditions in which surgery cannot be performed, since there are a number of contraindications to this type of treatment.

Hemorrhoid surgery is not performed in the following situations:

  • acute inflammatory processes in the colon;
  • exacerbation of chronic inflammation of the large intestine;
  • malignant neoplasms of any location;
  • decompensated heart failure;
  • decompensated pulmonary failure;
  • decompensated liver failure;
  • decompensated renal failure;
  • acute infectious diseases;
  • violation of the blood clotting system (hemophilia, hemorrhagic diathesis and others);
  • severe somatic condition of the patient;
  • agonal state.

The preparatory stage for hemorrhoidectomy consists of examining the patient to identify contraindications for surgery, preparing the body for anesthesia, preventing bacterial complications and bleeding during the rehabilitation period, and also preparing the large intestine for surgical procedures.

In the preoperative period, patients are required to undergo examinations such as:

  • general blood analysis;
  • general urine analysis;
  • blood chemistry;
  • blood test for glucose content;
  • coagulogram;
  • test to determine blood group and rhesus;
  • test for determining antibodies to HIV and hepatitis;
  • Wasserman reaction;
  • electrocardiography;
  • fluorography;
  • digital rectal examination of the rectum;
  • anoscopy;
  • sigmoidoscopy or colonoscopy for hemorrhoids;
  • ultrasound examination of the abdominal organs;

The above studies allow us to identify concomitant pathologies and contraindications for surgery.

Special attention is paid to nutrition in the preoperative period, since constipation or diarrhea can complicate the operation and also aggravate the course of hemorrhoids.

A few days before surgical treatment, patients are prescribed an easily digestible diet for hemorrhoids. From the patient's daily diet, it is necessary to exclude foods that cause flatulence, constipation or diarrhea, as well as those that irritate the digestive tract and can aggravate hemorrhoids.

List of foods that need to be excluded before hemorrhoid surgery:

  • legumes;
  • rice;
  • semolina;
  • White cabbage;
  • grape;
  • soda;
  • alcohol;
  • black bread;
  • sweets;
  • smoked meats;
  • marinades;
  • pickles.

It is recommended to give preference to liquid soups, cereals, lean meats, poultry and fish, fermented milk products, and white bread. In addition, you need to increase your drinking regime to 1.5-2 liters of water per day.

Preparing the patient the day before and on the day of surgery to remove hemorrhoids includes the following points:

  • the last meal should be no later than 12 hours before surgery;
  • before the operation in the evening, the patient should take a bath or shower and put on clean underwear;
  • On the evening before surgical treatment, a cleansing enema is required for hemorrhoids. You can use drugs such as Normacol, Fortrans or Microlax.

Any type of radical surgery for hemorrhoids is performed under general anesthesia or epidural anesthesia, since the operation can last several hours and local anesthesia will not be enough.

Radical operations for hemorrhoids, or more precisely, to remove them, can be performed in open and closed ways.


One of the methods for removing hemorrhoids has the name of its creator and was developed by Milligan Morgan.

The open method does not involve suturing the postoperative wound, that is, the area of ​​the rectal canal mucosa from which hemorrhoidal cones were removed. With this type of operation, the rectum heals on its own.

Surgery to remove hemorrhoids can be performed using two surgical techniques:

Radical operations in patients with hemorrhoids are necessarily carried out in a surgical hospital and require long-term rehabilitation.

For hemorrhoids, preparation for surgery is the most important stage of surgical treatment, as it allows you to increase the effectiveness of surgery, prevent complications and facilitate the rehabilitation period.

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General idea of ​​enemas

Enema translated from Greek means “washing.” The procedure involves the introduction of liquid through the anus for the purpose of cleansing. But enemas can be used to diagnose or treat certain diseases. Siphon enemas are sometimes used. To carry out these procedures you need an Esmarch mug.

The device is a container resembling a heating pad, 1 - 3 liters in volume with a rubber tube. The container can be made of rubber, silicone, plastic or metal. Regular pharmacies sell Esmarch rubber mugs. Plastic and metal appliances are durable, but more expensive. If you do not plan to use the device often, it is enough to buy a rubber one.

The mug comes with a long hose. This important part is needed in order to attach the container to a high stand while the patient is in a horizontal position. A nozzle is attached to the hose. There may be several different lengths and shapes in the package. Some are intended for vaginal use, others for anal use.

Another part of the device is a small faucet. It is needed to control the flow of fluid. Thanks to this, you can increase the pressure of water or medicine. It is necessary to regulate the flow of liquid after the tip has already been inserted into the anus.

What types of enemas are there?

As noted above, enemas may differ in their purpose. Most often they are produced for:

  • bowel cleansing;
  • diagnostics;
  • treatment of intestinal diseases.

A siphon enema is done when a regular one does not give the expected result. Artificial emptying is done not only before surgery. Women before childbirth or cesarean section also need to cleanse the intestines. During the postoperative period, patients should not push excessively. In addition to pain, this can affect the condition of the stitches. Therefore, patients need to take the enema seriously, without shame or inappropriate jokes about it.

A diagnostic enema is used when it is necessary to examine the intestines. A special medicine is injected into the rectum using a Bobrov device. A contrast agent is administered during an X-ray examination of the intestines. Using this procedure, doctors are able to detect various diseases or examine the condition of the intestines as a whole.

Therapeutic enema is used, for example, in the treatment of staphylococci or other infections. The medicinal liquid is injected into the rectal cavity. Half an hour before, they do a cleansing. A siphon enema can be done before intestinal surgery. It allows you to remove decay products and putrefaction from the body. But the main indication for it is getting rid of toxins and poisons.

Siphon cleansing is a specific procedure. It is carried out only in a hospital by doctors or nursing staff. If the procedure is performed by a nurse, the doctor must be present. Rinsing is done until clean water appears. Carrying out a siphon enema before surgery is an event that is unpleasant for the patient not only physically, but also psychologically. Therefore, the doctor needs to be tactful and discuss all aspects with patients in advance.

Use of hypertensive enema

The presented enema is used in cases where constipation occurs associated with pathologies of the rectum

When talking about how to do an enema at home, pay attention to the following features of the process:

  1. To carry out the procedure, a rubber bulb with a plastic tip is used;
  2. using a pear, a solution of salt or, for example, magnesium is injected into the rectal area, which allows increasing osmotic pressure;
  3. this has a positive effect on the dilution of fecal formations, stimulates the activity of the intestinal wall - all this improves the process of bowel movement;
  4. The effect of such cleansing begins to appear seven minutes after the introduction of the solution.

Despite the significant effectiveness of the presented remedy, this technique of performing a cleansing enema should not be used too often without consulting a gastroenterologist or other specialized specialist.

How to properly cleanse with an enema

The purchased Esmarch mug must be washed before use. Sterilize the parts. The disposable device is sold sterile and must be thrown away after use. Fill the mug with water. Typically, boiled water at room temperature is used for an enema. It is forbidden to use hot or very cold water, as this can damage the intestinal mucosa.

The next step is to hang the mug on a tripod so that the water flows freely down the hose. Attach a previously suitable tip and lubricate it with Vaseline or vegetable oil. You need to run water through a hose to get rid of the air. As soon as the air comes out, turn off the tap. The patient should be placed on a couch and covered with plastic oilcloth. Its free end should be lowered into the basin so that the liquid can drain freely.

Before the procedure, you need to wash your hands thoroughly. The patient lies down on the couch closer to the edge on his left side. Legs must be bent at the knees and pulled towards the stomach. Gently spread the buttocks and insert the tip into the anus. To avoid injury, the tip should be inserted slowly with a rotating motion. After this, the tap can be opened. At first, it is better to keep the water pressure small.

If you feel the urge to defecate, the water supply must be stopped by turning off the tap. To reduce discomfort, you can do circular massage movements of the abdomen. If the tip is clogged with feces and water does not pass through, it is removed. It is necessary to empty Esmarch's mug completely, but a small amount of water should remain at the bottom so that air does not enter the intestines. After this, the tip is removed, and the patient must lie down for 5-10 minutes.

For a cleansing enema, you can use water with apple cider vinegar or freshly squeezed lemon juice. For 2 liters of water, 2 tablespoons of vinegar. Some people add 2 tablespoons of glycerin.

Enema solutions

Various solutions are used for cleansing enemas. The temperature of the liquid should be 22–23 ° C, or 36–38 ° C. The cold solution enhances intestinal motility and is prescribed for atonic constipation. Warm – relaxes, relieves spasms. If it is necessary to cause severe intestinal irritation, it is recommended to use liquid cooled to 12–20 ° C.

  • saline;
  • soda;
  • herbal;
  • oil;
  • emulsion;
  • potassium permanganate.

Even boiled water is used for enemas.

Saline

Hypertensive enemas effectively cleanse the intestines. They help remove a larger volume of fluid, soften stool, stimulate the release of loose stools, and enhance intestinal motility. Apply:

  • 10% sodium chloride solution (10 g of table salt per 100 g of water);
  • 20–30% solution of magnesium sulfate;
  • 20–30% sodium sulfate solution.

The procedure requires 100 ml of solution. It is heated to 37–38 °C. After administering the liquid, it is not recommended to stand up for 20–30 minutes.

It is contraindicated for ulcers, anal fissure, acute inflammation of the lower part of the large intestine, and edema.

Soda

Soda solution is prescribed for increased acidity of stool. It helps relieve pain caused by irritation of the intestinal mucosa with liquid feces during diarrhea. It is believed to be effective in the treatment of helminth infections. Recommended for cleansing the intestines with acetonemia.

To prepare the solution you need:

Sodium bicarbonate is dissolved in warm water. To cleanse the intestines, 1–1.5 liters of liquid are administered. The solution temperature should be 37–38 °C.

Herbal

Herbal infusions are recommended for cleansing enemas. Prescribed:

  1. Melissa infusion. Crushed shoots (3 g) are poured with a glass of boiling water and left for 20–30 minutes. Strain thoroughly. A warm solution (37–38 °C) should be administered. This enema relieves spasms.
  2. A decoction of flaxseed (oats, barley) and mallow leaves. The collection (1 tbsp) is poured into 1 liter of water. Boil for 10 minutes, filter, add 1 tbsp. l. salt, 2 tbsp. l. oil (linseed, hemp). I use this enema as a laxative for chronic constipation.
  3. Chamomile decoction. Chamomile flowers (6 tablespoons) are poured into 0.5 liters of boiling water. Place in a water bath and boil for 15 minutes. Allow the broth to cool, filter, and squeeze out the remaining raw materials. Add boiled water to the resulting broth to a volume of 0.5 liters. Add 2 tbsp. l. honey. This solution not only cleanses the intestines, it is anti-inflammatory and antibacterial.

Decoctions should be prepared in enamel containers. It is better to buy plant raw materials at a pharmacy or collect them yourself (away from railways, roads, and factories). It is strictly not recommended to buy herbs by hand, as they could have grown in contaminated areas and harmful substances have accumulated in them.

Oil

Used to empty the lower part of the colon from feces and gases during spastic constipation, in the postoperative period, after childbirth. This is a long-acting enema. After it you should lie down for at least 8 hours. Therefore, it is better to put it before bed (the act of defecation should occur in 10–12 hours).

The oil has the following effects:

  1. Mechanical. The solution penetrates between the feces and the intestinal walls. The feces soften and are easily excreted.
  2. Chemical. The oil in the intestines is partially broken down and saponified. It relieves spasms and helps restore normal peristalsis.

To prepare the solution, take 100–200 ml of vegetable oil (linseed, hemp, sunflower, corn). It is heated to 36–38 °C.

An oil enema is prescribed for a gentle cleansing of the intestines, when it is undesirable to strain the muscles of the perineum, abdominal wall, or strain. Its contraindications are the same as for all types of enemas.

Emulsion

It is recommended for seriously ill patients. Prepare an emulsion enema as follows:

  1. Prepare 0.5 ml of chamomile infusion. Chamomile flowers (4 tbsp) are brewed in 0.5 liters of water. Strain, squeeze out the remaining residue, add water to a volume of 500 ml.
  2. Take 1 yolk. Beat thoroughly. Add 1 tsp. baking soda.
  3. The yolk is mixed with chamomile decoction. Add 2 tbsp. l. Vaseline oil or glycerin.

When using an emulsion enema, bowel movement occurs within half an hour.

Potassium permanganate solution

For an enema, use a slightly pink solution of potassium permanganate. 4–5 crystals of potassium permanganate are dissolved in 1.5 liters of water heated to 36–38 °C. A more concentrated solution, instead of benefit, will cause irreparable harm (burn of the mucous membrane).

An enema with potassium permanganate is prescribed for treatment:

  • diarrhea;
  • hemorrhoids (if there is no bleeding).

Contraindications to the procedure

Although the cleansing procedure using an enema is considered safe, there are still contraindications to its implementation. Some women get into cleansing to lose weight. But you need to take into account that during cleansing, not only waste and toxins are removed from the body, but also useful substances. It has been observed that women who practice enemas develop arrhythmia due to loss of minerals such as potassium.

Therefore, before you begin cleansing with enemas, you should consult your doctor. Contraindications to an enema are:

  • purulent diseases;
  • the presence of ulcers in the anus and colon;
  • peritonitis;
  • appendicitis;
  • stomach or intestinal bleeding;
  • anal fissures;
  • bleeding of hemorrhoids;
  • rectal prolapse.

It should be remembered that bowel cleansing is possible during planned operations, but in emergency cases, when doctors are forced to operate without delay, bowel cleansing becomes impossible.

Therefore, in the postoperative period, additional recommendations will be given to avoid congestion and constipation.

An enema before surgery is done in the evening and again in the morning. Cleansing the intestines makes the surgeon's job easier during surgery. Therefore, do not refuse the procedure just because of psychological discomfort.

How to do a cleansing enema at home

Perhaps the maternity hospital will accommodate you if you want to do an enema according to all the rules at home at the beginning of labor. However, be sure to consult with your doctor about possible contraindications to an enema. For this you will need Esmarch's mug. It can be purchased at any pharmacy. Before use, it is necessary to carry out its initial processing according to the instructions. If you have an assistant, you can carry out the procedure according to the method given above. But you can cope on your own. You need to think in advance about where and how you will hang the mug in the bathroom when you have to do an enema. The mug should be higher than your pelvis. Before carrying out the procedure, fill the reservoir with warm water (28-30 C) and lubricate the tip with vegetable oil.

Get on all fours in the bathtub (knee-elbow position), leaning on one elbow, and with your other hand slowly and carefully insert the tip into the rectum. After inserting the tip, open the tap, lower your head and shoulders lower, and begin to breathe deeply and frequently

If you feel cramps in your intestines, turn off the tap on the hose and breathe deeply. Then continue the procedure. When the water in the mug is almost empty, remove the tip, hold the diaper between your legs and lie on your back or right side for 10 minutes. Pain and feeling of fullness in the abdomen soothe by stroking

After inserting the tip, open the tap, lower your head and shoulders lower, and begin to breathe deeply and frequently. If you feel cramps in your intestines, turn off the tap on the hose and breathe deeply. Then continue the procedure. When the water in the mug is almost empty, remove the tip, hold the diaper between your legs and lie on your back or right side for 10 minutes. Soothe the pain and feeling of fullness in the abdomen with stroking.

Remember that an enema stimulates labor, so if contractions come more often than once every 10-15 minutes or your previous birth was quick, then it is better not to do a cleansing enema at home before going to the maternity hospital.

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