Colonoscopy is one of the most effective ways to examine the large intestine. The procedure requires advance preparation. Intestinal cleansing before colonoscopy is an important preparatory stage, allowing the specialist to obtain reliable data on the patient's state of health.
Diet for 3 days: what can you eat before a colonoscopy
The most important principle of a slag-free diet is to exclude from the diet foods that cause gas formation, fermentation and lead to the consolidation of stool. The menu should not include fatty meats.
After lunch, only water and sour-milk, necessarily fresh products are allowed in the diet. Meals should be fractional, not overfilling the stomach.
What to eat before the examination of the intestines:
- Lean meat without fat (diet turkey, rabbit, chicken white meat),
- Lean sea and river fish,
- Cereal cereals from rice (better than brown), buckwheat,
- Whole-grain bran bread, sweet biscuits, biscuits,
- Low-fat dairy products (kefir, yogurt, cottage cheese).
You can drink tea without sugar, compotes (useful from dried fruits), fruit drinks, natural juices.
Sample menu for the day
- Breakfast: buckwheat porridge with chicken breast, tea without sugar, biscuits,
- Lunch: natural yoghurt,
- Lunch: lean broth with meat, pasta with fish, compote of dried fruit,
- Snack: juice with a piece of bread
- Dinner: cottage cheese with low fat sour cream,
- Second dinner: kefir
During the day, it is recommended to drink water, drink at least 2 liters of clean water. Boil fish and meat or steam.
What not to eat before colonoscopy
It has long been observed that the most harmful ones are among the most attractive and tasty foods. If it is necessary to prepare for a colonoscopy, it is necessary to abandon the products and dishes that will cause bloating due to abundant gas formation, lead to fermentation in the intestines, constipation, difficulty defecation. These include:
- Bean cultures - soy, peas, haricot, lentil, beans,
- Fatty, smoked, salty meat and its products,
- Strong drinks - tea, coffee,
- Carbonated drinks, including bread kvass,
- Fresh milk, cream, butter,
- Fast food - chips, sticks, snacks, pizza,
- Barley and millet groats,
- Rye flour and bread from it,
- Most fruits, spinach, sorrel,
- Raspberry, gooseberry.
12–15 hours before the examination, meals are stopped, and on the day of the procedure transparent liquids such as broth, water, and birch sap are allowed to be consumed. You can drink weakly brewed green tea.
Enema - cheap and practical
More recently, enema was the only way to cleanse the large intestine from fecal masses. Today, she has an alternative, but at home rubber pears filled with water are used quite often.
Instructions for use enema:
- The procedure is repeated three times - twice in the evening on the eve of the colonoscopy and in the morning, on the very day of the examination,
- In the evening, an enema is placed twice at an hour, approximately at 19-20-21 hours,
- It is recommended to use a pear with a volume of 0.5 liters. The procedure must be repeated until clean water is poured out of the intestine,
- If necessary, an enema in the morning can also be done twice within an hour.
Together with the enema, you can take laxatives, for example - castor oil. Laxatives are discussed below.
- the cleaning method is simple, affordable and very cheap (the price only includes the purchase of a pear),
- making an enema is inconvenient for yourself, you need to contact someone for help,
- there are contraindications - hemorrhoids, inflammation of the mucous membrane of the large intestine.
Laxatives - a modern way to clean the intestines
- Preparations, containing macrogol (moviprep, fortrans, endofalk, fordrayv, D-forzhekt, forlax, lavacol) as an active substance,
- Lactose-based powders and suspensions (picoprep, duphalac),
- Salt preparations (fleet, magnesia)
- Forlax is a white, well soluble in water crystallized powder with a citrus smell. Contraindicated with individual intolerance, inflammatory processes in the intestine, intestinal obstruction, during pregnancy and lactation. To prepare for colonoscopy, 2 sachets are dissolved in 0.5 l of warm water and drunk in the morning and evening of the day before the examination. On the morning of day X, they do only an enema. An emergency method of cleaning involves taking a loading dose of the drug at the rate of 1 l of medication per 20 kg of body weight. Drink a solution of 0.2 liters every half hour. It is necessary to start the reception 3 days before the colonoscopy, preferably at home at this time, since such a dose causes intense diarrhea. Reception forlaksa finish 6-7 hours before the survey.
- Forddrive is a preparation made in Belarus, designed to prepare the intestines for endoscopic examination. The average dose is approximately 3-4 liters, which is drunk either the night before or divided into 2 portions (in the evening and in the morning no later than 4 hours before the colonoscopy). Drink a glass of medicine every quarter of an hour. Not recommended for severe conditions, bowel disease, adolescents up to 15 years.
- Endofalk combines macrogol and electrolytes, after dissolving in water, forming an isoosmotic laxative solution. It is recommended to take on ½ -1 Art. every 15 minutes. The dose is 3-4 liters. purification begin in the evening. If the examination is scheduled for the morning, then the whole portion should be drunk in the evening. In cases where a colonoscopy is performed after lunch, half of the solution can be taken in the morning, but no later than 4 hours before the examination. 3 hours before the endofalk reception can not be eaten. The solution should always be fresh. It is prepared as follows: 2 bags are dissolved in 0.5 l of warm water, then the volume of liquid is brought to 1 l.
- Fortrans is specifically designed to cleanse the colon before the examination or surgery. Macrogol, which forms the basis of the drug, is not adsorbed and is not included in exchange reactions, without actually changing in the gastrointestinal tract. Individual intolerance, the serious condition of the patient, diseases and neoplasms in the intestines, pregnancy, lactation, children's age - contraindications to the use of Fortrans. For bowel cleansing, the contents of 1 sachet are stirred in a liter of water and drunk in the evening before the examination at the rate of a single dose per 20 kg of body weight. Macrogol provokes severe diarrhea, thanks to which the intestine is released from the feces.
- Duphalac is a mild lactose based lactulose. For complete bowel cleansing, 200 ml of duphalac is stirred in two liters of water, then drunk in small portions for 3 hours. Defecation will begin in 1.5-2 hours.
- Flit, a saline laxative, is gaining increasing popularity. To prepare the solution, dilute 45 ml of the drug in 0.1 l of water and take it at a time, in the morning, after drinking a glass of water. The second dose (prepared the same way) is taken in the evening. For lunch - liquid food (weak broth, water, tea). After taking the flute you need to drink cold water from 0.2 liters or more (not limited). The effect comes after half an hour to several hours.
Reviews of patients undergoing colonoscopy indicate a clear advantage of laxative drugs over bowel cleansing with enemas. If a large amount of liquid that needs to be drunk in order to provoke diarrhea, cause nausea, heaviness in the stomach, discomfort, it is recommended to take one or two tablets of motilium or another similar drug.
Whatever method a patient chooses for himself, one should understand that he is required to strictly adhere to all recommendations, including a diet without foods that cause constipation and increased gas formation, fasting 48 hours before the examination, taking the necessary amount of drugs with a laxative effect.
After the examination, it is necessary to gradually withdraw from a slag-free diet, gradually introducing high-calorie, fatty foods, meat, and vegetables into the diet.
If you are taking drugs containing iron, blood thinning, anti-inflammatory drugs, consult your doctor. He will decide whether to give up a particular medication.
The doctor should know about all your diseases. For example, antibiotics are prescribed for artificial heart valves. With a tendency to constipation, laxatives should be taken.
Five days before the survey, you cannot eat products that contain seeds and grains: tomatoes, grapes, cucumbers, muesli, whole grain bread.
Three days before colonoscopy, a slab-free diet is recommended.
On the eve of the examination day, the intestines must be completely cleaned.
During the procedure will have to undress below the belt. Many patients are embarrassed and uncomfortable. Briefs for colonoscopy with a special hole help to get rid of discomfort. They are sewn from non-woven material that does not cause allergies. Such underwear is worn immediately before the procedure. Before buying, do not forget to measure the size of the waist.
Two days before the examination
Breakfast: low fat cottage cheese or casserole.
Second breakfast: A glass of tea and 2-3 crackers.
Lunch: a glass of broth with a piece of meat, steamed cabbage.
Lunch: a glass of ryazhenka.
Dinner: buckwheat porridge, tea.
The day before the procedure, the last meal is recommended no later than 14 hours.
Diet before colonoscopy contributes not only to cleanse the intestines, but also improves metabolism, general well-being, restores normal peristalsis. Slags and toxins are removed from the body. Despite strict food restrictions, there are enough vitamins and minerals.
We'll have to suffer a little. Without adherence to such a diet is impossible to prepare for the survey.
Successful diagnosis depends on the purity of the intestines.
The main requirement in preparation for the FCC is a thorough cleansing of the intestines. It is conducted at home on the eve of the study day.
There are several preparation schemes.
Enema or drug method?
Preparation for a colonoscopy with an enema is a simple procedure. It is conducted on the evening before the FSC and in the morning of the examination. For the procedure you will need an Esmarkh mug. About two liters of water are poured into it. The mug is suspended at a convenient level. Air is released through the faucet, the tip is lubricated with Vaseline.
After that, you need to kneel down, lean on one hand, insert the tip in circular movements of about 5 -10 cm, lift the pelvis and open the faucet.
Water should be boiled, about 30 degrees. With constipation, you can use colder water.
Advice from a specialist. Breathe actively during the procedure. The fluid will enter the intestines faster.
Water should be kept for at least 10 minutes. If your stomach hurts, you can stroke it clockwise.
The second enema is done in an hour.
The feeling of emptiness in the stomach indicates that the procedure was successful.
In the morning, bowel cleansing with an enema is also performed twice.
If the inspection is scheduled for the afternoon, you can change the enema time.
This method is contraindicated for people with hemorrhoids, rectal fissures.
Independently difficult to properly put an enema, so many people prefer to take laxatives.
Reviews of patients about the enemas are contradictory. Many say that this method delivers less discomfort than taking a few liters of liquid.
Medical bowel cleansing - safe and convenient
At home you can spend a quick bowel cleansing with special drugs. They allow you to remove toxins throughout the intestinal tube.
Experts recommend several drugs.
Created specifically to prepare patients for surgery and diagnosis of gastrointestinal diseases. Fortrans is available in powder form. To properly prepare for the survey will have to drink a lot of water (1 liter of fluid per 20 kg of weight). A bag of powder is diluted in a liter of water. Purification by Fortrans can be done in two ways.
For example, you need to drink 4 liters of solution. Divide it into two equal portions. One is taken the night before the colonoscopy, the second - in the morning, but no later than 3 hours before the procedure.
Such a large dose is hard to drink. Usually while taking a second liter nausea occurs. To get rid of it, every glass of liquid jam lemon.
The second method is easier. Starting from 15 o'clock every hour you need to drink a glass of solution.
Preparation Fortran relatively inexpensive method to achieve a more complete cleaning than an enema.
Mild laxative drug. Available in the form of a syrup. In two liters of water 200 ml of product are diluted. The solution begins to take two hours after lunch. For three hours you need to drink the entire dose. Duphalac's taste is slightly cloying, but quite tolerable. With bloating, you can drink Espumizan.
A bag of powder is diluted in a glass of warm water just before taking. The unpleasant salty taste of the liquid can be slightly improved by adding a spoonful of syrup. A glass of solution is drunk every 15-30 minutes. At 5 kg of weight Lavacol package is taken. It is better to start cleansing three hours after lunch.
The drug contributes to the rapid emptying of the intestines. The feedback is positive. Patients note a pleasant fruity taste of the solution, the absence of nausea.
A bag of tools is diluted in a liter of water. With a weight of 50-80 kg, three packages of Endofalc will be required. In the afternoon, preceding the study, two liters of solution are drunk. After the start of the reception, the chair begins to depart in about an hour.
The remaining fluid is consumed the next morning, but no later than 4 hours before the colonoscopy.
The day before the examination, 45 ml of the drug is diluted in half a glass of water and drunk after breakfast. The same dose should be drunk after dinner.
It is important that breakfast, lunch and dinner consist only of broth, tea or juice without pulp.
If the colonoscopy is scheduled for the second half of the day, then you need to begin cleansing Fleet with phospho-soda after lunch. Between the two doses of the drug should drink as much as possible liquid.
All methods allow you to properly prepare for fibrocolonoscopy at home. Of these, you can choose the most appropriate, taking into account the characteristics of the organism.
If you can not reach the clear chair, then tell your doctor. Perhaps the inspection will have to be postponed.
How to behave after the FCC
After examining the diet is not necessary to adhere. You can eat your usual food.
It is desirable that the first portion was small and did not consist of fried foods.
If the stomach hurts, the doctor will prescribe antispasmodics. In most cases, the pain stops after the gases come out. Acceptance of activated carbon will accelerate this process.
Despite the fact that the examination itself and the preparation for it are rather unpleasant, it is impossible to refuse colonoscopy. This is the only highly informative method to assess the condition of the intestines and prevent the occurrence of cancer.
The presence of such symptoms as:
- smell from the mouth
- stomach ache
- nausea, vomiting
- increased gas formation (flatulence)
If you have at least 2 of these symptoms, then this indicates a developing
gastritis or ulcers. These diseases are dangerous by the development of serious complications (penetration, gastric bleeding, etc.), many of which can lead to
to the end Treatment must begin now.
A colonoscopy may give a positive result, provided that it follows the recommendations regarding preliminary preparation, carried out by analogy with the methods of purification preceding the X-ray and endoscopic examination methods. Without preparation, the results may not be true.
Rules for preparing for colonoscopy
Preparation for colonoscopy is a must!
There are two stages to go:
- a slag-free diet is a prerequisite without which it is impossible to get the right results,
- intestinal cleansing, carried out in various ways.
The preparatory stages should pass in advance, you should not postpone the diet and cleansing on the day of the procedure.
Slag-free diet prior to colonoscopy
The most common questions that arise when discussing a slag-free diet are: which foods can be consumed, which should be abandoned without fail?
The category of slag food includes products, the consequences of which are loose stools and flatulence. These products must be discarded 3 days before the examination. The following products should be excluded from the diet:
- fresh vegetables (carrots, cabbage, onions, garlic, turnips, radishes, radishes, beets),
- millet, barley, oatmeal,
- greens (spinach, sorrel),
- legumes (beans, peas, beans, lentils),
- black bread,
- berries (raspberries, gooseberries)
- fruits (apples, dates, oranges, apricots, peaches, grapes, raisins, bananas, tangerines),
- kvass, carbonated products,
You can eat the following foods:
- diet broths,
- dairy products,
- lean fish, beef, poultry,
- bakery products from coarse flour.
The last meal on the day before the procedure can be no later than 12-00. You can drink plain and mineral water, tea. For dinner - only tea. On the day of the colonoscopy, you can have breakfast only with liquid.
Enema for colonoscopy
Enema as a way to clean the intestines
Thorough bowel cleansing is a must, without which it is impossible to achieve a positive result. Until recently, enemas were the most common method. Many patients prefer this method to this day.
How to do enemas?
Proper cleansing with enemas is designed for two stages:
- in the evening preceding the day of the procedure,
- in the morning before the colonoscopy.
In the evening, two cleansing procedures are to be carried out, approximately at 19-00 and 20-00, or to shift the time by several hours, depending on the mode of the patient’s day. The minimum amount of enema is 1.5 liters, washing the bowel should be carried out before the appearance of clean water.
Laxatives can be taken to enhance the effect. For example, before washing, take 100 ml of a 25% solution of sulphate of magnesia, 40 - 60 g of castor oil. It is recommended to accept funds before 16-00. In the morning, enema is also done twice: 7-00, 8-00.
The procedure of cleansing through enemas has its disadvantages and pros. The indisputable advantages of the method is simplicity, minimal cost. The disadvantages of the method include the inconvenience; it is quite difficult to carry out the procedure without assistance: it is necessary to control the flow of fluid, to keep it for a certain period of time in the intestine.
Care should be taken to enemas patients who are faced with problems of cracks of the mucous membrane of the rectum or hemorrhoids, there is a high probability of injury to the tip.
Recently practiced the use of a more gentle method of purification: special laxatives, which are recommended to be taken according to certain schemes.
Preparation Fortrans for preparation for colonoscopy
The action of the drug Fortrans is to cleanse the intestines without absorption into the gastrointestinal tract, the agent is excreted in an unchanged state. Preparation by Fortrans is extremely simple: a package of the product is diluted in 1 liter of water. 20 kg of patient body weight - 1 liter of solution. Practiced two ways to apply the solution:
- the tool is taken in the evening, from 15-00, 1 glass, at intervals of 1 hour,
- half of the solution is taken in the evening, the rest - in the morning.
The last time you take Fortrans 3-4 hours before the survey. The drug is intended directly for the stage of purification preceding radiological, endoscopic examinations, operations on the colon.
Preparation using Duphalac
Duphalac is a category of laxatives, characterized by a mild effect on the body, effectively cleans the intestines. 2 hours after the dietary lunch, start taking the drug. 200 ml of the drug is diluted in 2 liters of water, within 2-3 hours you should drink the entire solution. The drug begins to act after 1-3 hours, depending on the individual characteristics of the organism. The main advantage of Duphalac is a soft action, excluding the painful sensations of the patient.
Rules of preparation with the help of the drug Flit
- Accepted in two doses.
- In a half glass of water dilute 45 ml of the means, use immediately after breakfast,
- the second dose (45 ml) - in the evening after the dietary dinner.
- If the patient has time, you can take another dose in the morning on the day of the examination, no later than 8-00.
- Breakfast and dinner should include only 1 glass of water.
- Lunch should be dietary, include no more than 750 ml of water.
- Each dose of Flit should be taken with 1-3 glasses of cold water, after taking the drug, the liquid can be consumed in unlimited quantities.
- Fleet begins to act approximately 30 minutes after ingestion.
Choosing a purification method
New drug Flit
Modern drugs designed to prepare for the colonoscopy, have a lot of advantages, compared with enemas, this is confirmed by patients and physicians.
Regardless of which method of purification you prefer, the main thing is to follow the recommendations regarding the sequence of procedures, the volume of fluid.
Only high-quality cleansing can produce results that are not in doubt. The choice of purification method depends on several factors:
- Experience in the implementation of the enema procedure. If you plan to independently carry out the procedure for the first time, it is better to give up and give preference to modern methods that exclude injuries. If you have enough experience, you can not give up the usual way of purification.
- Ease of use of modern drugs. The choice of a modern drug depends on the personal preferences of the patient, the characteristics of his body. Fortrans involves the intake of large amounts of fluid, it can cause gag reflex, nausea. Fortrans and Duphalac are preparations with the help of which preparation begins in the evening, respectively, the patient should have enough free time. Fleet is taken on the day of administration, the drug acts after a short period of time.
Each preparation has contraindications, the means intended for clarification are not an exception. Fit and Duphalac is strictly forbidden to take during pregnancy, diabetic patients. Castor oil should not be taken in patients with gallstone disease.
Approximate cost of preparation
The most affordable way that does not require material costs is an enema. Castor oil also has a negligible cost. Duphalac and Fortrans are more expensive, but the ease of use and effectiveness of drugs justify the cost to the full.
There is another drug that is quite in high demand - Lavacol. It should be noted that currently most customers prefer Fortrans. Before preparing for a colonoscopy, it is recommended that you seek qualified advice from a doctor who will perform the procedure, especially if the patient does not have experience with bowel cleansing, you must also take into account the individual characteristics of the body.
In conclusion, it is worthwhile to say that you should consult with the doctor who prescribes the examination (colonoscopy) for you - he will certainly recommend you the most suitable way for you to prepare for the procedure.
But how a colonoscopy is performed can be seen in the video:
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Colonoscopy is a painless procedure if there is no inflammatory process. In some cases, it may be performed with local anesthesia or under general anesthesia. Today it is the only method to determine the cancer of the intestine in the early stages.
The colonoscopy procedure helps to investigate the state of the colon throughout its length with the help of a fibrocolonoscope apparatus.
Many patients refuse to exercise because of false shame, risking their health.
The device is a flexible tube with tools attached to it:
- miniature camerathat transmits an image enlarged several times to a computer monitor,
- cold light flashlight, excluding burns of the intestinal mucosa,
- tools for mini-operations: cauterization of the source of bleeding, removal of small polyps or other neoplasms, taking tumor material for analysis, removing stuck foreign bodies, freeing the passage of fecal masses during blockage.
The length of the device is 160 cm, which is enough to examine the entire large intestine.
When is a study prescribed?
A colonoscopy is prescribed by a doctor in case of detection of certain diseases or in case of suspicion of serious disorders in the area of the large intestine, malignant neoplasms.
Symptoms for which an event is scheduled:
- pain in the colon, the presence of a violation of the chair in the form of constipation or diarrhea,
- suspicion of cancer,
- depletion of the body due to constant diarrhea, unexplained cause,
- hemorrhoids, accompanied by frequent internal bleeding,
- the presence of blood in the feces,
- colon diverticulosis,
- inflammation of the mucous membrane with the formation of ulcers,
- the need to take material for examination,
- removal of small polyps that often precede a cancerous lesion.
In addition to the above, the procedure is useful to all who are over 50 years of age, since at this age the risk of malignant tumors increases.
The procedure, despite its benefit and painlessness, is not allowed for all patients. Categories of persons who can not conduct a fibrocolonoscope study:
- pregnancy at any time,
- ulcerative colitis, Crohn's disease,
- problems with blood clotting,
- acute phase of intestinal diseases
- peritonitis, the appearance of pus with diverticulosis,
- intestinal blockage
Such studies are made only by order of the attending physician. Independently decide whether to conduct research is life threatening.
Methods of cleaning the intestines before the study
In order for the study to be as truthful as possible, it is necessary to clean the intestines thoroughly before the procedure.
There are several methods of preparing for colonoscopy of the intestine, the meaning of which boils down to activities:
- cleaning the large intestine with a slag-free diet, which is carried out 3-4 days before the procedure,
- removal of feces using a strong laxative,
- cleansing with water poured into the intestines by means of an enema.
The cleaning method is prescribed only by a doctor in accordance with the general condition of the patient. In order for the event to bring tangible benefits, you must thoroughly clean the intestines and remove all fecal matter from its walls.
The essence of the procedure is to fully examine the intestinal mucosa to prevent dangerous diseases.
To ensure that the colonoscopy is as effective as possible, it is recommended to carry out cleaning procedures several days before the examination.
First of all, it is recommended to switch to a therapeutic diet, which provides nutrition with a minimum fiber content, excludes products from the menu that promote bloating of the gastrointestinal tract, the formation of bulk fecal masses.
During cleansing with modern laxatives, you need to drink plenty of fluids to avoid dehydration. After the start of taking the drug should be consumed only liquid food.
Slag-free diet - it’s worth starting
2-4 days before the event (it is recommended to check the exact date with the attending physician), it is recommended to switch to fractional feeding with liquid food.
Slag-free diet menus before colonoscopy:
- fermented milk drinks: ryazhenka, kefir, yogurt without filler,
- weak broths from lean meat or fish,
- fruit juices without pulp. Preference should be made to apple and grape,
- You can eat jelly, fruit ice cream,
- tea, weak coffee.
On the day of the procedure to stop drinking the liquid should be 2 hours before the start.
The following products are recommended to completely exclude from the food for the 2 days preceding the study:
- whole grain cereals and flour products,
- milk, cottage cheese, sour cream, hard and processed cheeses,
- beans, seeds, dried fruits,
- vegetables and fruits in their raw form.
It is allowed to eat boiled vegetables, boiled shredded meat, liquid milk cereals, boiled eggs, but one day before the colonoscopy one should switch to clear broths and drinks. Eating completely stops 2 hours before the event.
Fortrans - what's in my name?
Fortrans is a laxative of the last generation that binds water in the intestines, protecting it from absorption into the walls. As a result, the large intestine self-cleans, getting rid of fecal content.
Preparing for colonoscopy by Fortrans begins 12-14 hours before the study, so you should calculate the start of the medication alone. It is possible to carry out such cleaning since evening if diagnostics is appointed in the morning.
The laxative comes in powder form in sachets designed for 15 kg of weight. In the original package is 4 identical in weight, powders, each of which should be dissolved in 1 liter of water.
The resulting amount is recommended to be divided into individual doses of 250 ml, which must be taken every 15 minutes.
The last dose is 5-6 hours before the procedure. Exit the contents of the large intestine after the last dose of laxative should be made with almost pure water. This means that bowel cleansing is carried out correctly.
The drug is contraindicated in children under 15 years old, pregnant women, people who have problems with the supply of water to the body, with heart failure.
The action of Lavacol, a laxative, causing an increased excretion of feces from the intestines, occurs 1.5 hours after it is taken.
Preparation for colonoscopy with Lavacol begins 17-19 hours before the procedure begins. It is necessary to take the last dose of the drug no later than 4 hours before the start of the diagnosis. The unpleasant taste of the medicine can be changed by adding a little sugar or fruit syrup.
A large amount of water consumed can lead to bloating of the intestines, but it is not recommended to take means to help get rid of the unpleasant feeling, without the knowledge of the doctor.
The first excretion of feces is observed 1-1.5 hours after the initial dose of the drug. The medicine is packaged in small bags that need to be diluted in a glass of warm water.
It is necessary to drink a laxative every 30 minutes, calculating the time of the last dose of the drug no more than 4 hours before the start of the colonoscopic examination.
Do not use the tool without the recommendation of a doctor, using it every time in case of constipation. An overdose of the drug can cause nausea, nausea, vomiting, headache.
Briefly about the survey
Colonoscopy refers to the instrumental methods of endoscopic diagnosis, carried out through the introduction into the body of a special device - a colonoscope equipped with a video camera. The survey is aimed at assessing the state of the lower part of the digestive system - the colon. The procedure is performed by the rectal method, that is, medical instruments are inserted directly into the rectal lumen.
The proctologist analyzes the internal state of the intestines in the image that the video camera transmits to the monitor. The study of the large intestine is made to identify inflammatory processes, erosive and ulcerative lesions, tumor and hemorrhoidal tumors, growths (polyps) or the detection of foreign objects in the body.
The procedure can bring some discomfort, so children, people with an increased threshold of sensory or mental illness have a colonoscopy under anesthesia. The time range of the study is from a quarter of an hour to 25 minutes. Preliminary preparation is an obligatory component, without which the doctor is entitled to refuse to be examined.
The purpose and objectives of the preparation
The purpose of the preparatory activities is to create inside the body comfortable conditions for the study of the epithelium (cells of the inner surface of the intestine). Cleaning the intestine will allow the colonoscope to penetrate unhindered, and the doctor will thoroughly examine the health status of the lower part of the digestive tract and establish the correct diagnosis.
The main task is to properly clean the colon of slag deposits, fecal accumulations, gases, possible blood clots and mucus. Full preparation is made in two directions:
- compliance with the three-day diet and 12-hour fasting regime,
- forced cleaning of the intestines with laxatives and using enemas.
Among the drugs used before the colonoscopy, the leading positions are taken by modern laxatives, made on the basis of linear macrogol polymer. This group of drugs has a non-aggressive osmotic effect. Efficiency provides enhanced hydrostatic pressure in the lumen of the intestine, resulting from the elimination of fluid from the body and preventing its absorption.
This process irritates the intestinal walls, which leads to the natural process of bowel movements. Most of the drugs in this group are saline solutions. Their main advantage is a mild effect, in which the rectum in the process of defecation, does not suffer from excessive tension.
Osmotic laxative agent for the treatment of chronic constipation and preoperative lavage (cleansing).
- composition: macrogol, potassium and sodium salts of hydrochloric acid, baking soda, food additive E 954,
- pharmacological parameters: the drug does not interact with the bloodstream, does not undergo processing by the digestive system. Laxative effect occurs 60–90 minutes after application. Repeated dose halves the interval of action
- form and dosage: the drug is made in powder form. Packed in bags, the powder must be stirred in water before use (1 sachet per 1000 ml of boiled water at room temperature). For the purification of Fortrans, an adult is recommended a dose of one liter of prepared solution per 20 kg of body weight. Prepared drink should be divided into two equal parts. In the evening, on the eve of the survey, drink half the solution, in the morning, 4 hours before the appointed time - finish the rest,
- contraindications: cardiac decompensation, childhood and adolescence, cancers in the gastrointestinal tract,
- undesirable manifestations: emetic urging due to the intake of a large volume of saline solution.
The absolute analogue of Fortrans is the Russian medicine Lavacol, produced by the Moscow pharmaceutical factory, at a price of 200 rubles.
A laxative agent based on polyethylene glycol (macrogol), specifically designed to clean the intestines before rectal examinations.
- pharmacoparamerty: not absorbed, not metabolized, has carminative property,
- form and dose: made in the form of a powdery substance intended to be dissolved in water. Half a liter of the solution is prepared from one packet of powder and an appropriate volume of pure water. From 3.5 to 4 liters of liquid medication is recommended for high-quality bowel cleansing. Drink should be one glass with an interval of a quarter of an hour. Consumption of the entire solution lasts 4–5 hours. The result of the lavage procedure should be clear water when emptying,
- contraindications: violation of swallowing (dysphagia), stenosis of the lumen of the stomach, intestinal obstruction, ulcerative colitis,
- adverse events: cardiac arrhythmia, nausea and vomiting, skin allergic reactions (rare).
Produced in Italy. Cost - from 500 to 600 rubles. Similar drugs with active macrogol that are used for lavage before colonoscopy: Forlax, Tranzipeg, Forteza, Moviprep. The drugs have an identical effect, similar contraindications, side effects and dosage regimen.
Another group of drugs used for the purpose of lavage before colonoscopy, are drugs with the active substance lactulose (synthetic disaccharide). The action of lactulose reduces the pH level of the intestinal environment and a sharp increase in wave-like contractions of the esophagus, stomach and intestines (peristalsis). The advantage of these drugs is their safe use by women in the perinatal period. In addition, according to taste, lactulose is well perceived by children.
The drug is made in the form of a syrup, which consists of only two components: water and lactulose. The medicine is packaged in vials of 200 ml and 500 ml.
- pharmacodynamics and pharmacokinetics: stimulates the activity of motility, speeds up the metabolism. A small percentage of the drug is absorbed into the digestive system. Quickly reaches the large intestine, where it undergoes splitting,
- contraindications: diabetes mellitus, hereditary intolerance of the main active ingredient, suspected appendicitis,
- side effects: increased gas formation, gagging, weakness, dizziness,
- application: in each case, the doctor prescribes the dosage. While using Duphalac, you must observe abundant drinking regime.
The drug can be taken in a concentrated or diluted form.
Treats laxative medications. In addition to lactulose, it contains active simethicone - a chemical compound that has a carminative effect.
- release form: produced in the form of a suspension of 100, 200, 500 ml in a bottle,
- pharmacoparameters: increases peristalsis, activates metabolic processes, absorbs gases. The drug is not absorbed and easily leaves the body unchanged,
- contraindications: intestinal obstruction, allergic reactions to lactulose,
- adverse events: impaired cardiac activity, fatigue, headache.
The dosage for the bowel lavage procedure is prescribed individually by the doctor. It is manufactured by the Russian pharmaceutical company AVVA-RUS. Pharmacy price - about 500 rubles. Lactose-based laxatives act more slowly than osmotic preparations with macrogol.
Preparing for the examination with a colonoscope can be done by means of an enema. The enema cleansing procedure is performed on the evening before the appointed colonoscopy and on the morning of the examination. It is possible to clear the small intestine with plain water or a non-concentrated solution of herbal decoctions. A single dose of rectal liquid should be at least two liters of water. Alternatively, medicinal microclysm is used.
Combined laxative for rectal use in the absence of regular stools and for preparation for examinations.
- Ingredients: sodium citrate, sorbitol, purifying emulsifier - sodium lauryl sulfoacetate
- release form: made in liquid form, in special microvials of polymeric material in 5 ml for a single individual use,
- pharmacodynamics and pharmacokinetics: dilutes and removes the contents of the intestine. The time interval between clipping and emptying is from 5 to 20 minutes,
- contraindications: rectal fissures, irritation of the anus,
- dosage: to eliminate constipation one microclyster is used once a day. For the purpose of cleaning, it is applied twice (in the morning and in the evening), as during normal clipping,
Cheaper lavage products, such as Bisacodil, Senade, Fitolax, have a rather aggressive action on the digestive tract, causing pain and cramps. In addition, forced cleansing may be poor quality. Slags and feces remain in the intestinal folds, this becomes an obstacle for informative research.
All drugs intended for lavage have a laxative effect. To avoid dehydration, the drugs should be strictly followed the instructions. Before choosing a medication, special attention should be paid to the available contraindications and side effects, as well as to consult a doctor.
The need for bowel cleansing before colonoscopy
In the intestines of a healthy person are constantly found substances formed during the digestion of food, food debris, fiber fibers, water, salts, trace elements, mucus, enzymes of bile and pancreas, bacterial flora. Different eaten dishes require unequal efforts for digestion. The longest in the intestine lingering fatty meat remains (12 hours or more). Therefore, the use of meat before the procedure is prohibited.
Light foods from carbohydrates and proteins are digested faster. Cellulose of vegetables and fruits, incoming water create conditions for enhanced movement of fecal masses through the large intestine, stimulate peristalsis. However, natural bowel movement is insufficient for inspection.
The walls and lumen of the intestine should be as clean as possible to visually assess the state of the tissues. Endoscopist reveals scars, erosion, ulcers, adhesions, small polyps, tumors. For subsequent treatment, it is necessary to correctly determine the degree of inflammation or destruction, localization of the process. To study gave reliable results, training is carried out. It includes:
- compliance with the regime (smoking cessation, physical exertion),
- slab-free diet, which allows the maximum absorption of digested substances,
- use of mechanical excretion by enemas,
- the use of special drugs to cleanse the intestines before colonoscopy.
In practice, a combination of these methods is required. What methods of cleaning are suitable for a specific patient before a colonoscopy, and how the doctor needs to be prepared.
The drug is produced in Spain by the company "Cacén Recordati, SL". The active ingredients are salts of sodium bicarbonates and sodium phosphate. Each package contains 2 bottles of solution. To improve the taste used lemon-ginger flavor.
The effect causes an increased osmotic pressure in the intestine due to salts. Fluid retention allows you to soften and remove fecal masses. When conducting a colonoscopy in the morning for the day, it is recommended to drink the prepared solution at the rate of 45 ml of the drug per 120 ml of water;
At 19 o'clock, repeat the scheme. It is advisable to drink more fluids throughout the day.
Frequent negative consequences include:
- dizziness, headaches,
- diarrhea with abdominal pain, flatulence, nausea and vomiting (significantly interferes with the inspection during colonoscopy),
- chills, pain in the chest.
Rare manifestations include:
- neurological symptoms (loss of consciousness, convulsions, paresthesias),
- violation of water and electrolyte balance in the form of dehydration, increasing the concentration in the blood of salts of phosphorus, sodium, a drop in potassium and calcium, acidosis,
- arrhythmias, angina attacks,
- renal failure.
The drug does not apply to patients under 18 years of age.
In addition to intestinal obstruction (as for other laxatives), it is not recommended for patients to use:
- with parathyroid hyperfunction and hypercalcemia,
- with ascites,
- with megacolon,
- with renal and heart failure,
- amid symptoms of nausea and abdominal pain.
Preparation for colonoscopy
If, prior to the colonoscopy, the patient is receiving drugs containing iron and blood thinning, you should learn about the feasibility of their further administration. Also, before the diagnosis is necessary to tell the doctor about all the existing diseases. If the patient has an artificial heart valve, then he is prescribed antibacterial drugs. For people who are prone to constipation, you need to take laxative medicines.
5 days before the diagnosis you should not use products containing stones and grains: tomatoes, cucumbers. The day before the examination it was recommended to completely clean the intestines.
If the enema is contraindicated or is not suitable because of the aesthetics of the procedure, you can resort to taking medication.
Submitted drug belongs to the group of laxatives. It has a mild effect on the body, effectively cleans the intestines. The drug is taken after 2 hours from the moment of taking the lunch. The required dosage is 200 ml per 2 liters of water. Use the solution within 2-3 hours. The effect of the reception is noticeable after 1-2 hours. It all depends on the individual characteristics of the organism. The main advantage of Dufak is a soft influence that does not cause any pain.
To clear the intestines before colonoscopy using Flit, dilute it (45 ml) in a glass of water. Use in two doses. One - immediately after breakfast, and the second - in the evening after dinner. If the diagnosis is scheduled for the second half of the day, then in the morning you can use another dosage. But this must be done no later than 8.00.
In the morning and in the evening you can drink only water. Lunch involves dietary meals and not more than 750 ml of water. Each dosage of the drug must be washed down with 1-3 glasses of water. After that, the fluid intake can be carried out in unlimited quantities. The effect of the drug Flit noticeable half an hour after administration.
Lavacol medicine is produced in the form of powder. Before a colonoscopy, it is necessary to dilute the sachet in 200 ml of water and use immediately.The resulting solution has an unpleasant taste, so you can add a spoonful of syrup. Drinking a glass of medication is necessary every half hour. To clean the intestines is 3 hours after lunch.
It is advisable to take Endofalc when it is necessary to achieve a quick bowel cleansing. The solution has a pleasant fruit flavor. There is no nausea when taken. Place one bag in 1 liter of water. For those with a body weight of 50-80 kg, you must use 3 sachets. After lunch, the solution is drunk in an amount of 2 liters. After applying the medicine, the person goes to the toilet within 1 hour. The liquid that remains should be consumed in the morning, but no later than 4 hours before the colonoscopy.
Enemas for bowel cleansing
The day before the study of the large intestine should go on a moderate meal, easy to digest.
After lunch, it is recommended to take castor oil in an amount of 50 ml, as an effective laxative, providing cleansing of the intestines from fecal masses.
People suffering from diseases of the gallbladder, you must first consult with your doctor.
At bedtime after intestinal emptying, it is recommended to take 2 enemas in a row for 1.5 liters of warm water each. Use for the procedure should be Esmarch's mug, hanging it to a height of about 1.5 meters above the couch.
In the morning, repeat the exercise until practically clean water comes out of the intestines.
Despite the apparent simplicity of the procedure, it is not recommended to do it yourself when bleeding hemorrhoids, in order to avoid wounds with an enema tip.
Tips to help prepare for the study
The procedure for colonoscopy should be prepared in advance - find out the time of purification, purchase the necessary drugs, diet products, hygiene products.
It is advisable to spend the day before the diagnosis at home, entrusting the care of children and parents to assistants. Frequent trips to the toilet will not allow you to cope with household chores.
Additives help to improve the taste of the laxative: lemon, sugar syrup, ginger. You can use a straw, putting it on the back of the tongue, so as not to feel the taste of the drink.
It is advisable to wear loose-fitting clothing in order to take it off without delay, as it is extremely difficult to delay a bowel movement after a laxative.
It is recommended to provide yourself with a lesson at the time of going to the toilet: reading books, classes on the computer, listening to pleasant music.
Diagnostics should be taken seriously, correctly following all the requirements and recommendations of the attending physician. Indeed, many diseases, including cancer, can be prevented and cured if they are detected at an early stage.
Colonoscopy provides the proctologist with a rare opportunity to visually inspect and evaluate the inner surface of the colon. The procedure is performed using a special tool - a colonoscope. A patient who first received a referral for such an examination often experiences fear and anxiety, and often refuses to diagnose at all. In order to dispel unnecessary fears, below we consider the features of the procedure, find out how to prepare for a colonoscopy and talk about the consequences.
The preliminary stage includes not only the work of certain physical manipulations, but also a favorable emotional state, the absence of fear and prejudice. Therefore, it would not be superfluous to dwell on some general aspects of the procedure.
The device for diagnostics
To study the internal cavities of the colon, physicians have developed a special tool to identify the disease in the early stages of its development. The colonoscope possesses a sufficiently high degree of resolution and is a flexible structure 180 cm long with a miniature camera and flashlight attached to the end. The kit includes a device for mini-operations.
Colonoscope is not a disposable instrument, but you should not worry about it.
Colonoscopes special and universal
Interesting. Processing equipment in modern disinfecting devices provides for the disinfection of each channel of an optical device separately and completely eliminates the risk of infection.
Indications for colonoscopy
Endoscopic procedure can be both diagnostic and therapeutic orientation. More recently, colonoscopy is increasingly used when the following symptoms appear:
- pain of unknown etiology in the intestine,
- violation of the chair,
- feces with patches of mucus and blood
- quick weight loss.
Colonoscopy is necessary for taking biopsy material, removing single polyps of small size and cancerous alertness. In addition, the procedure is desirable for people who have stepped over the 50-year-old frontier.
Interesting. In the United States, colonoscopy is included in the register of mandatory annual examinations for people over 45 years of age, and in Germany after 48 years.
Intestinal colonoscopy preparation
For the procedure to be quick and painless, you need to perform a number of preliminary activities. Preparation for colonoscopy, carried out in strict accordance with the recommendations of the doctor, will allow to clean the intestines from the feces and increase the accuracy of diagnosis.
There are two main stages of preliminary activities:
- Special diet.
- Colon cleansing.
The method of preparation is determined by the doctor on the basis of the general condition of the patient and the presence of concomitant diseases.
What is forbidden
3-4 days before the prescribed procedure, you should limit the use of products that cause fermentation in the intestine and the formation of a large number of feces:
- fat and fried meat and dishes from it, sausages, lard,
- fruits and berries with seeds,
- vegetables, especially with skins (tomatoes, sweet peppers), cabbage,
- flour products from yeast dough or wholemeal flour,
- dried fruits, greens, alcoholic and carbonated drinks.
From the diet should be excluded all vegetables with skin
Before colonoscopy, you should stop taking iron supplements or report them in advance to your doctor.
What is allowed
During the diet is recommended to eat liquid and light meals. Especially welcome:
- lactic products: kefir, yogurt, sour milk, ryazhenka, cottage cheese,
- broth on lean meat,
- juices from pitted fruit and pulp,
- white bread crackers
- porridge - oatmeal or rice,
- boiled potatoes,
- from drinks - tea, coffee, clean water, jelly.
The main condition of the diet - all food should be transparent, liquid and without stones or other hardly digestible ingredients. Sugar, honey and butter can be consumed in very small quantities, and it is better to do without them.
A day before colonoscopy, the ration should consist of clear liquids.
Attention. The last meal should take place 18–20 hours before the colonoscopy. The rest of the time it is recommended to consume liquid, transparent dishes and drinks: broth, jelly, jelly, tea or water.
Stage II - cleansing
On the eve of the inspection it is necessary to thoroughly clean the rectum from the feces. This is not difficult to do with the 1.5 liter Esmarch mug or use special preparations to prepare for colonoscopy, which is more effective. Laxatives should be used strictly according to the instructions, without changing the dose or order of admission.
If for any reason the purification of the gastrointestinal tract did not work, you should ask the doctor to postpone the procedure to another time.
Use of enema
The intestine without residues of feces is a prerequisite for high-quality and reliable endoscopic diagnosis. The most common cleaning method to this day is considered an enema. It is the Esmarkh circle that most patients prefer.
High-quality intestinal lavage is carried out in 2 stages:
- The first enema before a colonoscopy is performed on the evening before the study,
- the second - in the morning, before the diagnostic event.
In the evening, it is recommended to carry out 2–3 washing procedures in a row, before the appearance of “clean water”. Fill the Esmarkh mug with a warm liquid so as not to cause a painful spasm. It is advisable to “hold” water for at least 5–10 minutes.
In the morning before the inspection, rinsing should be repeated. Requirements for the event are the same - to "pure". Only in the case of complete removal of feces from the intestine, the preparation for a colonoscopy can be considered successful. In pathologies that are accompanied by frequent and loose stools, volumetric enemas are contraindicated. In this case, for the procedure will be enough 0.5 liters of water.
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Intestinal cleansing on the eve of colonoscopy is often performed using an Esmarch mug.
The use of the Esmarch cup has its advantages and disadvantages, which should be remembered. The undoubted advantage is the simplicity and accessibility of the method. Enema does not take much time and effort, it is easy to do it alone, without attracting outsiders. The disadvantages include the need to keep fluid in the rectum for some time, which is not everyone's strength. In addition, the procedure has contraindications.
Patients suffering from hemorrhoids or having anal lesions and fissures should report this to the doctor. It is possible that the specialist will advise another way of preparing for the endoscopic examination.
Cleansing the digestive tract before colonoscopy with laxatives
Recently, experts are increasingly applying more gentle methods of cleaning the intestines - special medical preparations based on macrogol, which must be taken according to a certain scheme.
A laxative before colonoscopy will help to quickly and gently remove fecal masses from the rectum and qualitatively prepare for the diagnostic procedure. Doctors recommend for the use of several drugs, each of which copes with the task.
One of the most popular macrogol-based bowel cleansers. It acts gently and quickly, increases peristalsis and restores the evacuation process, prevents the loss of electrolytes.
Popular Fortrans Laxative
The regimen for taking Fortrans depends on the time of the diagnostic examination. If the procedure is scheduled in the morning, preparation for a colonoscopy with a laxative begins the day before. The last meal should take place no later than 13.00-13.30. After 3 hours, it is advisable to take the first portion of Fortrans. There is no longer possible at this time, it is only allowed to use pure water.
Council Prepare a laxative before each use. It is recommended to drink slowly, in small sips.
The first urge to defecate appear within an hour after using the drug. The chair is fluid. Intestinal cleansing is quick and ends with bowel movement with clean water. This means that the patient is ready for examination.
If a colonoscopy is scheduled for the afternoon, the mode of preparation for the diagnostic procedure changes. In this case, only ½ of the scheduled dose should be taken the night before. The rest of the solution is recommended to use the next morning. It is advisable to do this early, at about 6 o'clock.
Despite the popularity among doctors and patients, the tool has a number of contraindications:
- pregnancy, breastfeeding,
- Crohn's disease,
- abdominal pain of unknown etiology,
- intestinal obstruction.
In childhood, Fortrans is used with caution and only under medical supervision.
Intestinal cleansing before colonoscopy can be done with Lavacol. The drug is also very popular and is often used to prepare for endoscopic examination of the colon. It has a quick laxative effect, accelerates the evacuation of contents from the gastrointestinal tract and effectively cleans the intestines.
Lavacol is often prescribed to prepare for endoscopic examination.
It is recommended to start taking Lavacol 19–20 hours before performing a colonoscopy. Apply on an empty stomach, diluting the contents of the bag in a glass of water. Drink 200 ml of solution every half hour.
Council During the intake of laxative and after it is recommended to use only liquid food. The drug is better to use from 14.00 to 19.00 hours.
The first defecation appears 60–90 minutes after the initial portion of Lavacol.
Do not use a laxative without prescription. The drug has contraindications and often causes adverse reactions. Overdose can cause vomiting, headache and worsening of general well-being.
Which drug to choose - Fortrans or Lavacol
For various endoscopic studies of the large intestine, specialists with the same frequency prescribe both drugs or give a choice to the patient. Often, having received a referral for diagnostics and detailed explanations of how to clean the intestines before a colonoscopy, the patient faces a difficult dilemma - which drug to prefer.
We will conduct a comparative analysis. Both medications are based on the same active substance, have an identical effect on the body and have almost the same contraindications.
At the same time, there are some differences between them:
- Producing country. Fortrans is produced in France, and Lavacol - in Russia.
- Cost Imported drug is much more expensive.
- Taste. Lavacol has an acceptable taste, resembles a sweet-sour solution. Fortrans very unpleasant, can provoke vomiting. It does not affect its pharmacological qualities.
Both means must be dissolved in water and taken on the eve of the study or in the morning on the day of diagnosis (Fortrans).
Thus, there are no significant differences between the drugs in question. So what is the best for colonoscopy - Lavacol or Fortrans? In this case, the decisive choice should be made by a specialist on the basis of medical indications and patient preferences.
Another, equally effective drug based on lactulose. The surveyed consider it a more comfortable means than Lavacol or Fortrans due to the pleasant taste and fewer contraindications. Often assigned to newborns, pregnant and lactating mothers.
The mild taste and lack of contraindications allows Dufalac to be prescribed to children and pregnant women.
Preparation for colonoscopy by Duphalac begins 4 days before the diagnosis - 45 ml once a day, preferably at one time. All these days you should follow a slag-free diet and drink more.
On the eve of the inspection, it is recommended to dilute 200 ml of syrup according to the instructions immediately after lunch and take the solution for the rest of the day. In the intervals between the intake of a laxative, you can use tea, light juice or light broth. The result of the purification event should be clear water.
Whichever method of preparation for endoscopic diagnosis is preferred — an enema or medication — you must carefully follow all the doctor's recommendations. Then the effort and time spent will not be wasted and the event will be successful.
Attention. The article is for informational purposes only and is not a guide to action. Need to consult a doctor.
Which medication is better for cleansing the colon before colonoscopy?
The choice of drug depends on the patient's condition, age, blood pressure, other diseases. The best cleansing, of course, have medicines created on the basis of macrogol and other polymers. They wash out all the slag substances from the intestines. However, it is too difficult to drink 4 liters of liquid to any person. There are enough contraindications, restrictions.
Other drugs with a laxative effect are good in treating constipation, but do not have the necessary cleansing properties. For each patient before the study, it is necessary to conduct a series of tests, ECG, to identify contraindications. Less active drugs can be combined with enemas, diet, increase the period of preparation.
Judging by the reviews of people who have undergone a colonoscopy, medication has played a significant role in preparing for the study.
Larisa: “I asked for leave from work for several hours in the afternoon for a colonoscopy, followed a diet, I was shaken from hunger. Talked with the doctor about drugs. Drink on the eve of such a volume of liquid is simply unrealistic. I have no constipation, rather, on the contrary. In the evening I drank Duphalac, I didn’t get off the toilet all night. But the procedure was successful. "
Galina: “My mother was prescribed a colonoscopy. She is hypertensive. How to drink so much water? The doctor ordered to strictly follow a slag-free diet for a week, not 3 days. In the evening and in the morning I gave her enemas. It cost.
Marina: “And I immediately realized that I could not work. Took 3 days off. Fortrans can be sustained if you drink and lie without doing anything. ”
Do not try to choose the best laxative drug yourself. In order not to disrupt the desired procedure, you should carefully consider all training options. The combination of convenient in time and mode of operation of drugs and actions will help to correctly perform the purification scheme.