- What to expect from your first consultation?
- What should you do before your appointment?
- How to cleanse the rectum
- Recommended diet before visiting a proctologist
If you are concerned about pain in the rectum and anus, then you need to make an appointment with a proctologist. Unfortunately, many people put off visiting the doctor because of embarrassment and lack of understanding of what awaits them at the appointment. But without an examination, it is almost impossible to make a correct diagnosis, and, therefore, prescribe effective treatment. In order for everything to go without complications, you need proper preparation for visiting a proctologist.
Constipation in children
Constipation is a common problem in children (up to 53%)1, impairing quality of life2. Symptoms of constipation include: a decrease in the frequency of the child going to the toilet less than 3 times a week; hard, scanty stool; a feeling of incomplete emptying of the intestines and the need for additional efforts (prolonged, sometimes unsuccessful straining) 3. Constipation can also contribute to the occurrence of pain, inflammation of the intestines, changes in its microflora and decreased immunity3.
Microclysters
(From the book by A.P. Azizov Prostatitis, fiction and reality, Makhachkala, 2004)
Microclysters
To create a high concentration of medicinal substances in the prostate gland and pelvic organs, microenemas are used. Medicines introduced into the rectum are absorbed and most quickly enter the pelvic veins. This route of drug administration avoids side effects of drugs on the liver and other vital organs.
To reduce the inflammatory process, microenemas (80-100 ml of liquid at 40-42 °C) with various medications ( analgin , Shostakovsky balm , ichthyol ) and herbal infusions ( chamomile , wort , sage ), fir oil , propolis infusion , etc. are widely used. d. Chamomile infusion is prepared as follows. Take 15-20 g of chamomile flowers and brew in 120 ml of boiling water, leave for 2-3 hours, cool to 40-42 ° C and inject 80-100 ml into the rectum before bed. For microenemas you can also use romazulan , rotokan . The course of treatment is 10-15 microenemas.
Microenemas from infusions of the herb yarrow (5-8 g per 200 ml of boiling water), leaves of sage (10-15 g per 200 ml of boiling water), decoction of flaxseed ( 1 part flaxseed and 30 parts water), decoction of the mixture peppermint herb , chamomile flowers , wort herb and 20 drops of liquid belladonna extract . Kruglyak L.G. (1996) recommends the widespread use of fir water and oil in the form of microenemas in the treatment of chronic prostatitis.
Method one: Take 40-50 ml of fir water into a syringe and place it in a water bath. After heating to 38-40°C (check by dropping a few drops on the back of the hand) and squeezing out excess air, the contents of the syringe are injected into the rectum. Then you should lie on your stomach for 7-10 minutes. Microclysters are done after a stool or cleansing enema. Duration of treatment is 40-50 days. We recommend repeating the course after 3-4 months.
Along with microenemas, it is recommended to rub pure fir oil into the perineum, but given its irritating effect, it must be applied very carefully - do not touch the scrotum and anus.
Method two. Fir oil is added to a syringe with fir water. Start with five drops and, if there are no unpleasant sensations, increase the dose every 2-3 days, bringing the number of drops to 10-12. The course of treatment is 25-30 days, repetition is possible after 2-3 months.
Method three. Fir oil is mixed with sea buckthorn, peach or sunflower oil in a 1:1 ratio. The mixture is shaken, a small piece of bandage or cotton wool is moistened and squeezed so that it does not drip. They insert it into the rectum (using the index finger with a rubber fingertip on it) and leave the tampon there until the next bowel movement.
dimexide to microenemas allows you to increase the absorption and permeability of other medicinal substances. Dimexide itself has anti-inflammatory, anti-edematous and analgesic effects. A.V. Sagalov (2002) offers the following composition for microenemas:
- chamomile decoction (or boiled water) - a quarter cup (45-50 ml);
- dimexide, 2 ml (forms a 4-5% solution in chamomile decoction);
- antibiotic (powder from one capsule of doxycycline, ¼ - ½ tablets of Ciprolet 250, crushed into powder with a spoon ).
Chamomile decoction and solution for microenemas should preferably be prepared fresh each time. If the drug is poorly tolerated (poorly retained in the rectum), it is necessary to start with a low concentration of dimexide. For example, with 0.5 ml, gradually increasing the dose. The medicine should be kept in the rectum for 4 hours or more. It is better to do a microenema at night after a bowel movement and a cleansing enema.
For pain syndrome, microenemas with heated fish oil are recommended (20 ml 2 times a day for 2 weeks).
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Causes of constipation in children and solutions
The causes of constipation in children vary depending on age. In children under one year of age, the causes of constipation may include poor nutrition of the mother during breastfeeding, switching to artificial feeding, introduction of complementary foods, rapid transition from one formula to another (in less than 3 days), etc. In older children, stress may be considered as a cause. , dietary changes, travel and other factors3. You can learn more about the causes of constipation in children at different ages in the articles “Constipation in children under one year of age” and “Constipation in children over one year of age.”
There are many types of laxatives to combat constipation in children with different mechanisms of action. However, we would like to focus on the use of microenemas, since the frequency of their use is growing every year4. Let's figure out what the frequent use of microenemas can cause for constipation in children.
Disadvantages of microenemas
The effect of microenemas is limited to the rectum. The product softens only its contents and does not affect most of the large intestine, where stool formation occurs. Therefore, the problem may recur, which, in turn, may provoke drug abuse5.
If a child suffering from constipation quickly clears the intestines after using microenemas, mothers are happy and make regular use of such products a habit. Unfortunately, the very fact of going to the toilet does not mean that bowel function has returned to normal. This only means that the hard contents of the rectum have softened and come out, but the problem may remain. Recurrence of symptoms again prompts the use of laxatives. As a result, parents may develop the habit of frequent use of microenemas, and the child may forget how to go to the toilet independently.
Thus, microenemas are an “emergency” remedy for constipation in children, since their use can stimulate bowel movements. However, the use of microenemas does not allow the formation of natural regular stool, which is one of the main objectives of treating constipation. Therefore, microenemas may not be suitable for frequent and long-term use6.
What to expect from your first consultation with a proctologist
The first appointment is a consultation and visual examination. The doctor collects anamnesis and reads the medical documentation. The examination can be carried out on a couch or in a special chair. The doctor may perform a digital examination of the rectum. It can be performed after anesthesia with ointment or gel, but this is only required in 5% of cases, because all manipulations are absolutely painless. During a digital examination, the condition of the skin in the anal area, mucous membrane, sphincter contractility, and whether there are hemorrhoids or other neoplasms are assessed.
The specialist begins the appointment with a conversation, studying the medical history and tests (if available). But the matter is not limited to conversations alone - the doctor conducts a visual examination of the perineum and anus, as well as a digital examination. If necessary, anoscopy and sigmoidoscopy are performed, for which special devices are used.
In order for the doctor to get a true picture of what is happening to the body, the patient needs to prepare in advance.
Kolosovsky Yaroslav Viktorovich
surgeon, mammologist, oncologist, phlebologist
A timely visit to a proctologist is incredibly important for the patient, since in many cases contacting a doctor immediately after the onset of symptoms allows you to save life and health. Many diseases of the rectum are very dangerous. About 33% of all outpatients are treated for hemorrhoids, which are often complicated by bleeding. 5% of patients are diagnosed with colorectal cancer during an appointment with a proctologist, and the earlier it is detected, the greater the chance of successfully curing the pathology.
Proctological diseases are becoming more common today due to physical inactivity, a sedentary lifestyle and poor nutrition. Impaired defecation, pain in the projection of the rectum, discharge from the anus - all these symptoms are reasons to consult a doctor as soon as possible, because any disease is easier to treat at an early stage, and the prognosis for it becomes much better.
What helps restore bowel function when a child is constipated?
If constipation recurs in children, it is important to improve bowel function. For this purpose, Duphalac® may be the optimal remedy. The drug has a double effect: working throughout the large intestine, it gently cleanses it and has a laxative effect, and due to its prebiotic properties, Duphalac® normalizes the balance of microflora7. As a result, the drug helps restore the natural rhythm of the intestines and provides a long-term effect in normalizing stool7-9.
After considering the mechanism of action and features of the use of two types of laxatives (microenemas and Duphalac®), you can consciously approach the choice based on your specific situation and goals (stimulating rapid bowel cleansing and/or treating constipation in children to obtain a long-term effect).
Duphalac® is approved for various categories of consumers, including children from the first days of life, as well as pregnant and lactating women7.
Read more about the benefits of the drug in a separate material.
RUS2124077 from 05/07/2020
How to cleanse the rectum
The cleansing method is chosen in accordance with the state of health. This can be a mechanical method using an enema or microenema, as well as taking laxatives.
Enema cleansing
In the absence of contraindications (no acute pain, no bleeding), cleansing is carried out with a water enema. If the appointment is scheduled for the first half of the day, then two cleansing enemas are done the night before:
- Take Esmarch's mug - it resembles an ordinary rubber heating pad, at the bottom of which is attached a hose (1.5 m) with a plastic tip and tap.
- Fill it with two liters of warm (about 36.6°C) drinking water.
- Lubricate the clean tip with Vaseline.
- Carefully insert it into the anus while kneeling or lying on your right side (if you can’t do it yourself, then ask your loved ones for help).
- Open the faucet.
- Relax your stomach so that water can easily fill your intestines.
- Try to hold the water for about 10 minutes, and then empty your bowels if you have a strong urge.
Keep the interval between enemas from 15 minutes to half an hour.
In the morning, two hours before the visit, you need to do another similar enema.
Microenema cleansing
In many cases, when preparing for a visit to a proctologist, you can use a mild product called Microlax (sold in pharmacies without a prescription). It is also used by pregnant women, since regular enemas are undesirable.
Microlax can be used from the age of one year, as well as by pregnant women. The contents of the capsules (5 ml) soften stool and increase the volume of fluid in the intestines.
All that is required is to squeeze the gel from the tube into the rectum and wait 15 minutes for the product to take effect.
Cleansing using the laxative drug Fortrans
The amount of powder used depends on the person's weight. One sachet is designed for 20 kg of patient weight. It is diluted in one liter of water. Adult patients are most often prescribed three to four sachets.
It is usually recommended to start cleansing the day before your appointment, since the product acts individually - as a rule, cleansing begins after 2-3 hours and ends after six hours, but it can take much longer.
You should drink 250 ml of the solution every hour until everything is drunk.
