It uses a fiber optic camera, mounted at the apex of a flexible tube that is inserted through the anus. Colonoscopy can thus provide a visual diagnosis (for example of ulcers, polyps, diverticula, cancerous lesions, etc.); when needed, this examination also offers the possibility to perform a biopsy or the removal of suspected cancerous or precancerous lesions (polyps) in the colon rectal area; these, once removed, must be studied under a microscope to determine their histological type (benign, malignant, stage, etc.).
ATTENTION! In order to avoid unnecessary alarmism, we remind you that an intestinal polyp can take up to 15 years to turn into a cancerous lesion; however, upon reaching a certain age (around 55-60 years), colonoscopy should be considered a "screening test."
In certain subjects considered potentially at risk (due to familiarity, clinical history of other injuries, inflammatory bowel sufferings, etc.), it would be desirable for it to be programmed and repeated systematically from the age of 40.
Being a visual examination, colonoscopy requires a preparatory phase of colon cleansing, in which diet plays a very important role (for more information read the article: Diet in preparing for colonoscopy).
On the other hand, not everyone knows what diet to follow immediately after the exam. In the next chapter we will describe the most suitable diet for the recovery phase from colonoscopy.
Moreover, it should be kept in mind that, after a colonoscopy, the colon is:
- Almost devoid of intestinal bacterial flora
- Undernourished (like the rest of the body)
- Washed out of the physiological protective mucus.
The basic principles to avoid the classic intestinal symptoms (especially constipation, but also diarrhea) are:
- Avoid alcohol and beverages / foods or supplements containing nerve molecules (caffeine, theobromine, theine, etc.) for at least 12-24 hours; among these: wine, beer, grappa, coffee, chocolate, cocoa, fermented teas, energy drinks, thermogenic supplements, etc.
- Avoid foods that are too fatty and recipes that involve the use of many condiments, including salt and spices (stews, roasts in the oven with lard, pasta all "amatriciana, pan-fried spinach with sausage and the like).
- In the event that the colonoscopy has foreseen heavy sedation, or that the subject is particularly affected, it is advisable to structure a liquid or semi-liquid diet; the most suitable foods are peeled and well-cooked fruit, vegetables and legumes (for example, vegetable and / or legume puree - not pureed - and cooked - peeled - apples).
This recommendation is necessary because, in some cases, anesthesia causes nausea and / or vomiting; a clouded mind is not able to better manage this kind of impulses, which is why it would be better to optimize the expulsion process. - Prefer a diet with a low insoluble residue, increasing the intake of soluble fibers. These have a prebiotic action, improve the consistency of the faeces and regulate intestinal activity without excessively stressing peristalsis.
- Avoid recipes cooked with systems that tend to produce toxic molecules; also avoid foods that contain nitrates and nitrites. This is also a valid criterion for healthy people, however, considering that the intestine is more vulnerable, it is better to avoid these potentially carcinogenic elements coming into contact with the mucosa.
To limit nitrates and nitrites, it is essential to avoid preserved meats (sausages) and to wash the vegetables carefully. To limit toxic molecules it is essential to discard cooking on the grill, griddle, spit, frying and cooking in a pan over a too high flame. On the other hand, we recommend cooking by boiling, pressure, steam, vacuum-packed and in jars. - Introduce foods gradually, especially those poorly tolerated. For example, on the first day consume only: rice, veal, lettuce and extra virgin olive oil, which are among the most universally tolerated foods.
- Respect the criterion of subjective tolerance, based on the knowledge of one's own organism; for example, knowing that ginger or chilli could irritate the intestine causing diarrhea and cramps, postpone their use until full recovery.
- Increase the amount of water and minerals in the diet. Patients undergoing colonoscopy tend to be dehydrated due to the diet and preparation solutions for the visit (basically osmotic). By eating brothy first courses, the water intake increases significantly and does not conflict with the other recommendations mentioned above. In addition, it is advisable to drink little and often; isotonic drinks of hydro-saline supplementation may be desirable.
- In the most difficult cases, or those in which there is an "alteration of the alvo" (constipation or diarrhea), food, or supplements or drugs, with probiotic action (with lactobacilli and bifidobacteria), prebiotic and nourishing, could be very useful. for enterocytes. These include yogurt, soy-based fermented products (tofu, miso, tempeh, etc.), buttermilk, kefir, added yogurt (to drink), enterogermin, etc. It is always good to rely on your own feelings and experience, avoiding taking foods that have never been tried before.
The products with prebiotic action are basically complex and gelatinized carbohydrates (for example, in parboiled rice) and soluble fibers (from algae such as glucomannans, from vegetables such as inulin and from fruit such as pectin). Probiotics and prebiotics help to nourish the cells of the intestine (with the production of butyric acid and polyamines) but, if this were not enough, remember that some molecules such as lauric acid (from coconut oil) and butyric acid (from butter) can improve condition of the mucous membrane.
The dietary measures to be adopted following polypectomy are the following:
- First 48 hours: liquid diet, without solid foods; moreover, it is advisable to structure a nutritional regime based on easily digestible foods, poor in insoluble fiber (legume peel, cereal bran, etc.) and free of spices and stimulants (coffee, cocoa, red or black tea, etc.).
- First 72 hours: avoid alcohol and other irritants, including solid foods.
- Over 96 hours: respect the criteria of the post colonoscopy diet avoiding the enemas in the most absolute way. In case of anal bleeding or other symptoms, it is recommended to resume fasting and go to the emergency room for examination.
