1. Anoscopy
8 cm in length, used in rubber band ligation or sclerotherapy of hemorrhoids
2. Proctoscopy
rigid proctoscope used for examination of the rectum and distal sigmoid colon standard proctoscope is 25 cm in length
3. Flexible Sigmoidoscopy and Colonoscopy
Sigmoidoscopes measure 60 cm in length, may allow visualization as high as the splenic flexure, although the mobility and redundancy of the sigmoid colon often limit the extent of the examination
Colonoscopes measure 100 to 160 cm in length and are capable of examining the
entire colon and terminal ileum
4. Bowel preparation for colonoscopy
Oral balanced electrolyte solutions with polyethylene glycol (PEG) in patients with Hx of renal dysfunction, cardiac disease or electrolyte disturbances
(Golytely)
(Nulytely): remove sodium sulfate from Golytely, increase PEG
-do not damage the colonic mucosa
-minimal osmotic fluid shifts into the gut lumen
-useful in patients with active lower GI bleeding
-large volume of (4 L) to swallow, unpalatable taste
-split dosing: 2L of PEG at 6:00 PM the night before the colonoscopy and 5 mg of oral bisacodyl (Dulcolax) at 8:00 PM. The following morning drink an additional 1L of PEG, completed at least 2 hours before the procedure
-contraindications: ileus, significant gastric retention, mechanical bowel obstruction, severe colitis, neurologic impairment preventing safe swallowing
normal renal function, no Hx of cardiac disease or electrolyte disturbances
-> magnesium citrate
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