Colon Wash: what it is, what it is for and when it needs to be done

By Cristiano Antonino On Jan 14, 2023

The colon wash procedure is indicated for performing thorough colon washing prior to colonoscopy, which cleanses the mucosa to allow optimal endoscopic viewing

COLON WASH AND ENEMA: WHAT’S THE DIFFERENCE?

ln general, the traditional enema allows partial cleansing of the last part of the large intestine (the rectum and the sigma), whereas the colon wash, due to its pressure regulation characteristics, allows complete washing of the colon.

COLON WASH AND TRADITIONAL COLONOSCOPY PREPARATION

Colon Wash, if performed by experienced personnel, is as effective as traditional colonoscopy preparation, but in a limited number of patients (as with traditional preparation) the result may not be optimal for performing colonoscopy.

In that case, further suggestions will be given to complete the intestinal cleansing.

COLON WASH: RISKS AND BENEFITS, CONTRAINDICATIONS

Colon Wash is contraindicated when colonoscopy is contraindicated.

So if your doctor has indicated colonoscopy, you can also perform a colon wash as a correct and effective preparation for colonoscopy.

Since colonoscopy is not recommended during pregnancy and breast-feeding, this indication also applies to Colon Wash as preparation for Colonoscopy.

Therapy with antiplatelet or anticoagulants (TAO and NAO) does not contraindicate the performance of colonoscopy but may interfere with the possibility of performing biopsies and/or polypectomies.

HOW IS THE COLON WASH PERFORMED?

A patient lying on his side or supine is inserted into the rectum with a cannula equipped with two tubes, a smaller one for water intake and a larger one to remove faecal material and used water.

The cannula is connected to a device that controls the pressure and temperature of the water.

The operator performs successive irrigations and during the session can change the pre-set parameters in order to achieve a better effect and customise the therapy.

A massage of the abdomen is also performed to encourage fragmentation and detachment of faecal materials from the colon mucosa.

There are no unpleasant odours as water and faeces are fed in and out via a closed-loop system.

HOW LONG DOES IT LAST?

The colon wash lasts about 45 minutes, after which the patient will immediately undergo colonoscopy in the adjacent room.

IS THE COLON WASH PAINFUL?

The Colon Wash is not painful.

Instead, it offers the patient a feeling of wellbeing thanks to the lukewarm water running in cycles and at low pressure through the colon and the massage that is performed on the abdomen.

Sedation is not absolutely necessary both because the test is painless and because the patient’s cooperation is important.

No drugs are required for the execution.

The alternative to performing the Colon Wash as preparation for colonoscopy is to perform a “traditional” colonoscopy preparation.

BEFORE THE TEST

Report current therapies, especially anti-platelet and anticoagulants;

in the case of serious liver disease, it is necessary to notify the doctor before undergoing the endoscopic examination and it is advisable to carry out laboratory tests of coagulation parameters (blood count, INR) beforehand;

advise if you suffer from serious heart or arrhythmia diseases or respiratory system diseases: in such cases, it is advisable to enclose an electrocardiogram, tests or results of specialist examinations;

report the presence of inguinal hernias and previous operations on the abdomen;

report any allergies;

it is not necessary to suspend current therapies, but it is advisable to take them with a little water at least 2 hours before the test;

if you have diabetes and are being treated with insulin, consult your doctor in advance before the date set for the endoscopic test.

PREPARATION INSTRUCTIONS

For the perfect performance of the test, please follow the following instructions scrupulously.

In patients with chronic constipation

the day before the test observe a waste-free diet (do not eat fruit, vegetables, unrefined cereals such as wholemeal bread, wholemeal pasta, bran) and continue with a traditional laxative regime. If you do not habitually use laxatives, take Macrogol 1 sachet + Pursennid 2cp in the evening before going to bed;
in the 5 days preceding the test take Macrogol 1 sachet + Pursennid 2cp at the same time, in the evening, before going to bed;
on the evening before the test do not take any liquids (other than those required for personal needs) for intestinal cleansing;
on the day of the test be fasting for 12 hours; clear liquids (water, camomile tea, herbal tea) can be taken up to 2/4 hours before the procedure.

In patients with regular bowel movements

the day before the test eat a diet free of vegetable waste (no fruit, vegetables, unrefined cereals such as wholemeal bread, wholemeal pasta, bran);
on the 3 days before the test take Macrogol 1 sachet + Pursennid 2cp in the evening before going to bed. The evening before the test do not take any liquids (other than those required for personal needs) for intestinal cleansing;
on the day of the test fast for 12 hours; clear liquids (water, camomile tea, herbal tea) can be taken up to 2/4 hours before the procedure.

WHAT IS THE DIFFERENCE BETWEEN COLON WASH AND HYDROCOLON THERAPY?

Although similar, the two procedures have different purposes. The colon wash replaces the use of an enema in the traditional preparation for colonoscopy, and is performed to free the intestine and cleanse the mucous membranes of the colon in order to obtain an accurate endoscopic view.

Hydrocolon therapy, on the other hand, cleanses the intestine of toxins and waste and is considered an adjunct in the treatment of conditions such as chronic constipation, neurological diseases, skin allergies, and disorders related to altered intestinal bacterial flora.

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