![]() These cases emphasize the difficulty and importance of differentiating between IBD and SRUS, and should encourage practitioners to include this differential diagnosis earlier on to improve diagnostic accuracy and begin implementing effective treatment. We present two cases in the pediatric population whose diagnoses of SRUS were delayed because the symptoms and macroscopic findings initially supported the differential diagnosis of IBD. Furthermore, macroscopic ulcers and inflammation can be seen in both diseases, making it difficult to diagnose without a biopsy. Both SRUS and inflammatory bowel disease (IBD) can present with rectal bleeding, constipation, diarrhea, and abdominal pain. It is often misdiagnosed as malignancy, Crohn’s disease, and ulcerative colitis due to its wide and varying clinical presentations. If your bowel isn’t completely clear, and the colonoscopist isn’t able to see your full bowel during the procedure, then you may have to come back for another colonoscopy.Solitary rectal ulcer syndrome (SRUS) is a benign rectal disease that is rare in pediatric populations due to its underdiagnosis and misdiagnosis in children. Preparing your colon ready for the examination can be unpleasant and time-consuming, however it is necessary to ensure the intestinal lining can be viewed clearly. You may be asked to stop taking some medication - such as warfarin, aspirin or clopidogrel - as well as painkillers such as ibuprofen and iron tablets. The laxative is often provided as a liquid for you to drink at home and some people do not like the taste. You should continue to drink clear fluids (such as water or squash) to prevent yourself from getting dehydrated as a result of the diarrhoea. The laxatives will give you diarrhoea so you may want to make sure you are able to stay close to a toilet during this time. Therefore, you may be asked to follow a specific diet and take strong laxatives (bowel prep) in the day or so leading up to the examination. The colon needs to be clear for the images from the colonoscope to be clear. Your doctor or nurse will advise you on exactly how they want you to prepare, but an outline of what to expect is given below. This is to help the passage of the colonoscope and to get the clearest pictures possible.ĭuring the procedure biopsies may be taken to be examined and polyps (small growths) may be removed. As the colonoscope is passed through your colon you may need to move position or the doctor/nurse may press on your abdomen. A lubricant will be used to make this as easy as possible. It is long enough to also go into the end of the small intestine (known as the terminal ileum). You will be asked to lie on your left-hand side and the colonoscope will be carefully fed through your anus and all the way through your colon. This will be discussed with you before the examination. You may receive a sedative or local anaesthetic before the test starts to make the examination more comfortable for you. The procedure should take no more than an hour to carry out. Sedatives are sometimes used during the procedure so it’s important to have someone who can collect you from the hospital and to avoid driving for 24 hours after the procedure. Unless you are already staying at hospital you will probably be seen as a day-case, meaning you do not need to stay overnight. ![]() A colonoscopy is usually carried out in hospital by a specially trained doctor or nurse.
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