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Bowel ultrasound is a non-invasive method that is well tolerated even by children and allows the physician to examine the bowel loops and help diagnose or monitor an existing disease.
What is bowel ultrasound?
Bowel ultrasonography is a diagnostic procedure used to analyze the condition of the intestines, especially the terminal ileum, the appendiceal region, and the colon.
It is a non-invasive diagnostic method that uses ultrasound waves for visualization. Special ultrasound probes with a frequency of 7.5 MHz and higher are used, depending on the patient’s body habitus and the intestinal segment being imaged.
The best results of bowel ultrasound are achieved when assessing inflammatory changes in ulcerative colitis, Crohn’s disease, and in suspected appendicitis.
It should also be emphasized that, in addition to assessing bowel wall thickness and, consequently, the presence of inflammatory or other pathologies (e.g., diverticula or neoplasms), bowel ultrasound also allows evaluation of structures surrounding the intestine and detection of lymph nodes, possible fistulas, and abscesses.
Regarding appendiceal pathology, in the overwhelming majority of cases ultrasound makes it possible to visualize an inflamed appendix and any periappendiceal abscesses.
In diverticulitis, ultrasound, in addition to identifying the site and extent of inflammation, allows monitoring of the course of medical therapy and the possible appearance of complications.
Thanks to ultrasound, it is possible to assess not only the thickness of the bowel wall loops and, consequently, the degree of inflammation, but also motility (i.e., movement) and distension of the loops, as well as the presence of fluid, which is an important sign of certain pathologies. In such cases, in addition to ultrasound, an X-ray may be prescribed.
Types of ultrasound
Assessment of the bowel by ultrasound can be performed using two methods.
• Transabdominal ultrasound. In this case, the examination is performed through the abdominal skin. Although this method usually causes no discomfort, it is insufficiently informative.
• Endorectal ultrasound. It is performed using a very thin probe that is inserted into the anus. Before this, the rectum is filled with fluid to increase diagnostic yield and to examine each bowel loop in detail. The manipulation is painless.
• Transvaginal ultrasound. It is performed by inserting a cavity probe into the vagina. This method is used in women when a rectovaginal fistula is suspected to determine the fistulous tract and its length. It also allows better visualization of the sigmoid colon and rectum when preparation is insufficient.
The attending physician may recommend using several options for bowel ultrasound.
Indications for bowel ultrasound
Bowel ultrasound is performed to check for abnormalities in the bowel loops, the appendix, and the colon; in suspected mesenteric vessel thrombosis or ischemia of a segment of the intestine; intestinal bleeding; perforation of the intestinal wall; the presence of a fistulous tract or abscess; and it may be useful in suspected acute and chronic inflammatory bowel diseases such as:
• Crohn’s disease,
• diverticulosis or diverticulitis,
• appendicitis,
• segmental colitis associated with diverticula,
• non-specific colitis or enteritis.
Ultrasonography may be useful in the diagnosis of small-bowel neoplasms, which are rare tumors without characteristic symptoms. During bowel ultrasound, neoplastic lesions of the large intestine may also be detected. In such situations, bowel ultrasound is an additional diagnostic method and does not replace colonoscopy or studies such as CT or MRI of the bowel.
Clear indications for ultrasound also include the following symptoms:
• unpleasant taste, foul-smelling breath,
• prolonged constipation or diarrhea,
• heaviness in the abdomen after eating,
• heartburn, abdominal bloating or flatulence,
• unexplained nausea or vomiting,
• blood or white mucus in the stool,
• unpleasant sensations when attempting to defecate.
IMPORTANT: If the listed symptoms are accompanied by fever, it is necessary to consult a physician as soon as possible.
How bowel ultrasound is performed
Bowel ultrasound is similar to a classic abdominal ultrasound: the physician applies gel to the patient’s abdomen and, using an ultrasound probe, checks for thickening or changes in the bowel loops.
This is a painless diagnostic method, except when performed over inflamed areas; in such cases the patient may feel slight discomfort.
If the examination is performed to assess small-bowel loops, it may be helpful to have the patient drink about one liter of water; whereas if the indication is to assess intestinal transit and peristalsis, the study can also be performed at intervals. In this case, its total duration will be approximately 2 hours.
A standard bowel ultrasound lasts about 20 minutes.
Patient preparation for bowel ultrasound
This type of ultrasound is performed on an empty stomach, 8–10 hours after the last meal, and requires the following preparation:
• Follow a light diet for 3 days, avoiding fried, fatty, and spicy foods,
• Refrain from alcohol during the same period,
• Avoid foods that promote gas formation (legumes, dark bread, whole milk, large amounts of vegetables and fruits),
• If prone to flatulence, use carminative agents,
• On the eve of the examination, perform a cleansing enema until clear return, or use bowel-prep medications as for colonoscopy.
Contraindications
As for transabdominal ultrasound, there are no absolute contraindications. Its performance may be postponed in the presence of severe skin damage (burns and injuries).
Endorectal ultrasound should not be performed in the presence of mental disorders, infectious diseases of the intestine, and stenosis of the terminal section of the gastrointestinal tract.
Advantages of seeking care at Expert Clinics
At Expert Clinics in Moscow, high-precision, next-generation diagnostic equipment is used. Most importantly, physicians here practice an interdisciplinary approach to the correction and prevention of various diseases.
They will help not only to eliminate symptoms, but also to find the root cause of the disease and help eliminate it using personalized therapy. At Expert Clinics you have every chance to improve your quality of life by overcoming disease.
Bowel ultrasonography is a diagnostic procedure used to analyze the condition of the intestines, especially the terminal ileum, the appendiceal region, and the colon.
It is a non-invasive diagnostic method that uses ultrasound waves for visualization. Special ultrasound probes with a frequency of 7.5 MHz and higher are used, depending on the patient’s body habitus and the intestinal segment being imaged.
The best results of bowel ultrasound are achieved when assessing inflammatory changes in ulcerative colitis, Crohn’s disease, and in suspected appendicitis.
It should also be emphasized that, in addition to assessing bowel wall thickness and, consequently, the presence of inflammatory or other pathologies (e.g., diverticula or neoplasms), bowel ultrasound also allows evaluation of structures surrounding the intestine and detection of lymph nodes, possible fistulas, and abscesses.
Regarding appendiceal pathology, in the overwhelming majority of cases ultrasound makes it possible to visualize an inflamed appendix and any periappendiceal abscesses.
In diverticulitis, ultrasound, in addition to identifying the site and extent of inflammation, allows monitoring of the course of medical therapy and the possible appearance of complications.
Thanks to ultrasound, it is possible to assess not only the thickness of the bowel wall loops and, consequently, the degree of inflammation, but also motility (i.e., movement) and distension of the loops, as well as the presence of fluid, which is an important sign of certain pathologies. In such cases, in addition to ultrasound, an X-ray may be prescribed.
Types of ultrasound
Assessment of the bowel by ultrasound can be performed using two methods.
• Transabdominal ultrasound. In this case, the examination is performed through the abdominal skin. Although this method usually causes no discomfort, it is insufficiently informative.
• Endorectal ultrasound. It is performed using a very thin probe that is inserted into the anus. Before this, the rectum is filled with fluid to increase diagnostic yield and to examine each bowel loop in detail. The manipulation is painless.
• Transvaginal ultrasound. It is performed by inserting a cavity probe into the vagina. This method is used in women when a rectovaginal fistula is suspected to determine the fistulous tract and its length. It also allows better visualization of the sigmoid colon and rectum when preparation is insufficient.
The attending physician may recommend using several options for bowel ultrasound.
Indications for bowel ultrasound
Bowel ultrasound is performed to check for abnormalities in the bowel loops, the appendix, and the colon; in suspected mesenteric vessel thrombosis or ischemia of a segment of the intestine; intestinal bleeding; perforation of the intestinal wall; the presence of a fistulous tract or abscess; and it may be useful in suspected acute and chronic inflammatory bowel diseases such as:
• Crohn’s disease,
• diverticulosis or diverticulitis,
• appendicitis,
• segmental colitis associated with diverticula,
• non-specific colitis or enteritis.
Ultrasonography may be useful in the diagnosis of small-bowel neoplasms, which are rare tumors without characteristic symptoms. During bowel ultrasound, neoplastic lesions of the large intestine may also be detected. In such situations, bowel ultrasound is an additional diagnostic method and does not replace colonoscopy or studies such as CT or MRI of the bowel.
Clear indications for ultrasound also include the following symptoms:
• unpleasant taste, foul-smelling breath,
• prolonged constipation or diarrhea,
• heaviness in the abdomen after eating,
• heartburn, abdominal bloating or flatulence,
• unexplained nausea or vomiting,
• blood or white mucus in the stool,
• unpleasant sensations when attempting to defecate.
IMPORTANT: If the listed symptoms are accompanied by fever, it is necessary to consult a physician as soon as possible.
How bowel ultrasound is performed
Bowel ultrasound is similar to a classic abdominal ultrasound: the physician applies gel to the patient’s abdomen and, using an ultrasound probe, checks for thickening or changes in the bowel loops.
This is a painless diagnostic method, except when performed over inflamed areas; in such cases the patient may feel slight discomfort.
If the examination is performed to assess small-bowel loops, it may be helpful to have the patient drink about one liter of water; whereas if the indication is to assess intestinal transit and peristalsis, the study can also be performed at intervals. In this case, its total duration will be approximately 2 hours.
A standard bowel ultrasound lasts about 20 minutes.
Patient preparation for bowel ultrasound
This type of ultrasound is performed on an empty stomach, 8–10 hours after the last meal, and requires the following preparation:
• Follow a light diet for 3 days, avoiding fried, fatty, and spicy foods,
• Refrain from alcohol during the same period,
• Avoid foods that promote gas formation (legumes, dark bread, whole milk, large amounts of vegetables and fruits),
• If prone to flatulence, use carminative agents,
• On the eve of the examination, perform a cleansing enema until clear return, or use bowel-prep medications as for colonoscopy.
Contraindications
As for transabdominal ultrasound, there are no absolute contraindications. Its performance may be postponed in the presence of severe skin damage (burns and injuries).
Endorectal ultrasound should not be performed in the presence of mental disorders, infectious diseases of the intestine, and stenosis of the terminal section of the gastrointestinal tract.
Advantages of seeking care at Expert Clinics
At Expert Clinics in Moscow, high-precision, next-generation diagnostic equipment is used. Most importantly, physicians here practice an interdisciplinary approach to the correction and prevention of various diseases.
They will help not only to eliminate symptoms, but also to find the root cause of the disease and help eliminate it using personalized therapy. At Expert Clinics you have every chance to improve your quality of life by overcoming disease.
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