Scheme of preparation for colonoscopy with the drug "Fortrans"

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The presence of contraindications should be checked with a doctor.

If the preparation is carried out using the drug “Fortrans”, there is no need for cleansing enemas. 2 days before the colonoscopy, you need to switch to a special (slag-free) diet, excluding vegetables and fruits, potatoes, herbs, berries, mushrooms, legumes, and black bread from the diet. Allowed: broth, semolina porridge, egg, boiled meat, boiled sausage, fish, cheese, butter, fermented milk products, except cottage cheese.

It is advisable to start taking the Fortrans solution no earlier than 2 hours after eating. For effective preparation, you need to purchase 3 or 4 packages of the drug at the pharmacy. Four packages must be purchased for those patients who have a large body size, constipation, adhesive disease of the abdominal cavity, previously identified lengthening or prolapse of the colon (during the passage of barium through the intestines, irrigation or colonoscopy).

Composition of Fortrans

The active component is macrogol 4000. It is this ingredient in the drug that causes its laxative effect. Among the auxiliary components used in the production of Fortrans:

• sodium chloride (table salt);
• sodium bicarbonate (soda);
• sodium saccharinate;
• sodium sulfate anhydrous.

The medicine is available in the form of a powder packaged in paper bags, which must be dissolved before use. The weight of each sachet is 73.69 g, of which 64 g is macrogol, the rest is filled with auxiliary components.

The powder has a white color and a fine structure, due to which it dissolves almost instantly. There are 4 sachets in one package, their total cost is about 150 rubles. Fortrans is produced in France.

Mechanism of action of the drug

Fortrans is a laxative with osmotic action. Macrogol refers to polymer compounds with many intermolecular bonds. This structure of synthetic polyethylene glycol ensures the attraction of water and its retention, due to which macrogol quickly swells, greatly increasing the total volume of intestinal contents. As a result, intestinal peristalsis is activated, active contraction occurs and feces move towards the rectal sphincter, after which emptying occurs.

Features of the pharmacological mechanism of action of Fortrans include:

• The effect of the drug is only on the intestinal contents
  . Once in the body, macrogol passes unchanged into the intestines, where it begins to attract water. The components of the laxative do not penetrate the bloodstream, which means they do not have a systemic effect on the body.
• Using only the water needed to soften feces is what is in the intestines
  . Due to this, Fortrans does not lead to dehydration.
• Powerful cleansing effect
  . The drug begins to act from the uppermost parts of the colon, that is, all accumulated toxins are completely removed from the digestive system.

• Rapid development of laxative effect
  . The first urge to defecate appears within an hour and a half after taking the first portion of the dissolved powder.

The auxiliary components contained in the drug maintain water and electrolyte balance and replenish the loss of fluid excreted in the stool.

Fortrans must be dissolved in the amount of water recommended by the manufacturer, this ensures the most pronounced laxative effect.

The medicinal components of the drug do not remain in the body and are released along with the contents of the intestine. The laxative effect after taking the last dose of Fortrans lasts for 2-6 hours.

One-stage preparation scheme

It is recommended when conducting the study in the morning before 11:00.

1. 3 and 2 days before the test, follow a slag-free diet.
2. 1 day before the test, before 13:00, take only liquids and do not eat solid food.

From 16:00 to 20:00 - take 1 liter of Fortrans (for 4 hours, 1 glass every 15 minutes).

On the day of the examination, during the procedure without painkillers, you can drink tea with honey or still water. When performing the procedure under sedation (with pain medication), you must avoid eating and be on an empty stomach.

The indicated administration time can be changed, but it is important to remember that it is recommended to finish taking the last dose of Fortrans 3-4 hours before the start of the study.

In what cases is it used?

Doctors primarily prescribe drinking Fortrans to cleanse the intestines during the period of preparation for diagnostic procedures, such as:

• irrigoscopy;
• colonoscopy;
• irrigography.

Complete cleansing of the large intestine improves the visualization of its location and pathological changes, which allows you to make the most accurate diagnosis. Fortrans is often prescribed instead of a cleansing enema before operations on the digestive and pelvic organs.

For constipation, Fortrans is not recommended to be used too often - maximum 2-3 times a year.

Frequent use of Fortrans for chronic or episodic problems with bowel movements can cause microflora disturbances, colitis and other digestive problems. The medicine can be used up to 3 times a year to cleanse the body in order to remove accumulated toxic compounds and toxins.

The procedure improves liver function, helps cleanse the skin, and has a positive effect on digestion.

General admission rules

The medicine is intended for oral administration. Before use, the powder is diluted in water - one liter of clean water is needed for each packet of powder. The dosage is calculated based on weight - for every 15-20 kilograms, 1 packet of Fortrans is required. Thus, an average weight adult (70 kg) may need 3-4 sachets to cleanse the intestines. Rules of use:

• The entire required volume of Fortrans should be dissolved in the required volume of water. That is, for 4 bags you will need to take 4 liters of boiled water.
• The drug should be taken 2 hours after dinner. It is also recommended to review the timing of taking the medications used; their evening dose should also be taken no later than 2 hours before cleansing.

• The entire prepared solution should be drunk during the evening. The rate of its intake is 1 liter over one hour.
• Fortrans is drunk in small sips in a glass. The break between drinking a glass of laxative solution should be 10-15 minutes.

The total dose of the medicine can be divided into 2 times, half taken in the evening and the other in the morning. But this option of using a laxative is allowed only if the study or surgical intervention is scheduled for the daytime or evening hours.

Fortrans begins to act in most cases within an hour and a half and the laxative effect after taking the last portion lasts up to 3, less often 4-5 hours.

Due to the rapid and long-lasting laxative effect, it is better to start using this medication no later than 18:00 in the evening. In this case, complete cleansing of the intestines can be achieved before 11-12 am.

Slag-free diet

YOU CAN take refined foods and easily digestible foods:

• Boiled meat (low-fat varieties), fish, chicken
• Bouillon
• Low-fat fermented milk products without fruit additives
• Boiled eggs
• Omelette
• Honey
• Jelly
• Not strong tea or coffee, clear juices without pulp
• Not sparkling water

DO NOT eat foods rich in fiber and poorly digestible foods:

• Grain products, cereals
• Fruits, vegetables, berries, greens
• Cereals, legumes, nuts
• Fatty meats, fish, poultry, mushrooms
• Cream soups, smoked meats, canned food, sausages
• Full fat dairy products
• Bread, sweets
• Alcohol and carbonated drinks

special instructions

Fortrans is considered one of the most powerful laxatives. To ensure that the drug does not have a negative effect and does not worsen your well-being, it must be taken correctly:

• It is imperative to accurately calculate the dosage of the medicine. To do this you need to know your weight.
• After starting to take a laxative, you should not eat. But you can and should drink - filtered water, tea, compote.
• Dissolved Fortrans has a not very pleasant taste, which causes nausea and vomiting in many people. To reduce their severity, you should drink the medicine in small sips, and after taking it, dissolve a slice of lemon or orange in your mouth, wash down the medicine with plain or acidified water.

• The day after cleansing, it is advisable to follow a rice diet. Eating rice has a strengthening effect and thus prevents the development of diarrhea.

Some doctors recommend taking probiotics for 7-10 days after taking the medication. Their use will eliminate the risk of developing dysbiosis and improve the restoration of normal intestinal function. Medicines from this group are especially necessary for people with chronic diseases of the digestive system.

After starting to use Fortrans, it is not advisable to go outside, since defecation can happen at the most inopportune moment.

Preparation for intestinal irrigoscopy with Fortrans begins 2-3 days before the procedure and involves following a special laxative diet.

The patient is asked to exclude heavy foods from the diet, that is, brown bread, potatoes, legumes, meat and fatty foods.

They need to be replaced with vegetable and lactic acid foods, light vegetable soups, and water porridge. On the day of taking Fortrans, the last meal should be no later than 3 o’clock in the afternoon, then from 17-18 o’clock in the evening you can start drinking the dissolved powder.

Two-stage preparation scheme

We invite you to familiarize yourself with the two-step preparation scheme for colonoscopy using the drug Fortrans. Preparation is preferable as it provides better quality of preparation and is easier to tolerate by the patient.

It is recommended when conducting the study at lunchtime after 11:00.

1. 3 days before the test, follow a slag-free diet.
2. 1 day before the test, before 15:00, take only liquids and do not eat solid food.

Stage 1 of taking Fortrans (1 day before the study):

• 18:00-19:00 - take 1 liter of Fortrans (1 glass every 15 minutes).
• 19:00-20:00 - take another 1 liter of the drug (1 glass every 15 minutes).

Stage 2 of taking Fortrans (on the day of the study):

If the examination is carried out without anesthesia (sedation), you can drink tea with honey or still water. If the test is carried out using painkillers, you must be on an empty stomach.

• 5:30-6:30 - take 1 liter of Fortrans (1 glass every 15 minutes).
• 6:30-7:30 - take 1 liter of Fortrans (1 glass every 15 minutes).

Fortrans for weight loss

Laxatives are often used as weight loss aids. Fortrans really promotes weight loss; just taking a single dose, calculated based on body weight, helps to remove an extra 2-3 kilograms. However, such weight loss is due only to the release of accumulated feces and excess fluid from the body. Thus, Fortrans does not affect the reduction of fat in problem areas.

Long-term, that is, daily use of the drug is extremely dangerous. This method of losing weight leads to the fact that the body begins to experience a deficiency of vitamins and microelements, which has an extremely adverse effect on the functioning of internal organs, leads to weakness, apathy, and provokes hair loss, dry skin and other health problems.

However, Fortrans can be used in preparation for weight loss. The medicine is used as a means to cleanse the intestines, which greatly improves metabolic processes and makes it easier to follow a diet for weight loss. The peculiarities of taking a laxative in this case are no different from the recommendations that must be followed when using it before diagnostic procedures and operations.

Contraindications and side effects

Undesirable changes in well-being due to the use of Fortrans in the form of nausea and a tendency to vomit occur in almost everyone and are due to the specific taste of the solution. As a rule, they are usually pronounced in the first hour of taking the medicine, then decrease significantly. Other possible adverse reactions to Fortrans include:

• allergic reactions in the form of rashes on the body, swelling, urticaria;
• increased gas formation;
• heaviness in the stomach;
• weakness.

In rare cases, symptoms of anaphylactic shock are recorded. In the first two days after taking it, loose stools may bother you; a rice diet helps speed up the restoration of intestinal functions.

Absolute contraindications to taking Fortrans:

• severe dehydration;
• malignant tumors of the rectum;
• intestinal obstruction;
• erosive and ulcerative pathologies of the gastrointestinal tract;
• perforation of the stomach and intestines;
• hypersensitivity to polyethylene glycol;

• age up to 15 years;
• severe heart and kidney diseases.
• abdominal pain of unknown etiology.

The use of Fortrans during pregnancy is not recommended, as increased intestinal motility can increase the tone of the uterus. It is not advisable to use the drug while breastfeeding - dehydration can lead to disruption of breast milk production.

Fortrans®

Elderly people with poor health are recommended to use the drug only under the supervision of medical personnel.

You should avoid eating solid food at least two hours before using Fortrans® and until the end of the examination. Drinks such as tea, coffee (without milk) and other non-alcoholic drinks are allowed.

The patient must maintain an interval of at least 1 hour between taking Fortrans® and other medications.

The drug contains Macrogol 4000 (polyethylene glycol). Allergic reactions (anaphylactic shock, angioedema, urticaria, skin rashes) have been reported after the administration of drugs containing polyethylene glycol.

Caution must be exercised when prescribing Fortrans® to patients with inflammation of the intestinal mucosa, including the rectum.

The drug should be used with caution and only under the supervision of medical personnel in patients with a tendency to aspiration, in bedridden patients, in patients with neurological disorders and/or in patients with impaired motor function due to the risk of developing aspiration pneumonia. For such patients, the drug is administered in a “sitting” state and through a nasogastric tube.

Semi/unconscious patients should be carefully monitored while using the drug. If symptoms of pain or bloating appear, the rate of administration of the drug should be reduced or the use should be suspended until these symptoms disappear.

Due to the isotonic composition of the drug Fortrans®, patients are not expected to develop electrolyte imbalance after taking it, with the exception of patients at risk of fluid and electrolyte balance disorders. Patients with fluid and electrolyte imbalances must undergo appropriate therapy to eliminate them before

carrying out a bowel cleansing procedure. The drug should be used with caution in patients prone to developing fluid and electrolyte imbalances, including hyponatremia and hypokalemia, as well as in patients at higher risk of side effects (patients with impaired renal function, heart failure, or patients with concomitant diuretics). therapy). The use of the drug in such patients should be carefully monitored.

Particular caution must be observed in patients with cardiac and renal failure, as due to fluid overload they are at risk of developing acute pulmonary edema. Experience with the medical use of the drug in patients with impaired renal function is limited. The effectiveness and safety of Fortrans® in children under 18 years of age have not been established.