Intestinal tube
An intestinal tube is constructed like a catheter , except that it is specifically designed to be inserted through the anus into the intestine. There are intestinal tubes in different diameters made of plastic, latex or silicone. In the past, they were made of metal , glass or red rubber , but today these materials are practically no longer used. They are used to fill or empty the intestine with liquids or gases; this usually happens for diagnostic (examination-related) or therapeutic (treatment-related) reasons.
Intestinal tube types
Different intestinal tubes are used depending on the requirements. In the past, the intestinal tubes were often made of red rubber or latex, whereas today they are made of PVC or silicone . Special intestinal tubes for diagnostic purposes often also have a small channel with the help of which gases (e.g. air) or liquids (e.g. drugs , contrast media ) can be brought into the intestine.
The tip of the intestinal tubes can be open or closed, and they usually have two eyes (openings) that are offset in height. Intestinal tubes with an open tip are normally only used for diagnostic purposes, in order to bring the irrigation fluid far into the intestine. Compared to catheters , single-use intestinal tubes are less flexible so that they can be better inserted and advanced into the intestine . Intestinal tubes with a closed tip, on the other hand, cause slight pressure on the intestinal wall when the liquid enters and thus additionally stimulate the peristalsis of the intestine. For diagnostic purposes there are also intestinal tubes with an olive (thickening) at the tip, a central and two or four lateral openings. The olive holds the intestinal tube in the anus better and does not slide out by itself. In addition, balloon intestinal tubes are used that have an inflatable cuff, thereby sealing the anus from the inside and preventing the intestinal tube from sliding out.
Normal intestinal tubes
Disposable intestinal tubes are mainly made of PVC and are sterile packed. They are available in diameters from Charrière made 16 to 40 cm and a length of about 20 to 40 wt. The end of the intestinal tube is flared and often color-coded, with the color code of the cone indicating the diameter. Normal disposable intestinal tubes have a closed tip and two lateral eyes. Disposable catheters can also be used as an alternative to the intestinal tubes for infants and young children . Colon tubes made of red rubber are rarely used today because they have to be cleaned and sterilized again after use.
Balloon intestines
The balloon intestine tubes are constructed like the disposable intestine tubes, only that they have an inflatable cuff that can be unfolded in the intestine, seals the anus from the inside and thus holds the balloon intestine tube in place. In most cases, the balloon has a diameter of about 5 cm and can cause an uncomfortable feeling of need to defecate in the rectum . Disposable balloon intestinal tubes often have an inflatable cuff made of silicone, which lies tightly against the intestinal tube when the intestinal tube is inserted, making it more comfortable for the patient to use. The usual diameter of these intestinal tubes is about 6 to 12 millimeters with a length of about 15 to 20 centimeters. The approach of the balloon intestine tubes is often tapered inwards so that it can be connected directly to a hose . Only balloon intestines made of red rubber have a cone that widens outwards. Balloon tubes made of red rubber are rarely used today because they have to be cleaned and sterilized again after use.
For special cases, so-called double balloon intestinal tubes are available, which are used in patients who, due to a weak sphincter, cannot hold the incoming liquid or the air blown in so well, especially during X-ray examinations. Since the two balloons of this intestinal tube are very close to one another, the anus is reliably sealed . The double balloon intestinal tube is placed in the intestine so that the anterior balloon is inserted through the anus while the second balloon is outside the sphincter. When both balloons are now inflated, they press firmly against the sphincter from the inside and outside and thus seal it securely.
Rectal catheter
The rectal catheters, which are used in irrigation , represent a special form of the intestinal tubes . They are made in diameters of about 20 Charrière and a length of about 40 cm. The end of this intestinal tube has a Luer-Lock connection that is connected to the supply hose of the irrigation device. The rectal catheters have an open tip and two side eyes. There is a cone on the rectal catheter that can be moved and is pressed against the anus by hand after the rectal catheter has been inserted about 5 to 15 cm into the intestine. The contact pressure of the cone ensures that the anus is securely sealed during the irrigation.
Intestinal tube sizes
The intestinal tubes are available in different sizes from Charrière 16 to 40 and in lengths from 20 to 40 cm. The intestinal tubes are identified by a color code or by the size printed on them. For children, intestinal tubes with 16 to 28 charrière and a length of 20 to 30 cm are often used, intestinal tubes for adults are usually 30 to 40 cm long and have a lumen of 28 to 40 charrière. For diagnostic purposes such as B. a colon contrast enema , mostly short and large-lumen intestinal tubes are used, while the longer intestinal tubes are used for colon cleansing .
| Color coding of intestinal tubes | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Size in charrière | CH 16 | CH 18 | CH 20 | CH 22 | CH 24 | CH 26 | CH 28 | CH 30 | CH 32 | CH 35 | CH 40 |
| Color code | orange | red | yellow | violet | blue | White | green | Gray | orange | black | turquoise |
| Diameter (mm) | 5.3 | 6.1 | 6.6 | 7.6 | 8th | 8.6 | 9.3 | 10 | 10.6 | 11.6 | 13.3 |
application
Colon tubes are mainly used to bring liquids or gases into the intestines. The disposable intestinal tubes are mainly used for normal enemas such. B. for bowel evacuation , while the balloon intestine tubes are mainly used for diagnostic purposes such. B. can be used for colon contrast enema , but also for fecal incontinence . Large-volume intestinal tubes with at least Charrière 32 are used for the administration of contrast media or for rectal intestinal irrigation in order not to obstruct the flow of the liquid.
However, intestinal tubes can also be used to relieve the intestine through an intestinal tube inserted into the anus in the event of severe flatulence and thus contribute to the discharge of the flatulence . The intestinal tube then remains in the intestine for 30 minutes (blocked) to a maximum of three hours (unblocked); a longer period in the intestine can lead to pressure points on the intestinal wall.
In order to make the insertion of the intestinal tubes as less stressful as possible for the patient, the intestinal tubes are coated with a lubricant. Normal petroleum jelly or a lubricant gel with a local anesthetic additive such as lidocaine can be used as a lubricant . B. guaranteed for hemorrhoids or anal fissures . If endoscopic examinations are planned after the enema, petroleum jelly is not used; instead, z. B. Endosgel be taken, otherwise the optics of the instruments could be smeared.
literature
- Olaf Kirschnick: Care techniques from A – Z. Thieme, 3rd edition, Stuttgart 2006, ISBN 3-13-127273-2 .
Individual evidence
- ↑ Susanne Wied, Angelika Warmbrunn: Pschyrembel Dictionary Care. 1st edition. de Gruyter, Berlin / New York 2003, ISBN 3-11-016948-7 , p. 146.
- ↑ Care Today. Textbook for nursing professions . 3. Edition. Elsevier, Urban & Fischer, Munich 2004, ISBN 3-437-26770-1 , pp. 740-742.
- ^ Hugo Van Aken: Intensive Care Medicine. Georg Thieme Verlag, 2007, ISBN 3-13-114872-1 , p. 206.
