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Pathologies of the rectum, colon, anus and anorectal region require careful, diagnostic, correctly selected treatment by a proctologist (coloproctologist). What does a proctologist do, how is an examination done in women? What are the indications for visiting this specialist and are there many stages of the examination?

Before proceeding with the examination of the patient, the specialist needs to collect an anamnesis to identify the causes of the problems that have arisen. To do this, first of all, a survey of the patient is carried out. Usually, the doctor is interested in the following questions:

how often does the defecation process take place;
whether there are bloody, mucous or purulent discharges in the stools;
whether there are pain or burning sensation at the time of bowel movement, itching in the anus;
does the patient experience a feeling of not completely emptying the intestines;
Are there any symptoms of poisoning?
what foods have been eaten most recently.

Important! For the most accurate detection of pathologies, it is necessary to provide the doctor with the most accurate and detailed information on the questions asked, to tell about all the exciting symptoms. This will avoid errors in the diagnosis and prescribe the correct one.

For a more productive consultation, it is desirable to be prepared for the survey, so it is important to know what questions the proctologist will ask and how the examination is carried out in women.

Visual inspection

After talking with the patient, collecting all the necessary information, the doctor proceeds to a visual examination. It can help you discover:

hemorrhoids (external form);
dermatitis of the perianal type;
anal fissures, fistulas;
papillomatosis (papillomas, condylomas);
benign and malignant neoplasms.

Examination in women takes place in a proctological chair, reminiscent of a gynecological chair. The woman lies on her back, her legs are bent at the knees and spread apart, leaning on special stands. The accepted posture allows the doctor to fully examine the anus of the examined patient.

Attention! Before visiting the coloproctologist, it is necessary to carry out hygiene procedures: take a shower, wipe the anus and genitals with a damp cloth.

Indications for visiting a doctor

An indication for the need to contact a proctologist is the discovery of a number, including:

pain or itching in the anus;
pain in the perineum, anus, arising in a sitting position;
difficulty, feeling of discomfort at the time of bowel movement;
tactilely felt swelling, visually noticeable swelling, other changes in the anal area;
the presence of warts, papillomas.

For preventive purposes, it is imperative to visit a proctologist and undergo an examination in women during pregnancy, especially in the last trimester, after recent childbirth, since it is during these periods that the risk of hemorrhoids is high, as well as during menopause.

Blog for moms: "Happy pregnancy or how I defeated hemorrhoids ..."

sedentary lifestyle;
excess body weight;
after surgical treatment carried out on the rectum and colon, in the perianal zone;
trauma to the anus or colon.

Advice: many pathologies of the rectum at the initial stage proceed without the appearance of any symptoms, therefore it is advisable to visit a proctologist every year and know how women are examined. Then you will be ready for any surprises.

Inspection steps

In addition to the visual examination described above, which is not always sufficient to diagnose the disease, there are several more stages of the examination:

Palpation. A finger examination of the anus is carried out in gloves with petroleum jelly or antiseptic ointment applied to the finger, which reduces possible unpleasant or painful sensations from the procedure. The method makes it possible to assess muscle tone and peristalsis of the anus and rectum, to identify internal hemorrhoids, anal fissures, intestinal ulcers, etc.
Instrumental inspection. The most commonly used and simple tool is the rectal speculum (). It can be used to detect various tumors, fistulas, cracks, nodes. For a deeper study, which makes it possible to examine the sigmoid colon (especially if malignant neoplasms are suspected), a rectoscope is used.

Before the examination, it is necessary to correctly: empty the intestines with an enema with laxatives. A procedure performed 3 times is sufficient: 2 enemas in the evening, with a break of 1 hour, and 1 in the morning, 1 hour before the specialist's appointment. At least a day before visiting a doctor, fatty foods should be excluded from the diet, switching to cereals, broths, and lean meat.

Reference: examination of a coloproctologist is carried out on an empty stomach.

A visit to a proctologist is, although not very pleasant, but often a necessary procedure. Do not be embarrassed in the doctor's office, especially if the examination is carried out for the first time. The goal of a specialist is to help detect and eliminate existing problems, and the result of the examination largely depends on how much you trust him.

Now you know who a proctologist is, how women are examined.

As a rule, a teenage girl should go to a gynecologist for the first time for an examination somewhere around the age of 15-16-17 or go right after she starts having sex. After that, doctors recommend undergoing a gynecological physical examination twice a year and taking tests. This is at least. In this regard, it will be important to be ready to go to the gynecologist, receive and examine on the chair and, possibly, take a smear.

A girl should plan a visit to the gynecologist not only in the event of any manifestations of trouble in the intimate sphere, whether it be unusual discharge, discomfort and burning in the genital area, pain in the lower abdomen, lack of sexual satisfaction, pain during intercourse or unwillingness to have it at all, etc. Annually, for preventive purposes, you should go to a specialist and undergo a medical examination. Do not ignore recurring symptoms - it can be a manifestation of a gynecological disease - this should be told to the doctor at a preliminary conversation.

Before going to the gynecologist

What you need to know before visiting a gynecologist? We will try to draw your attention to a few simple points that are most often neglected by women, but which you need to know in order to experience a minimum of discomfort and at the same time receive competent advice and treatment. So, what can and what is not recommended to do if you have planned a trip to the gynecologist and how to prepare for a gynecological examination?

Can I have sex before visiting the doctor?
Undesirable. It is recommended to refrain for 2-3 days.

Should I shave in front of a gynecologist, epilate an intimate place, or leave everything as it is?
The type of intimate hairstyle does not affect the quality of diagnosis. No one forces you to shave your genitals before visiting a gynecologist. But for the convenience of inspection, the hair can be made shorter. That is, cut with scissors. Then, upon examination, the doctor will be able to see the skin around the genitals. After all, the skin also has different manifestations of diseases.

Intimate hygiene.
If you are going to visit a gynecologist, you should take care of the proper level of personal hygiene. To do this, it is enough to take a shower or bath and put on clean clothes.

Should I douche?
Absolutely not! Just taking a shower is enough. Hygiene procedures inside the vagina will not allow the doctor to get a true picture of the state of the microflora and may affect the quality of the tests.

Enema in front of a gynecologist - to do or not?
If there is such an opportunity, it is better to do it. If not, then be sure to visit the toilet before the appointment. The filled intestine greatly complicates the study of the uterus and appendages, including ultrasound. This is especially important for virgins (they are examined through the anus), as well as women, if necessary. Before entering the gynecological office, visit the toilet to empty your bladder and bowels.

Menstrual cycle.
It is not recommended to undergo a gynecological examination during normal menstruation. With bloody discharge, an examination of the genital organs is required in exceptional cases, for example, in case of bleeding and cycle disorders.

Should I take a diaper and socks with me?
Yes, these things are essential items, sold in any pharmacy. However, in our clinic, disposable shoe covers and diapers are given to the patient free of charge.

Taking medications.
Antifungal drugs, like antibiotics and vaginal suppositories, change the microflora of the vagina, and tests can give an unreliable result. Their use must be stopped at least 7 days in advance.

Clothing and footwear.
Make sure that undressing before a medical examination in the doctor's office does not cause excessive difficulties, so it is advisable to choose a skirt or dress in advance before going to the gynecologist.

If there are highlights.
In fact, everyone has them, only for some they are always transparent, for others at some point they become yellowish and thicker. They are stable only in one case: when a woman takes oral contraceptives. It is very important to regularly monitor how the amount and consistency of discharge changes during the menstrual cycle. This will help to notice certain deviations in time. Their unusual properties are a sign of some kind of infection. Many diseases in gynecology have similar manifestations. Only a doctor, based on a comprehensive examination, can make a correct diagnosis and prescribe the right treatment.

How to pass a gynecologist to virgins.
Examination of virgins by a gynecologist is carried out in much the same way as all women. Only the examination on the gynecological chair differs - the mirror is not used, the examination of the uterus and appendages is performed not vaginally, but through the rectum. The study of girls - virgins through the vagina is carried out according to special indications - with a suspicion of a foreign body, a tumor process, and some others. These manipulations are carried out carefully, with minimal risk of damaging the hymen.

Have you ever been to a gynecologist for a medical examination?
Find out in more detail that it is useful to know where it is better to go to a doctor in Moscow if this is the first visit to a gynecologist.

Visit to the gynecologist

Going for a medical examination and getting a consultation with a gynecologist is recommended if you are just planning to have sex and want to know about your health status, consult a specialist about methods and methods of contraception. It is especially important when a new sexual partner appears, because this increases the risk of bacterial vaginosis, chlamydia and trichomoniasis. These diseases often resolve without significant symptoms and, if left untreated, can lead to infertility, ectopic pregnancy, or premature birth.

An experienced doctor will observe you during pregnancy, prepare for childbirth and help in the postpartum period. If pregnancy is currently undesirable for you, the specialist will advise which way to solve the problem will be less dangerous for you. In addition, he will tell you how to protect yourself from all kinds of disorders, infectious diseases, diagnose and, if necessary, prescribe effective treatment.

An important factor in maintaining a woman's health is the individual selection of contraceptive methods, which, in turn, is the prevention of abortions and their complications. Modern medicine offers women a wide selection of such remedies.

Thank you

Book a Gynecologist

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At the moment, an appointment is being made with specialists and clinics in Moscow and St. Petersburg.

What happens at the reception at the gynecologist in the antenatal clinic?

When examining a patient gynecologist collects data on complaints that disturb her, after which she performs the necessary diagnostic manipulations. This allows him to suspect a particular diagnosis, to confirm which he can prescribe additional laboratory tests or instrumental studies.

Where does the gynecologist receive - in the clinic or in the hospital ( maternity hospital)?

A gynecologist can be visited at the clinic or in a special department of the maternity hospital. With a planned visit, first of all, you should sign up for a consultation with a doctor at the clinic. During the examination, the doctor will be able to assess the condition of the woman's genitals, take material to detect infectious or neoplastic diseases, as well as ( if necessary) prescribe additional tests and studies ( including pregnancy detection). After evaluating all the data obtained, the gynecologist can make a diagnosis and prescribe the appropriate treatment for the patient. At the same time, he must explain in detail and clearly to the woman everything about her pathology, about the possible consequences and complications.

If during the examination the doctor doubts the accuracy of the diagnosis or if a pathology is detected that requires surgical treatment, long-term observation or the use of special instruments, the patient may be hospitalized in the appropriate department of the hospital. There, under the constant supervision of medical personnel, she will undergo all the necessary diagnostic and treatment procedures, and will be provided with assistance in case of any complications.

After discharge from the hospital, the woman will be given recommendations regarding further treatment. She will also need to regularly visit a gynecologist at the clinic to monitor the effectiveness of treatment, make adjustments to the treatment regimen, as well as to identify and eliminate possible complications or relapses in a timely manner ( cases of recurrence).

Equipment standard for a gynecologist's office

A modern gynecologist's office should have all the devices and tools necessary to examine a woman and perform light diagnostic or therapeutic procedures ( operations).

The minimum equipment for a gynecologist's office includes:

Screen. The gynecologist's office should have a special place, enclosed by a screen or curtain, behind which the patient can undress and prepare for the upcoming examination.
Gynecological chair. This chair is equipped with special footrests. During the examination, the woman lies in a chair on her back, and puts her legs on stands located on the sides. Thus, optimal ( for a doctor) conditions that allow for an examination of the genital organs, as well as perform diagnostic and therapeutic manipulations.
Mobile medical lamp. Allows you to create optimal lighting for the examination.
Gynecological mirror. This is a special device with which the doctor examines the mucous membrane of the vagina and cervix. Today, most gynecological surgeries use disposable sterile speculums, which are destroyed after use.
Cervical spoon. This is a thin sterile tube, at the end of which there is a special thickening. With the help of this instrument, the doctor takes biological material ( cells) from the surface of the vaginal mucosa, which is necessary to identify infectious agents. It is worth noting that in some medical institutions special sterile cotton swabs are used for this purpose.
Sterile gloves. The gynecologist should carry out all diagnostic or therapeutic measures only after washing his hands with soap ( or other disinfectant solution) and put on disposable sterile gloves. Performing any procedures with bare hands is unacceptable.
Colposcope. This is a complex apparatus equipped with an optical system and a light source. It is intended for colposcopy - a visual examination of the mucous membrane of the vagina and cervix under high magnification. Modern colposcopes are also equipped with special cameras and monitors, which allows you to take a photo or video of the study and save the data on digital media.
Stethoscope. This is a special device designed to listen to the patient's breathing or heartbeat. The gynecologist should also have a special obstetric stethoscope designed to determine the fetal heartbeat.
Scales. Designed to determine the body weight of the patient, which is especially important when assessing the course of pregnancy.
Tape measure. Gynecologists use it to measure the circumference of a woman's abdomen at different stages of pregnancy, which makes it possible to indirectly judge the development of the fetus.
Tonometer. Designed to measure a woman's blood pressure.
Tazomer. This device looks like a compass, equipped with a special centimeter scale. It is used to measure the size of the pelvis of a pregnant woman, as well as the head of the fetus ( allows you to determine the approximate gestational age). This is necessary in order to determine whether the patient will be able to give birth to a child through the natural birth canal. So, for example, if the fetus is too large and the pelvis is too narrow, natural childbirth will be impossible ( the baby's head just won't pass through the birth canal), in connection with which the gynecologist will prepare the patient for a caesarean section ( surgery in which the fetus is removed from the uterus).
Amniotest. With this test, you can quickly identify a rupture of the amniotic membrane ( surrounding the fetus during its intrauterine development) and excretion of amniotic fluid. The fact is that in some cases this gap can be very small, as a result of which the amniotic fluid will flow out unnoticed by the woman. If such a situation is not recognized within 24 to 36 hours, the risk of infection of the fetus increases. The essence of the amniotest is that when examining the cervix, the doctor touches it with a special marker paper that measures the acidity of the tissues ( the acidity of the amniotic fluid is different from the acidity of the vagina). If the amniotic fluid still leaks, the strip will immediately change its color, which will allow the doctor to confirm the diagnosis and take the necessary measures in a timely manner to prevent the development of complications.
bactericidal lamp. Designed to decontaminate the office and can only be used when there is no one in the office ( the light emitted by the lamp can harm the eyes and other tissues of patients or medical personnel).

Do I need to completely undress at the gynecologist?

During the consultation, the gynecologist may need to examine the woman's genitals or perform any diagnostic manipulations. To do this, the patient will have to undress below the waist and lie down on a special gynecological chair. That's why before going to the doctor it is recommended to choose clothes that will be easy to remove and put back on.

It is worth noting that in the gynecologist's office there should be a special place fenced off by a screen or a separate room in which a woman can undress and prepare for the study. A woman should not undress in the presence of a doctor, nurse, other health workers of patients.

Will it hurt during a gynecological examination?

When examining a patient, a gynecologist can examine her external genitalia, as well as perform some diagnostic manipulations to examine the mucous membrane of the vagina and cervix, take samples to detect infections, tumor diseases, and so on. During these procedures, the patient may experience discomfort associated with the touch of instruments to the genitals. However, it is worth noting that a woman usually does not experience severe pain. If the upcoming procedure may be painful, the doctor informs the patient in advance, and if necessary, performs local anesthesia ( the surface of the mucous membrane is treated with special medicines, as a result of which for some time it becomes immune to pain).

Pain during an examination by a gynecologist may be due to:

inflammatory process. With the development of an acute infection in the vulva, the affected mucous membranes become inflamed, resulting in increased sensitivity. At the same time, ordinary, even the lightest touches on them can be painful.
The ineffectiveness of anesthesia. The cause of this phenomenon may be an insufficient dose of local anesthetic or a too long procedure. Also, painkillers may not be effective if the patient is using any drugs. In any case, if a woman feels severe pain during diagnostic manipulations, she should immediately inform the doctor about it.
Careless or rude manipulations of a doctor. This phenomenon is extremely rare and is usually associated with a lack of experience of the doctor.

What questions does a gynecologist ask?

The first thing that awaits any woman at a consultation with a gynecologist is a detailed survey about the state of health and previous diseases, as well as about the characteristics of sexual life.

During the interview, the gynecologist may ask:

What worries the woman at the moment? When answering this question, you should list all the symptoms and complaints that caused you to see a doctor ( pain, abnormal vaginal discharge, miscarriage, and so on).
How long ago did the listed symptoms appear and how did they develop?
Have you experienced similar symptoms in the past? If so, which doctors did the woman go to and what treatment did she take?
At what age did the patient start menstruating?
How long after the first menstruation did the cycle become regular?
How many days does a menstrual cycle last?
How long does menstrual bleeding usually last?
When was the last menstruation and how did it proceed ( whether there was excessive bleeding, soreness, or other unusual phenomena)?
Does the woman have premenstrual syndrome? a pathological condition characteristic of some women during menstruation, manifested by emotional disorders, nausea, vomiting, metabolic disorders and other symptoms that completely disappear after the end of menstrual bleeding)?
At what age did a woman begin sexual activity?
Does the patient experience pain or other discomfort during intercourse or immediately after?
Does the woman have a permanent sexual partner or not?
What means of contraception ( ) is used by a woman?
Has the woman had any pregnancies? If yes, how many, at what age and how they ended ( childbirth, miscarriage, abortion, etc.)?
Does the woman have children? If yes - how much, what age and how did she give birth to them ( through the natural birth canal or by caesarean section, were there any complications during childbirth)?
What gynecological diseases did the woman suffer before?
Does the patient suffer from any chronic diseases of the cardiovascular, respiratory or other systems?
Does the woman smoke? If yes, how long and how many cigarettes per day smoked ( approximately)?

This is not a complete list of questions that a gynecologist can ask during the first conversation with a patient. Based on the answers received, he will form a general idea of the woman’s health status, and will also be able to suggest a particular diagnosis.

Examination of the vagina and cervix with a mirror

After the interview, the gynecologist asks the woman to undress from the waist down and lie down in the gynecological chair for an examination of the genital organs. First of all, the doctor examines the external genitalia with the naked eye, assessing their anatomical development, the presence or absence of signs of inflammation ( redness and swelling of mucous membranes), pathological secretions, and so on.

The next stage of the examination is the examination of the mucous membranes of the vagina and cervix using special mirrors. Having warned the patient about the upcoming actions and having received her consent, the doctor opens the package with disposable sterile mirrors, which are a kind of dilator with a handle. Having parted the large and small labia of the patient with his fingers, the doctor inserts the working part of the mirrors into the vagina, and then presses the handle. At the same time, the blades of the mirror expand, pushing the walls of the vagina and making them accessible for inspection. At this point, the patient may experience some discomfort, but pain usually does not occur.

After the introduction of mirrors, the doctor carefully examines the condition of the mucous membrane of the genital tract, revealing the presence or absence of signs of inflammation, as well as ulcerations, polyps and other pathological conditions. After the procedure is completed, the gynecologist carefully removes the mirrors from the patient's vagina and proceeds to the next stage of the examination.

Examination with mirrors is contraindicated:

Patients who have not yet begun sexual activity. In this case, the study will be prevented by the hymen - a fold of the mucous membrane that blocks the entrance to the vagina.
If there are signs of infection of the external genital organs. In this case, there is a high risk of infection during the introduction of mirrors.
In the presence of severe pain. This can be observed in the presence of an infectious-inflammatory process or during menstruation.
When a woman refuses. The gynecologist has no right to perform any procedure without obtaining the consent of the patient.

Manual examination by a gynecologist

The study is carried out after removing the mirrors from the vagina. Its essence is as follows. The gynecologist puts the left hand on the front wall of the patient's abdomen, and two fingers of the right hand ( index and middle) introduces into the vagina and presses the front wall of the vagina to the left hand. This allows you to identify various volumetric formations ( tumors) or developmental anomalies. After that, the doctor moves the fingers of the right hand under the cervix and slightly lifts it, also feeling and detecting changes in the consistency of the organ, the presence of pathological seals or anatomical defects.

Colposcopy

This is a diagnostic procedure during which the gynecologist examines the mucous membrane of the vagina and cervix using a colposcope, an optical device that allows you to magnify the image of the surface under consideration several times. During colposcopy, the doctor detects pathological changes in the mucous membrane, as well as inflammatory processes and other lesions.

The procedure itself is carried out as follows. The woman lies down in a gynecological chair, and the gynecologist introduces mirrors into her vagina, thereby making the mucous membrane available for examination. Then he sets the colposcope so that the light from it is directed directly to the cervix, and he examines the surface of the mucosa through special eyepieces. No parts of the device touch the patient, and therefore the examination is completely painless.

Hysteroscopy

During hysteroscopy, the doctor examines the inner surface of the uterus and its cervix using a special device - a hysteroscope, which is a long tube equipped with an optical system.

Hysteroscopy can be diagnostic ( carried out to clarify the diagnosis) or medical, during which the gynecologist performs various procedures.

Diagnostic hysteroscopy reveals:

polyps;
uterine cancer;
anomalies in the development of the uterus;
cause of infertility;
remnants of the fetal egg in the uterus;
foreign bodies in the uterus;
source of bleeding and so on.

No special preparation before hysteroscopy is required. The procedure itself is performed under local or general anesthesia. In the first case, the tissues of the vagina and perineum are treated with special preparations that temporarily eliminate pain sensitivity. With general anesthesia, medications are injected into the vein of the patient, as a result of which she falls asleep and also does not feel anything during the procedure.

After anesthesia, the gynecologist inserts mirrors into the vagina and pushes them wide apart, thereby opening access to the uterus. Then he introduces the working part of the hysteroscope, equipped with a video camera and a light source, into the uterus. This allows you to examine the mucous membrane of the organ, revealing pathological changes or removing pathological formations.

After the procedure, the patient must remain in the doctor's office for 30 to 60 minutes until the pain medication wears off, and then she can go home. Within 2 to 3 days after the procedure, a woman may feel a slight tingling, numbness or soreness in the genital area. If these phenomena are pronounced, the patient can contact a gynecologist who will prescribe painkillers for her.

Hysteroscopy is contraindicated:

in the presence of an infection of the external genital organs;
during pregnancy;
in the presence of an acute systemic infection ( like the flu);
with confirmed cervical cancer during the procedure, damage to the affected tissues and the spread of cancer cells to other organs is possible).

Puncture of the posterior fornix of the vagina

Puncture ( puncture) is performed in cases where the doctor suspects that the patient may have abnormal fluid in the pelvic cavity ( blood or pus). The presence of such fluid may be a sign of bleeding or an infection that poses a health risk to the woman.

The essence of the procedure is as follows. First, the patient undresses and lies down in the gynecological chair. After local or general anesthesia, the doctor treats the patient's external genitalia with disinfecting solutions. Then he inserts a mirror into the vagina, thereby opening the vaginal part of the cervix for inspection. Lifting it with special forceps, the gynecologist takes a syringe with a long needle and pierces the posterior fornix of the vagina. Entering the game 2 - 3 centimeters deep ( it enters the pelvic cavity), the doctor carefully pulls the plunger of the syringe, drawing pathological fluid into it ( if any). Then he carefully removes the needle, and sends the resulting material to the laboratory for research.

After the end of the procedure, the patient should stay in the treatment room for 30-60 minutes until the effect of painkillers wears off.

Why do brown or bloody discharge appear after a visit to the gynecologist?

Even if the examination by the gynecologist was carried out in accordance with all the rules, upon returning home, a woman may notice that she has a slight bloody or brown discharge from the vagina. Sometimes this phenomenon may be the result of manipulations performed by the doctor, while in other cases it may indicate the presence of any pathology.

The cause of spotting after examination by a gynecologist may be:

Mucosal injury. Carrying out such studies as examination in mirrors or hysteroscopy is associated with trauma to the vessels of the mucous membrane of the vagina and cervix with hard instruments. Traumatization can be facilitated by rude, inaccurate actions of the doctor or the patient's disobedience ( for example, if she does not lie still and constantly moves during the insertion of speculums or a hysteroscope).
Menstrual bleeding. All women are advised to visit a gynecologist a few days before or after their menstrual bleeding. If this rule is not observed, it is quite possible that after visiting a doctor, a woman may begin a normal period.
Diseases of the genital organs. If a woman has any disease of the cervix ( e.g. erosion) or the uterus itself ( endometritis, endometriosis), hysteroscopy may be accompanied by severe traumatization of pathologically altered tissues, as a result of which more profuse bleeding is possible after the study.

It is important to remember that the release of a small amount of bloody fluid after gynecological procedures is normal. At the same time, it is necessary to distinguish between pathological conditions in which vaginal discharge can pose a danger to a woman's health in order to seek medical help in a timely manner.

The reason for a second visit to the gynecologist may be:

Continued bleeding. If the bloody fluid continues to stand out from the vagina even 2-3 days after visiting the doctor, this may be a sign of the development of an inflammatory process or severe trauma to the vessels of the mucous membrane.
Profuse bleeding. In this case, damage to large blood vessels is possible, which requires urgent medical intervention.
The appearance of pain. If spotting is accompanied by severe pain in the genital area or in the lower abdomen, you should not immediately take painkillers. First, you need to consult with a gynecologist, who will exclude the presence of any dangerous pathology, after which he will prescribe painkillers to the patient.

Why does my stomach hurt after visiting a gynecologist?

Light painful or unpleasant "pulling" sensations in the genital area and lower abdomen that occur after visiting a gynecologist are quite normal. The fact is that during the examination, the doctor palpates ( probes) tissues of the vagina and cervix, as well as the uterus itself. In addition, during diagnostic procedures ( examination with mirrors, hysteroscopy) the gynecologist inserts hard instruments into the patient's vagina, which will certainly damage the delicate mucous membrane ( even if the doctor performs the procedure slowly, gently and carefully). All of the above is accompanied by tissue injury, as a result of which a slight inflammatory reaction develops. This is the direct cause of pain after examination by a gynecologist.

Under normal conditions, a woman may experience pain for 1 to 2 days after a visit to the doctor. To reduce their intensity, the gynecologist may prescribe mild painkillers to the patient. At the same time, it is worth noting that in some cases the occurrence of pain may be due to the development of any complications ( for example, damage to the tissues of the uterus or vagina, bleeding, infection, and so on). That is why the persistence or progression of the pain syndrome for 3 or more days after visiting a gynecologist is a reason for a second visit to the doctor. Should not be on its own without a specialist appointment) “suppress” pain with painkillers for a long time, since the pathological process that is present in this case can continue to develop, damaging the uterus, vagina and other tissues and organs.

Gynecologist services paid or free ( according to the compulsory medical insurance policy)?

in state medical institutions in hospitals, clinics, maternity hospitals) any woman who has a compulsory health insurance policy can receive a free medical consultation from a gynecologist, during which the doctor will also conduct a full examination.

You can count on free help from a gynecologist:

pregnant women;
women in labor;
women with pathology of pregnancy;
women with any gynecological diseases.

At the same time, it is worth noting that some procedures or tests that a gynecologist will prescribe may be paid ( For more detailed information, please check with your doctor.). Also, consultations of gynecologists who receive in private medical institutions will be paid ( clinics or hospitals).

Does the gynecologist give sick leave?

A sick leave is a document confirming that for a certain time the patient could not go to work due to her illness.

A gynecologist can issue a sick leave:

Women who have been diagnosed with a pathology of pregnancy requiring hospitalization.
When a disease requiring bed rest is detected.
When performing operations after which the patient must remain in the hospital ( under the supervision of doctors) for a certain amount of time.
In cases where a visit to work may worsen the patient's health or cause the progression of her disease.

The sick leave is issued on a special document, which the patient must provide at the place of work. The maximum duration of sick leave can be 15 days, but if necessary, the doctor can extend it.

Can I call a gynecologist at home?

Today, many private medical centers provide such a service as calling a gynecologist at home. It should be noted right away that such a consultation will be limited, that is, the maximum that a doctor can do is talk with the patient, collect an anamnesis ( ask about her complaints, health problems, past illnesses, and so on) and conduct a surface survey. Based on the data obtained, the doctor can assume a particular diagnosis, and if necessary, set a date when the patient will have to come to him for an appointment at the hospital, where he can conduct a more thorough examination.

The gynecologist will not be able to perform any diagnostic procedures at home, since he will not have the necessary tools for this ( gynecological chair, hysteroscope) and conditions.

What laboratory tests can a gynecologist prescribe?

After examining a woman, a gynecologist may suspect that she has a particular disease. To confirm the diagnosis, the doctor may prescribe certain laboratory tests to the patient.

In the process of diagnosis, the gynecologist may prescribe:

general blood analysis ;
general urine analysis ;
analysis for sexually transmitted infections;

hormone tests;
smears on the flora of the vagina;
cytology analysis.

General blood analysis

This study allows you to assess the state of the hematopoietic system of the female body, as well as to identify signs of some pathological conditions. Blood for analysis is taken from a vein or from a finger. No special training is required for this.

A general blood test reveals:

anemia. This is a pathological condition characterized by a decrease in the total number of erythrocytes ( red blood cells) and hemoglobin ( substance that transports oxygen throughout the body) in blood. Anemia is most often caused by menstrual bleeding, during each of which a woman loses about 50-100 ml of blood.
Infection. The presence of an infection may be indicated by an increase in the number of leukocytes - cells involved in protecting the body from pathogenic bacteria, viruses and fungi.

Analysis of urine

This study allows you to identify urinary tract infections ( this may be indicated by the presence of pus or white blood cells in the urine), as well as to suspect the presence of kidney disease ( this may change the density or chemical composition of urine). For analysis, the patient must collect morning urine in a special sterile jar, which she will be given in advance at the clinic.

How does a gynecologist take a smear on the flora?

The purpose of this study is to identify pathogenic bacteria in the patient's vagina. The procedure for taking the material is carried out in a gynecological chair. After the introduction of the speculum, the doctor takes a sterile swab or a special gynecological spoon and runs it several times over the mucous membrane of the vagina and cervix, trying not to touch the patient's external genitalia.

Part of the obtained material is transferred to special glasses, stained and examined under a microscope. In some cases, this allows you to identify pathogenic bacteria and suspect a particular infection. Another part of the material is sent for bacteriological research, in which colonies of bacteria obtained from the female genital tract are grown under laboratory conditions. This allows you to establish the exact type of pathogen and choose the most effective treatment.

It is important to note that before taking material for research, it is not recommended to wash the genitals with soap or other disinfectants, as this can destroy the bacteria present there and make the analysis uninformative. The same effect will be observed if a woman takes antibacterial drugs before taking the test.

Cytology analysis

The purpose of this study is to identify abnormal cells that may indicate the presence or high risk of developing cervical cancer. It is recommended to perform a cytological examination once a year for all women over 30 years of age.

exclude sexual intercourse for 2 days;
exclude the presence of an infectious-inflammatory process;
do not use sanitary tampons for at least 2 days;
do not insert any medications, creams or other means into the vagina for at least 2 to 3 days.

It is also worth noting that the study should be performed at least 2 days before or 2 days after menstrual bleeding, gynecological examination or hysteroscopy ( examination of the uterine mucosa with a special instrument).

The material is taken in the gynecological chair. After the introduction of gynecological mirrors, the doctor visually or under the control of colposcopy assesses the condition of the mucous membrane of the vagina and cervix. If at the same time he reveals pathologically altered areas ( e.g. erosion), the material should be taken from the affected tissue. To take the material, special brushes are used, with which the gynecologist runs several times over the surface of the mucous membrane. After that, he carefully removes the brush from the patient's vagina and runs it several times over a special glass. The resulting cells adhere to the glass, which allows them to be examined under a microscope and to reveal pathological changes characteristic of the cancer process ( If there are any).

Tests for infections HIV, syphilis, gonorrhea)

Detect bacterial infections e.g. gonorrhea) is possible in the study of a smear or in the process of bacteriological examination. At the same time, identify the causative agent of the viral infection ( e.g. HIV, human immunodeficiency virus) is thus impossible because viruses are too small ( they are not visible under a microscope.) and do not grow on conventional nutrient media. Difficulties may also arise in the diagnosis of latent, chronic infections that occur without a pronounced clinical picture.

To clarify the diagnosis, the gynecologist may examine:

estrogen levels. Responsible for the development of primary and secondary sexual characteristics ( development of external and internal genital organs, female-type hair growth, and so on). Estrogens are also involved in the regulation of the menstrual cycle.
androgen levels. These are male sex hormones that are produced in the female body in small quantities. An increase in their concentration can lead to male-type hair growth, sexual dysfunction, and so on.
progesterone level. It is produced by the ovaries and prepares the female body for the onset of pregnancy, and also ensures its normal course and development.
Prolactin level. This hormone ensures the formation of milk in the mammary glands.

If a deficiency of any hormone is detected, the gynecologist may prescribe the patient a replacement treatment with artificial hormonal preparations. It is important to take medications exactly as directed by your doctor, as the success of hormone therapy depends on it.

What diagnostic studies can a gynecologist prescribe?

During the diagnosis, the doctor may prescribe certain instrumental studies to the patient, allowing to assess the functions of the internal organs and plan further treatment tactics.

ultrasound

ultrasound ( ultrasonography) is a diagnostic procedure that allows the gynecologist to assess the shape, structure, size and consistency of the internal organs of the patient. The principle of the method is as follows. A special apparatus sends ultrasonic waves into the woman's body, which are reflected from the internal organs and tissues. Reflected waves are captured by a special sensor and converted into a visual image of the organs under study, which is displayed on the monitor.

With the help of ultrasound, a gynecologist can identify:

Uterine pregnancy- the development of the embryo in the uterus.
Ectopic pregnancy- a pathological condition in which the embryo begins to develop not in the uterus, but in other tissues and organs ( in the abdominal cavity, in the fallopian tubes and so on).
Tumors of the uterus- myoma, polyps.
Ovarian diseases- for example, cysts ( fluid-filled cavities).
Fallopian tube obstruction is a common cause of infertility.
endometriosis- disease of the uterine mucosa.
Remains of the fetus or membranes in the uterus ( after childbirth).
The presence of fluid in the pelvic cavity- may be a sign of an infectious-inflammatory process or bleeding.

The procedure itself is absolutely painless, safe and practically has no contraindications. Before performing the study, the patient lies on the couch and exposes the lower abdomen. The doctor applies a thin layer of a special gel to the skin ( this is necessary in order for the ultrasonic waves to pass more easily into the tissues of the body), after which he begins to drive the device's sensor over the surface of the skin, evaluating the results on the monitor screen. The procedure itself lasts no more than 10-15 minutes, after which the patient can immediately go home.

It is worth noting that in some cases, the gynecologist may prescribe other types of ultrasound ( transvaginal - when the ultrasound probe is inserted through the patient's vagina or transrectal - when the probe is inserted through the anus). Such techniques give more accurate results in the study of the ovaries and uterus, but require special equipment and experience of the doctor.

Fluorography

This is an x-ray study, during which the lungs and chest of the patient are examined. The purpose of the study is to detect foci of tuberculosis or tumor diseases of the lungs.

A gynecologist may prescribe a fluorography for a woman in order to exclude pulmonary tuberculosis ( for example, if she is going to have any kind of surgery or long-term hospitalization). However, it is worth noting that this study is strictly contraindicated for pregnant women, since X-ray radiation can disrupt the development of fetal organs.

Biopsy of the cervix

A biopsy is the process of removing a piece of an organ in vivo for the purpose of examining it in the laboratory. Such a study allows to identify tumor diseases of the genital organs of a woman, as well as to determine the nature of the tumor ( that is, whether it is benign or malignant), on which further treatment tactics will depend. Most often, the reason for a biopsy can be poor results of a cytological analysis, as well as erosion, polyps, or other precancerous processes.

It is recommended to perform a biopsy 2 to 3 days after the end of menstruation. Preparation for the procedure consists in avoiding sexual contact and using tampons for at least 2 days. Also, do not insert any medications or other means into the vagina. On the eve of the study, you should take a shower without using soap or other hygiene products.

The procedure itself is performed under general anesthesia, that is, the patient is asleep and does not remember anything. First, the gynecologist inserts a mirror into the vagina, after which, under the control of a colposcope ( an optical device that allows you to get an enlarged image of the mucous membrane) finds pathologically altered areas. After that, the doctor takes a syringe with a special ( thick and sharp) with a needle and pierces the "suspicious" area a few millimeters deep. The cells of the mucous membrane thus enter the cavity of the needle. After that, the doctor removes the needle, and the resulting material is sent to the laboratory for further research.

After the procedure, a woman may experience slight bleeding from the vagina for 1 to 2 days. During this time, she is advised to use sanitary napkins ( not tampons), as well as refrain from sexual intercourse.

When can a gynecologist refer you for a consultation with another specialist ( urologist, oncologist, surgeon, therapist)?

If during the examination of a woman the gynecologist reveals any diseases in her from other organs and systems, he can refer her for examination to the appropriate specialist.

A gynecologist may prescribe a consultation:

Urologist- a doctor who diagnoses and treats diseases of the urinary system.
Oncologist- A physician who diagnoses and treats including surgical) benign and malignant tumors.
surgeon- when an acute disease of the abdominal organs is detected ( for example, with appendicitis - inflammation of the appendix of the intestine).
therapist- in the detection of diseases of the cardiovascular, respiratory, digestive or other body systems.

Treatment at the gynecologist

After examining the woman and making a diagnosis, the doctor may prescribe treatment, which can be conservative or surgical. In the process of treatment, a woman should periodically visit a gynecologist who will monitor the effectiveness of the therapy, and, if necessary, make certain changes to the treatment regimen.

What pills can a gynecologist prescribe?

Drug therapy is the first and main therapeutic measure that the doctor prescribes to patients with various diseases. When using the prescribed drugs, the dosage prescribed by the doctor should be strictly observed, since its excess can lead to the development of undesirable side effects.

The gynecologist may prescribe:

Antibiotics- for the treatment of bacterial infections of the genital tract.
Antivirals- for the treatment of viral infections.
Antifungal drugs- for the treatment of fungal infections of the genital organs.
Hormonal drugs- as a replacement therapy for a lack of sex hormones, as well as a means of contraception ( preventing pregnancy).
Painkillers- are prescribed for the relief of pain, including after some painful gynecological procedures ( hysteroscopy, biopsy, etc.).
Iron preparations- are prescribed for the detection of iron deficiency anemia ( a decrease in the concentration of red blood cells against the background of regular bleeding).

What operations can a gynecologist perform?

If it is impossible to eliminate the patient's problem with conservative means, the doctor may prescribe surgical treatment. Surgery may be urgent prescribed for diseases that threaten the life of a woman or fetus) or planned, in which there is no immediate danger to the life of the patient. Before a planned operation, the patient undergoes a series of tests and undergoes additional examinations to clarify the diagnosis and plan the extent of the surgical intervention.

If necessary, the gynecologist can perform:

Removal of fallopian tubes- with their obstruction due to the formation of adhesions or other pathological process.
Oophorectomy- with the formation of a cyst in it ( cavity filled with liquid) or cancer ( in this case, a preliminary consultation with an oncologist is required).
Operations on the uterus- removal of benign tumors ( polyps, myoma).
Removal of the cervix- in the presence of precancerous diseases or cervical cancer.
Uterus removal- may be required for multiple fibroids, as well as for malignant tumors, with uterine rupture during childbirth, and so on.

Teenage girls should visit the gynecologist once a year after their period. The first examination may cause some psychological discomfort. That is why it is important to talk to your child. Conduct an educational program, tell us about how the doctor will conduct the examination.

How is a gynecological examination performed?

Examination of adolescents consists of several stages:

Identification of complaints;
- Examination of the external genital organs;
- inspection with a mirror;
- palpation of the abdomen;
- taking a smear.

Identification of complaints is a necessary step during the examination. The doctor may ask about general well-being, as well as about previous diseases. Also, the gynecologist should examine the mammary glands and body hair -.

Girls who are not yet sexually active do not need to be examined with mirrors. The procedure itself in the gynecological chair can last no more than five minutes, and a visit to the doctor usually fits in twenty minutes.

Often, a gynecological examination of adolescents is carried out even in high school. But this procedure is not mandatory, so you can write a letter of resignation if your daughter is not mentally ready for this.

You should be prepared for the fact that the doctor will visually examine the external genitalia for inflammation or discharge. Also, the gynecologist can take a smear for research.

For this, a special tool is used, similar to an ear stick. A pediatric gynecologist runs her along the vaginal mucosa.

Usually, immediately after the examination, the doctor asks a series of questions. For example, “When did menstruation first start?”, “What discharge is present?”. You need to answer these questions honestly.

Preparing for an inspection

You can agree in advance whether you need to accompany your daughter during a visit to the doctor. This will help relieve psychological discomfort.
You should stock up on everything you need. It is advisable to bring a diaper, rubber gloves, and a disposable plastic mirror.

It is possible to go to a private clinic or a youth health center rather than a regular antenatal clinic. Teenagers often try to put off seeing a doctor for a long time due to embarrassment, psychological discomfort, and a number of other reasons. In this case, it is important to have a conversation with your daughter.

In the event that you have signed a school screening waiver, you will need to select a qualified doctor. To do this, call private clinics, consult with friends.

Buckwheat is one of the most popular cereals in Russian cuisine. It is boiled in broth - meat, mushroom, vegetable, milk and even cream. But buckwheat porridge on water fully reveals all its qualities, you just need to know how to cook it. Who knows how to cook buckwheat porridge on water, crumbly or slurry, can enjoy different tastes and structure of the dish - each option has its own advantages.

Crumbly has a more pronounced aroma, and slurry - delicate and even silky in structure - is more suitable for dietary or baby food.

How to cook loose buckwheat

In loose buckwheat, each grain is easily separated from the others.

To achieve this effect, you should choose unground buckwheat or, in extreme cases, peeled buckwheat.

Nucleus- these are whole grains, steamed, retaining grain shells.

Peeled groats almost devoid of shells and also steamed.

Prodel- crushed steamed cereals with shells - more suitable for porridge-smear.

Like the famous Smolensk- cereals, in which only the middle remains after processing, since all the upper layers are removed.

There are many ways to cook delicious crumbly buckwheat.

Method of cooking in a saucepan

The most traditional method is in a pot. Here's how to cook buckwheat porridge on water in a saucepan:

the cereal is washed in several waters. In many recipes, it is advised to fry it in a dry frying pan - a stronger characteristic aroma and taste. Yes it is, but frying significantly reduces the usefulness and increases the calorie content of the finished dish. Therefore, those who monitor their weight or simply prefer healthy food skip the frying stage;
then the cereal is poured into a saucepan, poured with boiled cold water, salted and heated over high heat;
when the water boils, you should cover the pan with a lid and reduce the heat to medium;
after boiling for 3 minutes in this mode, you need to reduce the heat to a minimum and, without removing the lid, cook the porridge for 15-17 minutes.

To make buckwheat more fragrant and crumbly, you can add a teaspoon of vegetable oil, such as fragrant sesame oil, directly into the pan.

Cooking in a thermos

Cooking loose buckwheat in a thermos is an unusual way.

The thermos is rinsed with boiling water.

The cereal is also washed with boiling water.

Put pure buckwheat in a thermos, add salt, vegetable oil if desired, and pour very hot or boiling water in a ratio of 1: 2.

Close the thermos and leave for several hours. Ideally, all night long.

Buckwheat prepared in this way retains all the useful and nutritious properties.

Ideal for this method of preparation - not steamed, but only peeled greenish groats.

Loose buckwheat in a pan

Another unusual way to cook delicious buckwheat porridge on water is to use a frying pan. The washed cereal is laid out in a thick-walled pan, poured with cold water, salted and tightly closed with a lid. Put the pan on low heat and cook for 20 minutes without removing the lid.

Porridge in a pot

Washed buckwheat is placed in a pot, poured with warm water, tightly covered with a lid and put in the oven.

The oven must be cold so that the pot heats up simultaneously with the air to evenly heat the walls and contents of the pot.

This preserves the whole aroma of buckwheat and its beneficial properties.

We set 180 degrees, after 30 minutes we turn off the oven and let our porridge “reach” for 15-20 minutes.

Easy cooking in a slow cooker

Put the prepared buckwheat in the multicooker bowl, pour water - hot for cooking in the "Heating" mode (temperature - 70-80, time - 1 hour) or cold for cooking in the "Porridge" or "Groats" mode (for them, the time and temperature will be set by the multicooker itself).

in a sachet

It is very convenient to cook loose buckwheat in bags. Many manufacturers of cereals pack their product in bags of 80-100 g. Such porridge is cooked from 8 to 20 minutes - as indicated on the box - depending on the degree of processing and the variety of buckwheat.

The bag is dipped into boiling water (the amount of water is indicated on the package and usually ranges from 200 to 350 ml). After the time has elapsed, the bag is shaken off the water, opened along a special seam and laid out on a plate. Even a child can handle the preparation of such buckwheat, it is absolutely impossible to spoil it.

Cooking delicious porridge

To cook buckwheat porridge on the water, it is better to take prodel or Smolensk groats. Prodel is considered a more nutritious cereal, and the Smolensk dish is ideal for therapeutic diets due to its excellent enveloping properties. The famous "downy porridge" was cooked precisely from their Smolensk cereals.

These cereals are not washed or roasted.

To cook liquid buckwheat porridge on water, you need to pour buckwheat with water and cook for 30-40 minutes under a lid over low heat, stirring regularly.

Proportions and other secrets of delicious buckwheat on the water

To cook buckwheat porridge on water, the proportions of cereals and water should be 1:2 for crumbly porridge and 1:3 for slurry porridge.
Boiling water can be added to the slurry as needed, but for crumbly this is unacceptable, since it significantly worsens the taste and structure of the grains.
Do not forget about adding vegetable oil at the beginning of cooking friable porridge, the calorie content of the dish will increase slightly, but the taste, smell and appearance will be much better.
By the way, the calorie content of dry cereals for a beginner in proper nutrition, and even more so if he is aimed at, can repel - almost 300 kcal. Do not be afraid, when cooked, the numbers are smaller: without oil - about 100 kcal, and with oil - 120-130 kcal.

How to cook crumbly buckwheat in the microwave

In a microwave oven, making crumbly porridge on water is even easier. The method is well shown in this video: