I’ve undergone five colonoscopies in my life, and I’m not yet 23. These are not the end of the world (although my last one seemed that way for a little while); for a person without digestive issues, they’re just an inconvenience, possibly a nauseating one, and possibly a life-saving one. For the average person, their biggest benefit is that they make catching colon cancer very easy, which most people should consider after a certain age.
My experience with colonoscopies has thankfully not been cancer-related; they have all been to check on the extent of inflammation in my colon. My first colonoscopy was to find out why I had been having diarrhea and stomach pains for a month, and I was diagnosed with UC based on what they saw. My second colonoscopy was after I recovered from a flare to make sure my colon was looking as healthy as I felt. The other three colonoscopies have all been within the past year, the last two being my impetus for avoiding colonoscopies for at least another year. There are times to have colonoscopies, and there are times not to.
Backtracking…what is a colonoscopy? During a colonoscopy, a gastroenterologist guides a flexible tube with a camera at the end through your colon and possibly the very end of the small intestines. He can see what’s happening on a video screen and takes pictures at points along the way. With a colonoscopy and a sigmoidoscopy, the tube enters the colon through your bottom, and the difference between the two is that a sigmoidoscopy only goes through the sigmoid colon, which is the s-shaped part of the colon seen in the picture below. An upper endoscopy, on the other hand, is put through your mouth and allows the gastroenterologist to see the esophagus, stomach, and the very beginning of the small intestines.
Preparing for a colonoscopy involves clearing out your colon so that views of its walls are not obstructed by fecal matter. The day before, you are on a clear liquid diet. This means that you can only drink broth (which is murky but considered clear), tea and coffee (no milk), juice (as long as it’s not red, which could look like blood), and of course, water. If you want something to chew, a popsicle stick would be okay. In the evening, you begin drinking a concoction developed by Satan. You buy a powder that causes diarrhea (also packed with electrolytes so you don’t get dehydrated), and mix it with about a gallon of a clear liquid. (The amount of liquid required depends on the prep powder.) You drink eight ounces every 10 minutes, and by the time you’re done, you will not want to drink that particular liquid for at least a month. I’ve used Sprite, Gatorade, and water with Crystal Light, and it’s hard to say which was the least horrible. None of them completely mask the flavor of the prep powder, and these are drinks I can’t stand one glass of, let alone 16 glasses.
During the time it takes to drink all of that, you’ll begin having diarrhea, which comes on somewhat urgently, and you might feel nauseous from the drink. It’s not uncommon to throw up, but don’t worry about making up for the lost liquid (unless it’s really extreme I suppose). I’ve never thrown up, and maybe that’s due to the particular prep powder I used, which was GoLytely. Maybe I was just lucky. Your diarrhea should run clear by the time you finish the drink, and you’ll continue to use the bathroom after the drink is done, although not as often. The morning of your colonoscopy you can’t drink anything.
Anesthesia is administered through an IV at the hospital, so it is a painless procedure (minus getting the IV put in).
My first colonoscopy was probably the best one. It had a greater purpose than the rest of them since I was given a diagnosis from it, the prep went smoothly, and I felt fine afterwards.
The morning of my second colonoscopy, I ate a chocolate chip that was lying on the counter without thinking. I considered not telling my gastroenterologist because I didn’t want him to tell me I needed to go through the entire prep again, but I did tell him, and it was not a problem, although not desirable. To be safe, they put a nasal cannula (I googled “nose breathing tube thing” to find that word) in my nose, in case the chocolate chip caused any problems. I’m not sure exactly what would happen, but nothing did happen, so that was good. Moral of the story: tell your doctor if something went wrong with the prep.
For my third colonoscopy in May of 2011, I was already in the hospital since this was at the beginning of this flare, and I had to drink more than double the prep drink because my stool was not running clear. It actually never ran clear, but they had me stop at 2am anyways. It ended up being clear enough for the scope, but gosh that was miserable.
More miserable was my fourth colonoscopy in December of 2011 and again, I was in the hospital as an inpatient. This time, I had a nasogastric feeding tube in for supplementary nutrition, and they put the prep drink through this. Easiest prep of all time! But the next day, the scope was scheduled for 3pm but they were so backed up that I didn’t get in until 7pm. I had no idea it would be four hours – we just had to wait for word from my gastroenterologist, and I couldn’t drink anything or even suck on ice chips. This colonoscopy was also miserable because of the results; my colon looked like a war zone, and for the first time, I thought that surgery might actually be necessary. My symptoms also got much worse for about a week afterwards, due to the scope roughing up what was already roughed up and sensitive.
But then I started working with my herbalist, and within a week, I noticed some improvement. After a few weeks, I was feeling much better. It was actually Christmas Eve that I had a shift in my symptoms. In January, I had c. diff but recovered, and after that I was doing quite well, left the hospital, and set up a colonoscopy at Mass General with my new gastroenterologist.
This latest colonoscopy you can read about in my last post. Lesson learned: let a sleeping dog lie. Everyone (my herbalist, my gastroenterologist, and I) wanted to see what my colon looked like after such sweeping improvement in symptoms, and indeed it did look remarkably better, but I paid the price for confirming what I thought would be true. I was hospitalized afterwards with increased symptoms and dehydration, and although I’m over that now and it seems like it never happened, I know how difficult that time was for me, and I certainly didn’t think the scope was worth the misery it caused me.
This colonoscopy makes me wonder about the necessity of colonoscopies for someone who’s not yet concerned with colon cancer. They say that improved symptoms don’t always mean that the colon is improved, but in my experience, symptoms and actual improvement have always reflected each other. On one hand, it is nice to know exactly what the inflammation looks like, not just in terms of how much, but what type – Are there pseudo-polyps? Is there any inflammation outside of the colon that might suggest Crohn’s? I had both inflammation outside of my colon and pseudo-polyps in the colon. But despite this knowledge, we’re not changing my treatment; we’re still relying on symptoms to guide the way. So it can be a tough call. I do know that my next colonoscopy won’t be until at least a year after I’m in remission.