Colonoscopy Prep, Experiences and Tips

Today starts another prep for colonoscopy # 44. I do a prep similar to the original prep from the late 70's, when I had my first one. I'm scheduled for 1300 Wednesday. Last solid food was 1930 Sunday. Will use Dulcolax tablets and ONE dose of Miralax, YUK! Not a fan of oral osmotics as they tend to make me throw up. Will also use heavily caffeinated tea, as caffeine tends to have the same results (for me) as Miralax.

That's the no fun part. The best part is the large volume enemas, many of them! All are hypotonic (9 gm/L table salt) and a few will have some Dr Bronners castile soap. First today will be 2L to "clear the path". All the rest, 3L, which should be able to fill the entire large colon. I had surgery several years ago and they took the entire ascending colon, hepatic flexure, terminal ileum, ileocecal valve, appendix and the last 2 - 3 feet of small bowel, so 3L should do the job. My GI knows what I do to prep & doesn't have a problem with it. Always clean, although he says he as to ride the suction button. I'll post some pictures of the equipment I'm using later today or tomorrow. Using a Sherema 4 qt red bag and an old German 3L teardrop shaped bag. Insertables include Wally Woodcutter douche style nozzle, 30" OHN silicone colon tube, double balloon B@*^@X retention nozzle and a 16" colon tube from SN. Will ask wifey for help with insertion of all except the Wally Woodcutter nozzle. Might get a raised eyebrow when she sees the SN colon tube.......only 16", but way bigger diameter than the OHN tube. If necessary, I'll explain that it will keep water out of the rectum & prevent the rectum from sending the "I GOTTA go NOW" message to the brain. And it does feel SOOOoooooooo good sliding in.......and out.......and in. 😄

Will post progress repots as time permits. Gotta go now, as caffeinated tea is having the desired effect.....that works faster than a Fleet enema, without the irritation & burning!

Best

vapor

The best part is the large volume enemas, many of them! All are hypotonic (9 gm/L table salt)

NO it isn't.

9 g/l is ISOTONIC and a physiologic concentration

NO it isn't.

9 g/l is ISOTONIC and a physiologic concentration

Absolutely right, fingers working faster than brain. Don't want any electrolyte imbalance.

vapor

Posted some equipment pictures here: https://www.zity.biz/index.php?mx=gallery;ox=showalbum;ax=8685

C U later 😎

Today starts another prep for colonoscopy # 44.

What did you do to get that? That's a lot.

Interesting about the soap being OK. I had always read that it caused inflammation and shouldn't be used prior to diagnostics (along with the implication that the inflammation might cause other issues but never any information on what and whether it does. I guess they might be worried about the inflammation -> cancer link perhaps?)

Soap is not recommended for colonoscopy preps.

Why so many colonoscopies?

Soap is not recommended for colonoscopy preps.

I'm still a day and a half out & they (2) were very mild, just one tsp of Dr Bronners Lavender in 2L for the first one and one tsp in 3L for the second one. Each was followed by a hypotonic saline rinse. All subsequent enemas will be hypotonic saline.

Why so many colonoscopies?

Crohn's disease.........symptomatic in mid teens, diagnosed at 23. Almost 50 years of inflammation in the ascending colon resulted in a cancer discovered by biopsy during a colonoscopy several years ago. Everything LOOKED fine, but one of the 62 biopsies came back positive. Pathologist here said it was high level dysplasia, pathologist @ Mt. Sinai labeled it a cancer. Six one, half dozen of another, either way, the ascending colon had to go. Done at Mt Sinai, they removed the hepatic flexure, ascending colon, terminal ileum, ileocecal valve, appendix, and the last 2.5 to 3 feet of small bowel, because it was riddled with inflammation. Surgeon also found thickened mesentery layer (Paper thin membrane that supports the large & small bowel & carries the veins & arteries that supply blood to the intestines) that was almost 1.5" thick. They removed the thickened portion and did vascular surgery to reconnect the arteries & veins. Also removed an ileo-duodenal fistula that was .75" in diameter. Removal of the thickened mesentery also solved another unrelated problem: getting up to pee 3 / 4 times a night. It was putting pressure on the bladder, and my brain got the "I gotta pee" signal.

My GI wanted me at Sinai & recommended a surgeon who only does Crohns related surgery and has decades of experience. In my case, I got what I paid for.

Best,

vapor

What did you do to get that? That's a lot.

Interesting about the soap being OK. I had always read that it caused inflammation and shouldn't be used prior to diagnostics (along with the implication that the inflammation might cause other issues but never any information on what and whether it does. I guess they might be worried about the inflammation -> cancer link perhaps?)

See post #7

That explains it. With the Crohns the soap inflammation is probably not noticeable.

That's the sort of thing where I take a deep breath and say sure, I can put up with the inconvenience of mere functional issues. It can be so much worse. Hope everything comes out clean this time.

.Update: yesterday did Dulcolax tabs & 4 enemas, I usually do 3 and 3, but I got a late start. 2L mild SSE followed by a 2.5L hypotonic saline rinse. Couple hours later, a 2.5L mild SSE, followed by a 3.0L hypotonic saline rinse. Will try to do a series of three this morning and same this afternoon, followed by 64 Oz of the miralax oral prep. Right now, output is dark yellow, probably from the continuous bile drip into the duodenum (gall bladder long gone). Some particulate matter, but not much. Been on clear liquids for 39 hours at this point, so I don't imagine there's much going on in the small bowel.

CUL 😎

Man that just not sound like fun at all. I've had one colonoscopy at 60 which I only did because a good friend died of colon cancer. I drank the prep twice, spent a half hour in the bathroom each time and thought the procedure was pretty easy. Once they give you the versed you don't remember much although I did wake up at the end in time to watch something with scissors on the screen clip something off and then drifted back off again. It really wasn't as bad as I thought it was going to be but 44 is a crazy number. At this point I usually make a crack about 4 monkeys on mopeds but I think I'll refrain in your case. Have fun!

Moppy

Man that just not sound like fun at all.

The early ones were GAWD AWFUL! My first one was right after the procedure was approved by the FDA. The pain killer cocktail was valium & Demerol and the scope was light years behind todays scopes. After the first scoping, I told my GI that I would NEVER undergo that procedure again. He spent countless hours explaining to me that I was at much higher risk than the general population for colon cancer, because of the continuous inflammation. He went on to say that caught early, colon cancer is very curable.

On a subsequent visit, we spoke again and he asked me this question: Are you willing to risk your life to avoid an unpleasant, one hour procedure? He had me.........I knew he was right and reluctantly agreed. That was in the late 70's. Newer generations of scopes were smaller diameter & more flexible. Pain killer cocktail was Demerol & versed, so you wouldn't remember how awful the procedure was 😁 One time, all they had available was a pediatric scope and that made the procedure a lot easier to handle. After that, I told him I wanted the pediatric scope everytime.......he said ok. In the eighties I had real problems with the disease and some years I had 2 or 3 procedures,,,,,,,,not good times.

That all changes in the late 80's. I had a really bad case of salmonella poisoning & was in severs septic shock & near death for several days. Spent 16 days in the hospital, 12 in ICU. That episode did something to my immune system.........and I've never had severe flare ups like I used to have.

Now, there is no reason anyone should avoid a colonoscopy if their GI recommends one. The scope is smaller diameter & more flexible than ever, propofol is great, 10 minutes after you wake up you feel great, no fog like previous drugs. If you need one, just get it done!

CUL 😎

Well pal have fun with that. They told me I don't have to come back for 10 years (Which is in 4 more years) and I don't plan to.

They told me I don't have to come back for 10 years (Which is in 4 more years) and I don't plan to.

10 years between colonoscopies.........lucky you

10 years between colonoscopies.........lucky you

There are advantages to being a perfect asshole.

Suprep seems to be the "choice" approach today.

This should all be done in the afternoon of the a day in which no solid food, dairy products, or alcohol was consumed

It's nothing too weird.

Sodium Sulfate 17.5 grams

Potassium Sulfate 13 grams

magnesium Sulfate 1.5 grams

Initially in 6 ounces of distilled water, then once fully dissolved and allowed to set, it can be diluted with additional water or pulp-free fruit juice.

A second Identical dose should be taken 4 hours later, and 20mg oral bisacodyl 4 hours after that

Fewer than 10% of people vomit, so you may be uncomfortable but you should be OK

While what you say is correct, there is a rub of sorts. Unless you happen to have access to a chemical catalog, the magnesium sulfate (Epsom salts) as described is a problem. The recipe for SuPrep calls for anhydrous (containingg no water) magnesium sulfate. If you look in the stores and pharmacies, what is for sale is magnesium sulfate heptahydrate. That means each magnesium sulfate molecule is bound up with 7 water molecules. If you want to make SuPrep, you have to take that into account. The weight of the water molecule is 18, there are 7 of them so that is 126. The weight of the Magnesium has a weight of 24, the 4 oxygens is 64, and the sulfur is 32. So the basic weight of anhydrous magnesium sulfate is the sum (24+64+32) or 120. Magnesium sulfate heptahydrate has a weight of 246 because of all the water it contains. To add the equivalent of 1.5 grams of anhydrous magnesium sulfate, you will need 246/120 x 1.5 grams of magnesium sulfate heptahydrate. If you just double the amount of Magnesium Sulfate heptahydrage (3 grams) you will be close enough.

This is an issue only with magnesium sulfate, Potassium Sulfate and Sodium Sulfate are always sold as anhydrous

Update: had the procedures (Colonoscopy & Upper endoscopy) on Wednesday. Got to watch the entire colonoscopy in HD, as I requested twilight sedation. The buzz from the Propofol was nice, too. GI doc wanted me out for the upper endoscopy. Got to see the anastomosis and about 30 cm of small bowel. There was some minor inflammation at the anastomosis, otherwise, everything looked great.

I'd been having some upper GI symptoms & found out why. Looks like the Crohn's disease has decided to set up shop in the Duodenum. Doc found a fair amount of inflammation & some small ulcerations. This 12" piece of small bowel plays a vital role in the absorption of nutrients from food & the absorption of iron, phosphorus, calcium, zinc, copper. In gastric bypass surgery, this 12" piece of small bowel is what is bypassed. Will find out what the plan is when I see GI doc next week. Hope he's not thinking about biologics......I see those commercials on TV & the side effects are worse than the disease itself.

On a positive note, GI doc was pleased with the prep, said I was exceptionally clean. I'll tell him how I got so clean when I see him next week. I was on liquids for 64 hours prior to the procedure, had only 1/2 of the Miralax dose and took 1/3 of the Dulcolax the instructions said to take. The fun part was the 11 enemas taken over a 2 1/2 day period 😁 😁 .

Best,

vapor

Vapor,

It sounds as though you have already been through enough with the parts that you have lost, so I sure hope they are able to take care of the inflammation without having to do more surgery on you.

With the thorough clean out you did after fasting, I am sure they were very pleased.

Take care.

Dan

Was scheduled for my 10th scoping last Wed. Dr. instructions said to begin drinking PEG solution at 5 pm on Tue. drink half of it. No mention of oral laxatives. I drank half the gallon and at 10:30 pm I still had not had a BM. I could feel my small bowel bloated and my ascending colon. I was getting worried and took 1500cc tap water enema and 2 Dulcolax tabs. At 1:30 am I started to drip small amounts of fluid every 15 min. At noon, I was still dripping small amounts of highly colored fluid. I phoned my Gastro. and cancelled cause I knew I wouldn't be clean by 3 pm, scheduled time. The dripping continued until Thurs. AM.

This has never happened before in any of my 9 previous scopings. The Gastro office said they'd come up with an alternative prep. Haven't heard anything yet. Every other prep I've ever had started with a strong oral laxative like a bottle of Mag. Citrate, or 4 Dulcolax tabs.

This whole thing was a nightmare; my anal area was bleeding from cleaning it up every 15 min for so long, even though I was wiping with baby wet wipes.

Anyone have any thoughts on staring a prep with strong laxatives, or enemas (Containing Dulcolax dissolved tabs, or tap water)?

Since this discussion seems to have discussions regarding polyps, I have a question that I have not found and answer using google and would appreciate input from the vast knowledge and experience of this group.

Does it make sense that I can feel what feels like a polyp while doing a DRE on myself? It is anterior towards one side and based on what knuckle I get in up to when I feel it I'm guessing it's like 3-4cm inside the rectum (anus-not sure the correct term or where one ends and the other starts).

It was there when I had a colonoscopy 5 years ago and although my primary doctor recommend the colonoscopy because I told him I felt something just inside - I failed to be specific with the GI doctor so when he said all was fine I assumed it was nothing.

Now 5 years later I've noticed it still there maybe a little bigger. It feels like all the pictures of polyps look... I have a urologist appointment coming up, and I'm going to ask him to check it out when he does a DRE anyway and I think my regular doc wants me to have a new colonoscopy so I'm going to ask him about it too.

I'm interested in feedback from y'all.

Thanks

It could be a polyp, although the colonoscopist should have found it when he retroflexed the scope. It could also be a none bleeding hemorrhoid. Just a guess. Be sure to mention to your urologist to be on the safe side.

It could also be a none bleeding hemorrhoid. Just a guess. Be sure to mention to your urologist to be on the safe side.

I've never had hemroids to my knowledge.

That's the plan. Just awkward to say I found it ... Thanks

I have my 5th one on Thursday not looking fwd to Wednesday but it is what it is get checked It could save your life!!!?

Just a quick comment ...

The standard colonoscopy has become somewhat antiquated. While it has a few minor drawbracks, it is far less invasive, and has pluses besides its less invasiveness and much quicker procedure and result, and much more confortable if you request (demand!) a Virtual Colonscopy (4D).

Most HMOs and insurors will cover the virtual procedure. If you run into a hassle, or anticipate one, have your doctor write the order specifically for a VIRTUAL colonoscopy, and, or note on the order that you have "issues" with anesthesia.

While the prep is the same, the procedure is a breeze by comparison!

Play safe!

In some cases the prep is not the same, some groups "tag" the fecal material rather than require it to be all flushed out. I looked into options when I thought that it would be an imminent issue, but now I have a feeling that my doc will say that since my dad has polyps cut out every couple of years and my grandpa had cancer that the virtual might not be the way to go - but if you don't have family history and are likely clear I'd say go ahead. Probably MRI rather than CT.

Having my fifth one tomorrow. I have only had a few bad experiences first one had complications and spent three days in the hospital from bleeding. Got my second the next day to cauterize the polyp site. Third one was a year later and I woke up during and felt like I was being run through with a sword but was back to sleep soon after. I think everyone is different with not being sedated or getting sedation . I would always prefer for me to be sedated. The prep is the worst part but even the preps are better these days.

Only had one!!! Prep "Miralax!!" and "NO Anastesia! FINE!! No video replay so I got "To WATCH!!" and after years of doing "ENEMAS!!!" I Was All "PINK AND PRETTY" on the in side!!!

Next in 3 years!!

highwater

I've never had hemroids to my knowledge.

That's the plan. Just awkward to say I found it ... Thanks

The urologist did a DRE, felt it and said not to worry about it. He doesn't think it is a polyp maybe a small hemroid.

Just trying to be safe.

Feeling it is one thing, looking at it is another. Have your primary MD use an anoscope to see it or have him refer you to a specialist who can made the determination, just too be safe.