Heads up. Info about colonoscopy exam.

[snagglepuss]

My sister's friend has to have a colonscopy done every year due to colon polyps. Her advice for anyone planning to get the exam is to not eat any solids 2 days prior to the exam, to only drink liquids which can include soups. By doing this the colon purge that is required before the exam is alot less odious. My sister followed the advice and recommends it. My Mom who did not follow the advice for her first exam deeply regrets that she didn't listen to it but has followed the advice on subsequent exams. (My Mom's first colonoscopy 5 yrs ago actually discovered a malignant tumor. She had it out and has not had a recurrence so it pays to endure the test.)


The other piece of info is rather cautionary. The pill containing sodium phosphate used to cleanse the colon has serious risks to kidneys that can take years to manifest. In fact the FDA has issued warning not to use it for bowel cleansing. There is an less risky option to the pill called PEG but it requires one to drink several quarts of a terrible tasting liquid.

"You may hear rumours that Fleet Phospho-soda and other oral sodium phosphate bowel preps are going off the market.This is partially true. Some of these products are going off the market in the U.S...due to new FDA warnings not to use them for bowel cleansing. So far there are no plans to remove them in Canada...but Health Canada has previously issued warnings and is re-evaluating their safety. Oral sodium phosphate solutions can cause acute kidney injury due to precipitation of calcium-phosphate crystals in the kidneys."


http://www.canadianpharmacistsletter.com/(S(crboc2afc4yr53zhkckuah55))/pl/ArticleDD.aspx?nidchk=1&cs=&s=PLC&pt=6&dd=250123&utm_source=CTV&utm_medium=TV&utm_campaign=media

[left coaster]

1. Ummm... patients don't usually have to find out what to do on their own..

Specific dietary and medicinal instructions to empty the bowel, pre-procedure, are given routinely to patients by the attending physician.. I'd be wary of any doc who didn't provide this information.

[snagglepuss]

3. I'm mystified by your remark. Doctors

prescribe medication that will fully empty the bowels. If medication isn't taken the test might have to be aborted because of fecal matter in the colon.

My Mom's specialist never mentioned taking liquids instead on solid foods and so she ate solid foods and then took the medicine as prescribed however she regretted it because she spent hours on the toilet. Now before any colonoscopy, she avoids solid foods for the 2 days prior and says the difference is remarkable.


<edit to remove sarcasm>

[Ms. Toad]

5. Preparation for a colonoscopy isn't just taking a medication

It generally involves a graduated period of fasting, with specific things removed from the diet at specific times, and a complete ban on foods and liquids.

It may not be rocket science to clear the bowels, but it is at least medical science to make sure that you do it safely and aren't dehydrated, or injure your kidneys or your heart, or create electrolyte imbalance.

[asjr]

6. You are correct--it is torture.

[Ms. Toad]

15. I don't know that I'd go so far as to call it torture -

but it isn't pleasant, and none of the three doctors we deal with just have us take medication.

[DrDan]

8. no - not a complete ban

you can have certain liquids - diet sodas, coffee, tea etc. Also popsicles and jello (sans red die), bullion, etc.

It is not that bad.

24 hour prep is all that is necessary - not 2-3 days.

I have had a couple.

The anticipation is much worse than the actual prep.

[snagglepuss]

12. According to the NIH a clear diet can be taken 1-3 days before the exam.

You have followed the similar regime my Mom followed for her first colonoscopy and it did the job because a cancerous tumour was detected however from hersubsequent experience it seems that the prep is alot less unconfortable when a liquid diet is taken 2 days prior to the exam.

Of course doctors must always be consulted.

[DrDan]

13. I did not find it all that uncomfortable

lots of jello and popsicles. It really wasn't that bad.

[Ms. Toad]

14. For each of the 3 doctors we have worked with

there is a complete ban from around midnight the night before the procedure through the procedure.

Two doctor used slightly different 3 day preps (not counting a ban on certain medicines that is even longer), the other uses a 2-day.

We have been doing this regularly for 15 years, with multiple doctors. That is why I emphasized that you need to check with your physician - each physician and the team she works with expect that you have followed the procedure she has set out - and if their expectations do not match reality, your procedure will be risky than it otherwise might be.

My daughter has had to have regular colonoscopies since she was 4; annual since she hit 14, and the two adults have reached the age at which we need screening exams - so we've had quite a bit of experience with the prep. The one constant, though, starting sometime the evening before the exam, all food and drink is prohibited.

[DrDan]

16. yeah - I remember the midnight ban now - forgot about it earlier

I do remember the jello and popsicles the day before

[left coaster]

10. Mystified, really?

I, and anyone I have ever known who has had a colonoscopy, as I already posted, along with med., received SPECIFIC DIETARY INSTRUCTIONS before the procedure from their physician. This is SOP.

No offense, but your mom's specialist sounds like he/she was negligent in not fully instructing your mom, pre-procedure. That's all I was pointing out.

[snagglepuss]

11. As stated by the NIH there is a range of days of taking a liquid diet. The

regime the specialist gave my Mom was fine as he had no problem detecting a tumour. However in terms of reducing discomfort of the bowel prep my Mom found that a 2 daily liquid diet made the prep much less disagreeable.

[Ms. Toad]

4. My concern is patients not following their doctor's advise,

rather than doctors not providing prep information. We've been through this with a number of physicians (there are three of us who need colonoscopies, and each has a different prep - all of which were clearly spelled out by the physician.

There are risks associated with the prep itself - altering the preparation without consulting your physician can be very risky, even more so if everyone involved in the procedure isn't well informed about what the preparation was.

Certainly ask your physician about liquid only diet in advance of the formal preparation, or about concerns about risks the preparation materials might pose - but I wouldn't alter the preparation without consultation.

[snagglepuss]

7. According to the NIH a clear diet is standard. By all means ask the doctor

but my sister, her friend and my mother each said that a 2 day liquid diet made it less an ordeal. Like I said the regime my mother was given did not specify a clear diet but the specialist had no issue when she took a 2 day liquid diet prior to subsequent tests. The real concern I believe is the Sodium Phosphate that is used.


From NIH
"Generally, all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. Patients should not drink beverages containing red or purple dye. Acceptable liquids include

fat-free bouillon or broth
strained fruit juice
water
plain coffee
plain tea
sports drinks, such as Gatorade
gelatin "



http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/

[dixiegrrrrl]

2. Appreciate the info.

[TNDemo]

9. And if you are doing the prep and drinking Gatorade,

which is the way I did it - mixed the medicine into it - if you get really nauseated, insist on having a fingerstick when you go in for the procedure. I had no idea I was diabetic and after the first bottle of Gatorade I was terribly nauseated (was fine all day while fasting and drinking clear liquids), even with the anti-nausea pill. I never could drink the second bottle but luckily I was clear enough for a successful procedure. I found out a few months later that I had an Hb A1c of 15, which is an average blood glucose for the last three months of about 400. With all the glucose in the Gatorade I cannot even imagine what my glucose was and it is no wonder I was so sick. They just acted like I was a weinie and whiney but they should have looked a little further and I could have gotten diagnosed earlier. If you are diabetic, they can give you a different prep.