Colonoscopy: The Facts

This post isn’t for the faint-hearted but it IS for those people who are obsessively Googling, worried about abdominal pain and /or changes in bowel habits. The fact is, any symptoms like that can scare the hell out of you – I know I’ve spent the last four weeks stressed out of my mind. My story over that time isn’t particularly dramatic or exciting, but it may provide some information that helps put your mind at rest – particularly in regard to having a colonoscopy. Stop reading here if you don’t want to read about bowels and related matters.

 July 2007

I had an episode of renal colic which resulted in nearly a full day’s stay in hospital on morphine while they ran tests. It came on that morning – severe lower left abdominal and back (flank) pain. It was truly excrutiating and it was impossible to get comfortable, hence the trip to hospital. My blood tests came back ok (some raised protein and albumin levels which were to be expected given the situation), my urine tested positive for blood (again not unusual if you have kidney stones gouging down your ureters) and my abdominal x-ray came back clear (no bowel issues and most kidney stones don’t show up on plain x-ray). At the end of the day I was sent home with a diagnosis of renal colic and lots of painkillers.

 I felt totally washed out the next few days and the codeiene-based tablets accentuated that. Slowly got back into eating and also started by best new habit: drinking lots of water. You hear people lecturing all the time on the importance of water intake and it was something I just never really did much of – I never felt that thirsty. I now drink 1500-2000mL of water daily and thankfully I’ve not had any more renal colic. The stone or stones appear to have passed the day I went to hospital because a follow-up ultrasound came back fine as well (even ultrasound won’t show up fine gravel in the kidneys).

I also made a number of other lifestyle changes. For as long as I remember I’ve been running on around 6 hours sleep per night. I’ve increased that to 8. I’ve also changed my dietary intake significantly – no more eating late at night, lots less chocolate and fatty lunches at work. I haven’t felt like a new person but I feel good that I’ve made the changes and I’ve lost a few kilos.

 August 2007

 After a month of improved nutrition and sleep I noticed a change in bowel habits. Much looser stools and had sometimes been waking a little earlier than usual with abdominal pains. Also, for the past six months I’d had discomfort in the left groin area – a feeling that something was ‘there’ but nothing that could be felt – this had been diagnosed as a reducible inguinal hernia but on consult with a surgeon he stated he wouldn’t be operating as the hernia wasn’t palpable to him. The combination of the groin discomfort and the bowel habit changes led me to going back to my GP asking for a way forward. My GP (who I think is brilliant – the rare combination of wonderful humanity and clinical skill) did a thorough examination, couldn’t feel anything but ordered a colonoscopy to be on the safe side. I went home pleased that further investigations were underway but then the doubts started to set in: what if I had bowel cancer?

That set in motion a month of obsessive Googling of my symptoms (the first appointment I could get for a colonoscopy was a month down the track). I now have a good working knowledge of everything you’d want to know about stools, colon cancer, IBS, IBD and diverticular disease. In the process I managed to scare myself to death and drive my wife insane with my constant ruminating on what I may have. Combine that with a new and stressful job role and I felt at the end of my tether most of the month. The weight I’d dropped in the previous month didn’t help my stress either – everytime someone said ‘gee, you’ve lost some weight’ I’d get a knot in my stomach. Six months previously I would have loved someone to have said it.
 

September 2007

As the time for my colonoscopy grew closer, the more stressed I got. Not because of the procedure itself – but what it may find. You can imagine the impact that had on my bowels let alone anything else that was going on. That said, I was glad to start the low residue diet because it meant I was doing something.

Where I live, there are two options for bowel preparation before colonoscopy: Glycoprep or PicoPrep. Glycoprep involves drinking 3-litres of lemon-tasting liquid over four hours and you can continue your low residue diet until the afternoon before the procedure. PicoPrep involves a lower volume of fluid to drink but you have to stop eating (just drink clear fluids) more than 24-hours before the procedure. I chose the Glycoprep because I didn’t think I’d cope with not eating for the longer time frame. In retrospect I’d choose the PicoPrep because of the lower volume of fluid to consume. Drinking three litres of something you’d never usually drink is very difficult – it took me five hours and the last 500mL seemed to take forever. About 90 minutes after my first glass I started my intimate relationship with the toilet, which continued until I went to bed and then again when I got up the next morning. Overall, the prep wasn’t anywhere near as bad as I thought it would be – I didn’t feel really weak and the toilet trips weren’t uncomfortable, just regular. You may have read that the prep is the worst part of the whole thing: it’s true but even then it’s a long way off a traumatic experience.

The day of the procedure finally came and I was scheduled for the afternoon so I had another four hours of feeling anxious, wanting the whole thing to be done so I know either way what my next step was. My father-in-law picked me up just before one and off I was dropped at the endoscopy clinic. The clinic staff from start to finish were superb, from the receptionist through to the nurses, anaesthetist and GI consultant himself. A nurse asked me a range of health questions then weighed me and took my blood pressure before I was asked to change into a gown. I could leave my t-shirt and socks on which I found comforting for some reason.

I’d just changed when the anaesthetist came in to quiz me clinically and he then led me into a room with a trolley where I lay down whilst he inserted an IV into my hand. If you’ve never had an IV inserted before, it’s no big deal – feels exacly like having a small injection. I of course knew I was having IV sedation for the procedure. Everything you read tells you you’ll be very drowsy and won’t remember anything – how right they are. The anaesthetist told me he was going to give me the sedation so I’d start to feel drowsy. I remember saying to him 15 seconds later that I was starting to feel drowsy, and then that was it.

I woke up 30 minutes later in recovery. I knew it was over because I was now lying on my right side (you always lie on your left side for a colonoscopy). I felt great, albeit drowsy. A key point needs to be made here for those of you stressing about having a colonoscopy: aside from being able to feel air in my intestines, there was absolutely no physical sensations from having had a scope inserted rectally. I’m convinced that’s what scares a lot of people – they believe they’ll feel like they’ve had a watermelon shoved up there. Let me tell you, there is no sensation whatsoever.

Ten minutes after coming to, the GI consultant came out to give me the news: everything was clear. No pathology, no polyps. His only recommendation was that maybe I had Irritable Bowel Syndrome so I was to have a high fibre diet for the next month and if my bowel habits and intermittent left abdominal discomfort continued, to see my GP about going on an anti-spasmodic called Colofac. I asked him if it was worth having a gastroscopy and his view was no, not at this stage. I was relieved (to say the least) that nothing had been found but still a little peturbed about the symptoms and what may be causing them. That said, at least I now knew I didn’t have bowel cancer, something for which I am so grateful.

 I was allowed to sit in a chair / get dressed and an hour after that I was allowed to go home (you can’t drive yourself though). I had some minor crampy pain that evening but otherwise no discomfort at all.

Summary

If you have bowel symptoms that are worrying you – see your doctor. If he / she orders a colonoscopy, don’t freak. It is such a painless procedure to have and gives you excellent peace of mind. Your dignity is respected the whole time and the people who care for you are professionals who want to see you get the best outcomes you can. One other bit of advice I was given by friends and family was NOT to Google symptoms. You know what – they are totally correct. It does nothing to put your mind at rest and actually increases the stress. There was nothing from the week’s of searching online that truly helped me in the end aside from the knowledge that lots of people had similar concerns.

Of course, if you’re reading this then you’re already Googling….. Good luck with it all!