It is recommended that everyone have a colonoscopy for cancer screening once every five years beginning at age 50 (or earlier if you have a strong family history of bowel cancer), so it’s something that most people will have done at some point in their life.
Those of us with inflammatory bowel disease have the distinct pleasure of undergoing a bajillion colonoscopies for disease surveillance. I could lie and say, “colonoscopies are fun!”, but I know you wouldn’t believe me anyhow. Nope, they aren’t fun, but they really aren’t that bad, and there’s no need to be embarrassed. As you’ve probably heard, the prep and the first time are always the worst because you don’t know what to expect. Allow me to allay some of your apprehension.
I’ve had seven colonoscopies so far, including three upper endoscopies that were done at the same time, so I consider myself something of a veteran when it comes to this. I’ve got number eight on the books this coming week. I’ve already written something about what to do when you’re required to drink a gallon of laxative, so in this one I’ll elaborate a little more into the pre/after-prep. For example, what your diet should look like for 3-5 days before you’re scheduled to start drinking your
horseshit prep, and also what happens when you arrive for your photo shoot.
If you’re a person who eats a lot of whole wheat, fibrous grains, beans, and veggies, you’ll want to switch to a very low fiber diet (I call it a white diet because most of the foods are white) for 3-5 days before you begin your fast and need to chug your first dose of prep. Your ass will thank you when it comes time to open the flood gates. How soon you start this diet really depends on how regular you are. If you’re a 2x/day pooper, you should be safe starting 3 days beforehand. If you only go a few times a week, you’ll want to do this for a minimum of 5 days. A white diet is stuff with very little fiber, such as products with refined flour (plain cheese/meat pizza with no veggies, white bread, rice chex, white pasta, pastries – gluten free, if that’s your thing), potatoes without their skins (I suppose fries count), and strained vegetable juices like v8, nut/seed butters (but NO whole nuts or seeds!). Avoid stuff with skins and seeds, and try to go easy on the oils. Eggs and lean meat are also okay. You’ll probably want to cut back on dairy to minimize cramping during prep. It’s certainly not a healthy diet, but this is only for a few days and you can use it as an excuse to eat junk food! Sweet!
Some doctors will have you do the entire prep in one day, while others prefer you drink half of the prep the evening before, and the other half the morning of. I actually prefer the single dose prep, starting early in the afternoon the day before, but definitely follow your doctors instructions.
You’re allowed clear liquids, coffee/tea (no cream), broth, jello, soda, ice pops, and clear hard candies (like life savers and jolly ranchers), but nothing with RED or PURPLE dye, as this can show up as bleeding/inflammation in your GI tract, and you’ll be subjected to additional torture.
After you’ve spent about 16 hours crapping your brains out (if you don’t have IBD or IBS, this might help you understand a small portion of what it’s like), you’ll want to get yourself to the hospital/doctor’s office safely. Make sure you have someone to drive you, because you will be given sedative for the procedure and they’ll send you away if you show up without a “responsible” adult to drive you home. Allow plenty of time, in case you need to stop somewhere along the way. Take a couple of changes of clothes just in case, and put a towel down on the car seat. If you’re really smart, you can buy incontinence pads to help remove some of the accident anxiety.
Congratulations! You and your chaperone have made it in one piece, and you didn’t crap your pants. Or maybe you did, but believe me when I say it happens to the best of us. You’ll fill out your outpatient procedure paperwork, which includes listing all of your medications and supplements. It’s a good idea to write these down ahead of time, because you’ll probably be sleepy after spending all night on the toilet. If you’re a female under the age of 60, you will be required to submit a pregnancy test. Some places require that you do this within a week before your appointment, but most of the time they do it during intake.
A nurse will call you back to your little curtain cubicle, will take your vitals, and will give you a gown to change into. You will be given an IV (don’t be afraid to tell the nurse that you want it in a place other than your hand – they’re usually happy to do this…hand IVs suck), fluids will be started, a pulse oximeter will be placed on your finger, and the blood pressure cuff will be left on your arm. I’ve had colonoscopies in many different clinics, and they all slightly differ in their process. The best experiences I’ve had, I was given versed before I was rolled back into the procedure room. It’s a tranquilizer/amnesiac. You won’t remember much after that, but you’ll still be awake and able to do what they tell you while they get you all situated in the procedure room.
Once you’re in, you’ll be asked to roll over on your left side, with your left leg straight, and your right leg bent forward at the hip. They’ll place ekg leads on your chest, and if you’re really lucky, you’ll be able to tell your doctor he’s a literal pain in your ass before the anesthesiologist injects the sedative into your IV. I always have propofol sedation because I do well with it, save for a little nausea which they remedy with zofran post-procedure. If your anesthesiologist is a saintly, wonderful person, he or she will push a little lidocaine into the vein so it doesn’t burn. Otherwise, be prepared to feel intense burning near your IV site until you’re under (this usually takes less than a minute).
And you’re done! For you, it’s over as soon as it starts. Bless those anesthesiologists. I love them. That wasn’t so bad, was it? A doctor or nurse will come around after you’re awake to discuss the results with you. If you want, you can request a copy of your exam report that includes snapshots of your colon and the very end of your terminal ileum. It’s actually pretty cool, so I recommend it! You’ll get your discharge instructions, and your chaperone will sign them. You’re free to go once you’re able to walk.
You might have some major gas after this due to them blowing air through the scope to get a better view. If this is painful, Gas-x will help you to pass this gas more easily. It’s a good idea to have this on hand before your colonoscopy just in case. You may experience slight pain if biopsies were taken, so I recommend staying away from alcoholic beverages, giant steaks, and fried foods for a couple of days afterward.
If you had biopsies taken, your doctor should receive the results within 2 weeks. They may call you with these results, or you can call them.
If you have any questions, I’ve probably got answers, so ask away. Feel free to add anything I may have left out!