Colonoscopy: Yes or no?

[douglasmich]

Hello

I am seeing a very good Gastroenterologist in Australia for my severe intractable constipation. He has told me my best chance at recovery is Rifaxamin + Vancomycin followed with 10 days of FMT, with the first one via colonoscopy and the subsequent ones via rectal catheter.

The first one via colonoscopy is very important because it gets to the very start of the colon which is important from their clinical experience. However i have severe sensitivities and i am very very worried of this procedure and i am not sure if i should do it. I can only imagine how i will react to the sedatives, as things like panadol give me vertigo, anxiety etc.

What do you guys think?

 

[TiredSam]

I had one without a sedative, maybe you can too?

 

[douglasmich]

I had one without a sedative, maybe you can too?

What was it like? pain etc. I have a feeling that il be the guy that gets a perforated colon while im not under sedation

 

[TiredSam]

Well I said I'd rather try it without the sedative and they had it onhand to give it to me if I changed my mind. I just like to get these things over with and not have to wait for a sedative to wear off afterwards. It was uncomfortable, but I wouldn't say painful. I just lay there, did what I was told, and waited until it was over. In fact I even watched the camera going through my insides on the screen. You also have to be able to relax and co-operate so they can get the tube in and move it around. After they insterted the tube I don't think I felt much at all.

 

[ScottTriGuy]

I reacted to the solution I had to drink the night before the colonoscopy - racing heart, hands and feet felt tingly weird, vision narrowed, blood pressure dropped - felt really messed up, on the verge of having to call an ambulance - then all those symptoms lifted when I felt the solution 'turn a corner' in my GI tract - I had a much less intense reaction when I had the rest of the solution in the morning.

For the procedure, they gave me 'twilight' - I did not experience any after effects - and would request that again.

 

[*GG*]

Here is some documentation on Sedatives. I just had a hernia repaired almost 2 weeks ago, I am not sensitive to meds, and am not allergic to any like both of my parents. Perhaps this will help?:

I also have a couple of documents from the National CFIDS website, but they are papers, and not sure a Health Care provider is going to read all that!

 

[barbc56]

@douglasmich

I would think the benefits would certainly outweigh the risks. This is something to discuss with your physician and/or the anesthesiologist.

Good luck!

@TiredSam

No twilight sleep? Are you superman? Well you may be super and I think your a man but it's sometimes difficult to figure this out by ones avatar.

I asked the doctor to go easy on the twilight sleep medications, woke up in the middle of it screaming to give me more. The pain was excruciating. Funny thing though. I remember the pain as being awful but not the actual pain. Not sure if that's clear but then I was under the influence. I asked the nurse in recovery if this really happened. Her answer was that they did need to adjust the medication during the procedure which I think is code for yes.

 

[TiredSam]

No twilight sleep? Are you superman? Well you may be super and I think your a man but it's sometimes difficult to figure this out by ones avatar.

Yes, I am superman, I've changed my avatar to avoid any further confusion .

I hadn't had a colonoscopy before so didn't know what to expect, so just thought I'd try it without sedative, and was fortunate enough that in my case it wasn't painful and there were no complications. I had an endoscopy at the same time (well just after), which was also without sedative and I found it much more uncomfortable. I couldn't stop retching loudly (very loudly, being a superhero) until I got used to it. Of course afterwards I had to go back into the waiting room to await my results, everyone else in there seemed to be grinning and looking at the floor. They must have heard me down the street. Oh well.

 

[Insomniac]

I disagree about doing it without the sedative.
I did regular colonoscopies for tests and I felt a tiny bit of pain and discomfort even with a sedative, but it was bearable. It would have been much more difficult without. There is bound to be something that you don't react to.
The NCF stuff that ggingue posted is great advice.

 

[ahmo]

@douglasmich My husband has post-polio syndrome. There are specific instructions about type and amount of sedatives, anesthetics, as they are very sensitive to them. I can get those recommendations for you. I didn't know you were Aussie.

@TiredSam Brilliant avi!

 

[Andrew]

I had a colonoscopy. This included a prep of only eating fat free chicken soup and white grape juice. Plus taking a bunch of laxatives. And an enema. And although I was very worried about this, it all went okay. Except the doctor could not complete the exam because he could not navigate the instrument all the way to the top. The previous doctor (before I got ME) had the same problem.

The twilight sleep name is sort misleading. I was not in some half sleep. I was out. The do say, however, that they can bring someone out quickly.

 

[Sushi]

I can only imagine how i will react to the sedatives, as things like panadol give me vertigo, anxiety etc.

Generally you have a consult with the doc beforehand to discuss things like the choice of medications. I have had colonoscopies with full anesthesia and with "twilight." The full anesthesia took a few days to get over; the twilight didn't.

What was it like? pain etc. I have a feeling that il be the guy that gets a perforated colon while im not under sedation

With the "twilight" I had to ask for more medication during the procedure--it hurt! But it was fine when they gave me more. They have an IV line in to deal with things like this.

I reacted to the solution I had to drink the night before the colonoscopy

Some of the preps are safer than others. Generally the one where you drink about 2 liters is safer because it gives you balanced electrolytes.

For the procedure, they gave me 'twilight' - I did not experience any after effects

Nor did I. Very different from full anesthesia--which was great at the time, but had after effects.

 

[kangaSue]

I recently read a systematic review paper of FMT which drew the conclusion that FMT was less successful with the colonoscopy method when the stool was placed further into the bowel than the transverse colon. I don't recall there being a reason given why this would be the case and I can't lay my hands on the particular Pubmed paper but it had words to the effect of "systematic review of fecal microbiome transplant" somewhere in the title if you want to do a search.

An option to colonoscopy method is to do a couple of infusions top down through an nj tube into the small bowel at the same time as FMT enema's, I know Dr Borodey does it this way in some cases. Top down is the preferred route for infectious disease specialists and there's no evidence to say there are any more complications done this way compared to enema.

I've heard of one guy who had good results doing around 20 FMT infusions exclusively from top down through an nj tube over the course of about 6 weeks. It was either 10 or 14 consecutive days to start then tapered off.

If you think you are a perforation risk with colonoscopy, you could get a CT scan of the bowel done first. The perforation risk is higher if a CT picks up signs of a thickening or narrowing of the bowel wall.

 

[douglasmich]

I disagree about doing it without the sedative.
I did regular colonoscopies for tests and I felt a tiny bit of pain and discomfort even with a sedative, but it was bearable. It would have been much more difficult without. There is bound to be something that you don't react to.
The NCF stuff that ggingue posted is great advice.

OKay

@douglasmich My husband has post-polio syndrome. There are specific instructions about type and amount of sedatives, anesthetics, as they are very sensitive to them. I can get those recommendations for you. I didn't know you were Aussie.

@TiredSam Brilliant avi!

Hi, dont take time to do that, but if its quick for you then thats great thanks

I had a colonoscopy. This included a prep of only eating fat free chicken soup and white grape juice. Plus taking a bunch of laxatives. And an enema. And although I was very worried about this, it all went okay. Except the doctor could not complete the exam because he could not navigate the instrument all the way to the top. The previous doctor (before I got ME) had the same problem.

The twilight sleep name is sort misleading. I was not in some half sleep. I was out. The do say, however, that they can bring someone out quickly.

The prep is picolax. Anyone heard of it?

 

[douglasmich]

I recently read a systematic review paper of FMT which drew the conclusion that FMT was less successful with the colonoscopy method when the stool was placed further into the bowel than the transverse colon. I don't recall there being a reason given why this would be the case and I can't lay my hands on the particular Pubmed paper but it had words to the effect of "systematic review of fecal microbiome transplant" somewhere in the title if you want to do a search.

An option to colonoscopy method is to do a couple of infusions top down through an nj tube into the small bowel at the same time as FMT enema's, I know Dr Borodey does it this way in some cases. Top down is the preferred route for infectious disease specialists and there's no evidence to say there are any more complications done this way compared to enema.

I've heard of one guy who had good results doing around 20 FMT infusions exclusively from top down through an nj tube over the course of about 6 weeks. It was either 10 or 14 consecutive days to start then tapered off.

If you think you are a perforation risk with colonoscopy, you could get a CT scan of the bowel done first. The perforation risk is higher if a CT picks up signs of a thickening or narrowing of the bowel wall.

Interesting, i will try to look it up.

I dont want to do a CT scan, its too much radiation IMO.

If i dont do the colonoscopy i dont have to pay hospital costs. But im not sure if froomes will allow this.

I was in the 1% category thats gets permament side effects from the drug finasteride. I feel like il be the 1 percent that gets a perforated colon..lol.........

 

[barbc56]

Yes, I am superman, I've changed my avatar to avoid any further confusion

The twilight sleep name is sort misleading. I was not in some half sleep. I was out. The do say, however, that they can bring someone out quickly

I was too. In fact I didn't even remember that I asked for something to eat in recovery. While eating I guess I was going on and on how the graham crackers and milk provided were "the best damn food I have ever eaten". The person with me told me later about the nurse's reply to my question which I had also forgotten.

Several months later, my friend brought over my birthday present. One present turned out to be a box of graham crackers with a note attached saying I had to provide my own milk. I was puzzled and thought, yeah I like graham crackers, thinking it was a gag gift, but couldn'tfigure why this particular present. When she saw the puzzled look on my face, she started laughing as she realized I had completely forgotten about eating these in recovery.

I do have to say the prep is now much gentler and didn't get an enema. I don't think I got an enema for the first time either.

Edit

@TiredSam aka Superman

Are you sure the procedure you had was a colonoscopy and not a sigmoidoscopy

Not doubting your word but when I had mine, decades ago, I also had an enema and watched the procedure on a monitor. I didn't have a sedative but think I was offered one.

https://www.nlm.nih.gov/medlineplus/ency/article/003885.htm

I hate to break your bubble, but it does look like superman is doubled up on the floor writhing in pain.

Just sayin.

 

[merylg]

Ask for prep that does not contain Aspartame.

 

[TigerLilea]

I had my colonoscopy without any sedation. Except for a few seconds of pain when the scope was turning a corner, I didn't feel anything. It was interesting watching everything on the monitors and I was ready to go home 45 minutes after the procedure started.

 

[kangaSue]

Interesting, i will try to look it up.

I dont want to do a CT scan, its too much radiation IMO.

If i dont do the colonoscopy i dont have to pay hospital costs. But im not sure if froomes will allow this.

I was in the 1% category thats gets permament side effects from the drug finasteride. I feel like il be the 1 percent that gets a perforated colon..lol.........

An ultrasound will pick up a bowel wall thickening too, just not always as conclusive as a CT unless in the hands of a highly skilled technician.

I've joined that 1% club for perforatiion, my G.I. didn't think the prior CT finding of a bowel wall thickening was a significant issue. It was.

 

[TiredSam]

Are you sure the procedure you had was a colonoscopy and not a sigmoidoscopy

It was a colonoscopy, Darmspiegelung in German. I had to drink 2 litres of stuff the beforehand. I had it for the purposes of examination when I was ruling out everything else CFS might be. They didn't find anything and there were no problems to fix so it was quite straightforward, as @TigerLilea described. They asked me to change position a couple of times to help them get the tube round various corners. Afterwards they kept me in recovery for 20 minutes just to make sure all the air came out and that I was ok.

I hate to break your bubble, but it does look like superman is doubled up on the floor writhing in pain.

Nope, he's just practising his relaxation techniques whilst calmly waiting for his colonoscopy .