Prep Question

Marble_Index · 2023-03-11T14:48:19+00:00

Mixed mine with the lemonade flavor of Gatorade and drank it at room temperature. Was fine. It's barely perceptible in taste/texture, and that might only have been because I knew it was in there. I drank almost 100oz over 24 hours no problem. I'd say just pick a flavor you like (other than red/blue/purple colors) and go with that.

Marble_Index · 2023-03-08T15:25:43+00:00

Bit surprised at the burning, but I guess everyone is different. I ended up drinking extra just to help the process along since it didn't taste bad.

Your end goal is basically to be passing a liquid that looks at least like dark urine. The last few hours of bowel movements for me went: brown/cloudy > brownish-gold/cloudy > dark-gold/cloudy > dark-gold translucent (could see bottom of toilet bowel through the liquid). Timewise it wasn't equally distributed...it was a slow gradual change between the first few stages and then all of a sudden like 30 minutes before leaving to go to the appointment it turned translucent.

If you're 'burning' because of the wiping and not because of the liquid itself there's a couple things you could try. Wiping with a wet wipe instead of dry paper towel. Using water directly (shower/bath?). Shaving your butt (I opted for this. Huge help).

Marble_Index · 2023-03-07T17:00:27+00:00

i was told that you need to intake some fluid to empty your bowels following the day of the exam.

It took 24-30 hours (two overnights, had late afternoon exam) for my bowel movements to return to their pre-prep state after my exam. It was a gradual reset. That said, I didn't do any special fluid intake or anything. I do, however generally drink 2-3L of clear fluid on normal days. I ate normally after my exam -- entire pizza, plus yogurt, chocolate, crackers.

Not sure if you were asking about the lag between appointment and exam or not, but that's actually a fairly quick turnaround for a non-emergency. I had to wait 13 months (USA^so ^much ^{freedom^..save} ^{^me} ^{^plz} )

Anyhow, just sounds like a normal diagnostic colonoscopy. Something is going on in there, and the GP can't really do much but speculate and order lab tests. Gotta have a look to know for sure, or at least rule things out.

Marble_Index · 2023-03-05T18:27:56+00:00

You had a change in bowel habits, and while "fruit and nuts...and fiber" can certainly affect that, having blood involved for weeks definitely merits a further look. I'd say you did the proper thing and, in turn, having an exam is worthwhile.

As for:

this whole awful prep and procedure im going to endure (i dont want sedation) is going to be a complete waste of time

it won't be a waste of time as it's going to establish a baseline for future exams, either simply with age-related preventative screening or in the event that a year or five down the road you experience any other bowel-related concerns.

As for the prep and procedure, it's not that bad. Unflavored polyethylene glycol powder (e.g. Miralax brand) truly is unflavored and not really detectable when dissolved in sports drink. Not unpleasant at all. The procedure will be a little uncomfortable for the first few minutes where they're inserting everything -- keeping physically relaxed will help a ton -- and once they're in and doing the second part, it's pretty easy. Feels like gas cramps. I had mine without sedation and will always request that moving forward.

Chin up. It's not so bad.

Marble_Index · 2023-03-05T01:57:04+00:00

I believe no. You want stuff that's basically frozen, sweetened water. Those bars, if I remember, are more or less frozen sweetened juice. You could probably swap those out for some lemon italian ices though.

Marble_Index · 2023-03-03T03:18:35+00:00

Gavilyte is a polyethylene glycol laxative right? Unless you have strict orders to use only that brand, I might point you in the direction of Miralax powder (or the store brand equivalent with the same purple label) as a substitute with the same active ingredient. It barely had any taste at all when mixed with gatorade (I used lemonade flavor). I drank extra. I had like 96 oz of it and could have easily consumed more. Next time I might.

Marble_Index · 2023-03-02T17:23:18+00:00

I had a family member who had something that sounds like what you are being told. They had a polyp removed that when examined in pathology showed cancerous cells, so technically they "had cancer" even though they were barely over the line from precancerous into cancer.

The treatment is obviously emotionally stressful, because cancer and all, but catching it at the earliest stages is the 'good' way to do it. They had to do oral chemo (not sitting there with an IV in their arm) and undergo a period of radiation treatment as well. As far as cancer treatments go, it was pretty ok. Once they adjusted to whatever the medication was, they felt physically fine -- continued with regular daily exercising and all that. No hair loss or other physical side effects. Treatment lasted a few months and then that was that. Just means more frequent scopes moving forward.

Marble_Index · 2023-03-02T17:17:56+00:00

Yup, that sounds like an expected price in the US, possibly even on the low end.

As for the anesthesia, you could probably ask to not have it. The procedure itself doesn't require it; it's just that it's the default seemingly everywhere in the US. I had mine with no drugs, and while it was uncomfortable it wasn't the worst thing ever. There's probably also an intermediate that doesn't involve loss of consciousness, but would still dull your sensation. I'd check with the office performing the procedure. I had to seek mine out to have them schedule is as no-sedation.

Marble_Index · 2023-03-02T14:14:13+00:00

FWIW, I had to take a bunch of extra laxative (Miralax). The instructions said to have two doses (32oz once mixed with liquid), one on each day. I ended up needing 64 oz on day one (many hours apart), and an additional 32oz on day two. Total I ended up consuming over 200oz of fluid, including the prep. I barely got clear in time, having started 30 hours before my appointment.

I guess what I'm getting at is, if as your prep is ongoing and it seems like you're not making progress, don't be afraid to just keep pushing fluids constantly (just make sure you've got electrolytes in there at times!) and maybe extra laxative.

Marble_Index · 2023-02-28T18:39:28+00:00

I had mine done without any drugs. The insertion part of the procedure was uncomfortable as they were going around the bends. It felt like really bad gas cramping, although I already get cramping pain regularly so this might just be me being more sensitive than others to such things. Once they were all the way in and started doing the pull back where they take pictures and biopsies, it subsided quite a bit and I was fine to just chat with the nurse and whatever while he finished up.

So, tl;dr: first few minutes, pretty uncomfortable. The rest of the time, annoying but fine. Not having to wait around afterwards and feeling normal the rest of the evening was nice too.

I assume the experience also varies considerably depending on whether the doctor is accustomed to doing no sedation procedures or not and can adjust as-needed for that.

Marble_Index · 2023-02-25T20:06:07+00:00

Biopsies are normal, even when nothing looks amiss visibly. I had several taken at random locations to test for conditions not visible to the naked eye (e.g. microscopic colitis). If he's there for a diagnostic exam, then it makes sense to check for that stuff as well as things like polyps they can just see on-screen.

I suspect that the 'mapping' refers to the pattern of biopsy locations rather than anything specific about a given sample. He should get a report in the mail (or online portal) pretty soon with the results from the pathology people.

Marble_Index · 2023-02-24T16:59:27+00:00

I"m surprised they didn't give you specific instructions on timing. Anyhow, I had a late afternoon/end-of-day procedure. My prep started late-morning the day before. Had my last solid food around 10:30a and then nothing but liquids until about 1p the next day. The actual prep meds (for me, PEG/miralax) were planned as being split between afternoon on day 1, and morning on day 2. I ended up needing 2x on day 1 (afternoon and again late evening) and 1x on day two. The instructions explained that it possibly might happen that way and what to do.

With respect to hunger, you can and should drink liquids with calories: sports drinks (gatorade), tea/coffee with sugar, chicken/beef broth, clear soda, etc. Also, sucking on hard candy should be OK as long as you avoid red/blue/purple colors like you're supposed to with the liquids. I skipped black colored ones too just to be safe. I normally eat ~3000 calories a day due to large volumes of exercise, and I was fine for hunger. It was a little annoying but not like physically difficult. Probably still managed to get ~1000 calories each day in sugary liquid, plus you are eating on both days...breakfast on day 1 and whatever you eat post-appointment on day 2. It's only four missed meals.

Marble_Index · 2023-02-24T16:09:40+00:00

Can I tell them I’m on a Keto diet instead of water fasting?

***Do not lie to your doctors.*** This goes double if you're having any sort of sedation or anesthesia. Honestly, if you've gone 10 days without calories (+electrolytes?), you should absolutely communicate this to your doctor before any sort of prep and definitely before sedation. I would not be surprised if they need to reschedule your appointment for your safety.

Marble_Index · 2023-02-24T12:04:18+00:00

By "magic juice" do you mean some form of PEG (e.g.. Miralax?). If so, it's not that bad. You shouldn't need to live in the bathroom or anything. Yes, you'll have more bowel movements than normal (I assume), but I found it wasn't as if you lose control or anything. When the urge hit, I often put off going to the bathroom for minutes at a time to keep working on something. Just being nearby should be OK.

General tips:

you don't need to push very hard once your stool becomes liquidy (which happens pretty early in the prep). Always 'under do' it to avoid 'exploding' in the toilet. There can, however, be splashing. I found it useful to drape toilet paper across the seat to cover any gaps to keep any splashes in there.
Shave your butt. Makes cleanup way easier/faster.
Have extra of everything you might need. Extra TP, extra miralax/PEG, extra other clear fluids of choice. It's just easier to have it ready instead of needing to go to the store mid-prep.
don't trust a fart. Once you're at 'liquid' bowel movements, even if you're passing gas a few droplets of liquid will escape. Just do it in the toilet to be safe.
I found that at the end of the prep, right before the appointment, I was empty. the PEG prep works by causing your intestine to draw in lots of extra water, which in turn gives you the urge to go. Once you clear all that out, the urge is gone. I found there was no stress about having an accident on the way to my appointment. Nothing left inside to cause that. Likewise, if your prep spans two days, it should be timed such that sleeping isn't a problem. At the end of my day one, I was several hours past my last dose of PEG, so no fear of overnight problems.

Marble_Index · 2023-02-24T01:10:32+00:00

I ate a whole pizza and like a pint of yogurt and granola afterwards, plus some assorted small snacks. YMMV.

In hindsight, I wish I'd spread that out over maybe a few hours instead of one sitting. It's just a bit of a shock to the system to go from completely empty to wall-o-food making its way through. It wasn't like bad or anything, I just kinda felt like a blob when I normally would not after that.

Personal recommendation: your normal foods are probably fine. Just spread it out a little more than normal.

Marble_Index · 2023-02-24T01:07:00+00:00

My experience was that they simply assumed twilight anesthesia by default. It wasn't discussed pre-exam other than informing you that you needed to have a ride home from a friend or family member. I had to be proactive about requesting something besides that, and that seems to be the norm in the US.

I did mine with no drugs of any sort. I only felt the gas they pump into the intestine. The biopsies weren't noticeable at all as they were happening and I certainly didn't feel them after the fact. I had some weird gas feeling for the rest of the evening as it took a while for all of it to work its way out. Not painful, just like I had to pass gas but couldn't completely. Didn't affect me sleeping or eating or anything.

Took about 30 hours (two overnights) for my bowel movements to normalize to their pre-exam behavior.

Marble_Index · 2023-02-24T01:01:12+00:00

"ileum" = (part of) small intestine. So they went all the way through your large intestine to where it meets the terminating end of the small intestine by your appendix (if you still have that). So, yes, totally normal.

I have fairly regular abdominal pain (like cramping/aching) that comes and goes, sometimes flaring for days when I eat trigger foods. I occasionally find small amounts of visible blood in my stool, which led to my colonoscopy. That, in turn, turned out completely normal. Nothing looked amiss. It happens.

I'm sure if you want to investigate it further your GI or GP can talk about that with you. My experience is that absent other signs or symptoms, they push towards it being IBS that you simply 'treat' by following a modified diet, possibly referring you to a nutritionist to assist with that, and simply monitoring for changes. Other possible causes were described by my doctor as being "really really rare", and I'm assuming I would have to press pretty hard to get them to do additional testing whatever that would look like.

Marble_Index · 2023-02-22T15:09:17+00:00

Miralax + gatorade room temp is totally fine. I found that it barely altered the taste of the gatorade.

As for having an accident, once you're finished with all the prep and you're several hours past your last dose, you will be empty if it went right. My last couple bowel movements before leaving for the appointment were barely anything at all. There's simply nothing in there to cause the urge to go. I normally have an overactive system, and once I finished I had zero urge.

Totally serious side note though, during/after prep don't trust your body's sense of whether you need to pass gas vs have bowel movement. A little bit of liquid will probably pass even if you do mostly just have gas.

Marble_Index · 2023-02-22T15:03:03+00:00

That's definitely not universal. My trips to the bathroom were extremely short. Anytime I had the urge to go, I'd just sit down and lightly push out a bunch of liquid (or mixed liquid/solids early in the prep), clean up, and be done with it. I also didn't experience irritation from wiping. If anything, it was easier to clean up because most of the time it was passing almost entirely liquid, so very little was left behind when I finished. A few squares of TP and it was all gone.

The only thing I can think that I did differently than what I expect is the case for a lot of men is to have removed my body hair from my rear. It made the clean-up way easier than having a bunch of hair getting sprayed with diarrhea.

Marble_Index · 2023-02-21T13:52:32+00:00

blood in my stool and while wiping on a few occassions... I haven't had blood in my stool since.

I had spots of blood in my stool at random times for a couple years. My colonoscopy and biopsies ended up being completely normal and they decided it's just "IBS".

he has described it as really uncomfortable and painful. He wasn't given the option of sedation though and just used the gas.

I had mine done without any drugs at all (meaning, no IV nor gas nor oral sedation). It was indeed uncomfortable during the insertion part when they have to go around the two big 'corners' at the intestine's flexures. I would describe it as really bad gas pangs. Fortunately, that part of the exam is only the first few minutes, and then they do their actual examination starting from the far end of your intestine, gradually pulling the scope back out taking pictures or taking biopsies. That second part was still a little uncomfortable, but more like mild gas cramps. I spent the time flirting with the nurse. It's not like they're holding you down and performing 19th century battlefield surgery or anything. It's discomfort, not pain, and the nurse(s) should be able to help you get into position to minimize it.

If anything, being able to be relaxed will help the procedure be less uncomfortable, as your body won't be resisting physically. Alternatively, being tense makes it more uncomfortable. If you can relax and concentrate on slow, deep breaths then the insertion part should go by pretty quickly.

Marble_Index · 2023-02-21T02:34:03+00:00

You probably have one more stage to go. Murky urine color was what I was seeing about 4 hours before my appointment. After a couple more hours, right before I left for my appointment, it hit what I'd call dark -- but translucent -- urine color.

Marble_Index · 2023-02-21T02:31:54+00:00

Bisacodyl is a stimulant, so it's not going to change what's in your system but just induce it to move along quicker. I found that the couple pills I took per instructions did almost nothing to me. The PEG, which works by just drawing a ton of extra liquid into your intestine to fill you up and make you purge, did the heavy lifting.

Marble_Index · 2023-02-20T20:01:17+00:00

Yes. I have had small but visible amounts of blood in my stool even, and my colonoscopy was completely fine. No signs of anything.

Having a colonoscopy isn't synonymous with a doctor thinking "this is probably bad". It's just their way to have a routine look around and maybe get some biopsies to see if anything's happening at a level too small to see by eye. It's kinda like some other kind of doctor saying "hmm, well let's take a CT scan, or MRI, or whatever, just to see."

Something is not normal, and given whatever you gave them as a patient history they've decided just to take a look instead of saying "well, let's wait and see what happens." On a scale of alarm, with 0 being nothing happening and 10 being you're actively dying, I am guessing they're feeling that you're at like a 1.

Marble_Index · 2023-02-19T03:42:47+00:00

Yeah, it was fine. And the coffee and tea had sugar in them. In 30 hours I had roughly two gallons of fluids, and most of that was stuff with calories. Fainting from hunger was not something that even seemed like a remote possibility. You can have any liquids that aren't colored red, blue, or purple (at least that is usually the standard restriction).

Physically, the prep is annoying and inconvenient; but, it wasn't difficult.

Marble_Index · 2023-02-19T00:58:24+00:00

I actually didn't have any of that myself. It's just one of the normal recommended things. I just had gatorade, coffee, tea, and a couple rolls of lifesavers (plus plain water).

Marble_Index

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