giant colonoscope shining its light on a small person

The Dreaded Colonoscopy

Woody Allen once joked, “death is like a colonoscopy; life is the prep.” Whatever you think of Mr. Allen, it’s hard not to enjoy this quip. It’s a brilliant commentary on the unpleasantness of existence; what is more, it encapsulates the Buddha’s idea that “life is suffering.”

What to expect from a colonoscopy

It seems particularly relevant, though, to sufferers of Crohn’s disease, since, let’s face it, most of us have had one too many colonoscopies. In total I’d guess I’ve had close to twenty (over my thirty years with Crohn’s disease), and, as a result, I felt well-suited to offer the newly diagnosed a brief primer on what to expect.

Why is a colonoscopy test needed?

First, as to the reason for this test, let’s just say that it gives the most accurate assessment of the state of your disease (although other tests such as CT Scan with Contrast, MRI-E, MRI, and capsule endoscopy can also be helpful).

Not only can accurate pictures be taken, but biopsies can be sampled to check for polyps or cancer and assess levels of inflammation. Hence, while the prep for the test may be a bit unpleasant, and there are minor risks, the benefits outweigh the drawbacks.

The liquid diet and colonoscopy prep

Now, as per the test itself, what should you expect? Twenty-four hours before the procedure you will be asked to begin a liquid diet. This includes Jello, ice pops, consume, and various juices. You may be also be told to avoid red or purple Jello or ice pops, as this can be mistaken for blood in the colon.

The liquid diet is really not all that bad. The more irksome part comes later, the night before the procedure, when you are told take two tablets of Dulcolax, as well as a whole bottle of Miralax, which you pour into glasses of Gatorade (usually around 8) and drink in fifteen-minute intervals. (Often you are instructed to finish the bottle of Miralax in two separate periods, one say at 5PM, and the other early the next morning.)

It can be difficult, at times, to ingest this much fluid. Also, keep in mind that, once you drink a ton of Miralax, you will be running to the bathroom every five minutes or so. My advice: stock up on toilet paper. Seriously, a few rolls minimum. And don’t make any wild plans that evening...indeed, don’t even think about leaving the house!

While the prep can be unpleasant, and even make you feel depleted, it serves a useful function: to clean you out so the gastroenterologist can examine your digestive tract. Hence, do a thorough job.

The day of the colonoscopy

Once you arrive at the hospital, you will be asked to change into a hospital gown, get hooked up to an IV, meet your gastroenterologist and anesthesiologist (who will ask you about allergies to medicines), and be brought into a small room where the procedure will take place.

Often there are a series of televisions and monitors on the wall. Make the best of it! A whole medical team will be watching these monitors, carefully scrutinizing what is going on inside you. After signing some documents, absolving the medical team of any responsibility, (there is about a 1/3000 chance of an intestinal tear), they will pump some relaxation drugs into your IV, and then, after saying goodnight, pump Propofol into your veins. A few minutes later and you’ll feel relaxed; shortly thereafter, it’s off to LA LA Land.

What is colonoscopy recovery like?

Next thing you know, if all goes as planned, you will wake up in the recovery room. Rarely will you be awake at any time during the procedure. This happened, way more often, in the old days, when they used Demerol instead of Propofol (I recall one such procedure quite clearly).

You will be sent home an hour or two after your procedure with the friend or relative you appointed to pick you up. Generally, you should spend at least part of that day eating and resting to get back your strength. You also will be told not to operate any heavy machinery. Honestly, I’m not sure how many people are considering that? But, regardless, if that was in your post-colonoscopy plan, yes, stay away from huge machines!

In sum, a colonoscopy isn’t the horror it’s made out to be. Certainly, as mentioned earlier, the benefits far outweigh the risks. Besides, when you’re back home, relaxing in your bed, you’ll be thankful your doctor has new critical information about the state of your disease and can treat you accordingly.

Thanks for reading and feel free to comment or share your own colonoscopy stories!

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