1. < Digestive Health

I'm getting my first colonoscopy: What's your advice?

Posted by peabody88 @peabody88, Sep 26, 2018

I always knew this day would come, since my mom has ulcerative colitis and my dad has celiac disease and diverticulosis, but I'd always assumed it wouldn't come quite this soon...I have my first colonoscopy scheduled on Thursday. Watching my mom suffer through the prep every year, I know it's going to be unpleasant, but I need to make sure it's WORTHWHILE. Unfortunately, I don't have much confidence in the gastroenterologist/practice who will be doing the procedure -- he did an upper endoscopy a month ago that I have some concerns with his findings/methods.*

I've been chronically and inexplicably ill since June with extreme fatigue, low-grade fever (99-100), nausea and urinary frequency; more recently (after the endoscopy, in fact, although I don't think there's a causative relationship there other than they tell you to pay attention to your stool afterwards, which is something I never really did previously), I have had some issues with my anal area feeling "moist" (occasionally area will be wet in underwear) and like there's something moving down there, and I've seen increasing amounts of mucous and occasionally blood spots in my stool. With the as-of-yet unexplained fever of unknown origin and slightly elevated CRP, the nausea and strange bowel experiences, the infectious disease specialist spoke to the gastroenterologist personally and now he wants to do a colonoscopy. Even before this was advised, I had hoped to seek a second opinion from a different gastroenterologist/practice, but unfortunately, a slew of factors (running out of FMLA days/difficulty obtaining short-term disability without a diagnosis; the "re-set" of my out-of-pocket-maximum, which I'd reached in July, on October 1; repair surgery on Friday for an incisional hernia in my umbilicus from my gallbladder removal surgery in 2016; and honestly just exhaustion from feeling like crap) mean I'm pretty much stuck with this guy. So, I need to make sure I'm well educated and know exactly what to ask for and how to prepare. Particularly:

1. Are there any medications that need to be stopped/could affect any potential biopsies taken or testing done (Protonix/pantoprazole, a PPI, especially comes to mind, as well as the antibiotic Doxycycline, and maybe the probiotic)?
2. Is there anything in particular I should ask be done/tested for? I read @tdrell 's note to request biopsies be read by a gastric pathologist (how exactly would you do that? Do I ask the hospital somehow?) and @hokiefan 's suggestion to have stains for eosinophils/mast cells done (not sure what this would be for? I assume some kind of allergy or intolerance?), and I may request an acid-fast bacilli stain done as well in consideration of a positive Quantiferon Gold TB blood test a month ago. I'd like to ask (or if I have time, research beforehand) about whether anything special needs to be done/tested to consider parasites (I had frequent recurrent issues with pinworms as a kid; I've tried the "tape test" and checking my stool several times but don't see anything moving) and/or rectal yeast infection (I'm not entirely sure this is even a thing, but I've been struggling with chronic vaginal "yeast infections" -- the doctors swear that's what's going on and then the culture comes back negative -- so I want to make sure that's not somehow connected. Anything else? Doubting the upper endoscopy results after-the-fact was bad enough -- I do NOT want to have the same worries about this colonoscopy and perhaps have to have it repeated down the road/if I get into Mayo/upon a second opinion).
3. I realize my ignorance is showing, but is there anything gynecological that the gastroenterologist could see/explore in a colonoscopy, and/or anything liver related? There've been a lot of weird vaginal exam findings -- both my primary care and gynecologist were convinced I had a bad, acute yeast infection or (less likely) bacterial vaginosis, and I was started on Diflucan, but then the test results/cultures came back normal, and nobody's given me an alternate explanation other than "practice good genital hygiene", like no douching (never did), I've switched to cotton underwear, I take probiotics when on antibiotics (like I am presently), not sexually active, etc. Admittedly, I've never paid much attention to "down there", and am embarrassingly clueless about what everything is, but from my best understanding of some research (it's actually rather hard to find clear/understandable information on female anatomy that you can match to your own body), I think I have a polyp just inside my vaginal opening. I'm assuming the gastroenterologist can't, and I probably don't want, him taking a peek down there while I'm out and taking any samples or something, but assuming that's true, is there anything he WOULD be able to see/look for that could indicate a gynecological issue (other than the obvious like a prolapse or fistula or something)?

The liver is another thing that keeps coming up with abnormalities; there was a 7x7mm cavernous hemangioma identified and removed from my liver during my gallbladder/appendix removal surgery in 2016, and the biopsy report showed "mixed inflammation of the portal tracts, which is mild to moderate, and contains neutrophils, eosinophils and lymphocytes, predominantly. Foamy histiocytes are also seen in association with the portal tract." I haven't had much luck searching what that means -- my infectious disease specialist didn't think it was normal -- and I don't know for sure that it couldn't all have been from the gallstones that precipitated the surgery, but it's another question. My most recent MRI/ultrasound shows a new lesion, 4x2.7cm focal nodular hyperplasia (benign, but again, I'm 30 years old and not sure why I'm sprouting liver lesions right and left), and one of my abnormal blood results was an elevated LD5, "seen with striated muscle lesions (eg, trauma) and with liver diseases (eg, hepatic congestion, congestive heart failure, hepatitis, cirrhosis, alcoholism)" -- and not an alcoholic, FYI, and hepatitis blood work all came back negative and cardiologist said everything was fine there. But again, if there's anything I can ask him to check out/look for liver-wise, I think it might be a good idea.

Ugh, I always start off intending to write a short, succint post since I know these long honking things scare people off and probably decrease my chances of getting help, but it never seems to work out because there's so many variables or possible avenues to mention, and I don't want to leave out the one little detail that might inspire a lightbulb moment. If you're still reading this, or did a skim the top and bottom, any advice on how to make sure I'm making the most out of this colonoscopy would be greatly appreciated. Advice on how to make this as painless as possible wouldn't be amiss either. 😉 Thanks in advance!

*My main issue was, I asked his office about stopping Pantoprazole (a Proton Pump Inhibitor) prior to the upper endoscopy and was told no need to discontinue. After the procedure, I asked if that PPI use could prompt a false negative biopsy result -- again, was told no; however, all the peer reviewed articles I've read since say in fact it very often does affect the histopathology biopsy (it inhibits the bacteria growth, though you still have it), and should be stopped at least two weeks prior. Also, all the biopsy samples were taken from stomach body, when the evident inflammation was noted in the gastric antrum (and again, research and procedural guidelines seem to instruct taking biopsy samples from both sites). Lastly, the biopsy samples were sent to the pathologist labeled "rule out H. pylori" -- that sounds like it means no other pathology was studied, which seems like a huge waste. On a less technical side, I've also been very frustrated with his lack of communication with me -- right after the endoscopy, he had said I had "watermelon stomach" inflammation very common with H. pylori, but it could also be bile reflux, especially since my gallbladder was removed in 2016; then after the H. pylori biopsy came back negative, and I tried multiple times through his staff to set up an appointment to ask about the PPI use and how we explore bile reflux, and he left a message (I was, ironically, in the bathroom at the time) that "gastritis can be caused by anxiety and stress." That is very true, and I'm not saying that can't be the cause, but I just want to know why the other possible causes he mentioned are suddenly ruled out and the diagnosis is "anxiety". For all these reasons, I'm not thrilled that he'll be doing the colonoscopy, but I feel stuck at this point.

Interested in more discussions like this? Go to the Digestive Health Support Group.

peabody88 | @peabody88 | Sep 27, 2018
In reply to @peabody88 "Oh my goodness! Missed quite a discussion it seems. Hopefully, I'll be able to hit everybody's..." + (show)
@peabody88

Oh my goodness! Missed quite a discussion it seems. Hopefully, I'll be able to hit everybody's messages. I'll just start by saying, gastroenterologist's report after the procedure was that everything looked good -- no signs of colitis or inflammation. They did take biopsies from the ilium to check for microscopic evidence of colitis (@hokiefan, right before I went under at anesthesia I asked about doing a mast cell stain, and he said when I woke up that mast cell stains would only be done if the tests indicate irregularities), but just based on visual exam I'm in the clear. Mostly relieving, since this experience was absolutely awful and I did NOT want to have to do this again anytime soon, but still slightly disappointing/frustrating that it still means no answers for what's going on. I also do wish I had more confidence in the doctor who did the procedure, but it is what it is.

@travelgirl - Four in one year?! You are a much stronger person than I am. I don't think I could survive that. I've had kidney stones, gallstones/gallbladder surgery, etc. -- and this experience probably tops my list of worst ones (although maybe it's just dulled memory making those seem better lol).

@eliana5 , Suprep actually is what I was prescribed, and it was still just insanely awful. I think that's mainly because of the timing stresses -- you mentioned being able to drink it slowly over 2-3 hours, but my instructions were to get it down in 20 minutes, and trying to stomach that (when I've already been having nausea) was just a nightmare. I think the other thing is I was just grossly uneducated and underprepared about what to expect -- I had this vague notion that it was going to be really unpleasant, mostly from watching my mom go through it every year because of her ulcerative colitis, but I honestly had no idea what to expect, what the process would look like (and boy, some of that stuff that comes out is freaky if you have no clue it's coming lol), how long it would take, things to get to ease the process (BABY WIPES FROM THE START!!!), etc. It was only when I talked to the on-call physician (since I couldn't get that gunk down in the 20 minutes I was supposed to) that I learned the stages (brown sludge, yellow sludge, goal is urine-like, etc.), which I'm incredibly grateful for because it would have been even more disconcerting if I hadn't talked to him. Again, another thing I'm not too pleased about with this particular gastroenterologist/practice for not explaining upfront.

It sounds like the two things we all agree on, is the new lower-volume options are a definite improvement over the gallon gunk mixture, but ultimtaely it's still just a really unpleasant procedure. Doctors probably prescribe different options based on other issues you have/what they're looking for, and different patients probably tolerate the different treatments differently, so the main thing is just knowing and asking your doctor about the different available options. I probably wouldn't have asked about a different treatment even if I'd known about them, but I do think in light of my nausea I'd have requested a longer "intake" period so I wasn't so stressed about getting it all down by 4am. Live and learn, I guess.

Lastly, I did find the information about MiraLax intriguing. I'll have to look that up -- the gastroenterologist had recently told me to take that.

Thanks all for the advice and support! @travelgirl , your late night support and advice were particularly comforting in the middle of the madness. Thanks everyone!

Jump to this post

Also, now that I've gone through this, here's my takeaways that I wish I'd known beforehand:

1. READ YOUR INSTRUCTIONS IN ADVANCE (this includes papers from the doctor directly). I picked up the prep kit the day before I was supposed to start prep and didn't open it until it was "go" time. It was a surprise to find out I was supposed to be on a completely liquid diet the entire day before; fortunately, I'd only eaten a granola bar and it all worked out, but that could have turned out very different. Since most physicians' offices close before your initial dose "start" time, reading the instructions early also allows you to call during normal office hours to ask any questions or express any concerns without debating whether to call the "on-call for emergencies" number. Some medications also need to be stopped up to a week prior, so you'll need to know to do that if necessary (make sure you review your list of meds and supplements specifically with the doctor to make sure there's nothing unusual to stop). My doctor's office also had specific instructions that were different than the manufacturer's, so be sure to read both.

2. Speaking of, make sure you ask about and make a note of the on-call physician phone number and policies for using it if you're not given that information upfront, and don't hesitate to use it if you're having issues. You may be reluctant to wake anyone else up, but that's less of an inconvenience for them than having you show up with an "incomplete" or "inadequate" prep that forces them to postpone or reschedule the procedure (not to mention, extra discomfort for you -- I was miserable and terrified of the idea of having to repeat the prep, ugh!).

3. Ask your doctor in advance if there's any special considerations/adjustments that need to be made to your prep based on the issues you're experiencing. For instance, if one of your symptoms going into this is nausea (like me), swigging a cupful of rather unpleasant smelling liquid likely isn't going to be a cakewalk for you. Ask if you can take/the doctor will prescribe an anti-emetic like Zofran to help you "stomach" (pun intended) the prep (note you'd probably need to take the first dose an hour or so prior to starting prep otherwise it'll be flushed from your system fairly quickly), or ask if you can lengthen the amount of time you're given to drink the prep so you're not trying to gulp it down and can lay down for a bit if you start to feel nauseous before resuming. With constipation problems you may also want to ask about starting prep sooner since it may take your body longer to digest and cleanse your system, and start a liquid diet sooner (although again, I think this would probably help anyone). For diarrhea or nausea, or anyone really, ask if you need to continue taking a dose/complete a dose once you've reached the "goal consistency" of clear, see-through urine like liquid; the on-call physician told me I didn't need to, but doctors seem to have differing opinions on that and it may depend on your specific condition/problem. There are also different prep medications available, and in discussing your particular problems your doctor may suggest a different one or let you choose from a few options.

4. This is not the kind of procedure where you want to enjoy a "last supper" splurge, unless it's a week in advance. Food can hang out in there for quite some time, so it will likely make things "pass more smoothly" if you start a liquid or low-fiber diet several days to a week prior, regardless of what the instructions require. From what I've read this is particularly true if you have problems with constipation.

5. Treat your "bottom" gently from the beginning. I bought so-called "soft" toilet paper, but by about the first "runny" episode I was already incredibly sore and bleeding a little. I had also read and fortunately bought alcohol-free and fragrance-free, hypoallergenic baby wipes, but I wish I'd used those right from the start and maybe avoided or prolonged any bleeding at all. Have vaseline on hand also to use to soothe the area during periods where you're able to leave the toilet -- it does indeed help. So, your pre-prep shopping list (and you want to get it before starting, because you're not going to want to be far from the bathroom once you start) should include: Super soft toilet paper; alcohol-free, fragrance-free, hypoallergenic baby wipes; vaseline; hand soap (preferably something that's also gentle/moisturizing and nice smelling); liquid diet approved items like meatless, noodleness soup broth and apple juice/lemonade/gatorade (be sure nothing is red or blue though, since this can "color" your system in a way that mimics blood); odor fighters (whether it's plug-ins, air fresheners, etc. -- my #2 doesn't normally smell, but boy when you start getting to the stuff way up in there things change); and some form of ventilation (being shut-in the bathroom, sometimes straining, for quite some time did bad things for my nausea and I started to feel faint and overheated at one point -- if you don't have a window or it's not cool outside to open it, and you don't live alone or feel comfortable leaving the door open, a fan of some kind is something to have ready to go).

6. When it gets down to it, this is just an incredibly disturbing experience; you will have strange things coming out of places you'd never expected. Having a general idea of what to expect when you start might help make it less unsettling (although it's still probably always going to be weird to be "peeing" from your bottom).

A colonoscopy will never be something you volunteer to do for kicks, but you can make it more tolerable. Good luck!

Here's some helpful links I relied on during the process:
-- http://www.heartlandqc.com/images/uploads/services/Colonoscopy_-_One__Done.pdf (This has a photo scale of what color to expect your poop to look like from start to finish on p. 12, plus some typical FAQs like what you can eat/drink)
-- https://tearlines.wordpress.com/2013/09/16/some-extra-fun-colonoscopy-prep-tips/ (This has a lot of great tips, and is written in a really fun and frank way that gave me a good laugh when I was struggling)

REPLY
2 replies
Jackie, Alumna Mentor | @travelgirl | Sep 27, 2018
In reply to @peabody88 "Oh my goodness! Missed quite a discussion it seems. Hopefully, I'll be able to hit everybody's..." + (show)
@peabody88

Oh my goodness! Missed quite a discussion it seems. Hopefully, I'll be able to hit everybody's messages. I'll just start by saying, gastroenterologist's report after the procedure was that everything looked good -- no signs of colitis or inflammation. They did take biopsies from the ilium to check for microscopic evidence of colitis (@hokiefan, right before I went under at anesthesia I asked about doing a mast cell stain, and he said when I woke up that mast cell stains would only be done if the tests indicate irregularities), but just based on visual exam I'm in the clear. Mostly relieving, since this experience was absolutely awful and I did NOT want to have to do this again anytime soon, but still slightly disappointing/frustrating that it still means no answers for what's going on. I also do wish I had more confidence in the doctor who did the procedure, but it is what it is.

@travelgirl - Four in one year?! You are a much stronger person than I am. I don't think I could survive that. I've had kidney stones, gallstones/gallbladder surgery, etc. -- and this experience probably tops my list of worst ones (although maybe it's just dulled memory making those seem better lol).

@eliana5 , Suprep actually is what I was prescribed, and it was still just insanely awful. I think that's mainly because of the timing stresses -- you mentioned being able to drink it slowly over 2-3 hours, but my instructions were to get it down in 20 minutes, and trying to stomach that (when I've already been having nausea) was just a nightmare. I think the other thing is I was just grossly uneducated and underprepared about what to expect -- I had this vague notion that it was going to be really unpleasant, mostly from watching my mom go through it every year because of her ulcerative colitis, but I honestly had no idea what to expect, what the process would look like (and boy, some of that stuff that comes out is freaky if you have no clue it's coming lol), how long it would take, things to get to ease the process (BABY WIPES FROM THE START!!!), etc. It was only when I talked to the on-call physician (since I couldn't get that gunk down in the 20 minutes I was supposed to) that I learned the stages (brown sludge, yellow sludge, goal is urine-like, etc.), which I'm incredibly grateful for because it would have been even more disconcerting if I hadn't talked to him. Again, another thing I'm not too pleased about with this particular gastroenterologist/practice for not explaining upfront.

It sounds like the two things we all agree on, is the new lower-volume options are a definite improvement over the gallon gunk mixture, but ultimtaely it's still just a really unpleasant procedure. Doctors probably prescribe different options based on other issues you have/what they're looking for, and different patients probably tolerate the different treatments differently, so the main thing is just knowing and asking your doctor about the different available options. I probably wouldn't have asked about a different treatment even if I'd known about them, but I do think in light of my nausea I'd have requested a longer "intake" period so I wasn't so stressed about getting it all down by 4am. Live and learn, I guess.

Lastly, I did find the information about MiraLax intriguing. I'll have to look that up -- the gastroenterologist had recently told me to take that.

Thanks all for the advice and support! @travelgirl , your late night support and advice were particularly comforting in the middle of the madness. Thanks everyone!

Jump to this post

@peabody88 I am so happy it all turned out great for you. That is wonderful. Better good news than bad news. However I know that still doesn't answer why you weren't feeling feel well to begin with.
Hopefully soon you can find answers.
You take care, and whenever you feel like chatting medical pop on and say hello to all of us.
All my Best
Jackie

REPLY
Jackie, Alumna Mentor | @travelgirl | Sep 27, 2018
In reply to @peabody88 "Also, now that I've gone through this, here's my takeaways that I wish I'd known beforehand:..." + (show)
@peabody88

Also, now that I've gone through this, here's my takeaways that I wish I'd known beforehand:

1. READ YOUR INSTRUCTIONS IN ADVANCE (this includes papers from the doctor directly). I picked up the prep kit the day before I was supposed to start prep and didn't open it until it was "go" time. It was a surprise to find out I was supposed to be on a completely liquid diet the entire day before; fortunately, I'd only eaten a granola bar and it all worked out, but that could have turned out very different. Since most physicians' offices close before your initial dose "start" time, reading the instructions early also allows you to call during normal office hours to ask any questions or express any concerns without debating whether to call the "on-call for emergencies" number. Some medications also need to be stopped up to a week prior, so you'll need to know to do that if necessary (make sure you review your list of meds and supplements specifically with the doctor to make sure there's nothing unusual to stop). My doctor's office also had specific instructions that were different than the manufacturer's, so be sure to read both.

2. Speaking of, make sure you ask about and make a note of the on-call physician phone number and policies for using it if you're not given that information upfront, and don't hesitate to use it if you're having issues. You may be reluctant to wake anyone else up, but that's less of an inconvenience for them than having you show up with an "incomplete" or "inadequate" prep that forces them to postpone or reschedule the procedure (not to mention, extra discomfort for you -- I was miserable and terrified of the idea of having to repeat the prep, ugh!).

3. Ask your doctor in advance if there's any special considerations/adjustments that need to be made to your prep based on the issues you're experiencing. For instance, if one of your symptoms going into this is nausea (like me), swigging a cupful of rather unpleasant smelling liquid likely isn't going to be a cakewalk for you. Ask if you can take/the doctor will prescribe an anti-emetic like Zofran to help you "stomach" (pun intended) the prep (note you'd probably need to take the first dose an hour or so prior to starting prep otherwise it'll be flushed from your system fairly quickly), or ask if you can lengthen the amount of time you're given to drink the prep so you're not trying to gulp it down and can lay down for a bit if you start to feel nauseous before resuming. With constipation problems you may also want to ask about starting prep sooner since it may take your body longer to digest and cleanse your system, and start a liquid diet sooner (although again, I think this would probably help anyone). For diarrhea or nausea, or anyone really, ask if you need to continue taking a dose/complete a dose once you've reached the "goal consistency" of clear, see-through urine like liquid; the on-call physician told me I didn't need to, but doctors seem to have differing opinions on that and it may depend on your specific condition/problem. There are also different prep medications available, and in discussing your particular problems your doctor may suggest a different one or let you choose from a few options.

4. This is not the kind of procedure where you want to enjoy a "last supper" splurge, unless it's a week in advance. Food can hang out in there for quite some time, so it will likely make things "pass more smoothly" if you start a liquid or low-fiber diet several days to a week prior, regardless of what the instructions require. From what I've read this is particularly true if you have problems with constipation.

5. Treat your "bottom" gently from the beginning. I bought so-called "soft" toilet paper, but by about the first "runny" episode I was already incredibly sore and bleeding a little. I had also read and fortunately bought alcohol-free and fragrance-free, hypoallergenic baby wipes, but I wish I'd used those right from the start and maybe avoided or prolonged any bleeding at all. Have vaseline on hand also to use to soothe the area during periods where you're able to leave the toilet -- it does indeed help. So, your pre-prep shopping list (and you want to get it before starting, because you're not going to want to be far from the bathroom once you start) should include: Super soft toilet paper; alcohol-free, fragrance-free, hypoallergenic baby wipes; vaseline; hand soap (preferably something that's also gentle/moisturizing and nice smelling); liquid diet approved items like meatless, noodleness soup broth and apple juice/lemonade/gatorade (be sure nothing is red or blue though, since this can "color" your system in a way that mimics blood); odor fighters (whether it's plug-ins, air fresheners, etc. -- my #2 doesn't normally smell, but boy when you start getting to the stuff way up in there things change); and some form of ventilation (being shut-in the bathroom, sometimes straining, for quite some time did bad things for my nausea and I started to feel faint and overheated at one point -- if you don't have a window or it's not cool outside to open it, and you don't live alone or feel comfortable leaving the door open, a fan of some kind is something to have ready to go).

6. When it gets down to it, this is just an incredibly disturbing experience; you will have strange things coming out of places you'd never expected. Having a general idea of what to expect when you start might help make it less unsettling (although it's still probably always going to be weird to be "peeing" from your bottom).

A colonoscopy will never be something you volunteer to do for kicks, but you can make it more tolerable. Good luck!

Here's some helpful links I relied on during the process:
-- http://www.heartlandqc.com/images/uploads/services/Colonoscopy_-_One__Done.pdf (This has a photo scale of what color to expect your poop to look like from start to finish on p. 12, plus some typical FAQs like what you can eat/drink)
-- https://tearlines.wordpress.com/2013/09/16/some-extra-fun-colonoscopy-prep-tips/ (This has a lot of great tips, and is written in a really fun and frank way that gave me a good laugh when I was struggling)

Jump to this post

@peabody88 Thank u for sharing this.
Excellent advice for people who have to get Roto Rootered .(lol) AKA a Colonoscopy..
Jackie

REPLY
Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Sep 28, 2018
In reply to @peabody88 "Also, now that I've gone through this, here's my takeaways that I wish I'd known beforehand:..." + (show)
@peabody88

Also, now that I've gone through this, here's my takeaways that I wish I'd known beforehand:

1. READ YOUR INSTRUCTIONS IN ADVANCE (this includes papers from the doctor directly). I picked up the prep kit the day before I was supposed to start prep and didn't open it until it was "go" time. It was a surprise to find out I was supposed to be on a completely liquid diet the entire day before; fortunately, I'd only eaten a granola bar and it all worked out, but that could have turned out very different. Since most physicians' offices close before your initial dose "start" time, reading the instructions early also allows you to call during normal office hours to ask any questions or express any concerns without debating whether to call the "on-call for emergencies" number. Some medications also need to be stopped up to a week prior, so you'll need to know to do that if necessary (make sure you review your list of meds and supplements specifically with the doctor to make sure there's nothing unusual to stop). My doctor's office also had specific instructions that were different than the manufacturer's, so be sure to read both.

2. Speaking of, make sure you ask about and make a note of the on-call physician phone number and policies for using it if you're not given that information upfront, and don't hesitate to use it if you're having issues. You may be reluctant to wake anyone else up, but that's less of an inconvenience for them than having you show up with an "incomplete" or "inadequate" prep that forces them to postpone or reschedule the procedure (not to mention, extra discomfort for you -- I was miserable and terrified of the idea of having to repeat the prep, ugh!).

3. Ask your doctor in advance if there's any special considerations/adjustments that need to be made to your prep based on the issues you're experiencing. For instance, if one of your symptoms going into this is nausea (like me), swigging a cupful of rather unpleasant smelling liquid likely isn't going to be a cakewalk for you. Ask if you can take/the doctor will prescribe an anti-emetic like Zofran to help you "stomach" (pun intended) the prep (note you'd probably need to take the first dose an hour or so prior to starting prep otherwise it'll be flushed from your system fairly quickly), or ask if you can lengthen the amount of time you're given to drink the prep so you're not trying to gulp it down and can lay down for a bit if you start to feel nauseous before resuming. With constipation problems you may also want to ask about starting prep sooner since it may take your body longer to digest and cleanse your system, and start a liquid diet sooner (although again, I think this would probably help anyone). For diarrhea or nausea, or anyone really, ask if you need to continue taking a dose/complete a dose once you've reached the "goal consistency" of clear, see-through urine like liquid; the on-call physician told me I didn't need to, but doctors seem to have differing opinions on that and it may depend on your specific condition/problem. There are also different prep medications available, and in discussing your particular problems your doctor may suggest a different one or let you choose from a few options.

4. This is not the kind of procedure where you want to enjoy a "last supper" splurge, unless it's a week in advance. Food can hang out in there for quite some time, so it will likely make things "pass more smoothly" if you start a liquid or low-fiber diet several days to a week prior, regardless of what the instructions require. From what I've read this is particularly true if you have problems with constipation.

5. Treat your "bottom" gently from the beginning. I bought so-called "soft" toilet paper, but by about the first "runny" episode I was already incredibly sore and bleeding a little. I had also read and fortunately bought alcohol-free and fragrance-free, hypoallergenic baby wipes, but I wish I'd used those right from the start and maybe avoided or prolonged any bleeding at all. Have vaseline on hand also to use to soothe the area during periods where you're able to leave the toilet -- it does indeed help. So, your pre-prep shopping list (and you want to get it before starting, because you're not going to want to be far from the bathroom once you start) should include: Super soft toilet paper; alcohol-free, fragrance-free, hypoallergenic baby wipes; vaseline; hand soap (preferably something that's also gentle/moisturizing and nice smelling); liquid diet approved items like meatless, noodleness soup broth and apple juice/lemonade/gatorade (be sure nothing is red or blue though, since this can "color" your system in a way that mimics blood); odor fighters (whether it's plug-ins, air fresheners, etc. -- my #2 doesn't normally smell, but boy when you start getting to the stuff way up in there things change); and some form of ventilation (being shut-in the bathroom, sometimes straining, for quite some time did bad things for my nausea and I started to feel faint and overheated at one point -- if you don't have a window or it's not cool outside to open it, and you don't live alone or feel comfortable leaving the door open, a fan of some kind is something to have ready to go).

6. When it gets down to it, this is just an incredibly disturbing experience; you will have strange things coming out of places you'd never expected. Having a general idea of what to expect when you start might help make it less unsettling (although it's still probably always going to be weird to be "peeing" from your bottom).

A colonoscopy will never be something you volunteer to do for kicks, but you can make it more tolerable. Good luck!

Here's some helpful links I relied on during the process:
-- http://www.heartlandqc.com/images/uploads/services/Colonoscopy_-_One__Done.pdf (This has a photo scale of what color to expect your poop to look like from start to finish on p. 12, plus some typical FAQs like what you can eat/drink)
-- https://tearlines.wordpress.com/2013/09/16/some-extra-fun-colonoscopy-prep-tips/ (This has a lot of great tips, and is written in a really fun and frank way that gave me a good laugh when I was struggling)

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@peabody88
I am so glad that your ordeal is over. What great suggestions! Thanks.

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bobtheman2169 | @bobtheman2169 | Jun 5, 2019

Does anyone know if you can mix movi-prep with gatorade

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1 reply
dval | @dval | Jun 5, 2019
In reply to @bobtheman2169 "Does anyone know if you can mix movi-prep with gatorade" + (show)
@bobtheman2169

Does anyone know if you can mix movi-prep with gatorade

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Yes you can, as long as it’s not red. Good luck!

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Kanaaz Pereira, Connect Moderator | @kanaazpereira | Jun 6, 2019

Welcome, @bobtheman2169. May I ask what brings you to Mayo Clinic Connect?

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