http://checkyourinternalpipes.blogspot.com/
http://ilovecolonoscopies.blogspot.com/
all colonoscopy prep methods start by fasting the day before the procedure. this is no big deal. you're allowed to drink clear liquids including gatorade, clear apple juice, sodas and water. fasting is mostly a frame of mind. it's not that difficult at all to do, especially if you've fed yourself well the day before.
the Fleet phospho method of preparing for a colonoscopy involves having you drink two small bottles of laxatives before your colonoscopy procedure the next day. the first laxative bottle is taken about 6 pm to 7 pm the day before the procedure. the laxative will act within about 30 minutes or so. throughout the nite you may feel a need to move your bowels a few times, so your sleep may get interrupted a bit by a few trips to the bathroom. you're required and expected to drink clear liquids during this time so your body doesn't become dehydrated.
3 hours before your leave for your colonoscopy procedure, you drink the second Fleet phospho bottle. that will induce some more bowel movements. by the time you arrive at your colonoscopy, your bowels will be pretty much cleared of solid materials.
the other method, the Go-Lightly method, is much less fun. Go-Lightly is a laxative contained within a gallon of what tastes like sea-water. you're supposed to drink the entire gallon, having a glass of that material every 15 minutes.
yeah, right. i'm going to drink a GALLON of anything? most people don't make it past a quart of that stuff. my sense is that the Go-Lightly method was invented by lawyers who wanted to ensure that dehydration doesn't occur as the laxative takes effect. lawyers come up with some of the worst ideas in the world.
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Preparation
The colon must be free of solid matter for the test to be performed properly. For one to three days, the patient is required to follow a low fiber or clear-liquid only diet. Examples of clear fluids are apple juice, chicken and/or beef broth or bouillon, lemon-lime soda, lemonade, sports drink, and water. It is very important that the patient remains hydrated. Orange juice, prune juice, and milk containing fibre should not be consumed, nor should liquids dyed red, purple, orange, or sometimes brown, however cola is allowed. In most cases, black coffee is allowed.[6]
The day before the colonoscopy, the patient is either given a laxative preparation (such as Bisacodyl, phospho soda, sodium picosulfate, or sodium phosphate and/or magnesium citrate) and large quantities of fluid or whole bowel irrigation is performed using a solution of polyethylene glycol and electrolytes. Often, the procedure involves both a pill-form laxative and a bowel irrigation preparation with the polyethylene glycol powder dissolved into any clear liquid, preferably a sports drink such as Gatorade or Powerade brand sports drinks which contain electrolytes.
In this case, a typical procedure regimen then would be as follows: in the morning of the day before the procedure, a 238 mg bottle of polyethylene glycol powder should be poured into 64 oz. of the chosen clear liquid, which then should be mixed and refrigerated. Two (2) bisacodyl 5 mg tablets are taken 3 pm; at 5 pm, the patient starts drinking the mixture (approx. 8 oz. each 15-30 min. until finished); at 8 pm, take two (2) bisacodyl 5 mg tablets; continue drinking/hydrating into the evening until bedtime with clear permitted fluids.
A common brand name of bisacodyl is Ducolax, and store brands are available. A common brand name of polyethylene glycol powder is MiraLax. It may be advisable to schedule the procedure early on a given day so the patient need not go without food and only limited fluids the morning of the procedure on top of having to go through the foregoing preparation procedures the preceding day.
Since the goal of the preparation is to clear the colon of solid matter, the patient should plan to spend the day at home in comfortable surroundings with ready access to toilet facilities. The patient may also want to have at hand moist toilettes or a bidet for cleaning the anus. A soothing salve such as petroleum jelly applied after cleaning the anus will improve patient comfort.
The patient may be asked to skip aspirin and aspirin-like products such as salicylate, ibuprofen, and similar medications for up to ten days before the procedure to avoid the risk of bleeding if a polypectomy is performed during the procedure. A blood test may be performed before the procedure.[7][8]
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http://www.ucalgary.ca/colonscreening/coloncancer/colonoscopyfaq
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ReplyDeleteTime for Your Colonoscopy? Here are 9 Tips To Make It Easier
Colonoscopy is the "gold standard" for finding and removing precancerous polyps and colon cancers. But many people delay colonoscopy because of the uncomfortable pre-exam preparation. In this Health Alert Johns Hopkins provides practical advice to help you make the best of this necessary test.
Gary July 9, 2009 at 7:52 pm
ReplyDeleteThe advantages of unsedated colonoscopy are mainfold: perforation is virtually impossible, no risk from sedation, no need for a drive home and decreased time and cost. I work in a hospital and have seen numerous colonoscopies; too often the patient writhes in pain because the endoscopist is rough and does the exam too quickly, relying on “procedural amnesia” to prevent the patient from complaining immediately after the procedure. Then the poor patient goes home and often has flashbacks of a rushed, painful procedure and is haunted by nightmares. I found a wonderful woman Gi doc who listened to me and did mine unsedated; by taking some extra time I got a better, much safer exam without the often haunting “Versed creepy amnesia”. Embarassing? She asked me “would you be embarassed to expel the air that I pump into your colon in front of me and the endo nurses during the test”? I said no, of course not, she laughed and told me not to worry, expect some brief cramps but probably nothing bad. And you feel this anyway with sedation; you may or may not have temporary amnesia from Versed and you may have a bad sedation experience. She did make me promise to let her have a syringe full of fentanyl hooked up in the IV line, just in case it was too painful and she said that I had to let her use her judgement on using it. The exam was easy and I didn’t need the fentanly. I had some pain from trapped air which I couldn’t get rid of and when one of the nurses told the doc that my wife was my driver in the waiting room she told me it was time for the fentanly to get rid of the painful trapped air, so she have it at the end. No sedation issues, didn’t really feel anything for about 5 minutes then she put her hand on my shoulder and told me to “relax and close your eyes”. I remember farting loudly (to applause) as I had a brief nap. That was an easy test.
http://www.kevinmd.com/blog/2009/01/would-you-undergo-colonoscopy-without.html
Jerry September 19, 2009 at 6:23 pm
ReplyDeleteI have the misfortune of needing yearly colonoscopies and I do NOT like conscious sedation. My wife is a CRNA and when she explained that colonoscopy sedation is primarily given so that the endoscopist has an imobile, amnesic patient, not for patient comfort or safety (colonoscopy is more dangerous with sedation; if you are sedated you can’t feel the scope getting looped and that’s how perforations happen)..I could not believe the arrogance and deceit among endoscopist involving colonoscopy sedation; they “insist” on it so they can do the procedures more quickly ($$) and a lot of them don’t care about the patient. Once you are out the door, they could care less about grogginess, a missed days work or long-term amnesia. I arranged for a sedation-free exam and the gastro lied; he assured me that the exam would be sedation free, but before we started, he tried to inject Versed into my IV. I almost broke his wrist. If you want sedation, fine. It’s unecessary, but providers should not lie to patients. I have had 4 with nothing and they were a breeze; probably because the endo doc was gentle and honest; she said that sedation-free colonoscopy is the standard world-wide; in the US it’s a “secret” option…..
Lisa September 22, 2009 at 8:55 pm
ReplyDeleteOne thing that gastro doc’s often blur is the distinction between sedation and analgesia. I don’t want memory-loss and the trauma of versed-induced sedation (it’s scary and more common than you think), but I don’t want a painful exam. My doc then told me that if I wanted painkiller (fentanyl) only and no amnesia drug (versed), that was possible. Why isn’t the “painkiller only”option offered? A nurse told me it was because “we like to work with an amnesic patient”. I asked her if she would want versed herself and she said ‘no”…so they want YOU to have amnesia drugs but won;t take them..
if you tell people (and their designated driver) in advance about the drug's effects, you will have very few people who have "versed trauma"; but she told me that many patient's are not told about this. Also, if potential pain is an issue, you can get real anesthesia (propofol) and pay for it, and probably not feel of remember anything, but it requires an anesthesia provider which increases cost and greatly decreases the number of colonoscopies that a GI doc can do in a day (due to anesthesia scheduling).....I could not believe how honest this woman was with me; she said that I could do the test with nothing (men have straighter colons than women), but that it would probably hurt (possibly quite a bit) when she went around the corners and that a touch of Fentanyl would work wonders, no amnesia.
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