What can I expect from my colonoscopy?

May 14, 2008 3:06 PM

Have you had a colonoscopy before? Great. What can I expect from mine?

It has been determined by the powers that be that I am going to be undergoing a colonoscopy in a month's time. I'm more than a little anxious about the idea, to say the least. This anxiety became a bit worse once the gastrointestinologist started talking about the possible complications (i.e. 2 in 1000 of complications leading to a colostomy, if I remember correctly). It also isn't helped by the fact that it's a bit of an embarrassing issue, so I haven't exactly been telling all my friends or family about it.

What I'm looking for are people's experiences with colonoscopies in terms of the preparations (mental as well as the, err, pre-cleansing aspects), the procedure itself, and the recovery period afterwards. I'm hoping to set my mind at ease about this whole thing and get an idea of what I can look forward to on and around the big day.

If it's at all relevant, I am a 24 year old male university student.

Throwaway gmail account: [e-mail]

Thanks in advance!

posted by anonymous to health (34 comments total)

The "pre-cleansing" if you will, is by far the most unpleasant part -- stay close to a restroom is all I can say. The procedure itself, assuming the person sedating you knows what they're doing, you will hardly feel and you will even less remember.
posted by drpynchon at 3:20 PM on May 14 [1 favorite]

Seconding the doc. The prep is no fun, particularly having to drink a gallon or so of not-very-appetizing stuff. But, it's a couple of hours and you're done. It's not painful, just unpleasant. The trick is: set a kitchen timer to drink a glass of it every 5 minutes like clockwork, and just force yourself to do it every time the timer goes off. I don't know about the risks, but 2/1000 sounds little exaggerated. In any event, the procedure itself is a breeze. Relax about it already. They'll ask you if you want to watch. If so, they give you the mild sedative and you can view a trip through your innards on the screen. I elected to go under. When you wake up, the only problem is that your guts are full of air, and you will at some point let loose the most humongous farts you have ever let loose. Go ahead, they're used to it in the recovery room. Once you walk out, you're absolutely fine.
posted by beagle at 3:29 PM on May 14

After fasting for a day and a half, I was all excited about finally eating a gigantic hamburger with my wife when the whole thing was over. But by that point, I just felt like crap, and eating just made me nauseous. Terribly disappointing.

But the pre-cleansing part was actually easy and totally painless. Just make sure no one else is around, this is an indignity best suffered alone.

And the procedure itself was fascinating to watch (on video), and also not nearly as horrifying or as painful as I had expected. There are moments where you feel pressure, and you expect blinding pain to be in the offing, but it never happens. I don't think I even groaned from pain. But I did make awkward jokes from embarassment.
posted by M.C. Lo-Carb! at 3:29 PM on May 14

I have had 2. And it is embarrasing to chat about with friends, family, coworkers. I feel your pain.

The day prior, you start the whole cleansing process at 1PM. You are pretty much tied to the bathroom, from 3 to 8ish. Drink lots of water. Don't plan to do anything else at that time period.

Shoot for the earliest appointment you can get.

With one of my procedures, I was mostly awake. There are 3 or 4 ninety degree turns in your colon. Even through I was semi-sedated, I felt too much. It was not painful, per se, but extremely uncomfortable. With my second one (different city/ different doctor), I was completely out.

I took a really big nap after eating lunch and felt pretty good the next day (good enough to return to work, but not good enough to run 4 miles).

Barium treatments (I don't know what they are called - the one where you drink a gallon of chalk in an hour) are MUCH WORSE.

As far as the complications from colonoscopies go, I didn't care. I was sick both times and wanted to get better. Ulcerative Colitus. The 48 hours of prep/ procedure/ recovery were worth getting on good meds!

Someone has to be there to get you home. I also didn't listen to one thing the doctor said, as I was semi-out-of-it. My husband was there to get the details. You may need to have a follow-up visit for questions after the doc sees your insides. Don't expect to be in a good place for any conversation with your doctor afterward.

Good luck! I am sure it will be fine!
posted by beachhead2 at 3:30 PM on May 14

It's certainly not my favorite way to spend the day, but it's really not a big deal. The night before, as drpynchon said, you cleanse out your colon by drinking a bunch of nasty stuff and sticking close to the bathroom. I actually kind of like the idea of cleaning out my intestines, personally.

You will hardly remember the procedure. They sedate you and give you a drug that makes you mostly forget the experience. I remember feeling like the whole thing only last about 30 seconds, and I remember catching a glimpse of my colon on the big screen TV, which was neat. I don't recall any pain or discomfort.

The funniest part is the recovery room. During the procedure, they pump you full of air to see everything clearly. Afterwards, in the recovery room (where other folks who have just had colonoscopies may be as well), they encourage you to, um, let the air out. You will likely be in a room full of people farting. It doesn't smell though. It's just air. I had a little bit of cramping then like gas pains, but that's the only pain I had throughout the whole thing.

And that's it. I think I was in the recovery room for about an hour. You won't be able to drive home as you'll still be a little sedated, so plan to have someone pick you up.
posted by amro at 3:31 PM on May 14

I agree. The two enemas I had to do before going to see the doctor was the worst part. The procedure itself is uncomfortable but not really painful. (I wasn't anesthetized for mine.)

Maybe what they did for me wasn't formally a "colonoscopy"? They used a kind of flexible thing a bit thicker than a pen which they kind of pushed into me. It's very undignified, and feeling that thing inside is weird. But I wasn't anesthetized, and I don't recall any pain from it.
posted by Class Goat at 3:33 PM on May 14

After posting: and I wasn't inflated with air, either. After they got done, I put my pants back on and drove home.
posted by Class Goat at 3:35 PM on May 14

Class Goat, that was probably a sigmoidoscopy.
posted by amro at 3:36 PM on May 14

Ditto about the pre-cleansing. I last had a colonoscopy about five years ago and your set-up might be totally different, but you're pretty much rinsing clear by the end of it. It's not terribly pleasant and is a bit scary if you have GI issues anyway (hello, worst case scenario!) but it's what should be happening, if that's reassuring.. Do not plan on doing anything or being anywhere after you start taking the laxative, and it's good if you have someone around who can bring you water (which I was allowed up to midnight).

You will probably be weak the next morning, so having someone bring you to the hospital for the procedure helps, and it's no harm to bring your history in writing in case you're feeling fuzzy-headed.

The sedation is fine, the procedure is likely to feel like a weird dream, it shouldn't hurt, and anything embarrassing is not going to be new to the medical staff, as long as you've followed the preparation instructions.

After the procedure, you might be, um, very full of air. Again, it's not anything to be embarrassed about and you will be so drowsy that it won't be terribly real. Having someone to bring you home is good,

I had mine followed by a barium trace so I lost the after-effects in a blur of evil barium aftertaste, constipation and cramping, but I was fine the next day and think I spent the afternoon after the procedure napping.

I wouldn't dwell too much on the complication risks, and I'd suspect you know a lot of people who've had colonoscopies but are also too embarrassed to mention it. Best of luck with it!

(Having just overshared to hell and back, I'll throw in that the capsule endoscopy is the best development ever and a minute fraction of the discomfort of a traditional endoscopy, so there's at least exciting and comforting things happening elsewhere in gastrointestinal investigation.)
posted by carbide at 3:37 PM on May 14

on posting: sorry for the redundancy, I really need to be quicker off the mark.
posted by carbide at 3:39 PM on May 14

[on preview, what beachhead2 says]

Yep, the prep was the worst part. Once all the solid waste is out, you'll enjoy the surreal experience associated with passing LOTS of liquid out your butt.

The earlier the appointment, the better.

If you're going to be sedated, it really isn't a big deal -- you'll be a bit nervous, they'll give you an IV, you'll relax, then wake up in a recovery area.

I was out of it for a few hours afterward (as I have been any time I've been under anesthesia), took a nap, and felt significantly better. Have the person driving you keep track of what the doctor says, as you'll probably have some mild amnesia immediately after the procedure as the anesthesia wears off.

Overall, it was much less uncomfortable than having teeth pulled, as there really isn't any post-procedure pain (although the cleansing procedure does get old quickly).
posted by i love cheese at 3:45 PM on May 14

Ditto about the pre-cleansing.

Yea, that's what I've heard- my mother joked that she'd rather have colon cancer than have to drink that sludge.
posted by ThePinkSuperhero at 3:53 PM on May 14 [1 favorite]

I had one. As has my father. His advice about the prep is:

Don't leave any doors closed between you and the toilet.

I had a late afternoon appointment so all the cleanout happened in the morning. It was a bit tedious towards the end, but that was all.

I was sedated, not knocked out, and felt no discomfort at all. It seemed to be over in a few seconds - I retain very little memory of the event itself.

Either get someone to pick you up afterwards or make sure there is somewhere you can chill for a couple of hours - the combination of sedation + no food makes you feel woozy, and there is absolutely no way you should attempt to drive or negotiate public transport.

As to mental prep: my Dad is a tough old coot of the old school. If he could cope with the various unavoidable indignities, I can cope, and so can you. Enjoy the humorous aspect - it is kind of funny.

Also, presumably you're having one because something is creating cause for concern. It's going to be better to know one way or the other than to live with uncertainty, so look forward to have a weight of doubt lifted.
posted by i_am_joe's_spleen at 3:59 PM on May 14

This is wild, I am literally half way finished drinking my GALLON of "drain cleaner" right now. My appointment is tomorrow morning.

I haven't eaten since 10 o'clock last night. just coffee, sierra mist, and the dreaded GoLytel so far today. I am anxious about this as well, but i am doing mine more out of preventive maintence than an actual "medical need"

the 'cleansing of the system" has been a real treat so, I'm starving, stressed, and spent the last three hours running back and forth from bathroom.

i really hope the worst is over....
posted by Mr_Chips at 4:07 PM on May 14

The prep was not bad. I had to drink two 2-ounce bottles of some stuff that wasn't tasty, but at least it wasn't the gallon stuff. This was a Mayo Clinic procedure. They brought me into a room that had 4 other lucky participants--some waiting, some recovering. Then it was "NEXT!" and I went into The Room. A boom box was playing classic rock, I got the IV of sedation, met the DR. and was watching the scope on a monitor. I felt it once and IIRC, I yelped, got another shot, and that's all I remember. When I was done, they brought me back to the original holding area, gave me a box of juice, and I asked for another one--I was very thirsty--after about a half-hour they sent me home. I was tired and very hungry for a day, then I was just glad it was over.
posted by wafaa at 4:10 PM on May 14

Really, just as people are saying, the prep is much worse than the procedure itself. It's basically induced massive diarrhea for a few hours.

I wonder if what you're worried about with "complications" are related to whatever it is that the doctor is doing the colonoscopy for -- and not necessarily for the colonoscopy itself. Those of us middle-aged and older start having to have colonoscopies every few years, and it's routine -- not a big deal.

When I had mine, they gave me the sedation and I fell asleep. I didn't remember a thing.

The only bad part was that my partner took a photo me in the recovery room with his cell phone. It's the worst photo I've ever had. :-)

Afterwards, you may want to eat yogurt and/or take some dietary supplements (the doctor may give you some) to help rebuild your digestive system's bacteria. The cleansing, you know, pretty much clears out everything inside, including things that help you digest food. Ask your doctor about it, but again, it's not a big deal.
posted by Robert Angelo at 4:23 PM on May 14

There's a new prep - Gatorade with some OTC laxatives mixed in. I've had both the gallon of bad-tasting slimy stuff, and the 2-ounce stuff which made me quite sick, and the Gatorade prep's a ton better than both. If your doctors offer that prep, there's nothing at all to dread. It's a little unpleasant, but nothing major. If they don't, I'd suggest some research and then asking if you can do that instead.

There's also a new tablet prep, but from what I read, it's a lot like the 2 (or 3, as I remember it) ounce one. It's very unpleasant.

The test, as everyone else said, is simple, as you're not really there for it.

Good luck. In my experience, colonoscopies are nasty, but a lot better than what they're trying to prevent.
posted by still_wears_a_hat at 4:26 PM on May 14 [1 favorite]

Just to clarify, the purpose of drinking the special beverage is to empty out your intestines and colon of all matter until the walls are sparkley clean. You really do want to make this happen, because the whole point of the colonoscopy is to give the good doctor a clear view of the walls. If you showed up with dirty walls, they wouldn't be able to see, would they? So just make your way through the whole prep.

When the time comes, it helps to have a friend along to help you stay calm in the waiting room. Somebody low key and soothing. Then you'll be led into the back room and you'll get undressed and lie down on your side on a gurney. You'll be attended by a doc and probably a nurse too. Pretty soon the sedation will kick in and you'll be very relaxed.

The actual 'scopy is quite routine and you have very low chances of complications of any kind — assuming you've got a competent doc.

When you wake up in the recovery room, they'll ask you to wait until you're fully awake before leaving. You do not want to drive home, or even take a bus. A taxi or (preferably) a ride in a friend's car would work. Lie down and rest, maybe take a nap.

Be cautious about eating afterwards, even if they advise you to go ahead and tuck into a meal. Let the gas find its way out. When you're feeling better and feel hungry, sip some thin soup at first, then gradually work your way back to your favorite foods. (Don't do what I did — stop at a restaurant on the way home. My intestinal tract wasn't really ready for solid foods yet, and let me know that by returning the meal back out of my mouth and onto the table. Embarrassing!)
posted by exphysicist345 at 4:44 PM on May 14

I had my first last summer and it wasn't too bad at all.

The pre-cleansing was actually relatively pleasant. I got to drink Pico-Salax, which tastes like mutant Tang. It's packed with magnesium oxide, so when you dump the powder into water and stir, you actually get WARM, lightly carbonated Tang. Really, compared to the cloying nightmare that is GoLytely and the rest, it was quite bearable. I only had to drink two glasses of it, too, having Gatorade and other clear/light fluids for the rest of the day. I got bored and hungry, but never felt queasy from the prep.

I went to a major clinic that does lots of colonoscopies, where a doctor who had done literally thousands of them personally inserted the tube up my poor, empty ass. I was lightly sedated, so I talked a mile a minute during the procedure and watched as much of the tv as possible. I did get some sharp cramping when they went around a couple of turns, but my sister, who got heavier sedation for hers, said she felt no pain at all.

The doctor personally walked me out to the recovery room, supporting me by the elbow with one hand and carrying my shoes with the other. Once he settled me down on the couch, he even brought me a cookie. I was able to have a normal meal shortly after I left with no ill effects, but you may want to take things slowly as exphysicist345 recommends.

So you may or may not get a cookie from your doctor, but you should still be fine.
posted by wexford_arts at 4:51 PM on May 14

I've had two colonoscopies -- one in April 2007, and one in November 2007, so they're both fairly recent. I had the pills for the prep for the first one.. They weren't that bad, but the last few pills are hard to take -- I ended up gagging them.. The prep is the worst part simply because you can't eat anything normal and you are literally pooping water. For the second one, I was having somewhat of a problem with my Crohn's disease and I was in the hospital. They decided to give me a nasogastric tube and run the liquid prep through there. That was not fun because of the NG tube. I don't know what the liquid tasted like though as I didn't taste it -- though the nurses said it tastes horrible. The procedure itself isn't bad because you're going to be most likely asleep during it. You may be a little gassy afterwards though... As far as the enema goes, they're not that bad. It's weird the first time you have one, but it's not horrible.. (I actually ended up having a different type of enema for a total of THREE MONTHS. Every day. But you held it in all night -- it wasn't supposed to clean you)
posted by majikstreet at 5:16 PM on May 14

I had one once and it wasn't bad at all. they actually put me out cold (this was in germany) because I was so nervous about it, which meant I couldn't drive myself home but according to the person with me, I was in there for no time at all. I second pretty much everything everyone else has said about pills, not eating and pooping... it's as if you're having diarrhea - not fun but then you're done with it.

the upside is that it'll probably save you from little nasties like colon cancer for a couple of years.
posted by krautland at 5:26 PM on May 14

Just echoing what everyone else has said... I've had three of them, the last one being just a couple of weeks ago. The first two, I was out of it and don't remember the procedures, but I do remember the preparation day before as being pretty unpleasant.

This last one, I was awake (I'm breastfeeding and didn't want to be sedated), which was fascinating in some ways, but also pretty uncomfortable. But this last one, the prep was a lot easier. I had a different doc this time, and he gave me different preparation instructions, which included going on a "low residue" diet for four days before the procedure. This totally makes sense -- and made the 'cleaning out' part of things go a lot easier.

So even if your doctor's office doesn't specifically instruct you to do so, you may want to do it (though, depending on why you're having it done, like if you feel really awful, you might already by eating low-residue out of necessity).

It's really not that bad of a procedure, particularly if you're sedated for it. Don't worry too much, and hopefully it'll be a helpful diagnostic procedure that will set you on the road to feeling good. I was really sick, had the cscope, got a diagnosis, and now I feel really good. So good luck.
posted by luazinha at 6:04 PM on May 14

Other than a half day's worth of spectacular diarrhea, it is no big deal. You need someone to drive you home though. One thing to watch out for, and it is pretty rare, but unfortunately not rare enough, if you feel weak afterwards, really weak and tired, and even worse if you have a dark stool, then get thee to an emergency room as you may be bleeding. It happened to a friend of mine. Don't let this scare you, just be aware. It's usually just a lost day on the toilet, get some crossword puzzles, books or whatever might be your favorite diversion, and some mild sphincter discomfort. On the other hand, you get some great peace of mind. I know too many people who failed to take the test and are no longer with us because of that. Almost no one need perish from colon cancer if they get checked regularly.
posted by caddis at 6:43 PM on May 14

I've driven people home from colonoscopies on a few occasions and I just wanted to note something that I didn't see people mention. Whatever the knock-out meds are that they give you, they'll make you pretty much not remember the procedure and, if you're anything like the two people I drove home, maybe the SIX HOURS AFTERWARDS. In fact my first friend who I drove home actually called me in the evening to say "um thanks for driving me home, you DID drive me home, right?" So, none of this is particularly unpleasant, but you might want to make sure you're in the company of people you trust and care about so that they can sort of keep an eye on time you'll likely not be able to remember well.
posted by jessamyn at 6:52 PM on May 14

Yeah, basically what everyone else said. The "prep" is the worst part, and it's just unpleasant, not anything to be worried about. You drink/eat only clear liquids for a day, do your super-colon-blow cleanser in the early evening, and then get up in the morning and go to the hospital. For all of mine I've had the "memory-erasing" sedation, so you're awake during the procedure, but you remember hardly anything more than being wheeled into the room. My ex said the last time I had one I told him the same story 5 different times. If you're extra-lucky you'll get colon photographs and can gross out friends and family.
posted by MsMolly at 7:40 PM on May 14

Having accompanied my mother to her colonoscopy, and having then been presented with the images by her amused doctor, I feel qualified to impart the following advice: avoid popcorn for at least the week prior. Two if you want to be safe.

I did not have permission to tell you that.

Also, a doctor friend of a friend refers to the procedure as "Ass Nintendo." That doesn't really answer your question, I just think it's funny. The popcorn advice is sincere, however.
posted by granted at 7:44 PM on May 14

Mine featured excellent twilight sedation that made me giggle a lot afterwards and I probably looked like a drunk, staggering out to the parking lot, propped up between my husband and my daughter. Tee hee hee! Also, word from my Mom, get baby wipes and use them instead of toilet paper. You'll be glad you did!
posted by Lynsey at 7:55 PM on May 14

I have them every two years (I've had about a dozen of them) from my IBD - so I can confirm that you want the easiest most effective prep - it's by far the worst part. One note, that I haven't seen others mention - when you are going to the bathroom for 4 hours+ straight - be gentle with your wiping - things can get chafed down there if you are too dilligent each cleansing. TMI, for sure, but I wish someone had told me beforehand...
posted by birdsquared at 8:39 PM on May 14

I've had several. In general, you won't remember the procedure and it shouldn't bother you too much, assuming they sedate you. Once, I wasn't sedated and it was not a pleasant experience -- but you can just make sure they sedate you. I changed to a GI who promised to sedate me, rather than keep the waiting time down.

As for the prep, DO NOT decide to dilute the solution for the stuff you drink. A nurse told me I could do this, since I was having a hard time drinking it the first time. So then I had 3x as much awful stuff to drink. I should have just drunk the solution straight-up, like you're supposed to. (I never diluted it again. Note: you're not supposed to dilute it. A nurse just suggested I could do that to make it more palatable.)

If you need to do an enema and you are in the midst of major GI troubles, you might want to do it in the bathtub or on the bathroom floor beside the toilet. You will minimize your travel time. If you aren't already having major diarrhea or you aren't sensitive to the solution, you will probably not need to rush.

If you have fissures or anything like that, you might want to apply vaseline or anusol before you start any of the prep. Baby wipes are also good, but sometimes sting if you have fissures -- maybe test that out before you start.

As for the results of the prep, your mileage may vary. One time, when I did the prep, I was in the midst of an awful Crohn's-like flare-up. I had fissures and all sorts of problems before I even took the prep. So the results of the prep were difficult -- and the non-sedated procedure the next day was very difficult. HOWEVER, it was just that one time. And I was freaked out about things at the time, so it might be much easier now.

BUT...I am not trying to scare you! I never had those problems after that, not even with sigmoidoscopies or barium. It just happened to be that I had some issues that complicated things. I am telling you this so that, if you have similar troubles, you will not feel panicked or alone. I suspect that you will have no problems whatsoever. And, if you have fissures or are in the middle of a flare up, you can try some of the above tactics. If that doesn't work, call the after hours line or the office line for your doctor or hospital and get them or their assistant to tell you what to do.
posted by acoutu at 8:51 PM on May 14

The prep is the worst part, but once you resign yourself to the fact you're going to be onto the toilet for some time, it's more surreal than anything else. The constant shitting, combined with the lack of solid food, produces interesting mental states which are conducive to frantic sketching, so, I dunno, bring a sketchbook. Either way, the procedure itself will garner you some excellent drugs, and it'll be over before you know it.

Seriously, it's not that bad, and you really do owe it to yourself to get it all checked out earlier rather than later. My father passed away in his 40s because he did not. Colonoscopies are nothing to worry about. Urethroscopies, on the other hand...
posted by Sticherbeast at 11:46 PM on May 14

you're going to be onto the toilet for some time

Make that "you're going to be ON the toilet". Being "onto" the toilet sounds more like you're not fooled by its seemingly pleasant demeanor.
posted by Sticherbeast at 11:49 PM on May 14 [1 favorite]

You may also be interested in Dave Barry's experience.
posted by Arthur Dent at 11:51 AM on May 15

Like others have previously stated, the prep was the worst part by far. Drinking all of the liquid and spending the entire day on the toilet was miserable. I don't remember the actual procedure. It was very quick and painless.
posted by Silvertree at 5:55 PM on May 15

I did this a couple of months ago and agree with all the advice already here. One thing I would mention is that since you're not eating or drinking for quite some time before the procedure and afterwards you're quite sleepy and may just get right in bed for a nap, try to drink something before going to sleep. I ended up quite dehydrated after this experience and felt kinda crappy because of it. But that was mainly because i went straight from the doctor's office to my couch with no eating or drinking in between.
posted by kms at 11:40 PM on May 16