4 ms·

Had my first colonoscopy 4 months ago, after going for a couple of years with every red flag symptom under the sun. The procedure was a piece of cake. As the s

Had my first colonoscopy 4 months ago, after going for a couple of years with every red flag symptom under the sun. The procedure was a piece of cake. As the standard is where I'm from (Norway), I was only administered some sedatives - but honestly I couldn't feel much difference. I watched the procedure on the screen, which was quite fascinating. The worst part, by far, was the emptying / prepping. A month prior to the colonoscopy I took a stool sample (negative for blood), but my doc wanted to be safe. In the end they nothing was found, not even polyps. EDIT: I had put of going to it for the longest time, but a friend of mine (35 years old) was diagnosed with stage 4 last year, which pushed me to get it checked out. He had experienced prolonged constipation, that's it. When the tumor was found, the cancer had spread to both of his lungs and liver. He's still alive, and fighting it.

dyauspitr 4mo ago
How old are you? I’m 37 and my doc says you get one at 45
jedberg 4mo ago
> The worst part, by far, was the emptying / prepping. Protip to those who have it coming up: Ask for the pill prep instead of the "sludge" prep. You end up spending the day on the toilet either way, but at least it doesn't taste as bad with the pills.
- mrbonner 4mo ago
  I’m doing it this year. Does the pill work as effectively as the drink?
  - jedberg 4mo ago
    Some doctors will say yes, some no. Best bet is to do what your doctor suggests, but at least ask if the pills are an option.
  - skywhopper 4mo ago
    I can’t compare the two, but fwiw, in my experience, while the drink is mildly unpleasant it’s only the texture of the drink itself that’s bad and the fact that you have to drink quite a bit of it. It doesn’t taste bad per se (and you can add flavored drink mix to help) and the “purging” part is painless, ie no cramps or anything.
  - xattt 4mo ago
    > Oral sodium sulfate in a single dose has been found to cause increased gastrointestinal (GI) events > Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects Essentially, put in the effort and do the liquid bowel prep. Consider adding flavour drops to your drink, icing it or turn it into a slushie to make it slightly more interesting to drink. The PEG will make the ice crystals slightly more smoother. https://www.ncbi.nlm.nih.gov/books/NBK535368/ https://www.ncbi.nlm.nih.gov/books/NBK535368/
    - xaldir 4mo ago
      > Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects Well in my country, it's still wildly used for people without renal issues.
      - xattt 4mo ago
        These are best practices guidelines that are ultimately implemented (or rejected) by surgeons who still go by feel, whether following the latest-and-greatest or by what they are used to.
    - CWuestefeld 4mo ago
      Essentially, put in the effort and do the liquid bowel prep. It's not just about effort. I must do the liquid prep due to my Crohn's disease. And while I am able to get the liquid down (as you note, it helps to make it as cold as possible; also, suck on an ice cube before drinking to numb the taste buds), I can't keep it down. Within an hour it has me evacuating from both ends. For my last test, I barely slept at all the night before on account of the vomiting, and even once I got to the hospital I was lying on the wonderfully cold tile of the floor between rolling over to vomit in a trash can. They know it affects me badly, but still assess that it's necessary due to my risk factors. And because I'm losing much of the drug due to the vomiting, the prep is poor, so I have to start fasting a day early to ensure that I get sufficiently cleaned out. It's torture all around.
      - 4mo ago
- aeternum 4mo ago
  It depends, if you want the best possible colonoscopy quality, do the liquid/"sludge" prep, the general consensus is it cleans you out the best and gives the best possible view during the procedure. However that's only true if you actually do it properly and drink all the liquid. A decent number of patients can't/don't get through all the liquid in which case the pills are far better.
trebligdivad 4mo ago
Yeh if you want to improve the screening rate then someone needs to figure out how to make the prep easier.
- Findecanor 4mo ago
  There are slow-acting laxatives that you have to drink a lot of and tastes wile but is soft on the intestines, and then there is quick-acting laxative that is easier to get down. The former tends to be prescribed by default, obviously. If you have no prior intestinal diseases and are in for a routine check, ask for the quick-acting one. You will have to drink the same total amount of liquid, but at least most of it will not be drinks of your choosing. Also get anal cream, and apply it once before going to the toilet.
jhghbj 4mo ago
I ended up paying 15000 usd due tó complications.. that was the worst part for me
- grassfedgeek 4mo ago
  Which country are you in? Did you have insurance? What kind of complications? Have you recovered completely?
jchw 4mo ago
I didn't actually mind the prepping too much personally. Just to be safe I started early to go on the long end of what they suggested with the diet and basically just ate baked, unseasoned chicken for 10 days. Then did the bowel prep; a lot of people hate the drink, but idk. I thought it was fine. Maybe better to assume it will suck though, that way you at least can't be disappointed. > In the end they nothing was found, not even polyps. Same here, thank god.
- bitwize 4mo ago
  These days, in the USA, they're starting to give you an over-the-counter laxative rather than that nasty drink.
  - riotnrrd 4mo ago
    I just had my hole inspected and all the preparation was with over-the-counter supplies. My prep drink was gatorade with some flavorless powder mixed in. It made no change in the taste or texture of this drink. Having the squirts for a day was no fun, but other than that it was a breeze.
- pohl 4mo ago
  I overshot their requirements as well. I wanted them to have a clear view.
- yodsanklai 4mo ago
  Same here. I didn't find the drink especially nasty. I drank it very cold, it had a somewhat chemical taste but very fluid, not disgusting texture. I do remember it was a lot of liquid to drink though. As for the bathroom part, no pain or discomfort whatsoever. It took a couple of hours total if I remember correctly. No, the worst part is the risk of puncture. Rare, but it happens. Happened to a colleague of mine.
- jader201 4mo ago
  > a lot of people hate the drink, but idk. I thought it was fine. Aren’t there a lot of different drinks, though (at least 3 or 4)? E.g. I know Miralax can be an option for some which practically is tasteless.
hylaride 4mo ago
> The worst part, by far, was the emptying / prepping. This. The procedure itself was a snap (I was completely sedated; I'm in Canada), but it was NOT a fun 2 days of "pooping" pure liquid and being hungry. I don't think I was away from the toilet for more than 20 minutes at a time.
- susiecambria 4mo ago
  Having had three colonoscopies so far, my system for prep is to change what I eat at least the week before. Jello, ice pops. . . generally light stuff. At some point before I start drinking the beverage from hell, I get butt cream. Smear it on and then drink. Keeping a layer of diaper rash ointment on the tush helps a LOT. I suggested to the pharmacists at my local pharmacy they should recommend butt cream when someone buys the prep stuff. Not sure if they do it, but all agreed it was a good idea.
  - boarsofcanada 4mo ago
    +1 on low fiber diet 5-7 days before. And although I didn’t try the diaper rash cream, Balneol was definitely a life saver.
    - bamboozled 4mo ago
      Why can't you just fast the day before and then get an enema on the day ?
panarky 4mo ago
My doctor recommended a combination FIT+DNA test instead of colonoscopy (brand name "Cologuard"). She said it's not quite as good as the "gold standard" colonoscopy, but it also doesn't have the risks of colonoscopy. And the FIT+DNA test is so cheap and easy, you can do it every year or three instead of every 10 years with the colonoscopy. She still recommends colonoscopies for high-risk patients, but she thinks the risks outweigh the benefits for low-risk patients, so she recommends Cologuard in those situations. I appreciate this risk-adjusted and probabilistic approach rather than one-size-fits all recommendations.
- antinomicus 4mo ago
  Risks? The risks of a colonoscopy are crazy low though.
  - amanaplanacanal 4mo ago
    There is still the rush of perferating the colon, but I assume it doesn't happen very often. Cologuard has got to be cheaper though.
    - newtonianrules 4mo ago
      [dead]
  - ramesh31 4mo ago
    >"Risks? The risks of a colonoscopy are crazy low though." Not at the statistical level. Death rate from complications is about 1 in 10,000: https://www.endoscopy-campus.com/ec-news/risk-of-death-from-colonoscopy-in-a-fit-positive-program/ https://www.endoscopy-campus.com/ec-news/risk-of-death-from-...
    - panarky 4mo ago
      The risk of serious complications like major bleeding or perforation is closer to 40-80 per 10,000, significantly higher than the roughly 3-5 per 10,000 annual chance of actually having colorectal cancer for low-risk groups. My doctor says that since Cologuard catches a large percentage of those 3-5 per 10,000 without any of the colonoscopy risk, the marginal benefits from colonoscopy really aren't justified since FIT+DNA testing is almost as good, at least for low-risk cohorts. Very few things in medicine are zero risk. I wish more doctors would help balance the risk of doing A vs. the risk of doing B vs. the risk of doing nothing. It's all Bayesian conditional probabilities, considering your own individual risk factors, and considering the false positive rate and false negative rate of each test.
Hamuko 4mo ago
I had a colonoscopy without any sedatives and I agree, the prepping was worse. Not eating for 24 hours was easy, drinking the solution the night before was unpleasant, and drinking the solution the day of was awful. My pro tip would be to take the day off work. Trying to work while drinking the solution in the morning didn't really work.
- deleted 4mo ago
  [deleted]
wolfi1 4mo ago
I did one two years ago without sedation, I wanted to work afterwards. I didn't feel any pain, so sedation is really not necessary
- dgacmu 4mo ago
  I woke in the middle of my first one due to inadequate sedation and it felt like someone was pushing their fist into my stomach too hard and/or having cramps. Tolerable but unpleasant. I elected for propofol on my second and was happier (though both midazolam/fentanyl and propofol basically make you kinda useless for the rest of the day).
  - wolfi1 4mo ago
    my guess is that they take more care when they know you are not sedated. I know a guy whose intestines have been perforated during a colonoscopy if he wouldn't have been sedated he would have felt the perforation right away
twic 4mo ago
> The worst part, by far, was the emptying / prepping. As described in one of the great modern tales of legend: https://singletrackworld.com/2009/02/the-picolax-thread-returns/ https://singletrackworld.com/2009/02/the-picolax-thread-retu...
jrm4 4mo ago
Okay, so another pro-tip for prep. I can promise it's not bad at all if you're already very regular. So what you do is, schedule it for weeks or months out as you can and use that to develop good eating and fiber habits over that time. You have a deadline and real stakes in the game. You will literally hurt more unless you get that straight before then. Win-win.
- jrm4 4mo ago
  Most of my downvotes I'll take very proudly, but this one just confuses me
estetlinus 4mo ago
I’ve also done it, without finding polyps or anything. Obviously it’s normal to run through the entire Bristol Stool Chart in one sitting.
Findecanor 4mo ago
It is likely that your friend could have a genetic disposition for colon cancer. He should get a gene test once he has recovered. I was the same age. My doctor saw signs in an early blood test, and followed it up so mine got detected relatively early. My test was positive for Lynch syndrome, and I am now a colonoscopy veteran.
api 4mo ago
If you have red flag symptoms you should get checked out. This type of cancer is often not caught until stage 3-4, at which point even if you do survive you may end up with a colostomy bag or other serious issues. You're also looking at tons of grueling chemo. It's often caught late because people ignore minor symptoms, assuming them to be something like hemorrhoids or digestive issues or self-misdiagnosing as having Celiac's disease. If you catch it at precancerous or stage 1, it can often be removed with minimal side effects. Sounds like for you the red flag symptoms were something else, but others shouldn't treat it this way.
Double_a_92 4mo ago
Can also confirm that the worst part was the prepping. You have to dring 2 liters of liquid that give you diarrea... The second liter is the worst, since the body learns that it's "poison" and triggers all the reflexes to make you not swallow it.

dyauspitr 4mo ago

How old are you? I’m 37 and my doc says you get one at 45

jedberg 4mo ago

> The worst part, by far, was the emptying / prepping. Protip to those who have it coming up: Ask for the pill prep instead of the "sludge" prep. You end up spending the day on the toilet either way, but at least it doesn't taste as bad with the pills.

mrbonner 4mo ago
I’m doing it this year. Does the pill work as effectively as the drink?
- jedberg 4mo ago
  Some doctors will say yes, some no. Best bet is to do what your doctor suggests, but at least ask if the pills are an option.
- skywhopper 4mo ago
  I can’t compare the two, but fwiw, in my experience, while the drink is mildly unpleasant it’s only the texture of the drink itself that’s bad and the fact that you have to drink quite a bit of it. It doesn’t taste bad per se (and you can add flavored drink mix to help) and the “purging” part is painless, ie no cramps or anything.
- xattt 4mo ago
  > Oral sodium sulfate in a single dose has been found to cause increased gastrointestinal (GI) events > Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects Essentially, put in the effort and do the liquid bowel prep. Consider adding flavour drops to your drink, icing it or turn it into a slushie to make it slightly more interesting to drink. The PEG will make the ice crystals slightly more smoother. https://www.ncbi.nlm.nih.gov/books/NBK535368/ https://www.ncbi.nlm.nih.gov/books/NBK535368/
  - xaldir 4mo ago
    > Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects Well in my country, it's still wildly used for people without renal issues.
    - xattt 4mo ago
      These are best practices guidelines that are ultimately implemented (or rejected) by surgeons who still go by feel, whether following the latest-and-greatest or by what they are used to.
  - CWuestefeld 4mo ago
    Essentially, put in the effort and do the liquid bowel prep. It's not just about effort. I must do the liquid prep due to my Crohn's disease. And while I am able to get the liquid down (as you note, it helps to make it as cold as possible; also, suck on an ice cube before drinking to numb the taste buds), I can't keep it down. Within an hour it has me evacuating from both ends. For my last test, I barely slept at all the night before on account of the vomiting, and even once I got to the hospital I was lying on the wonderfully cold tile of the floor between rolling over to vomit in a trash can. They know it affects me badly, but still assess that it's necessary due to my risk factors. And because I'm losing much of the drug due to the vomiting, the prep is poor, so I have to start fasting a day early to ensure that I get sufficiently cleaned out. It's torture all around.
    - 4mo ago
aeternum 4mo ago
It depends, if you want the best possible colonoscopy quality, do the liquid/"sludge" prep, the general consensus is it cleans you out the best and gives the best possible view during the procedure. However that's only true if you actually do it properly and drink all the liquid. A decent number of patients can't/don't get through all the liquid in which case the pills are far better.

trebligdivad 4mo ago

Yeh if you want to improve the screening rate then someone needs to figure out how to make the prep easier.

Findecanor 4mo ago
There are slow-acting laxatives that you have to drink a lot of and tastes wile but is soft on the intestines, and then there is quick-acting laxative that is easier to get down. The former tends to be prescribed by default, obviously. If you have no prior intestinal diseases and are in for a routine check, ask for the quick-acting one. You will have to drink the same total amount of liquid, but at least most of it will not be drinks of your choosing. Also get anal cream, and apply it once before going to the toilet.

jhghbj 4mo ago

I ended up paying 15000 usd due tó complications.. that was the worst part for me

grassfedgeek 4mo ago
Which country are you in? Did you have insurance? What kind of complications? Have you recovered completely?

jchw 4mo ago

I didn't actually mind the prepping too much personally. Just to be safe I started early to go on the long end of what they suggested with the diet and basically just ate baked, unseasoned chicken for 10 days. Then did the bowel prep; a lot of people hate the drink, but idk. I thought it was fine. Maybe better to assume it will suck though, that way you at least can't be disappointed. > In the end they nothing was found, not even polyps. Same here, thank god.

bitwize 4mo ago
These days, in the USA, they're starting to give you an over-the-counter laxative rather than that nasty drink.
- riotnrrd 4mo ago
  I just had my hole inspected and all the preparation was with over-the-counter supplies. My prep drink was gatorade with some flavorless powder mixed in. It made no change in the taste or texture of this drink. Having the squirts for a day was no fun, but other than that it was a breeze.
pohl 4mo ago
I overshot their requirements as well. I wanted them to have a clear view.
yodsanklai 4mo ago
Same here. I didn't find the drink especially nasty. I drank it very cold, it had a somewhat chemical taste but very fluid, not disgusting texture. I do remember it was a lot of liquid to drink though. As for the bathroom part, no pain or discomfort whatsoever. It took a couple of hours total if I remember correctly. No, the worst part is the risk of puncture. Rare, but it happens. Happened to a colleague of mine.
jader201 4mo ago
> a lot of people hate the drink, but idk. I thought it was fine. Aren’t there a lot of different drinks, though (at least 3 or 4)? E.g. I know Miralax can be an option for some which practically is tasteless.

hylaride 4mo ago

> The worst part, by far, was the emptying / prepping. This. The procedure itself was a snap (I was completely sedated; I'm in Canada), but it was NOT a fun 2 days of "pooping" pure liquid and being hungry. I don't think I was away from the toilet for more than 20 minutes at a time.

susiecambria 4mo ago
Having had three colonoscopies so far, my system for prep is to change what I eat at least the week before. Jello, ice pops. . . generally light stuff. At some point before I start drinking the beverage from hell, I get butt cream. Smear it on and then drink. Keeping a layer of diaper rash ointment on the tush helps a LOT. I suggested to the pharmacists at my local pharmacy they should recommend butt cream when someone buys the prep stuff. Not sure if they do it, but all agreed it was a good idea.
- boarsofcanada 4mo ago
  +1 on low fiber diet 5-7 days before. And although I didn’t try the diaper rash cream, Balneol was definitely a life saver.
  - bamboozled 4mo ago
    Why can't you just fast the day before and then get an enema on the day ?

panarky 4mo ago

My doctor recommended a combination FIT+DNA test instead of colonoscopy (brand name "Cologuard"). She said it's not quite as good as the "gold standard" colonoscopy, but it also doesn't have the risks of colonoscopy. And the FIT+DNA test is so cheap and easy, you can do it every year or three instead of every 10 years with the colonoscopy. She still recommends colonoscopies for high-risk patients, but she thinks the risks outweigh the benefits for low-risk patients, so she recommends Cologuard in those situations. I appreciate this risk-adjusted and probabilistic approach rather than one-size-fits all recommendations.

antinomicus 4mo ago
Risks? The risks of a colonoscopy are crazy low though.
- amanaplanacanal 4mo ago
  There is still the rush of perferating the colon, but I assume it doesn't happen very often. Cologuard has got to be cheaper though.
  - newtonianrules 4mo ago
    [dead]
- ramesh31 4mo ago
  >"Risks? The risks of a colonoscopy are crazy low though." Not at the statistical level. Death rate from complications is about 1 in 10,000: https://www.endoscopy-campus.com/ec-news/risk-of-death-from-colonoscopy-in-a-fit-positive-program/ https://www.endoscopy-campus.com/ec-news/risk-of-death-from-...
  - panarky 4mo ago
    The risk of serious complications like major bleeding or perforation is closer to 40-80 per 10,000, significantly higher than the roughly 3-5 per 10,000 annual chance of actually having colorectal cancer for low-risk groups. My doctor says that since Cologuard catches a large percentage of those 3-5 per 10,000 without any of the colonoscopy risk, the marginal benefits from colonoscopy really aren't justified since FIT+DNA testing is almost as good, at least for low-risk cohorts. Very few things in medicine are zero risk. I wish more doctors would help balance the risk of doing A vs. the risk of doing B vs. the risk of doing nothing. It's all Bayesian conditional probabilities, considering your own individual risk factors, and considering the false positive rate and false negative rate of each test.

Hamuko 4mo ago

I had a colonoscopy without any sedatives and I agree, the prepping was worse. Not eating for 24 hours was easy, drinking the solution the night before was unpleasant, and drinking the solution the day of was awful. My pro tip would be to take the day off work. Trying to work while drinking the solution in the morning didn't really work.

deleted 4mo ago
[deleted]

wolfi1 4mo ago

I did one two years ago without sedation, I wanted to work afterwards. I didn't feel any pain, so sedation is really not necessary

dgacmu 4mo ago
I woke in the middle of my first one due to inadequate sedation and it felt like someone was pushing their fist into my stomach too hard and/or having cramps. Tolerable but unpleasant. I elected for propofol on my second and was happier (though both midazolam/fentanyl and propofol basically make you kinda useless for the rest of the day).
- wolfi1 4mo ago
  my guess is that they take more care when they know you are not sedated. I know a guy whose intestines have been perforated during a colonoscopy if he wouldn't have been sedated he would have felt the perforation right away

twic 4mo ago

> The worst part, by far, was the emptying / prepping. As described in one of the great modern tales of legend: https://singletrackworld.com/2009/02/the-picolax-thread-returns/ https://singletrackworld.com/2009/02/the-picolax-thread-retu...

jrm4 4mo ago

Okay, so another pro-tip for prep. I can promise it's not bad at all if you're already very regular. So what you do is, schedule it for weeks or months out as you can and use that to develop good eating and fiber habits over that time. You have a deadline and real stakes in the game. You will literally hurt more unless you get that straight before then. Win-win.

jrm4 4mo ago
Most of my downvotes I'll take very proudly, but this one just confuses me

estetlinus 4mo ago

I’ve also done it, without finding polyps or anything. Obviously it’s normal to run through the entire Bristol Stool Chart in one sitting.

Findecanor 4mo ago

It is likely that your friend could have a genetic disposition for colon cancer. He should get a gene test once he has recovered. I was the same age. My doctor saw signs in an early blood test, and followed it up so mine got detected relatively early. My test was positive for Lynch syndrome, and I am now a colonoscopy veteran.

api 4mo ago

If you have red flag symptoms you should get checked out. This type of cancer is often not caught until stage 3-4, at which point even if you do survive you may end up with a colostomy bag or other serious issues. You're also looking at tons of grueling chemo. It's often caught late because people ignore minor symptoms, assuming them to be something like hemorrhoids or digestive issues or self-misdiagnosing as having Celiac's disease. If you catch it at precancerous or stage 1, it can often be removed with minimal side effects. Sounds like for you the red flag symptoms were something else, but others shouldn't treat it this way.

Double_a_92 4mo ago

Can also confirm that the worst part was the prepping. You have to dring 2 liters of liquid that give you diarrea... The second liter is the worst, since the body learns that it's "poison" and triggers all the reflexes to make you not swallow it.