Gastrointestinal/Abdominal Colonoscopy

[Eric]

I know this was brought up elsewhere but thought I would start a thread on it. I'm scheduled for one but am seriously stressed out about it because I had such a bad experience with the drugs and getting sick last time. Doctor is refusing anything else, such as Cologuard because one time they found traces of blood during a FIT test which was attributed to a diverticulitis attack. I'm due for this though, just freaked out about it and wish there was an alternative.

 

[Citysnaps]

I know this was brought up elsewhere but thought I would start a thread on it. I'm scheduled for one but am seriously stressed out about it because I had such a bad experience with the drugs and getting sick last time. Doctor is refusing anything else, such as Cologuard because one time they found traces of blood during a FIT test which was attributed to a diverticulitis attack. I'm due for this though, just freaked out about it and wish there was an alternative.

I don't know if this will help... but I had one last year and it went smoothly. All I remember is being wheeled out of the waiting area where you change, to the room where it's performed, and then all of a sudden waking up in the waiting area wondering it had been done yet (it had).

The thing with Cologuard are the false positives (and negatives). If you get a positive result, you then need to have a colonoscopy to snare the polyp to have it analyzed.

 

[Cmaier]

I had mine on Monday. It was delightful. (Other than the prep, and really the most unpleasant part of that was I get bad chills until it starts working).

If you have a bad reaction to the propofol, tell them - they asked me like three times if I’ve ever had a bad reaction to anasthesia. (I assume those are the drugs you are talking about). I’m guessing they can control the dose or give you something else that doesn’t bother you as much.

I had a cologuard sitting in my closet for a year before I tossed it. Couldn’t bring myself to poke around with my own crap (the test requires you to stick a widget in it, shove it into a tube, etc.)

 

[Roller]

Eric, there are a number of drugs that can be used for sedation during a colonoscopy. Tell your physicians about your concern in advance so they can discuss options with you.

 

[Eric]

I had mine on Monday. It was delightful. (Other than the prep, and really the most unpleasant part of that was I get bad chills until it starts working).

If you have a bad reaction to the propofol, tell them - they asked me like three times if I’ve ever had a bad reaction to anasthesia. (I assume those are the drugs you are talking about). I’m guessing they can control the dose or give you something else that doesn’t bother you as much.

I had a cologuard sitting in my closet for a year before I tossed it. Couldn’t bring myself to poke around with my own crap (the test requires you to stick a widget in it, shove it into a tube, etc.)

They said it would be the twilight medication, probably the same as my last one which was fine but it made me dizzy and nauseous/sick upon sitting up. I've had propofol for my gallbladder removal and had zero issues, it was way smoother than my colonoscopy and I pretty much walked out there within an hour of the surgery.

My other concern is that I have pretty bad diverticulitis and I worry about a perforation from the procedure. For the record, my last colonoscopy 10 years ago was clean with nothing other than the known diverticulosis.

 

[Citysnaps]

They said it would be the twilight medication, probably the same as my last one which was fine but it made me dizzy and nauseous/sick upon sitting up.

That's a good point. Where I go they require you have another person drive you home. A smart move as I wouldn't want to be driving even though I felt more or less OK.

 

[Herdfan]

I don’t do well with anesthesia either. After my first knee surgery I basically projectile vomited as I woke up. (I was in college and they said no food after midnight. For some reason cheese fries at 10 pm seemed to follow the rules. LOL)

Ever since that I have asked for anti-nausea medicine and it has always worked.

Good luck. I’m due this year and am dreading it.

 

[Roller]

They said it would be the twilight medication, probably the same as my last one which was fine but it made me dizzy and nauseous/sick upon sitting up. I've had propofol for my gallbladder removal and had zero issues, it was way smoother than my colonoscopy and I pretty much walked out there within an hour of the surgery.

My other concern is that I have pretty bad diverticulitis and I worry about a perforation from the procedure. For the record, my last colonoscopy 10 years ago was clean with nothing other than the known diverticulosis.

Do you have active diverticulitis (inflammation of the diverticula) or diverticulosis (no acute inflammation)? Colonoscopy is generally contraindicated during and for some time after the former.

 

[Eric]

Do you have active diverticulitis (inflammation of the diverticula) or diverticulosis (no acute inflammation)? Colonoscopy is generally contraindicated during and for some time after the former.

It’s always active to some degree and the sigmoid colon shows bowel wall thickening on a regular basis during my attacks on a CT scan. This is what precipitated the first colonoscopy, to rule out a cancerous mass.

 

[Roller]

It’s always active to some degree and the sigmoid colon shows bowel wall thickening on a regular basis during my attacks on a CT scan. This is what precipitated the first colonoscopy, to rule out a cancerous mass.

Colonic segments with diverticulosis typically show wall thickening on CT. On the other hand, when the diverticula become inflamed (acute diverticulitis), there are other findings such as “stranding” in the adjacent peri-colonic fat. It’s possible to have chronic inflammation as well, though this is less common in my experience.

Certainly discuss this with your physicians when you ask about sedation.

 

[Cmaier]

They said it would be the twilight medication, probably the same as my last one which was fine but it made me dizzy and nauseous/sick upon sitting up. I've had propofol for my gallbladder removal and had zero issues, it was way smoother than my colonoscopy and I pretty much walked out there within an hour of the surgery.

My other concern is that I have pretty bad diverticulitis and I worry about a perforation from the procedure. For the record, my last colonoscopy 10 years ago was clean with nothing other than the known diverticulosis.

Oh! I did it through Sutter Health and they used propofol. I guess different doctors do different stuff. Let them know and I’m sure they’ll adjust.

 

[Eric]

Colonic segments with diverticulosis typically show wall thickening on CT. On the other hand, when the diverticula become inflamed (acute diverticulitis), there are other findings such as “stranding” in the adjacent peri-colonic fat. It’s possible to have chronic inflammation as well, though this is less common in my experience.

Certainly discuss this with your physicians when you ask about sedation.

Yes, stranding shows up with the wall thickening every time I get a CT scan during an attack. The question is will an uncomplicated attack come back by colonoscopy time, sometimes I go a couple of months without one, other times it's weekly. I've never been hospitalized for it though and I have a major attack (that typically includes high fever and pain) once every year or two and they told me this was normal for chronic diverticulitis and could not recommend resection surgery.

 

[Eric]

I backed out of the test, had a call with my GI doctor today who informed me that with my history (diverticulitis with no other family history of colorectal issues) puts me in the 5% chance of the positive FIT test 6 years ago being cancer. I'll just live with those odds because I have way too much anxiety around the test, even though I know it's safe and effective I'm not doing it.

 

[Roller]

I backed out of the test, had a call with my GI doctor today who informed me that with my history (diverticulitis with no other family history of colorectal issues) puts me in the 5% chance of the positive FIT test 6 years ago being cancer. I'll just live with those odds because I have way too much anxiety around the test, even though I know it's safe and effective I'm not doing it.

I hope you made the right decision.

Have you considered virtual colonoscopy? The prep is similar, but the procedure is much easier. It’s contraindicated in acute diverticulitis, however.

 

[Eric]

I hope you made the right decision.

Me too. Conditions were exactly the same before my first colonoscopy as well so I'm not as concerned. 95% chance of not having it isn't 100% but I still like the odds.

Have you considered virtual colonoscopy? The prep is similar, but the procedure is much easier. It’s contraindicated in acute diverticulitis, however.

This was the reason for my call, to ask if there is any other alternative and they said absolutely not. It's a colonoscopy or nothing and they were very clear about that. I guess all that stuff I've read about alternatives must be blowing smoke?

 

[Roller]

Me too. Conditions were exactly the same before my first colonoscopy as well so I'm not as concerned. 95% chance of not having it isn't 100% but I still like the odds.


This was the reason for my call, to ask if there is any other alternative and they said absolutely not. It's a colonoscopy or nothing and they were very clear about that. I guess all that stuff I've read about alternatives must be blowing smoke?

That doesn’t make sense to me. Did you specifically ask about virtual colonoscopy? Maybe they’re concerned about the insufflation required for the procedure, but they should say so if that’s the case.

Admittedly, if there’s a suspicious polyp or other abnormality you’d still need a colonoscopy, but at least you’d have more information.

 

[Eric]

That doesn’t make sense to me. Did you specifically ask about virtual colonoscopy? Maybe they’re concerned about the insufflation required for the procedure, but they should say so if that’s the case.

Admittedly, if there’s a suspicious polyp or other abnormality you’d still need a colonoscopy, but at least you’d have more information.

I asked for “any” alternative and she said after consulting the specialist that he said nothing other than a full colonoscopy. So I’m just not doing anything at all.

To reiterate though, 6 years ago when they found traces of blood in the FIT it was during a diverticulitis attack. I should’ve never taken that annual screening at the time, even the GI dr agreed because there’s always traces of blood at that time. I really should’ve just waited a few weeks. All subsequent FIT tests have been negative FWIW.

 

[Roller]

I asked for “any” alternative and she said after consulting the specialist that he said nothing other than a full colonoscopy. So I’m just not doing anything at all.

To reiterate though, 6 years ago when they found traces of blood in the FIT it was during a diverticulitis attack. I should’ve never taken that annual screening at the time, even the GI dr agreed because there’s always traces of blood at that time. I really should’ve just waited a few weeks. All subsequent FIT tests have been negative FWIW.

As long as you're comfortable with your decision, that's what matters.

 

[Eric]

As long as you're comfortable with your decision, that's what matters.

I would really rather them let me have a cologuard test when I'm not having a diverticulitis attack, but would've accepted other alternatives as well if they would allow it but they simply won't.

I'll also add that Kaiser is very much "this is the rigid standard no matter what" about everything, not just this. This where having a personalized doctor who knows your situation and is willing to work with you matters. Their doctors are served up more than they can handle and they treat you like cattle with a one size fits all approach.