Posted 10/28/2009 4:29 PM (GMT -6)
I am writing on behalf of my boyfriend. He had a very stressful presentation at work two weeks ago and stayed at work until 1am every day the week beforehand and ate only oatmeal for dinner. He developed constipation.
The day after the presentation, he had a small amount of blood on the toilet paper after defecating, and then when he got back to his desk he fainted briefly. He went to the walk-in clinic where he was referred for a sigmoidoscopy.
Since then, he has been experiencing low-level "wrenching" pain and a feeling of bloating or puffiness in his lower left side in what would seem to be the colon area, I guess about even with the navel.
-worse after eating
-also happens at other times, e.g. before eating
-lessens when he takes prilosec (which his doc rx'd for GERD)
-relieved by defecating and passing gas
He said he's seen potential blood one other time, but blood has not been a frequent thing. He says his stools have been about average--no particular constipation or diarrhea.
He is concerned about colon cancer or diverticulitis, but other possibilities are IBS and colitis, etc. I think he'll get the sigmoidoscopy to check for any major problems, and also perhaps to check for colitis or inflammatory bowel disease.
1) Will they check for colitis and inflammatory bowel disease in a regular sigmoidoscopy, or do they need to be instructed to look for these (since they're normally looking for cancer and polyps)?
2) I am concerned that if he had IBS, colitis, or hemorrhoids, the sigmoidoscopy prep (bisacodyl tablets and HalfLytely) and not eating solid food for 36 hours plus getting anesthesia (which can affect gut function, particularly when solid foods are resumed) might ironically make him worse off by messing with his digestive system.
At some hospitals, the prep is just eating a light breakfast and using two fleet enemas a few hours before and thirty minutes before. I've even heard that sometimes no prep is needed for sigmoidoscopy unless the patient is constipated. Might these be less GI system-affecting options for bowel prep, as opposed to inducing diarrhea with the standard prep?
3) Any other ideas for how to get a diagnosis?