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Is this scope necessary? Update

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Ulcerative Colitis
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naturalcurl
Regular Member
Joined : Nov 2010
Posts : 222
Posted 10/8/2019 9:01 AM (GMT -7)
I am not convinced that the benefits outweigh the negatives. But here I am starting a Miralax prep later today. Other preps have not gone down well.

The doctor wants another look only 14 months after the last one. I have been on Prednisone six times in the last year for short courses of about couple of weeks with decreasing effectiveness. Calprotectin has gone from 1200 to 2000. A biologic seems to be in the future, but when?

Someone recently reported taking one Xanax during the prep. I have one of my mom’s left over from 2011 and would like to know a good time to resort to that. Scope is 8 am tomorrow with an hour to get there. Two step Gatorade with Miralax: evening and 3 am for second quart. All these repeated scopes make the anxiety more not less.

Whoever sang the country hit “Help me Make it Through the Night” must have been prepping.

Post Edited (naturalcurl) : 10/8/2019 11:36:58 AM (GMT-6)

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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16180
Posted 10/8/2019 9:45 AM (GMT -7)
Good luck, let us know how it goes! Preps are like doing taxes not something any of us looks forward to. Correction, I'd rather work for H&R block doing everyone's taxes than undergo another colonoscopy...
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MarkWithIBD
Regular Member
Joined : Jun 2018
Posts : 442
Posted 10/8/2019 2:01 PM (GMT -7)
It's never a good time to get a scope, really. None of us want one. There are some things that can only be seen in a scope though and that's the trouble.

I personally avoid scopes as much as possible. I'm one of the unfortunate minority who is guaranteed to flare from scopes, mostly from the biopsies. Before my first scope, I had unconfirmed UC. The scope found patchy inflammation around my large intestine, but mostly continuous inflammation in my rectum. Anyway, they took biopsies of those mild areas. Two weeks later, I was having 30 BMs a day and was in the ICU with my first major flare ever.

The FDA has had to admit that scopes are impossible to completely sterilize. Here is a NYT article on duodenoscopes: https://www.nytimes.com/2019/08/06/health/duodenoscopes-infections-hospitals-antibiotics.html

In 2018 the FDA said that despite colonoscopes containing infectious material, they can't recommend that they stop being used because there is no better diagnostic procedure available.

So what you have to keep in mind is...

You take prep which flushes out the colon of its protective mucous and good flora. Then a possible dirty instrument is inserted that is used to take biopsies, thereby depositing pathogens into the bowel. Then you are sent home with no real after care.

The best thing you can do after a scope is overdose on probiotics. Get the gut so filled with good flora that any possible infection can't take hold.
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 10/8/2019 6:56 PM (GMT -7)
Duodenoscopes and colonscopes are 2 different things:

Medical Definition of duodenoscope
: a long, flexible endoscope that is inserted through the mouth and is used to visually examine and pass instruments into the duodenum (Merriam Webster)

Definitions of colonoscope
A flexible fibre-optic instrument inserted through the anus in order to examine the colon.(Oxford)

I googled sterilization of colonscopes and there are standard protocols established for cleaning and sterilization. There have been times when procedures weren't followed but the risk is minimal to get an infection from a colonoscopy. If you are concerned talk with your doc before your procedure.

Everyone hates getting scopes, but spreading fears as fact benefits no one.

naturalcurl -- try not to stress over the prep. The first part is usually the worst and hopefully you are done with that part by now. The next part will be easier.

Have you discussed biologics with your doc? Is there one that he recommends or that you would prefer? Whenever I have had to go on pred it's always started at 40 mg for 1-2 weeks and then slowly tapering over several weeks. What you described is unusual for UC. What other meds are you on right now?
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naturalcurl
Regular Member
Joined : Nov 2010
Posts : 222
Posted 10/8/2019 8:57 PM (GMT -7)
Thanks for the replies!
Sorry if profile didn't show. I'm on 9 Balsalizide (ug) and rotate Rowasa/Canasa/Uceris foam (ug). Entyvio is next but the doctor wanted this look first.

I turned down a very early scope appointment and I did wonder if the instruments would have an extra chance of sterility if I were first of the day. Let's hope the person ahead of me has healthy donor flora! In any case I have some concerns but microbes on the scope is not one of them.

I'll review Miralax/Gatorade another time. Not too good so far.
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Michelejc
Forum Moderator
Joined : Jan 2011
Posts : 2584
Posted 10/9/2019 8:41 AM (GMT -7)
If you do the miralax/Gatorade.....you can replace the Gatorade with White Grape Juice. For me, it was much better.
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Serenity Now
Veteran Member
Joined : Jan 2009
Posts : 2400
Posted 10/9/2019 8:49 AM (GMT -7)
I hate Gatorade so that's a good suggestion... but don't you need the electrolytes from the Gatorade?
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 10/9/2019 9:23 AM (GMT -7)
I usually do half with gatorade and half with water because I don't like gatorade. Never had any issues. I think it goes through you too fast for your body to extract the electrolytes
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18309
Posted 10/9/2019 10:17 AM (GMT -7)
Naturalcurl, please keep in mind the scope is necessary to check for any potential cancer too. Many years ago I had to have a scope every 6 months. I dread them to this day, the preps are not something any of us look forward to. I would rather have routine scopes than ignore my drs recommendations & one day find out I have a late stage cancer.

I have hung around HW for quite a while & have yet read of anyone getting an infection from instruments that were not sterilized properly. I am not saying it can't happen, however, hospitals do not want negligence claims either.
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 6235
Posted 10/9/2019 11:23 AM (GMT -7)

CCinPA said...
Duodenoscopes and colonscopes are 2 different things:

Medical Definition of duodenoscope
: a long, flexible endoscope that is inserted through the mouth and is used to visually examine and pass instruments into the duodenum (Merriam Webster)

Definitions of colonoscope
A flexible fibre-optic instrument inserted through the anus in order to examine the colon.(Oxford)

I googled sterilization of colonscopes and there are standard protocols established for cleaning and sterilization. There have been times when procedures weren't followed but the risk is minimal to get an infection from a colonoscopy. If you are concerned talk with your doc before your procedure.

Everyone hates getting scopes, but spreading fears as fact benefits no one.

naturalcurl -- try not to stress over the prep. The first part is usually the worst and hopefully you are done with that part by now. The next part will be easier.

Have you discussed biologics with your doc? Is there one that he recommends or that you would prefer? Whenever I have had to go on pred it's always started at 40 mg for 1-2 weeks and then slowly tapering over several weeks. What you described is unusual for UC. What other meds are you on right now?

Yep, thank you for saying all of this. I agree with everything said here. It is very unusual for you to only be on prednisone for 2 weeks. Maybe that's why you had to be on it 6 times this year? If I had to be on prednisone 6 times in one year, my doctor would definitely want me to try a biologic.

How did your scope go?
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Michelejc
Forum Moderator
Joined : Jan 2011
Posts : 2584
Posted 10/9/2019 11:42 AM (GMT -7)

Serenity Now said...
I hate Gatorade so that's a good suggestion... but don't you need the electrolytes from the Gatorade?

Nope. The first time I used the Gatorade and threw up. When I did it with the white grape juice I had no issues as all. My doctor suggested using the white grape juice.
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MarkWithIBD
Regular Member
Joined : Jun 2018
Posts : 442
Posted 10/9/2019 1:02 PM (GMT -7)

CCinPA said...
Duodenoscopes and colonscopes are 2 different things:

Thanks I know the difference. The FDA reports were on BOTH duodenoscopes and colonoscopes.

My original post is still 100% valid.
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 10/9/2019 4:52 PM (GMT -7)
The article you posted was about duodenscopes and though there were a couple mentions of colonscopes in the article they weren't a big concern for infections. Did you read of an FDA report about colonscopes somewhere else? I'd like to read it of you care to share. I tried searching for it but came up empty.
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 10/9/2019 4:56 PM (GMT -7)
natuarlcurl, how did the scope go?
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naturalcurl
Regular Member
Joined : Nov 2010
Posts : 222
Posted 10/9/2019 9:32 PM (GMT -7)
CCinPA thanks for asking! "Left side moderate colitis, biopsies, we will want you on Entyvio". Tell me something I don't know. A new finding was pseudopolyps, whatever that is.

I so get it Michelejc. The protocol started with 4 Dulcolax tablets. Gatorade went down easily and I took my time. The whole quart came up, and then some. For the second dose I mixed the Miralax with so-called Smart Water and followed my own slow schedule the night before. It was just like drinking water, no nausea, but I needed the several extra hours I had allowed for the bathroom trips to stop. The timing on the written instructions were highly unrealistic. No one complained about a poor prep.

Look at the Gatorade label. I don't think you need those wimp electrolytes. 12 ounces has 45 mg of potassium and 160 mg of sodium. Compare to 12 ounces of Pedialyte with 280 mg of potassium and 370 mg of sodium. Pedialyte does not taste that great so I would use it as a side dish (I only managed several sips) and mix the Miralax with water, or the white grape juice.

The crew in the procedure room were all shocked that I have had 5 colonoscopies in 9 years, and a few before that due to a family history of colon cancer.
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16180
Posted 10/10/2019 8:06 AM (GMT -7)
In medical jargon, "pseudo" means false/fake, so, you have fake-polyps. How are they fake? As inflammation heals, we can develop these inflammation-caused-polyps which do not require any medical intervention. The pseudopolyps fall of on their own, and carry zero risk of colorectal cancer. I've had a few in the past, asked my gasteroenterolgisit about it. He had zero concern, and said they'd fall off before my next scope, and they did.

I know most worry about the word polyp (what about CRC?), but in this case they're not really polyps and free of all of that baggage and worries.
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