Unfulfilled colonoscopy

Well just thought I'd follow up and let you folks know how my colonoscopy went -- in a nutshell, it was incomplete, so I'm pretty bummed.

I went in, they put the IV in and administered Versed and Fentanyl, both of which I've had for other conscious sedation procedures before, so I was feeling pretty comfortable at that point. I largely conked out due to the sedative and didn't feel the doctor pump air into my colon or insert the endoscope. So far so good. Then, at some later point (felt like seconds but was really maybe 10 minutes), I partially come to and feel a sharp pain in my abdomen, so I yell to tell the nurse and doctor that it hurts. They give me more drugs via IV (I can hear the doctor giving the orders) and tell me to relax and take deep breaths, but it still hurts real bad. I can barely make out the endoscope moving slightly inside me during this time. This repeats at least several times (I don't recall exactly how many times).

Finally, I conk out again and the next thing I realize is I'm being wheeled out to the recovery room. I ask the nurse how things went and she said they weren't able to finish the colonoscopy.

Apparently the pain I was feeling was when they were trying to make the turn into the transverse colon. They said I'm extremely sensitive there and my colon also has a bit of a twist there so it's hard to navigate. They spent 20 minutes trying to navigate the turn and then gave up because I was in pain despite being given considerably more pain meds than usual. They said that if I wanted to try a colonoscopy again in the future, it would have to be done under general anaesthesia (which I'm perfectly okay with -- in fact I wish I'd just done it under general anaesthesia this time!).

So the only good news I suppose is that there was nothing unusual in the first 1/3 of the colon that the doctor was able to visualize. I suppose this decreases the possibility that there's inflammatory bowel disease since one would expect the rectum or sigmoid colon to show signs of disease if it were responsible for my fissure (since they are closest to the anus). And I guess the other good news is that if I decide to get a colonoscopy again, I'll have nothing to worry about at all since I'll be out cold.

Anyhow thanks a bunch to you all for your support, it helped a lot and was a big part of my even following through with the procedure in the first place. I was hoping to get some peace of mind, but I guess things don't always go the way you'd like them to, and now I'm kind of left wondering why my colon is so sensitive and why there's a weird twist in it. If things had been straightforward, I'd agree that the procedure is no big deal though.

NG,

I had a somewhat "challenged" colon to maneuvre through also, but they did it. As I recall the report, it was getting up over a certain portion of it and not twisted.

There is an alternative to a colonoscopy that you might want to consider--the barium enema! It is not at all painful, and I was completely awake for it. There is some discomfort as they first put "air" into the colon prior to the barium. They had me turn side to side, so the barium can be distributed properly throughout the colon. But, my barium enema result was incomplete also in that if there were small polyps, they were not diagnosable because I was not "cleaned out" sufficiently. So, I do somewhat understand your disappointment and discouragement (bummed out feeling).

They wanted to repeat the barium enema here after 6 months had elapsed, but by that time I was dealing with my Mayo doc, and he did not recommend it. I think barium enemas were routinely given prior to the advent of the colonoscopy which can get rid of polyps during the procedure if necessary, and that is greatly preferable to the barium enema because of that feature.

They only do barium enemas at Mayos if a person cannot tolerate a colonoscopy. A person does have to be "cleaned out" similarly for the barium enema, so you might want to try to stick with the idea of a colonoscopy under GA if more testing is needed. Just wanted to share that there could be other means to look at your colon without GA!

Cheryl

Cherylk, thanks, I do mean to talk to my GI doc about alternatives, so I'll run this one by him. I think for now I'm going to keep an eye on the symptoms and decide if I want to get things evaluated further in a month or two.

I figure if the rectum and sigmoid colon don't show signs of disease, then it's less likely that ulcerative colitis or Crohn's are causing my fissure, since those parts of the colon are closest to the anal canal. The only question is whether anything like a polyp or tumor in the transverse or ascending colon is responsible for my other non-fissure related symptoms.

I had a barium x-ray of the upper GI years ago, and recall that procedure being unpleasant but tolerable (I pooped hard chalky white barium for a day or so after). Since it was upper GI I didn't have to prep the colon of course. But I could do the colon prep again, it wasn't fun but now I know what to expect. I'd entertain another colonoscopy too but have to admit this one has left a bit of a traumatic impression on me that will take some time to wear off. I felt pretty panicky when I woke up in the middle of the procedure from the pain...

BTW any reason your Mayo doctor advised against the barium enema? Was it only the fact that it doesn't allow biopsy and polyp removal or were there other concerns?

I'm glad I'm not the only one who's had a colonoscopy that wasn't as straightforward as expected. I walked out of there today not really sure what to think.

NG,

A couple of things. My colonoscopy was complete in 2001, and I felt good about what they found (nothing). It was in 2006 that I had the incomplete barium enema result, but only so far as if there were small polyps, they could not be diagnosed because I was not cleaned out sufficiently. Next time I will need a two day "cleanout." That was not the case in 2001 for the colonscopy which was complete although they had a challenge getting through the cecum part of the colon as I recall.

When I was communicating fairly regularly with my Mayo GI doc and his nurse via phone after my initial visit to him and as I was trying to regulate my Miralax dose, the nurse only told me that my doc there did not recommend having another barium enema. He was able to view my colon on his screen (along with me and my husband at the same time!), and I had a CT scan earlier that same year, and he felt confident that from the symptoms as I described them that I had IBS, which I doubted at that time. So, I guess he felt another barium enema was not necessary, and thinks I should just get another colonoscopy in 2111. One bad thing about the barium enema--it is constipating, and I had blood after it at time of BM, but only a small amount. I think it is traumatic on the rectum to go through all of what is expected of it during the cleanout and then be faced with constipation after the procedure. Don't despair--I think you might have IBS because I think you fret, worry, and have anxiety like many of us!! My son's small intestine and colon were both affected by Crohn's BTW.

Cheryl

I hope so I've been reading up on inflammatory bowel diseases and see that they usually present with severe debilitating pain, which I don't have at this point, so I'm thinking they're likely not the culprit. I'd wager it's IBS too particularly with the weird twists and turns my life has taken lately.

If you don't mind I may be back with more questions for ya once the meds and odd events of the day wear off and I get my bearings back. It sounds like you've garnered a great deal of knowledge on the matter from personal experience and I'd love to pick your brain some more.

Feel free to send me a PM if you prefer! I'll be glad to answer any questions. Have you eaten some food?????

cherylk wrote:Feel free to send me a PM if you prefer! I'll be glad to answer any questions. Have you eaten some food?????

Yep, I had 4 tacos for lunch I came to work for the afternoon afterward because I was feeling kind of disturbed about the whole waking up in pain during the colonoscopy thing so I figured some sense of normalcy might be good. Pretty tired now, though, and my stomach is growling so I must be hungry. My abdomen is still a little uncomfortable from the exam though so I'm trying not to eat too much today. That's probably some more of that paranoia/anxiety factoring in

Thanks for sharing your experiences and I'll definitely take you up on picking your brain some more, probably when I'm up late horsing around online! Off to go gobble down some sustenance now, I'll talk with ya later!

Well just talked with the GI doc who did the colonoscopy and he says that it's not uncommon for people to be sensitive and not tolerate them well. That seems weird to me since most literature I can find indicates that colonoscopies are generally well tolerated. So not sure what's up there. Maybe they need to work on their anaesthesia or maybe the literature is just overly optimistic?

He does say he sees little reason to repeat the exam under general anaesthesia though. Apparently he wasn't able to get the endoscope up very far at all (it was only up to the sigmoid colon, not even as far as the descending colon, which is a much shorter length of travel than I'd originally thought), but the little section he was able to see looks perfectly normal and gives no suggestion of inflammation.

He also says that my fissure looks relatively small, so that's good news. I wonder if it was always small or if it's healed up some.

Anyhow I think I'm going with a presumptive diagnosis of IBS unless something else changes, no need to subject myself to more exams simply out of paranoia.

IBS can cause moderate to severe pain which is greatly exacerbated by stress. Also, IBS-C means constipation (not alternating constipation and diarhea) is the principle complaint. Lastly, I have learned the gut is very sensitive as my Mayo doc told me!!! I have known of a couple of people who found their colonoscopies to be painful. One of my friends "woke up" during the procedure in pain, and they gave her more of a sedative, and she went back to sleep. Another of my relatives had a colonoscopy at Mayo's and indicated it was painful and felt they did not give her enough of a sedative. I didn't want to mention those people prior to yours!! Many people have no trouble at all with a colonoscopy. My husband watched the monitor as his polyps were removed!!! (Obviously, he was very much awake!)

Thanks, I definitely would have been more anxious hearing about other people's unpleasant experiences beforehand. Now that I've had an odd experience myself, I feel better knowing that others have had unexpected things happen too though. The gut does indeed seem sensitive. I've still got some lingering discomfort in mine from the procedure and am waiting for it to go away. Probably should've held off and not jumped into it so quickly. Oh well, live and learn I guess.

What a bummer NG! I think the silver lining here for you, though, is that your fissure seems fairly small. However, it's emotionally disappointing to go through all of the prep and then be told that it wasn't 100% accomplished. I think your symptoms definitely fit with IBS. Hope you feel better today!

Hey Anna,

Yep, definitely feeling a bit better today. Yesterday I was just tired and surprised by how things went down. Today I've just got some abdominal discomfort and that's it. I'm indeed glad my fissure isn't that big -- it probably explains why I've been able to eat a wider range of foods recently (although I'm trying not to push my luck too much). Maybe it even means the BOTOX is working, who knows. How are things post LIS day #2? Any happy BMs yet?

I've been searching around for information on colonoscopies since my somewhat disturbing experience and thought I'd post a quick follow-up. It looks like pain during colonoscopies isn't that unusual at all. Contrary to what most doctors and online accounts of the procedure suggest, it seems that there are significant numbers of patients who don't tolerate them very well.

This synopsis was interesting:

http://www.ncbi.nlm.nih.gov/pubmed/12048623

That plus most of the other literature I could find online indicates that the most common point of pain, and reason for failing to advance the colonoscope deep enough to complete the exam, is a loop in the sigmoid colon.

The reason I got interested in all this is because I requested a copy of the post-procedural report from my GI doctor today. In it, he indicates that I was very sensitive to the exam, and that at about 60 centimeters (roughly 24 inches) from the anal opening, he encountered a "very sharp and twisted turn" (those are the words verbatim), which is where I started screaming in pain and they had to discontinue.

I still don't like the fact that we weren't able to visualize the entire length of the colon, but am somewhat comforted by the knowledge that colonoscopies aren't a walk in the park for everybody, and thought I'd post this in case anyone else has had a weird experience with them before

Maybe you could have a virtual colonoscopy. http://digestive.niddk.nih.gov/ddiseases/pubs/virtualcolonoscopy/ I know the prep is the same but they don't insert through the but for it.

Hey Suzy, that's definitely one thing I'm considering. Right now, I'm just keeping an eye on the symptoms. If they persist, then I'm thinking about either a virtual colonoscopy, another conventional colonoscopy (but under general anesthesia), or a barium enema. In either case I'd have to do the bowel prep so I'm not too worried there.

The main downside about the virtual colonoscopy is that insurance generally won't authorize it, so I may have to pay out of pocket. So that option will depend largely on how much it runs me. A grand or so would be a big deal, but if we're talking several large then it might be a different story.