My "bowel cleansing" was not nearly as terrible as I remember is being the last time. My herbal laxative I took first seemed very gentle, and fairly soon I passed a soft motion, and not a lot else happened. Eight hours later I took the more heavy duty Citrafleet. This was a powder made up in water, which wasn't anywhere near as disgusting to drink as the Picolax I had to take the last time. It was very sweet and slightly orangey. I then had to drink a litre of water over the following two hours. It was another half an hour after this that I passed the first motion. The diarrhoea was fairly frequent after this and it did sting a little around the anus, but it wasn't as often as I remember it being, or as voluminous, or as urgent. This, I have to say was quite a releif, as although I thought I had done my best to ensure that I had left the day free and did not have to do anything but sit on the toilet if necessary, I found myself very busy. I seemed to be in charge of both my own children (4 and 2 years old) and my nieces and nephew (13, 8 and 3 years old). This was a little hectic and there was a lot of trying to play games such as Monopoly or puzzles, or cards. All of which were suitable for some ages but not for others. Then there was having to feed them when I couldn't actually eat anything myself, and having to share one toilet with them! This is a fairly hectic day for me normally, let alone when I am trying to perform a bowel cleansing preparation.
Anyway, that's enough moaning, I got through it, and my Mum very kindly drove me to the hospital for the endoscopy.
I arrived a few minutes before my appointment time and was ushered down to a room where my pulse and blood pressure was taken. I was then asked to get changed into a hospital gown and wait in a "ladies" waiting room to be called by a nurse. I put on the gown, a dressing gown (as the gowns are open at the back!) and my slippers.
In the waiting room already was an older lady. She immediately began talking to me, which at first I found a little annoying. I had come prepared with a book, as at this point I didn't want to think too much about anything. She was obviously nervous about what she was about to have done, and I softened a little and we chatted a little about how long we'd waited for the appointment, and how hungry we felt - how much we still felt like we needed the toilet etc. Another lady came in, also older, and then yet another lady - older still. It dawned on me that it was likely all these women were having endoscopies as a result of bowel screening and it was also likely the result that they were worried about was bowel cancer. It mus be awful to reach a late age with little or no problems with your gut and then be faced with such a procedure, looking for a potentially fatal disease. Whilst I know that Cancer is a risk with someone with crohn's, at my current age and my relatively low number of flares, it is not currently in the forefront of my mind.
After an hour of waiting, I finally entered the examination room for my colonoscopy.
I had opted not to have seadation during my pre-assessment, and was feeling rather nervous at whether I was going to experience a lot of pain. I voiced this worry with the endoscopist and she was very helpful. She said we would try without sedation and if I was too uncomfortable, just say and I could be sedated. As it was I managed without sedation, which I am very pleased about as it meant I could have a conversation with the consultant and IBD nurse straight after the examination and not worry about forgetting it!
The gastroscopy was uncomfortable, becase of having to swallow a tube, having air pumped down my oesophagus, and having to bite on a plastic guard which stopped me biting on the endoscope, but apart from that it wasn't too bad. My gag reflex wasn't too terrible, and due to the air being passed down there was some rather disgusting belching noises, but not nearly as horrific as I remember from last time. My Oesphagus, stomach and the top of my small intestine all appeared normal which was great news.
Next was the colonoscopy. The endoscope went in fairly easily and it was a little uncomfortable but not too bad. The best thing about it compared to the barium enema I'd had before was that it was all visible on a television screen, and I could look at it most of the way through. It was incredible. It didn't seem too bad. From my inexperienced eye, it looked like I was looking at a completely gut. Every so often it seemed to go out of focus and all I could see was pink blurr. Sometimes I could see brown patches which I wasn't sure whether they were remaining fecal matter, or ulcers. I kept being asked if I took Non-steroidal Anti-inflammatories - which I don't. I know you are not meant to if you have crohn's. I also kept being asked if I'd ever had any internal examinations apart from the one that diagnosed me ten years ago. At one point the consultant pressed hard on my abdomen, I assume to get the endoscope in the right place. Eventually I said "it looks like a pretty healthy gut to me?" At this point the consultant said:
"That's the interesting thing with Crohn's disease. You get perfectly healthy sections of gut and then - you see this bit's inflamed here." The bit he was talking about was the bit that was pink and out of focus. It turned out that the brown bits were in fact ulcers, and the pink out of focus bits was a stricture. In fact the consultant stopped the endoscopy part way a long because the stricture was too inflamed and the opening too narrow to get the endoscope safely further up the bowel!
And so, after this I have decided I must have a pretty high pain threshold, as I did not have sedation, just little gas an air, which quite frankly I could have done without. I hate the way it makes you feel tingly and giddy, and I would prefer put up with being uncomfortable!
Below a 're a couple of pictures from the endoscopy. The top is a section of my gut which is healthy, at the sigmoid. Although black and white, you can see a defined hole, where waste passes through to the rectum and anus. Below is where it is inflamed. And it is very difficult to make it the passage that feels all matter can take. This is the stricture.
Anyway, I shall leave this post here, and in the next post I will go through the discussion and treatment proposal I reaceived directly after my colonoscopy.
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