Bowel Preparation Guide https://bowelprepguide.com Your guide to excellent bowel prep Wed, 18 Oct 2017 04:11:14 +0000 en-US hourly 1 https://wordpress.org/?v=4.8.2 92279279 10 Reasons to Get Screened for Colorectal Cancer https://bowelprepguide.com/reasons-to-get-screened-for-colorectal-cancer/ https://bowelprepguide.com/reasons-to-get-screened-for-colorectal-cancer/#respond Fri, 13 Oct 2017 03:08:38 +0000 https://bowelprepguide.com/?p=471 Screening rates for colorectal cancer remain relatively low. According to 2010 data from the Centers for Disease Control (CDC), colorectal cancer screening rate was 58.6% compared to 72.4% for breast cancer, and 83.0% for cervical cancer. For those that qualify for screening but have not done so, Here are 10 reasons to get screened for […]

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reasons to get screened for colorectal cancer

Screening rates for colorectal cancer remain relatively low. According to 2010 data from the Centers for Disease Control (CDC), colorectal cancer screening rate was 58.6% compared to 72.4% for breast cancer, and 83.0% for cervical cancer.
For those that qualify for screening but have not done so,

Here are 10 reasons to get screened for colorectal cancer:
1. Screening prevents colorectal cancer. Colorectal cancer develops from pre-cancerous polyps. The detection and removal of pre-cancerous polyps during colonoscopy prevents the formation of colorectal cancer.
2. Screening detects early stage cancer. The next best thing to not having colorectal cancer is to have the colorectal cancer detected early. Cancer detected during routine screening is less advanced compared to cancer detected when you already have symptoms. A simple procedure may be all that is needed to remove the cancer without radiation or chemotherapy.
3. Screening saves lives. Death from colorectal cancer can be avoided when pre-cancerous polyps are removed or early colorectal cancer is detected and treated.
4. Screening options are many. There are several ways to screen for colorectal cancer including stool tests, special X-rays, virtual CT scan, flexible sigmoidoscopy and colonoscopy. Colonoscopy is the best test. However, any test is better than none.
5. 10 years before another screening. If you are an average-risk individual and your colonoscopy was normal, your next colonoscopy will be in 10 years. What other screening test gives you a 10 year break?
6. No co-pay for screening. The Affordable Care Act eliminates co-pays for preventive services including colorectal cancer screening. This removes another excuse for not getting screened. Unfortunately, you may have co-pay if a polyp is removed during your screening colonoscopy.
7. Screening may save your children and grandchildren lives. If pre-cancerous polyp or cancer is found in you, your children should start screening earlier. Also, the nature of your polyp or cancer may lead to the diagnosis of inherited forms of colorectal cancer like Lynch syndrome. This knowledge may save future generations from colorectal cancer.
8. Screening saves money. Colorectal cancer costs money. Surgery, chemotherapy, doctor’s visit and lost time from work are expensive.
9. Screening preserves quality of life. Colostomy bag, chemotherapy, radiation, and surgery impair quality of life. Screening can spare you from all of these.
10. Screening is Love. You are special. Your children, grandchildren, relatives, and friends want you around. Think of all the fun and memories yet to be made. Your loved ones would be glad you got screened.

Colorectal cancer is preventable. Get Screened!

 

 

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All Your Colonoscopy Questions Answered https://bowelprepguide.com/colonoscopy-questions-answered/ https://bowelprepguide.com/colonoscopy-questions-answered/#respond Sun, 08 Oct 2017 05:38:04 +0000 https://bowelprepguide.com/?p=6999 All your colonoscopy questions answered provides answers to commonly asked questions about colonoscopy. Questions like what is a colonoscopy? Why do I need a colonoscopy? What are the benefits and risks of colonoscopy? What are the alternatives to colonoscopy? How do I spot a complication after colonoscopy? How do I shop for a colonoscopy? When […]

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colonoscopy questions answered

All your colonoscopy questions answered provides answers to commonly asked questions about colonoscopy. Questions like what is a colonoscopy? Why do I need a colonoscopy? What are the benefits and risks of colonoscopy? What are the alternatives to colonoscopy? How do I spot a complication after colonoscopy? How do I shop for a colonoscopy? When should I get a screening colonoscopy? How often should I get a colonoscopy? How do I prepare for colonoscopy? Where is colonoscopy performed? Who performs a colonoscopy? Will I be put to sleep during colonoscopy? Will I feel pain during colonoscopy? Will my insurance cover my colonoscopy? What is the cost of colonoscopy? And lots more.

 

What is a colonoscopy?

Colonoscopy is a procedure that utilizes a flexible tube with light and camera at the end to look at the inner lining of a person’s large intestine (colon) through a video monitor. During the procedure, the physician has the ability to take a small piece of tissue from the colon (biopsy), remove a polyp (polypectomy), mark a specific spot (tattoo), treat a blockage, or stop a bleeding. Any tissue or specimen removed during colonoscopy is sent to the pathologist for analysis. Pictures are taken during the procedure and a colonoscopy report with pictures is generated. For a video on what to expect during colonoscopy, click HERE.

 

Why do I need a colonoscopy?

These are some of the reasons for having a colonoscopy:

  • Screening and surveillance of colorectal polyps and cancer.
  • Evaluation and treatment of gastrointestinal bleeding.
  • Evaluation of abnormalities seen on imaging studies such as X-ray or CT scan.
  • Evaluation of change in bowel habits like unexplained diarrhea.
  • Evaluation of unexplained abdominal pains.
  • Evaluations of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • Management of complications of surgery like strictures, leaks, fistula.
  • Removal of foreign body from the colon.
  • Excision and ablation of colorectal lesions such as angiodysplasias.
  • Relief of colorectal obstruction.

 

What are the benefits of colonoscopy?

Colonoscopy saves lives.

  • It can detect colorectal cancer leading to treatment and cure.
  • It can prevent colorectal cancer by removing precancerous polyps before they grow into cancer.
  • It can used to diagnosed several gastrointestinal diseases like colitis (infectious, ischemic, inflammatory, drug-induced, microscopic, segmental colitis associated with diverticular disease), diverticular disease, gastrointestinal bleeding (hemorrhoids, colitis, diverticulosis, angiodysplasias, dieulafoy lesions, solitary rectal ulcer syndrome, cancer).
  • It can be used to stop hemorrhage (bleeding) using several tools like hemoclip, injection of vasoconstrictors, electrocautery, coagulation therapies, sprays, ablation).
  • It can be used to relieve obstruction or blockage through dilation (stretching out) or placement of stents.
  • It can be used to block leaks and fistula.
  • It can be used to remove foreign bodies.
  • It can be used to perform fecal microbiota transplantation (fecal transplant).

 

What are the risks of colonoscopy?

Like all procedures, colonoscopy is associated with certain risks. Serious adverse events are rare.   Some of the risks of colonoscopy are:

  • Breathing problems from sedation (anesthesia).
  • Sneezing and running nose from oxygen given via nasal cannula.
  • Heart problems from anesthesia or the procedure.
  • Bleeding (hemorrhage).
  • Perforation (tear in the colon).
  • Missed polyps.
  • Abdominal discomfort or pain.
  • Infection.
  • Gas explosion (very rare; when electrical energy is used).
  • Spleen rupture.
  • Death.

For more information on complications of colonoscopy, click HERE.

 

How do I spot a complication after colonoscopy?

Click HERE to find out how to spot a complication after colonoscopy.

 

Are there alternatives to colonoscopy?

Yes. Though colonoscopy is unique in its ability to diagnose and treat at the same time or prevent colon cancer though removal of precancerous polyps, other tests are available.

Alternatives to screening and diagnostic colonoscopies include:

  • Stool tests: guaiac-based fecal occult blood test (gFOBT), fecal immunochemical test (FIT), FIT-DNA test (cologuard).
  • X-Ray.
  • Barium enema.
  • CT scan.
  • MRI.
  • CT colonography.
  • Capsule colonoscopy.

Alternatives to screening colonoscopy can be found HERE.

 

When Should I get a screening colonoscopy?

When and how often to screen for colorectal cancer depends on your family history.

  • Average risk individuals without family history of colon cancer should start at age 50.
  • African-Americans should start at age 45 according to the American College of Gastroenterology.
  • Individuals with one first degree relative with history of colorectal cancer or adenomatous polyps before the age of 60 or two or more first-degree relatives at any age should start screening at age 40 or 10 years earlier than the age of the affected relative.
  • Individuals with a first-degree relative with a history of colorectal cancer or polyp at age 60 or older or two second-degree relatives with colorectal cancer should start screening at age 40.
  • Individuals with familial adenomatous polyposis should start screening at age 10 to 12.
  • Individuals with Lynch syndrome should start screening at age 20-25 or 10years younger than the youngest affected immediate relative.

To learn more about the American Cancer Society recommendations for colorectal cancer early detection, click HERE.

 

How often should I get colonoscopies?

How often you get colonoscopies depend on your clinical condition (history of ulcerative colitis or Crohn’s disease, colon polyps, colorectal cancer) and your family history.

For the Multi-society Task Force on Colorectal Cancer guidelines on surveillance colonoscopy after screening and polypectomy, click HERE.

 

How do I prepare for colonoscopy?

The colon needs to be prepared for colonoscopy. It has to be cleaned out so that the physician can properly see the inner lining of the colon. This is called bowel preparation.

The adequacy of bowel cleansing is scored during colonoscopy using several bowel preparation scales. Adequate bowel prep is one that can detect polyps 5mm in size or more.

Inadequate bowel prep is associated with a reduced chance of detecting pre-cancerous polyps. It leads to longer procedure time and aborted procedure. Ultimately, it leads to higher healthcare cost.

Click HERE for a video on the costs of inadequate bowel prep.

There are many medications approved by the Food and Drug Administration as bowel cleansing agents. These include Colyte®, GoLYTELY®, NuLYTELY®, TriLyte®, HalfLytely®, MoviPrep®, SUPREP®, OsmoPrep®, and Prepopik®.

Regardless of the bowel cleansing agent used, the split dose regimen has been proven in multiple studies to be the most effective way to use the medication. In the split dose regimen, half of the bowel cleansing agent is taken the evening before the colonoscopy. The 2nd half is taken 4-5 hours before the scheduled colonoscopy.

Bowel preparation is often the most unpleasant aspect of colonoscopy. Certain tricks can improve a patient’s experience of bowel preparation:

  • Chill the bowel cleansing liquid. A cold cleansing liquid is easier to swallow than a warm one.
  • Improve the taste of the cleansing agent by adding flavor with lemon juice, lemon slices or sugar free flavor enhancers like Crystal Light®.
  • Use a straw to drink the bowel cleansing agent to reduce exposure of the taste to the tongue.
  • Suck on a menthol candy like Halls® cough drops while drinking the bowel cleansing agent. This has been shown in studies to improve taste and bowel preparation.

For frequently asked questions about bowel preparation, click HERE.

 

More colonoscopy questions answered ….

 

How do I shop for colonoscopy?

Click HERE for colonoscopy shopping list.

 

What is a high quality colonoscopy?

Read The 3 P’s of colonoscopy: Factors that determine the outcome of colonoscopy.

Watch a VIDEO on what makes a high quality colonoscopy.

 

Will I be put to sleep for colonoscopy?

Colonoscopy can be done the following ways:

  • Without sedation.
  • With minimal sedation.
  • With moderate sedation.
  • With deep sedation.
  • With general anesthesia.

 

Will I feel pain during colonoscopy?

It depends. If deep sedation or general anesthesia is used, you won’t. If minimal or no sedation is used, you may feel bloated or have some cramps depending on your pain tolerance and the skill of your doctor.

You will not feel pain when a biopsy is taken.

 

More colonoscopy questions answered ….

 

Who performs a colonoscopy?

Colonoscopy should be performed by a trained professional. It is usually performed by a gastroenterologist or a colorectal surgeon.

 

Where is colonoscopy performed?

Colonoscopy can be performed in the hospital, the outpatient department of the hospital (HOPD), an ambulatory surgery center (ASC) or appropriate office.

 

Will my insurance cover my colonoscopy?

Yes. Whether you have a co-pay or deductible depends on what kind of colonoscopy you are getting (screening or diagnostic), your insurance carrier (Medicare, PPO, HMO, Medicaid) and what was done during colonoscopy.  The Affordable Care Act eliminates co-pays for preventive services including colorectal cancer screening. Unfortunately, you may have co-pay if a polyp is removed during your screening colonoscopy.

 

What is the cost of colonoscopy?

The cost of colonoscopy vary greatly depending on where you live (zip code) , where it is done (hospital, ambulatory surgery center, HOPD, office),  and what is done during the colonoscopy (biopsy, polypectomy, etc.). On average, colonoscopy cost over $1000. For the cost of colonoscopy in your area, click HERE.

 

 

 

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Why People Hate Colonoscopy and What to do about It https://bowelprepguide.com/people-hate-colonoscopy/ https://bowelprepguide.com/people-hate-colonoscopy/#respond Mon, 25 Sep 2017 05:28:28 +0000 https://bowelprepguide.com/?p=6951 Hate colonoscopy? If the thought of having a colonoscopy makes you cringe, you’re not alone. Despite being dreaded, colonoscopy saves lives. Colonoscopy is the most effective test for the detection and prevention of colon cancer, the 2nd leading cause of cancer death in United States. In a study published in the New England Journal of Medicine […]

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Why people hate colonoscopy

Hate colonoscopy?

If the thought of having a colonoscopy makes you cringe, you’re not alone.

Despite being dreaded, colonoscopy saves lives. Colonoscopy is the most effective test for the detection and prevention of colon cancer, the 2nd leading cause of cancer death in United States. In a study published in the New England Journal of Medicine in 2012, removal of polyps during colonoscopy led to a 53% reduction in colorectal cancer death. Colorectal cancer detected during screening colonoscopy is easier to treat than cancer diagnosed through other means.

So if colonoscopy prevents colon cancer, why do so many people hate it?

Why People Hate Colonoscopy: Fear of bowel preparation

By far, the most unpleasant aspect of colonoscopy is the bowel preparation. Patients are worried about being on clear liquid diet for colonoscopy, hunger, using the bowel cleansing agents, and adverse reaction to the bowel cleansing agents.

Certain tricks can improve a patient’s experience of bowel preparation:

  • Chill the bowel cleansing liquid. A cold cleansing liquid is easier to swallow than a warm one.
  • Improve the taste of the cleansing agent by adding flavor with lemon juice, lemon slices or sugar free flavor enhancers like Crystal Light®.
  • Use a straw to drink the bowel cleansing agent to reduce exposure of the taste to the tongue.
  • Suck on a menthol candy like Halls® cough drops while drinking the bowel cleansing agent. This has been shown in studies to improve taste and bowel preparation.

For hunger pangs, you can have honey, hard candies, gelatin, popsicles, fruit ices and sorbet while still being on clear liquid diet for colonoscopy.

Though rare, adverse reactions to bowel cleansing agents have been reported. You will have diarrhea, so stay near a toilet. Use a soft toilet tissue. For anorectal irritation or discomfort, use baby wipes, Vaseline, Desitin or hemorrhoidal agents. If you have nausea or start vomiting, stop drinking for 30-45 minutes until the symptoms subside, then you may resume. Some people require anti-nausea medications.  You may call your provider at anytime if you feel very uncomfortable or sick.

For an infographic on 10 tips for making a colonoscopy preparation more tolerable, click HERE.

Why People Hate Colonoscopy: Fear of sedation

Patients are usually worried about not getting enough sedation during colonoscopy and feeling pain as a result. Some are worried about getting too much sedation and not being able to wake up after the procedure.

Colonoscopy can be done without sedation; with minimal sedation; with moderate sedation; with deep sedation or with general anesthesia.

If you are worried about too much sedation or adverse effects of sedation, you can have colonoscopy without sedation or minimal sedation

Most colonoscopies are done with moderate or conscious sedation using midazolam (versed) and fentanyl.

If you are worried about too little sedation, have chronic pain syndrome or if you’re on multiple pain pills, you can have colonoscopy with deep sedation. Deep sedation often requires monitored anesthesia care with propofol.

Why People Hate Colonoscopy: Fear of the colonoscope

Patients are worried about having a tube through their anus into the colon. What is the size of the number? Is it flexible? Will I have pain from the tube? Are the scopes clean? Will I get infected?

Colonoscopy is usually performed with the use of the colonoscope.  Different versions by different manufacturers exist. Manufacturers include Olympus, Fujinon, Pentax to name a few. The Olympus adult colonoscope is 12.8mm in diameter and the pediatric colonoscope is 11.5mm in diameter.

The tip is very flexible and can bend up and down to 180 degrees each and can bend either right and left to 160 degrees. The amount of tube inserted to reach the cecum (start of colon and completion goal) is dependent of a person’s unique colon (size, redundancy, presence of diverticulosis, previous abdominal surgeries, the technique used (water immersion versus water exchange versus air insufflation) and the expertise of the physician.

The colonoscope is manually cleaned and then sterilized using a machine called an automated endoscope reprocessor (AER). According to the Food and Drug Administration, AER are designed to kill microorganism in and on reusable endoscopes by exposing their outside surfaces and interior channels to chemical solutions.

Be rest assured that the tube is small, flexible, and sterilized. You will not feel it when a polyp is removed or when biopsies are taken.

Why People Hate Colonoscopy: Fear of the physician

Patients are worried about the competency and effectiveness of their physician. Will my physician miss colon polyps? Will I have complications like a tear in my colon?

Google your physician: Even though there is poor correlation between physician online rating and quality of care, online information about your physician is still helpful. Is she board certified? Where did he train? How does she perform on quality measures such as completion rates (cecal intubation rate), complication rates, and the ability to detect pre-cancerous polyps (adenoma detection rate)?

Talk to your physician: Express your colonoscopy fears to your physician and work together to address them. Colonoscopy can be personalized to address your fears.

Don’t let your fear of colonoscopy deprive you of its life saving potential.

To learn more about what determines a good colonoscopy, read The 3 P’s of colonoscopy: Factors that determine the outcome of colonoscopy.

 

 

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10 Fun Facts about Colonoscopy https://bowelprepguide.com/10-fun-facts-colonoscopy/ https://bowelprepguide.com/10-fun-facts-colonoscopy/#respond Tue, 22 Aug 2017 01:10:41 +0000 https://bowelprepguide.com/?p=6881 10 Fun Facts about Colonoscopy Nothing is funny about colonoscopy or colon cancer. These 10 fun facts about colonoscopy provide interesting numbers to keep in mind when you or your loved ones get a colonoscopy. 1.  2nd. Each time you think about the inconvenience of colonoscopy, remember that colorectal cancer is the 2nd leading cause of […]

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10 fun facts about colonoscopy

10 Fun Facts about Colonoscopy

Nothing is funny about colonoscopy or colon cancer. These 10 fun facts about colonoscopy provide interesting numbers to keep in mind when you or your loved ones get a colonoscopy.

1.  2nd.

Each time you think about the inconvenience of colonoscopy, remember that colorectal cancer is the 2nd leading cause of cancer death in the U.S.

2.  3rd

Colon cancer is the 3rd most common cancer in men and women. Read key statistics for colorectal cancer.

3. 50 years old.

Average risk individuals should begin screening for colorectal cancer at age 50.

4. 40 years

Individuals with family history of colorectal cancer or precancerous polyps (adenoma) in a first degree relative before age 60 years or 2 or more first degree relatives at any age should begin screening for colorectal cancer using colonoscopy at age 40 or 10 years before the youngest case in the immediate family. Screening with colonoscopy is recommended every 5 years in this population.

5. 10 years.

An average risk person without colon polyps on screening colonoscopy should have repeat screening colonoscopy 10 years after.

6. 6 minutes.

An effective physician should spend a minimum of 6 minutes withdrawing the scope from the cecum (start of the colon) to the anus in order to allow for adequate inspection. Physicians that spend less than 6 minutes are more likely to miss colon polyps.

7. 5 hours.

The split-dose regimen has been shown in multiple studies to be superior to non-split-dose regimen for bowel preparation. The superiority of the split-dose regimen is lost if the second dose is consumed more than 5 hours before the scheduled colonoscopy. The bowel cleansing agent should therefore be finished within 3 to 4 hours of scheduled colonoscopy. Read the 5hr rule study.

8. 25 percent.

An effective physician should detect precancerous polyps in at least 25% of average risk persons presenting for screening colonoscopy. This figure (25%) is for men and women.  For men, it should be 30% and for women, it should be 20%. According to a study published in the New England Journal of Medicine in 2014, each 1% increase in the adenoma detection rate was associated with a 3% decrease in colorectal cancer.

9. 95 percent.

An effective physician should be able to complete the colonoscopy (reach the cecum or the terminal ileum) in at least 95% of all screening colonoscopies.

10. < 1:1000.

An effective physician should have less than one in a thousand patients with a complication of perforation during screening colonoscopies.

To get the most out of colonoscopy, read the 3 P’s of colonoscopy: factors that determine the outcome of colonoscopy.

 

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Sneezing, runny nose and tearing after colonoscopy https://bowelprepguide.com/sneezing-running-nose/ https://bowelprepguide.com/sneezing-running-nose/#respond Mon, 14 Aug 2017 02:06:13 +0000 https://bowelprepguide.com/?p=6570   Sneezing, running nose and tearing after colonoscopy A study published in the Canadian Journal of Gastroenterology in 2011 confirmed that patients getting supplemental oxygen via nasal cannula during colonoscopy can develop symptoms of rhinitis. Symptoms of rhinitis include sneezing, rhinorrhea (runny nose), itchy nose, tearing. These symptoms only occur in about 3% of patients. […]

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sneezing and running nose after colonoscopy

 

Sneezing, running nose and tearing after colonoscopy

A study published in the Canadian Journal of Gastroenterology in 2011 confirmed that patients getting supplemental oxygen via nasal cannula during colonoscopy can develop symptoms of rhinitis. Symptoms of rhinitis include sneezing, rhinorrhea (runny nose), itchy nose, tearing.

These symptoms only occur in about 3% of patients.

The symptoms do not appear to be the related to seasonal allergies.

Symptoms can last a few days at times.

Treatment of these symptoms depends on the severity. For many, the symptoms will go away on their own. For some, treatment is necessary. Try humidifiers or saline nasal sprays first. Decongestants may help. Decongestants may be in tablet form like Sudafed or nasal spray like Afrin. Some people may benefit from an antihistamine nasal spray like Astelin or a steroid nasal spray like Flonase.

Over the counter antihistamines like Benadryl and Zyrtec do not seem to work well for this condition.

Rhinitis after colonoscopy is not life threatening and will eventually go away.

 

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Poop: Everything you wanted to know but too shy to ask https://bowelprepguide.com/everything-you-want-to-know-about-poop/ https://bowelprepguide.com/everything-you-want-to-know-about-poop/#respond Mon, 03 Jul 2017 05:33:21 +0000 https://bowelprepguide.com/?p=3131   Poop: Everything you wanted to know but too shy to ask Poop. We all do it. Poop is the end product of the digestive process. It is removed from the body through a bowel movement (defecation). It is mostly water, about 75%. The solid component, about 25% is composed of dead bacteria (30%), indigestible […]

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bowelprepguide.com answers your poop questions

 

Poop: Everything you wanted to know but too shy to ask

Poop. We all do it. Poop is the end product of the digestive process. It is removed from the body through a bowel movement (defecation). It is mostly water, about 75%. The solid component, about 25% is composed of dead bacteria (30%), indigestible fiber (30%), fat (20%), inorganic substances such as calcium phosphate and iron phosphate (10-20%), and protein (2-3%). Well formed poop is usually solid in consistency. It takes the shape of the colon and is often S-shaped. A well formed stool is denser than water and usually sinks to the bottom of the toilet. Loose stools tend to float more. Poop may float as a result of change in diet (e.g. high fat diet) that produces more gas, infection, or diseases can cause fat malabsorption like celiac disease or chronic pancreatitis. Some mucus in the poop is normal. It is abnormal if the amount is large, if it is persistent or if it is associated with other changes like blood in stool, diarrhea, fever, bloating or belly aches.

Poop never smells good. The bad smell comes from bacteria and gas associated with the breakdown of food.  Certain foods and medications can change the smell of poop. Persistently foul smelling poop can be due to serious conditions like infection, inflammatory bowel disease like ulcerative colitis or Crohn’s disease or malabsorption.

The brown color of poop comes from the action of bacteria on bilirubin. Diseases, food, and medications can change the color of poop. Black stool may be the result of bleeding from the stomach or intestine. Stomach acid turns red blood dark. This kind of poop is usually black and tarry.  Black poop can also be the due to use of iron tablets or bismuth containing substances such as PeptoBismuth®. Certain foods like licorice, grape juice and Oreo cookies can also turn poop black. Red poop can come from food and food colorings like beets, medications like Omnicef or a serious condition like bleeding from the gastrointestinal tract. Bleeding from the small intestine or proximal colon can lead to maroon-colored poop. Food, medications and rapid movement of food materials through the intestine that does not allow time for the action of bacteria on bilirubin can cause poop to be green. Food like milk only diet, medications like aluminum hydroxide and barium or diseases in which the bile flow is blocked can cause poop to be light gray or white.

No two individuals are the same when it comes to the frequency of poop. Frequency ranges from once in 3 days to 3 times a day. Most people poop once a day. Constipation has different meanings for different people but usually involves 2 or more of the following: straining when you poop, lumpy or hard stools, sensation of incomplete evacuation, sensation of blockage in the anus, manual maneuvers to aid pooping like digital evacuation, or fewer than 3 poops per week. Constipation can be idiopathic (unknown cause) or caused by medications, diseases like diabetes mellitus, multiple sclerosis, Parkinson disease, hypothyroidism, injuries like spinal cord injury, diseases that affect the gut, and cancer.

Diarrhea also has different meaning for different people but can be characterized by an increase in the volume or frequency of stool or a decrease in the consistency of stool (loose or watery). It can be acute (≤ 14 days in duration) or chronic (>30 days). It can be functional or secondary to other causes like infection, medications, inflammation. It can be bloody or non-bloody. Eating a wrong meal, eating too much or eating an exotic or unusual meal can give us acute diarrhea. This does not usually last long. Diarrhea can be caused by food poisoning, infections, inflammations, medications, toxins, cancer.

The Bristol stool chart is a useful tool to monitor your stool and detect changes in bowel habits (constipation or diarrhea).

Oily poop can be greasy or fatty. You may see oil droplets or skid mark in the toilet after flushing. The stool is also often foul smelling, pale, and bulky. The medical term for oily poop is steatorrhea. This can happen due to abnormal digestion (break down) and absorption of fat. Common causes of oily poop are chronic pancreatitis,  bile salt (detergent that helps remove fat) deficiency –cirrhosis, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), Crohn’s disease of the terminal ileum, terminal ileum resection, bacterial overgrowth; diseases of the small intestine like celiac disease, giardia infection, lymphoma.

The involuntary loss of stool is called fecal incontinence. It can be caused by aging, obesity, anal fistula, anal injuries, childbirth injuries, post-cholecystectomy syndrome, diabetes, stroke, and medications. Having diarrhea makes you prone to having fecal incontinence.

Pain with defecation or dyschezia can be due to a variety of conditions including anal fissure, hemorrhoids, proctalgia fugax, chronic proctalgia, proctitis, solitary rectal ulcer, anal cancer.

Poop is no longer a waste material. Poop is life.

The population of bacteria in our poop is a reflection of the population of microorganism in our gut. This population is called microbiota. Abnormal modification of this population is called Dysbiosis. Dysbiosis has been linked to several disease conditions like Clostridium difficile infection (C.diff), inflammatory bowel disease (ulcerative colitis or Crohn’s disease), irritable bowel disease, metabolic syndrome, obesity, behavioral disorders, to mention a few.

If bad poop cause diseases; can good poop heal diseases?

Stool transplant or Fecal microbiota transplantation (FMT) is a procedure in which stool or fecal material is collected from a healthy donor, processed, and then transplanted to a recipient.  Stool transplant is the most effective therapy for severe or recurrent Clostridium difficile colitis (C.diff).

Some studies have also shown FMT to induce remission in active ulcerative colitis. Multiple studies are ongoing.

Poop now exist in capsule form and may be available as a prescription soon.

So have you pooped today?  What was the consistency? The color? The shape? The effort to get it out? How did you feel afterwards?

For answers to all up your poop questions; click HERE

 

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How to spot a complication after colonoscopy https://bowelprepguide.com/spot-a-complication-after-colonoscopy/ https://bowelprepguide.com/spot-a-complication-after-colonoscopy/#respond Thu, 08 Jun 2017 01:43:33 +0000 https://bowelprepguide.com/?p=2325 How to spot a complication after colonoscopy Colonoscopy is a life saving procedure. Like most procedures, it comes with risks. These risks include bleeding, infection, and tear in the colon (perforation). These complications occur in less than one percent of patients.  Complications that occur during colonoscopy are usually addressed by your doctor. How can you spot a complication […]

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how to spot a complication after colonoscopy

How to spot a complication after colonoscopy

Colonoscopy is a life saving procedure. Like most procedures, it comes with risks. These risks include bleeding, infection, and tear in the colon (perforation). These complications occur in less than one percent of patients.  Complications that occur during colonoscopy are usually addressed by your doctor. How can you spot a complication after you have been discharged home from your colonoscopy?

  • Abdominal pain: You may have some abdominal cramps following a colonoscopy. This is often due to the air used to inflate the colon during the procedure. You should not hold unto any gas or flatus. You should pass gas as much as possible. If you have persistent abdominal pain or cramps or if your pain is getting worse, you should contact your doctor immediately. This may be a sign of perforation.

 

  • Fever: If you develop fever (temperature above 100.4 F) or chills after your colonoscopy, call your doctor. This may be a sign of infection.

 

  • Bleeding: A small amount of rectal bleeding may be seen after colonoscopy especially after a biopsy or removal of polyp. If rectal bleeding is severe (large amount) or persistent, you should contact your doctor immediately. This may be a sign of serious bleeding.

 

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Colonoscopy Prep Shopping List https://bowelprepguide.com/colonoscopy-prep-shopping-list/ https://bowelprepguide.com/colonoscopy-prep-shopping-list/#comments Tue, 30 May 2017 04:14:52 +0000 https://bowelprepguide.com/?p=2091 This colonoscopy prep shopping list provides a list of essential items for a successful colonoscopy.

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You’ve been scheduled for colonoscopy. It’s time to go shopping!

Like every great shopper, you need a list. Here is a list of items to shop for:

  1. Bowel cleansing agent. This is usually a prescription medication (Golytely, Suprep, Moviprep, Prepopik) or over the counter medication (Miralax plus Gatorade).  Often, your doctor also want you to use bisacodyl (Dulcolax). Dulcolax is available over the counter.
  2. Clear liquid diet. Most patients are told to be on a clear liquid diet a day before colonoscopy. Acceptable items that qualify as liquid diet include water, coffee without milk, tea without milk, lemonade from powdered mix, carbonated beverages and soda, clear juices such as apple and white grape, plain or flavored gelatin, sports drinks such as Gatorade® , All-Sports®, Powerade®; sorbet, popsicles, honey, sugar, hard candy, fat-free broth, bouillon or consommé.
  3. Flavors. You can add lemon juice, lemon slices or sugar free flavor enhancers like Crystal Light® to your bowel cleansing agents to improve the taste.
  4. Straws. Sipping is better than gulping; so get some straws.
  5. Sugar free menthol-candy. Suck on menthol candy (e.g. Halls menthol candy) during ingestion of the bowel prep solution. This has been shown in research to improve taste allowing patients to complete their bowel preparation.
  6. Wipes. Because you will be pooping quite a bit, use the softest toilet paper possible or adult wet wipes with aloe and vitamin E. You can also get medicated wipes like Tucks.
  7. Lube. To prevent or treat anal irritation and soreness as a result of diarrhea from the bowel cleansing agent, use Vaseline or Desitin. You can also use any cream or ointment for hemorrhoids.
  8. Ice. The bowel cleansing agent is better consumed cold. Chill the bowel cleansing liquid by putting it in a fridge or ice bucket. Do not put ice in the bowel cleansing agent itself.
  9. Alarm clock. Your doctor wants you to take your bowel cleansing agent at specific times. If you’re given the split dose regimen, you must take half of the bowel cleansing agent the evening before your colonoscopy (usually around 5:00-6:00PM) and the second half 4-5 hours before your scheduled colonoscopy. You should also arrive at the surgery center at a specific time and on time. An alarm clock will help you stay on track.  An alarm clock is often on your phone or wrist watch so you may not need to buy another one.
  10. Book, Magazine, Newspaper or DVD. To pass time during bowel preparation, get something to read or watch. Nowadays, our phone or ipad has everything we need to pass time.

Don’t be a poor prep. Good luck!

 

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Bowel Cleansing Regimen for Patients With Previous Inadequate Bowel Prep https://bowelprepguide.com/bowel-cleansing-regimen-for-patients-with-previous-inadequate-bowel-prep/ https://bowelprepguide.com/bowel-cleansing-regimen-for-patients-with-previous-inadequate-bowel-prep/#respond Mon, 29 May 2017 04:20:31 +0000 https://bowelprepguide.com/?p=1023 Up to 25% of all bowel preparations for colonoscopy are considered inadequate. What bowel cleansing regimen should be used for these patients with previous inadequate bowel preparation? In a study by Gimeno-Garcia et al published by the American Journal of Gastroenterology, patients with inadequate cleansing at index colonoscopy were randomized to 4-L split-dose polyethylene-glycol (PEG) […]

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poor bowel cleansing

Up to 25% of all bowel preparations for colonoscopy are considered inadequate. What bowel cleansing regimen should be used for these patients with previous inadequate bowel preparation? In a study by Gimeno-Garcia et al published by the American Journal of Gastroenterology, patients with inadequate cleansing at index colonoscopy were randomized to 4-L split-dose polyethylene-glycol (PEG) regimen vs. 2-L split-dose PEG plus ascorbic acid (PEG+Asc) regimen. All individuals underwent a 3-day low-residue diet and received 10 mg of bisacodyl, the day before colonoscopy. Cleansing was considered to be adequate if the Boston Bowel Preparation Scale scored≥2 at each colonic segment.

Adequate bowel cleansing was significantly higher in patients randomized to 4L PEG regimen vs. those randomized to 2L PEG+Asc regimen (81.1% vs. 67.4%).  There was no difference between the 2 groups on withdrawal time, polyp detection rate or adenoma detection rate.

This study is the first randomized study to examine bowel cleansing regimen in patients with previous inadequate bowel preparation.

How to use the regimen:

3 days before colonoscopy: Low residue (low fiber) diet

2 days before colonoscopy: Low residue (low fiber) diet

1 day before colonoscopy: Low residue (low fiber) diet

2 tablets of Bisacodyl (10mg)  at 19:00 hours

2 Liters of PEG-based agent (Colyte, Golytely, NuLYTELY, or TriLyte) at 20:00 hours

Day of colonoscopy: 2 Liters of PEG-based agent (Colyte, Golytely, NuLYTELY, or TriLyte)  4 hours before scheduled colonoscopy.

 

Reference: Gimeno-Garcia et al. Comparison of Two Intensive Bowel Cleansing Regimens in Patients With Previous Poor Bowel Preparation: A Randomized Controlled Study. Am J Gastroenterol advance online publication, 14 March 2017; doi: 10.1038/ajg.2017.53   .

 

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24 Ways to Prepare the Bowel for Colonoscopy https://bowelprepguide.com/24-ways-to-prepare-the-bowel-for-colonoscopy/ https://bowelprepguide.com/24-ways-to-prepare-the-bowel-for-colonoscopy/#respond Mon, 22 May 2017 02:15:42 +0000 https://bowelprepguide.com/?p=1263 There are 24 options for bowel preparation prior to colonoscopy. These options are based on available bowel cleansing agents on the market. The agents include Golytely, Nulytely, Trilyte, Colyte, Prepopik, Suprep, MoviPrep, Miralax, HalfLytely and OsmoPrep. They are all in liquid form except Osmoprep. Bisacodyl or Magnesium Citrate can be used in conjunction with some […]

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There are 24 options for bowel preparation prior to colonoscopy. These options are based on available bowel cleansing agents on the market. The agents include Golytely, Nulytely, Trilyte, Colyte, Prepopik, Suprep, MoviPrep, Miralax, HalfLytely and OsmoPrep. They are all in liquid form except Osmoprep. Bisacodyl or Magnesium Citrate can be used in conjunction with some of the bowel cleansing agents for enhanced purgative effect. Bisacodyl is often used because it comes in tablet form distinguishing it from the liquid form of the bowel cleansing agent.

Bowel Cleansing Agents Day-Before Regimen Split-Dose Regimen
Golytely/Nulytely/Trilyte/Colyte Yes Yes
Golytely/Nulytely/Trilyte/Colyte plus Bisacodyl Yes Yes
Prepopik Yes Yes
Prepopik plus Bisacodyl Yes Yes
Suprep Yes Yes
Suprep plus Bisacodyl Yes Yes
Moviprep Yes Yes
Moviprep plus Bisacodyl Yes Yes
Miralax and Gatorade Yes Yes
Miralax and Gatorade plus Bisacodyl Yes Yes
Halflytely Yes No
Osmoprep Yes Yes
2 day bowel prep regimen No Yes

 

Bowel cleansing agents can be consumed in 2 ways; as day-before or as split-dose.  In the day-before regimen, the bowel cleansing agent is completely consumed the day before colonoscopy. In the split-dose regimen, half of the bowel cleansing agent is consumed the day before colonoscopy and the remaining half is consumed on the day of colonoscopy, about 4-5 hours before the scheduled colonoscopy. The split-dose regimen has been shown in multiple studies to be the most effective way to prepare the bowel for colonoscopy. If bisacodyl is used in conjunction with a bowel cleansing agent, it is used before the bowel cleansing agent; usually about one hour before. The 2 day bowel prep is often used for a patient with prior inadequate bowel preparation and involve the use of bisacodyl and a large volume polyethylene-glycol (PEG) based bowel cleansing agent such as Golytely, Trilyte, Nulytely or Colyte in a split-dose fashion.

The 24 bowel preparation options are:

To see all the bowel preparation instructions, click here.

 

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