BowelPrepGuide https://bowelprepguide.com Your guide to excellent bowel prep Sun, 09 Dec 2018 21:48:16 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.8 92279279 How to prepare for upper endoscopy (EGD) https://bowelprepguide.com/how-to-prepare-for-upper-endoscopy-egd/ https://bowelprepguide.com/how-to-prepare-for-upper-endoscopy-egd/#respond Sun, 09 Dec 2018 21:35:51 +0000 https://bowelprepguide.com/?p=8252 To prepare for an upper endoscopy, you need to stop solid food for eight hours or more. You may need to stop blood thinners up to 7 days before the test. You can take your essential medications like those for blood pressure the morning of your test. What is an upper endoscopy (EGD)? An upper […]

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how to prepare for upper endoscopy (EGD)

To prepare for an upper endoscopy, you need to stop solid food for eight hours or more. You may need to stop blood thinners up to 7 days before the test. You can take your essential medications like those for blood pressure the morning of your test.

What is an upper endoscopy (EGD)?

An upper endoscopy is otherwise known as an esophagogastroduodenoscopy or EGD for short. This is an examination of the inside of your esophagus (food pipe), stomach, and duodenum using a fiber optic flexible tube (gastroscope or endoscope) that has light and camera at the end.

Why do you need an upper endoscopy?

An EGD is the best way to examine the esophagus, stomach and duodenum. EGD prevents hospitalization and saves lives. It is helpful in the following instances.

  • Evaluate upper abdominal symptoms such as pain, bloating, nausea, vomiting. .
  • Difficulty swallowing or painful swallowing.
  • Heartburn and regurgitation.
  • Diagnose H.pylori.
  • Gastrointestinal bleeding such as vomiting blood and blood in the stool.
  • Diagnose and treat Barrett’s esophagus.
  • Evaluate iron deficiency anemia.
  • Diagnose and remove polyps.
  • Before weight loss surgery.
  • Diagnose cancer of the esophagus, stomach and duodenum.
  • Treat bleeding from the esophagus, stomach or duodenum from things like ulcer, inflammation, abnormal blood vessels, cancer.
  • Relieve obstruction in the esophagus, stomach or duodenum.
  • Remove foreign body.
  • Diagnose and treat varices.
  • Treat leaks and fistula.
  • Manage achalasia by balloon dilation or injection of Botox.
  • Assess injury caused by ingesting caustic material.
  • Place a feeding tube.
  • Treat obesity.

 

What are the risks of upper endoscopy

Complications rarely occur with an EGD. The rate of occurrence varies between 1 in 200 patients to 1 in 10,000 patients. Risks of upper endoscopy include reaction to sedation, breathing problems, nausea, vomiting, abdominal pain, headaches, heart problems, bleeding, perforation, and death. The risks and benefits are discussed during consent before the test.

What are the alternatives to an upper endoscopy?

Few things can replace an EGD. X-ray, CT scan, MRI, medications, surgery are alternatives depending on the circumstances.

How do I prepare for my test

What do I do 1 week before the EGD?

  • Discuss all your medications with your provider.
  • You may need to stop your antiplatelet or anticoagulants such as Coumadin, Plavix.
  • You may continue to take your aspirin.
  • Arrange for a driver to take you home after the procedure.

What do I do 2-3 days before the EGD?

  • You may need to stop anticoagulants like Eliquis, Pradaxa, and Xarelto 2-3 days before your EGD.

What do I do a day before the EGD?

  • Confirm your transportation with a responsible adult driver.
  • No solid food 8 hours prior to your procedure.

What do I do on the day of the EGD?

  • You may take your essential morning medications with a few small sips of water, at least 4 hours before your procedure, unless as directed by your physician.
  • Nothing by mouth at least 4 hours prior to your procedure including gum, hard candies, mints, tobacco.
  • Leave your valuables at home.
  • Bring your ID, insurance cards, and any co-pay with you.

 

What to expect during the procedure

You will be given medicines to make you sleepy. Most people do not remember the test. You will be given oxygen and monitored throughout the test. Your doctor will insert the gastroscope or endoscope through your mouth and examine the lining of your esophagus, stomach and small intestine. Other tools be may passed into your upper gastrointestinal tract via the endoscope. For most people, the procedure only last about 15-30 minutes.

What to expect after the procedure

You will be monitored until you are awake. You may eat or drink once you are awake. Your doctor may discuss your result with you and whomever came with you. You may be given a copy of your report. If biopsies are taken, it may take a few days for those results to come from the pathologist. Someone should drive you home.

Suggested Reading

 

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Bland diet for digestive health problems https://bowelprepguide.com/bland-diet-for-digestive-health-problems/ https://bowelprepguide.com/bland-diet-for-digestive-health-problems/#respond Sat, 10 Nov 2018 22:10:26 +0000 https://bowelprepguide.com/?p=8049   Bland diet is a soft, non-spicy, low fiber diet. It is recommended for people with certain digestive conditions such as diverticulitis, pancreatitis, bowel obstruction, and colitis. Types of bland diet  Bland diets are clear liquid diet, low fiber diet and non-spicy diet. Examples of bland diet Cooked vegetables. Low fat or fat free milk. […]

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Bland diet for digestive problems

Bland diet is a soft, non-spicy, low fiber diet. It is recommended for people with certain digestive conditions such as diverticulitis, pancreatitis, bowel obstruction, and colitis.

Types of bland diet 

Bland diets are clear liquid diet, low fiber diet and non-spicy diet.

Examples of bland diet

  • Cooked vegetables.
  • Low fat or fat free milk.
  • Fruit juices and vegetable juices.
  • White flour breads, crackers, and pasta.
  • Light cereals with low fiber.
  • Lean meat.
  • Fish and sea food.
  • Peanut butter, jelly and seedless jam.
  • Pudding and custard
  • Eggs
  • Tofu
  • Soup and broth.
  • Weak tea.
  • Clear liquid diet.

What to avoid if you are on a bland diet

  • Raw vegetables.
  • High fat dairy products such as whipped cream or high-fat ice cream.
  • Strong cheeses, such as bleu, Monterey Jack  or Roquefort cheese.
  • Fried foods.
  • Dried fruits.
  • Whole-grain or bran cereals.
  • Whole-grain breads, crackers, or pasta.
  • Spices, such as hot pepper and garlic.
  • Foods with high sugar content.
  • Seeds and nuts.
  • Highly seasoned, smoked or cured meats and fish.
  • Very rich and creamy foods.
  • Alcoholic and caffeinated beverages.

Who should be on a bland diet

  • Patients recovering from abdominal surgery.
  • Those with diverticulitis.
  • Patients with severe colitis.
  • Those with severe esophagitis (inflammation of the esophagus caused by acid reflux).
  • Patients with persistent nausea and vomiting.
  • Those with bowel obstruction.
  • Patients with acute pancreatitis.

Who should not be on a bland diet 

  • Patients with diverticulosis.
  • Those with irritable bowel syndrome.
  • Patients with celiac disease.
  • Those with ulcerative colitis or crohn’s disease that are in remission.

How to do the bland diet 

  • Drink plenty of fluids. Stay hydrated.
  • Eat small meals multiple times a day.
  • Chew your food carefully.
  • Avoid late meals. Do not eat 2-3 hours before bedtime.
  • Stop tobacco.
  • Avoid alcohol.
  • The bland diet is not a permanent diet. If your bowel obstruction or diverticulitis resolves, you don’t have to remain on a bland diet.

Suggested Reading 

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Are probiotics bad? Probiotics can cause brain fog https://bowelprepguide.com/are-probiotics-bad/ https://bowelprepguide.com/are-probiotics-bad/#respond Sun, 04 Nov 2018 02:49:51 +0000 https://bowelprepguide.com/?p=8107   Are probiotics bad in any way? Millions of people use probiotics. They are everywhere. Drug stores and marts are filled with different brands of probiotics. Many assumed they are only beneficial and have no downside. In a recent study by Rao et al in Clinical and Translational Gastroenterology, 30 patients with gas, bloating, brain fog […]

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are probiotics bad

Are probiotics bad in any way? Millions of people use probiotics. They are everywhere. Drug stores and marts are filled with different brands of probiotics. Many assumed they are only beneficial and have no downside.

In a recent study by Rao et al in Clinical and Translational Gastroenterology30 patients with gas, bloating, brain fog and negative tests were compared to 8 patients without brain fog. All the patients with brain fog consumed probiotics. The brain fog group had more small intestinal bacterial overgrowth as well as D-lactic acidosis.

After discontinuing probiotics and completing a course of antibiotics, 23 of the 30 patients reported that their brain fog was resolved as well as their gastrointestinal symptoms.

The conclusion is that probiotics can also promote growth of bacteria in the small intestine and not just the colon. In addition, they can break down sugar and produce D-lactic acid. The brain fogginess come from the D-lactic acid.

This is a small study and the findings need to be confirmed in larger studies.

In a separate study published in Cell, probiotics did not change gut bacteria in some people. Meaning that some people may be resistant to the supplements. In another study, the group found that taking probiotics after use of antibiotics may delay the return of people’s normal gut microbiome. This finding is contrary to the common advice of using probiotics with or after use of antibiotics.

 

What are probiotics, prebiotics and synbiotics?

Probiotics are live microorganisms that are intended to have health benefits. They are found in fermented food like yogurt, kimchi, sauerkraut and kombucha. However, most probiotics are sold as supplements that do not require FDA approval.

Prebiotics are not live microorganisms. The promote growth of probiotics. They are soluble fermentable fibers that get to our colon undigested. They provide food to the bacteria in the colon and are fermented into short-chain fatty acids.

Synbiotics contain both probiotics and prebiotics.

When are probiotics beneficial?

According to a detailed analysis published in the American Journal of Gastroenterology, there are few strong evidence for the use of probiotics. Some evidence exist for their use in certain conditions. These conditions include using VSL#3 for maintaining remissions in patients with pouchitis or treating active ulcerative colitis, using Lactobacillus in patients with painful diverticulosis, using a variety of probiotics (Lactobacillus, Bifidobacterium, Streptococcus, or VSL#3) in patients with minimal hepatic encephalopathy, or providing synbiotics to patients postoperatively after liver transplantation.

What should you do? 

If probiotics are helpful to you, continue to take them. If you’re taking probiotics and have brain fog and bloating, contact your physician. Brain fog and bloating can be caused by probiotics among other things.

 

Suggested Reading 

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High fiber diet for digestive issues and colon health https://bowelprepguide.com/high-fiber-diet-for-digestive-issues-and-colon-health/ https://bowelprepguide.com/high-fiber-diet-for-digestive-issues-and-colon-health/#respond Thu, 01 Nov 2018 04:45:48 +0000 https://bowelprepguide.com/?p=8043 High fiber diet is good for colon health. Fiber improves health in many diseases such as constipation, diarrhea, obesity, irritable bowel syndrome, colorectal polyps, colorectal cancer, type 2 diabetes mellitus and cardiovascular diseases. People lose weight on fiber diets for so many reasons. It makes them feel full easily. High fiber foods are also low […]

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High fiber diet for digestive issues and colon health

High fiber diet is good for colon health. Fiber improves health in many diseases such as constipation, diarrhea, obesity, irritable bowel syndrome, colorectal polyps, colorectal cancer, type 2 diabetes mellitus and cardiovascular diseases.

People lose weight on fiber diets for so many reasons. It makes them feel full easily. High fiber foods are also low in sodium, added sugars and saturated fat.

The Academy of Nutrition and Dietetics recommends 25 grams of fiber for women and 38 grams for men.

Types of fiber 

There are 2 main types of fiber. Soluble and insoluble fiber. It can also be grouped as fermentable and nonfermentable. It can be natural or supplemental.

Soluble fiber attracts water and turns to gel during digestion. Therefore, it slows digestion. Soluble fiber is found in oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables.

Insoluble fiber is found in foods such as wheat bran, vegetables, and whole grains. It adds bulk to the stool and appears to help food pass more quickly through the stomach and intestines.

Soluble fermentable fiber can be found in wheat, legumes, garlic, onions are prebiotics. They feed gut bacteria but produce gas.

Insoluble, nonfermentable fiber can be found in nuts, seeds, and the skins of fruits and vegetables has a laxative effect and can help patients with constipation.

Natural fiber in foods contain antioxidants, vitamins and minerals and are preferred over supplemental fiber.

Examples of supplemental fiber are methylcellulose (citrucel), inulin (fiber choice), psyllium (metamucil), and wheat dextrin (benefiber).

Examples of high fiber diet

High fiber diet include potatoes, almonds, oats, popcorn, quinoa, split peas, chickpeas, kidney beans, beets, broccoli, Brussels sprouts, lentils, artichoke, carrots, banana, apples, avocado, raspberries, pears, strawberries, corn, and leafy green vegetables. A comprehensive list of high fiber foods can be found HERE.

Who should be on a high fiber diet

  • Those with diverticulosis.
  • Patients with colon polyps or prone to colon cancer.
  • Those with diarrhea.
  • Patients with constipation.
  • Those with irregular bowel movements.
  • Patients with irritable bowel syndrome.

Who should not be on a high fiber diet 

  • Patients with gastroparesis.
  • Those with recent severe inflammation like diverticulitis and colitis.
  • Patients with recent abdominal surgery.
  • Those preparing for colonoscopy.
  • Patients with bowel obstruction.

Suggested Reading 

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Bowel prep seizures. Colonoscopy in seizure patients https://bowelprepguide.com/bowel-prep-seizures/ https://bowelprepguide.com/bowel-prep-seizures/#respond Tue, 30 Oct 2018 04:00:24 +0000 https://bowelprepguide.com/?p=8098 Bowel prep seizures can occur with any bowel cleansing agent. All bowel cleansing agents have the potential to cause seizures because they all affect body electrolytes. They all cause diarrhea. Therefore, they can cause dehydration. What are seizures? Seizures are abnormal brain activities that can be provoked or unprovoked. Symptoms of seizures are staring, convulsions, […]

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bowel prep seizures. colonoscopy in seizure patients

Bowel prep seizures can occur with any bowel cleansing agent. All bowel cleansing agents have the potential to cause seizures because they all affect body electrolytes. They all cause diarrhea. Therefore, they can cause dehydration.

What are seizures?

Seizures are abnormal brain activities that can be provoked or unprovoked. Symptoms of seizures are staring, convulsions, muscle twitches, strange sensations, weird emotions, odd behavior and loss of consciousness. Symptoms vary depending on the part of the brain that is affected.

Seizures can be due to epilepsy or a variety of diseases that affect the body. Diseases like stroke, heart attack, brain tumor, dehydration, diarrhea, infection, parasites, electrolyte imbalance and many others.

What are the types of seizures?

  • Focal seizures
  • Generalized seizures

Common side effects of bowel prep

  • Nausea.
  • Abdominal distention.
  • Dehydration.
  • Abdominal cramps.
  • Lightheadedness.
  • Dizziness.
  • Abnormal electrolytes like low potassium, low sodium, low magnesium and low chloride. These can cause seizures.

Who should not be prepped for colonoscopy

  • Patients with hypersensitivity to any of the ingredients of the the bowel cleansing agent.
  • Those with a gastrointestinal obstruction that will prevent passage of liquid into the intestine.
  • Patients with an ileus.
  • Unconscious patients. In some instances, bowel cleansing agent can be given through a nasogastric tube.
  • Inability to swallow. In certain cases, bowel cleansing agent can be given through a nasogastric tube.
  • Patients with toxic colitis or toxic megacolon.

 

Which bowel cleansing agents should be avoided by people with seizures?

All bowel cleansing agents can cause seizures. This is because they can cause electrolyte imbalance, diarrhea and dehydration. You should avoid sodium phosphate products like Fleet Phospho Soda, Visicol, and Osmoprep. The Miralax-Gatorade bowel prep is popular among patients. However, it can cause severe low blood sodium and is not FDA approved for bowel cleansing prior to colonoscopy. It is approved for constipation and it has the same active ingredient as Golytely.

When preparing for colonoscopy, you should stay hydrated.

 

How to prep for colonoscopy when you have seizure problems

  • If you have ever had seizures before, let your doctor know.
  • Do not schedule colonoscopy if you’re having new seizures or worsening of your seizures.
  • Let your doctor know about your seizures. How frequent? When was the last one? What medications do you take?
  • Avoid medications that can lower your seizure threshold. Stay away from alcohol and illicit drugs.
  • Do not use sodium phosphate products as a bowel cleansing agent.
  • Take the bowel cleansing agent using the split dose bowel prep regimen.
  • Keep yourself hydrated with clear liquid diet throughout the bowel cleansing process.
  • Use your seizure medications as prescribed. Do not stop your seizure medications for colonoscopy.

Suggested Reading

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What is the best food to eat after colonoscopy https://bowelprepguide.com/eat-after-colonoscopy/ https://bowelprepguide.com/eat-after-colonoscopy/#respond Sun, 21 Oct 2018 05:43:23 +0000 https://bowelprepguide.com/?p=8040 Congrats! You just finished having colonoscopy. You are hungry and weak. What can you eat after colonoscopy? Can you go from the surgery center to a buffet restaurant? How your body feels after a colonoscopy? Colonoscopy involves several steps. These steps include restrictions on food, bowel prep, diarrhea, anesthesia, and then the colonoscopy procedure. These […]

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what is the best food to eat after colonoscopy

Congrats! You just finished having colonoscopy. You are hungry and weak. What can you eat after colonoscopy? Can you go from the surgery center to a buffet restaurant?

How your body feels after a colonoscopy?

Colonoscopy involves several steps. These steps include restrictions on food, bowel prep, diarrhea, anesthesia, and then the colonoscopy procedure.

These events leave you dehydrated, hungry and weak. You may have electrolyte imbalance. Some patients have inflamed colon from diverticulitis or colitis.  The colon may be partially or completely blocked.

Can you have a light meal immediately after a colonoscopy?

Most people think of food once they wake up from colonoscopy. Some surgery centers will give you a cup of juice once you wake up from anesthesia. You can eat after colonoscopy once you’re fully awake. To hydrate, drink plenty of water, sports drinks, and juices. Avoid alcohol. Your first meal after a colonoscopy should be light, non creamy and non-spicy. Bland diet is ideal as first meal to eat after colonoscopy. Examples include crackers, soups, toasts, eggs, sandwiches, rice, fish, chicken, Your gut is still not completely back to its normal state. You don’t want it to overwork to process certain foods.

Different diets prescribed after a colonoscopy

Diet if you have diverticulosis

A high fiber diet is recommended for patients with diverticulosis. 

Diet if you have severe colitis

There is no specific diet for patients with ulcerative colitis or Crohn’s disease. Neither is there a diet for patients with infectious colitis, microscopic colitis, ischemic colitis or radiation colitis. A low fiber or bland diet may be suggested because this is gentle on your body.

Diet if you have an obstruction

If you have bowel obstruction, you should avoid high fiber diet. A clear liquid diet and low fiber diet are recommended.

Diet if you are have iron deficiency anemia

Patients with iron deficiency anemia have low iron. Certain foods are rich in iron. These include beef or chicken liver, beef, veal, turkey, ham, mussels, clams, oysters, beef, sardines, salmon, halibut, tuna, spinach, lentils, beans, tofu, iron-fortifies cereals and dark chocolate. In addition, you will be placed on iron supplementation.

Suggested Reading

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Heart failure colonoscopy prep https://bowelprepguide.com/heart-failure-colonoscopy-prep/ https://bowelprepguide.com/heart-failure-colonoscopy-prep/#respond Thu, 18 Oct 2018 03:31:46 +0000 https://bowelprepguide.com/?p=8005   Heart failure colonoscopy prep is the bowel prep for a patient with heart failure. People with heart failure are often on many medications like water pills and blood thinners.  These medications can affect bowel prep for colonoscopy. Patients with heart failure can safely have colonoscopy. What is heart failure? Health failure is a medical […]

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heart failure colonoscopy prep

 

Heart failure colonoscopy prep is the bowel prep for a patient with heart failure. People with heart failure are often on many medications like water pills and blood thinners.  These medications can affect bowel prep for colonoscopy. Patients with heart failure can safely have colonoscopy.

What is heart failure?

Health failure is a medical condition in which the heart cannot pump enough blood to meet the needs of the body. It can affect both sides or just one side of the heart. Heart failure does not mean the heart has stopped working. Patients with heart failure have a variety of symptoms. These include swollen legs, difficulty breathing, cough, fatigue, dizziness and irregular heart beats.

What are the stages of heart failure

There are different stages of heart failure. For more information on the stages of heart failure, click HERE.

Who should not be prepped for colonoscopy

  • Patients with hypersensitivity to any of the ingredients of the the bowel cleansing agent.
  • Those with a gastrointestinal obstruction that will prevent passage of liquid into the intestine.
  • Patients with an ileus.
  • Unconscious patients. In some instances, bowel cleansing agent can be given through a nasogastric tube.
  • Inability to swallow. In certain cases, bowel cleansing agent can be given through a nasogastric tube.
  • Patients with toxic colitis or toxic megacolon.

Common side effects of bowel prep

  • Nausea.
  • Abdominal distention.
  • Dehydration.
  • Abdominal cramps.
  • Lightheadedness.
  • Dizziness.
  • Abnormal electrolytes like low potassium, low sodium, low magnesium and low chloride. These can cause seizures.

 

Which bowel cleansing agents should be avoided by people with heart failure?

Oral sodium phosphate should be avoided in patients with heart failure. Examples of oral sodium phosphate drugs are VisicolOsmoprep, and Fleet Phospho Soda. Some patients with heart failure also have kidney failure. Also, these medications should be avoided in patients with kidney failure. Read kidney failure colonoscopy prep.

In 2006, the US Food and Drug Administration (FDA) issued a warning regarding oral sodium phosphate use in high risk patients. These patients include those with kidney disease, liver disease, heart failure, high blood calcium, and elderly patients over the age of 55. Also included are patients taking certain medications like NSAIDS, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and diuretics.

Polyethylene glycol (PEG) based bowel cleansing agents such as Golytely, Nulytely, Trilyte, and Colyte are preferred in patients with heart failure. Suprep, Clenpiq and Prepopik can also be used.

All bowel cleansing agents have the potential to cause arrhythmia because of changes in electrolytes . Having heart failure does not mean you should not stay hydrated during the bowel prep process.

How to do heart failure colonoscopy prep

Suggested Reading

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My doctor found polyps. What makes colon polyp grow? https://bowelprepguide.com/what-makes-colon-polyp-grow/ https://bowelprepguide.com/what-makes-colon-polyp-grow/#respond Tue, 16 Oct 2018 05:22:46 +0000 https://bowelprepguide.com/?p=8036   What makes colon polyp grow? Gloria asked. She just had a colonoscopy after turning 50 a few months ago. This is a common question asked by patients with colon polyps. First, we need to know what colon polyps are. What is a colon polyp? Colon polyps are growths that form on the innermost layer of […]

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what makes colon polyp grow

 

What makes colon polyp grow? Gloria asked. She just had a colonoscopy after turning 50 a few months ago. This is a common question asked by patients with colon polyps. First, we need to know what colon polyps are.

What is a colon polyp?

Colon polyps are growths that form on the innermost layer of colon wall. They are caused by mutations in cell growth and proliferation. These mutations may be due to genetic or environmental factors. Colon polyps are fairly common especially in adults. About one-third to one-half of adults have them.

What are the types of colon polyps?

Colon polyps can be benign, precancerous or cancerous. On your colonoscopy pathology report, polyps are classified as adenoma or serrated polyps. Adenomatous polyps are further classified into tubular adenoma, villous adenoma and tubulovillous adenoma. Serrated polyps can be hyperplastic, sessile serrated adenoma or traditional serrated adenoma.

Hyperplastic polyps are generally benign without malignant potential. Adenomatous polyps, serrated adenomas and traditional serrated adenoma have the potential to grow into malignant tumor.

 

How are colon polyps treated?

The best way to treat a colon polyp is to remove it. Removal of a polyp is called polypectomy. There are several ways your doctor can remove a polyp.  These include forcep polypectomy, cold snare polypectomy, hot snare polypectomy, endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD) and endoscopic full thickness resection (EFTR).

If a colon polyp is completely removed, that polyp is gone forever. Because a new one can grow, this is why you need surveillance colonoscopy.

What makes colon polyp grow?

Polyps grow as a result of mutations in cells. Genes and lifestyles affect the growth of colon polyps. If you have any of the colon cancer genes, then you are more likely to have colon polyps. Tobacco use is associated with colorectal cancer. Excessive alcohol use increases of the risk of many cancers including colon cancer.

Red meat is associated with increased risk of colorectal cancer. Research suggests that there is a 20 percent higher risk of colorectal cancer per 100 gram per day increase in red meat and 50 gram per day increase in processed meat.

Fiber appears to lower colorectal cancer risk. Research suggests that there is a 10 percent reduction in colorectal cancer risk for every 10 gram per day in dietary fiber intake. Obesity is associated with colorectal cancer. Studies have shown that colorectal cancer risk increases by 2 to 3 percent per unit increase in body mass index (BMI) and per inch increase in waist circumference.

Physical activity reduces the risk of colorectal cancer regardless of body size and diet. The American Cancer Society recommends at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week (or a combination of these), preferably spread throughout the week.

 

How can I prevent another colon polyp from growing?

You should follow your doctor’s recommendation on when you come back for surveillance colonoscopy. This is one of the best things you can do. Do not use tobacco. Limit alcohol consumption. Restrict the consumption of red meat and processed meat. Eat more fiber. Exercise regularly and keep the weight off.

Suggested Readings

 

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Kidney failure colonoscopy prep https://bowelprepguide.com/kidney-failure-colonoscopy-prep/ https://bowelprepguide.com/kidney-failure-colonoscopy-prep/#respond Tue, 09 Oct 2018 14:00:54 +0000 https://bowelprepguide.com/?p=8003   Kidney failure colonoscopy prep is the bowel prep for a patient with kidney failure. There are different stages of chronic kidney disease. The most advanced stage is stage 5 in which the patient rely on dialysis to live. Patients with kidney failure can have colonoscopy. What is kidney failure? Kidney failure is the most […]

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kidney failure colonoscopy prep

Kidney failure colonoscopy prep is the bowel prep for a patient with kidney failure. There are different stages of chronic kidney disease. The most advanced stage is stage 5 in which the patient rely on dialysis to live. Patients with kidney failure can have colonoscopy.

What is kidney failure?

Kidney failure is the most serious form of kidney disease in which a person cannot live without dialysis or kidney transplant. There are 2 types of dialysis-hemodialysis and peritoneal dialysis.

What are the stages of kidney failure

The stages are based on estimated glomerular filtration rate or eGFR.

  • 1 with normal or high eGFR (eGFR > 90 mL/min)
  •  2 Mild kidney disease (eGFR = 60-89 mL/min)
  • 3A Moderate kidney disease (eGFR = 45-59 mL/min)
  •  3B Moderate kidney disease (eGFR = 30-44 mL/min)
  • 4 Severe kidney disease (eGFR = 15-29 mL/min)
  •  5 End Stage kidney disease (eGFR <15 mL/min). People with stage 5 kidney failure need dialysis to live.

Who should not be prepped for colonoscopy

  • Patients with hypersensitivity to any of the ingredients of the the bowel cleansing agent.
  • Those with a gastrointestinal obstruction that will prevent passage of liquid into the intestine.
  • Patients with an ileus.
  • Unconscious patients. In some instances, bowel cleansing agent can be given through a nasogastric tube.
  • Inability to swallow. In certain cases, bowel cleansing agent can be given through a nasogastric tube.
  • Patients with toxic colitis or toxic megacolon.

Common side effects of bowel prep

  • Nausea.
  • Abdominal distention.
  • Dehydration.
  • Abdominal cramps.
  • Lightheadedness.
  • Dizziness.
  • Abnormal electrolytes like low potassium, low sodium, low magnesium and low chloride. These can cause seizures.

 

Which bowel cleansing agents should be avoided by people with kidney disease?

Oral sodium phosphate should be avoided in patients with chronic kidney disease. Patients with chronic kidney disease are more likely to develop acute phosphate nephropathy after using oral sodium phosphate.

In 2006, the US Food and Drug Administration (FDA) issued a warning regarding oral sodium phosphate use in high risk patients. These patients include those with kidney disease, liver disease, heart failure, high blood calcium, and elderly patients over the age of 55. It also include patients taking certain medications like NSAIDS, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and diuretics.

In 2008, another warning was issued by the FDA. It required a black box warning for oral sodium phosphate drugs like Visicol and Osmoprep. Osmoprep appears to be better tolerated than Visicol. Also, the FDA warned against the use of Fleet Phospho Soda for bowel cleansing prior to colonoscopy.

Polyethylene glycol (PEG) based bowel cleansing agents such as Golytely, Nulytely, Trilyte, and Colyte are preferred in patients with chronic kidney disease. Manufacturers advised caution with use of Suprep, Clenpiq and Prepopik in patients with kidney disease.

All bowel cleansing agents have the potential to cause kidney failure because of diarrhea and changes in electrolytes. Having kidney disease does not mean you should not stay hydrated.

How to do kidney failure colonoscopy prep

Suggested Reading

 

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Consent for colonoscopy. The informed patient. https://bowelprepguide.com/consent-for-colonoscopy/ https://bowelprepguide.com/consent-for-colonoscopy/#respond Sun, 30 Sep 2018 02:34:54 +0000 https://bowelprepguide.com/?p=7900   Consent for colonoscopy is a precondition for colonoscopy. Several issues surround the idea of consent for colonoscopy. It is a legal requirement based on the principles of autonomy and self determination. Every person has the right to determine if they want a procedure such as colonoscopy or not. What is informed consent?  This is […]

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consent for colonoscopy

 

Consent for colonoscopy is a precondition for colonoscopy. Several issues surround the idea of consent for colonoscopy. It is a legal requirement based on the principles of autonomy and self determination. Every person has the right to determine if they want a procedure such as colonoscopy or not.

What is informed consent? 

This is a legal requirement for a physician to disclose relevant information to a patient in a way and manner that allows the patient to understand, evaluate, and authorize a specific surgical or medical intervention.

What should be disclosed during informed consent? 

  • The patient’s medical problems, diagnosis, and test results.
  • Nature of colonoscopy.
  • The reason for the colonoscopy.
  • Benefits of colonoscopy.
  • The risks of colonoscopy.
  • Alternatives to colonoscopy
  • The patient’s prognosis if colonoscopy is declined.

Risks and complications of colonoscopy

Common risks and complications

  • Adverse effects of medications given for sedation. 
  • Redness, pain or bruising at the injection site.
  • Mild abdominal pains and discomfort.
  • Nausea and vomiting.
  • Lightheadedness and dizziness.
  • Headaches.
  • Muscle aches and pains.

Uncommon risks and complications

  • Fewer than 1 in every 1,000 person accidentally get a hole in the colon. This is called perforation. If detected at the time of colonoscopy, it can be repaired without the need for surgery. Surgery may be needed to repair the perforation. A colostomy may be needed.
  • Less than 1 in every 1000 person experience a significant bleeding. This is usually from a site where a polyp is removed. Bleeding can occur up to 2 weeks after the colonoscopy. The bleeding may stop on its own, require blood transfusion or another colonoscopy to stop the bleeding.
  • Inability to see the entire colon. This may be due to inadequate bowel prep, a tortuous colon, a redundant colon or a blockage.
  • Difficulty breathing.
  • Pneumonia from aspiration.
  • Low blood pressure requiring intervention.
  • Abnormal heart rhythm.
  • Heart attack.
  • A polyp or lesion may be missed. Small polyps may be missed 5-10 percent of the time.
  • Sneezing and runny nose. 

Rare risks and complications

  • Anaphylaxis to medications used during the colonoscopy.
  • Infection such as bacteria in the blood stream. An antibiotic can be used to treat the infection.
  • Spleen rupture.
  • Stroke.
  • Death. This is very rare.

Who should obtain the informed consent?

  • The physician performing the colonoscopy.
  • Members of the health care team can help with the process.

Who should sign the consent form 

  • The patient, designated family member or the patient’s healthcare power of attorney.

Consent for colonoscopy in a emergency situation

  • In a life threatening situation, if there is not enough time to obtain consent from the patient or a family member, an informed consent can be forgone.
  • The emergency must be properly documented and other members of the healthcare team should agree with the decision.

Consent for colonoscopy in an incompetent person 

  • Consent can be obtained from a parent, adult child, legal guardian or surrogate.

 

Consent for colonoscopy is an integral aspect of colonoscopy. Colonoscopy saves lives. Know the risks and benefits. Read factors that determine the outcome of a colonoscopy. 

Suggested Reading

 

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