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Medical Forum / General / General / May 2007Colonsocopy cleanout always poor
Hi, I have recently had my first two colonscopy. Both times were unsuccessful because they say the clean out was not good enough. The first I simply got a Fleet kit and followed the instructions. The second time I added a day of soups (not clear), followed by a bottle of Mag Citrate at bedtime, then a day of clear broths, and a gallon of Golitely with four laxative pills as instructed Nonetheless when morning arrived I was only passing a bit (less than a cup) of brown water. At least 5 more times, cups(or less) of brown water untill the colonscopy which was at 2 PM (again unsuccessful) So.... I am again scheduled for another attempt. Thus my query. What can I do to achieve a successful clean out? If clean out is still not complete, is there some way the doctor can irrigate to clear things up? > Hi, > [quoted text clipped - 16 lines] > If clean out is still not complete, is there some way the doctor can > irrigate to clear things up? Two thoughts come to mind: 1) Presumably, the doctor has experience with this sort of problem and is the person to guide you. In addition, she presumably knows your history, which is helpful when giving medical advice. 2) There is a reason why you're not coming clean. Perhaps that is the reason for the colonoscopy in the first place. Again, your doctors are the right people to ask about this. Jeff > Hi, > [quoted text clipped - 16 lines] > If clean out is still not complete, is there some way the doctor can > irrigate to clear things up? \ Usually an iso-osmotic polyethyleneglycol prep (PEG) prep like GoLytely or Colyte is used when the Fleets prep doesn't work. Plus, there's that nasty little liability problem with phosphate-induced renal failure with phospha soda in a certain subset of patients. HMc >> Hi, >> [quoted text clipped - 24 lines] > > HMc Howard-- I had my first colonoscopy 2 years ago at age 53. I was given phosphosoda as my prep, and it worked well. I only heard of the renal risk afterwards. Is this predictable based on patient medical history, or should it just be avoided? Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Howard-- > > I had my first colonoscopy 2 years ago at age 53. I was given phosphosoda > as my prep, and it worked well. > I only heard of the renal risk afterwards. Is this predictable based on > patient medical history, or should it just be avoided? It's rare, but many practices have gone away from using phospho-soda preps because of the potential liability associated. There are television commercials seen fairly often these days from personal-injury lawyers trolling for patients who've had colonoscopy with phospho-soda preps. Here is the FDA advisory on the subject. http://www.fda.gov/cder/drug/infopage/OSP_solution/backgrounder.htm "Individuals at increased risk include: those of advanced age, those with decreased intravascular volume or kidney disease, and those using medicines that affect renal perfusion or function [diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and possibly nonsteroidal anti-inflammatory drugs (NSAIDs)]." HMc >> Howard-- >> [quoted text clipped - 18 lines] > > HMc Thanks Doc--I guess I have a few years before I have to worry about it again. That last one (NSAIDS) certainly would seem to increase the potential "at risk" pool. Steve > The > second time I added a day of soups (not clear), followed by a bottle [quoted text clipped - 8 lines] > > What can I do to achieve a successful clean out? Start the clear broth 24 hours before the test. Wake up earlier, test day, drink lots of water, don't leave house until you're passing "clear". J |
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