Having had the CT scan, I needed an urgent consultation with a surgeon specialising in bowel problems. I Phoned and old colleague which resulted in an urgent colonoscopy examination the next week. But before that, I needed the dreaded bowel preparation.
With the report of the CT scan in hand, I spoke to another one of my surgical colleagues MS who specialised in bowel surgery. Over the telephone I explained the symptoms I had been having. He recognised the problem as an episode of bowel obstruction and immediately arranged to see me a day or two later. I was told me to continue with the antibiotics for six more weeks at a high dose, He also arranged for me to have an urgent colonoscopy the next week. He also placed me on a low-residue diet and gave me some bowel prep to take.
What is a colonoscopy?
Colonoscopy is the procedure where a flexible telescope is passed up through the anus into the bowel. It allows the examiner to inspect the inside of the bowel and identify where the obstruction is, and what had caused it. In order to get a clear view of the inside of the bowel, the bowel has to be emptied. This is achieved by taking a bowel prep.
What is the Bowel-Prep for a colonoscopy
The bowel preparation was undertaken over several days. 48 hours before the colonoscopy I had to have a low residue diet of yoghurt, eggs, white bread and clear soup. Then for 24 hours before the procedure, I was to have nothing but water. In addition to that, I had to take Picolax on the day before the procedure. Picolax is a powder that is diluted in 1 litre of water and taken in the morning and again in the evening. Other patients had told me that this was dreadfully distasteful and the result uncomfortable. I had assumed that this was because Picolax resulted in them having severe diarrhoea. However, I had never dreamt of how horrible the Picolax tasted was and how severe the resulting effect was.
The high-electrolyte content of Picolax gives you the feeling of nausea and an intense feeling of wanting to vomit. Just to let you know, washing the fluid down with more water doesn’t take the taste away. Over the next hour or two, your stomach becomes a little distended and the rumbling begins. Patients may get dehydrated as fluid is sucked from the blood stream into the intestines. Then, the diarrhoea starts. Over the course of the next three or four hours, patients may go to the toilet perhaps 10 times, each time experiencing explosive watery diarrhoea.
Taking the dreaded bowel prep
When I took the picolax, I got the distension and rumbling but no diarrhoea. The distension became severe as did the pain. This was so bad that I couldn’t finish the second dose. I didn’t sleep that night but spent the time rolling around in bed with gross abdominal pain and distension. With waves of colic.
The Picolax had caused a bowl obstruction
The next morning, I managed to get into the hospital and to the day surgery unit. When I met with MS the befor my colonoscopy I told him what had trespassed the day before, he was shocked and seriously worried.
It appeared that the Picolax had tipped me over into another episode of bowel obstruction. The resulting diarrhoea was trapped within the bowel and couldn’t escape. Reluctantly, he attempted the colonoscopy, but curtailed the procedure once he identified that the obstruction was indeed in the region of the sigmoid in the lower large bowel. Even with the limited inspection, he thought the disease was at least in part due to diverticulitis. He halted the examination due to the risk of perforating the bowel. He suggested that I continue taking the high-dose antibiotics and return in four weeks’ time for a further colonoscopy.
Antibiotics for four weeks
During the next four weeks, I stayed on high-dose antibiotics. He had given me Augmentin which is a form of penicillin. I began to get diarrhoea after about three weeks, which seemed to clear out my bowels. Perhaps by the third week, I also began to get a skin rash. MS agreed this most likely developed as an allergic reaction to the high dose of Augmentin. He then switched me to another antibiotic called ciprofloxacin.
Then there was a problem of how to prepare my bowel prior to the next colonoscopy. MS was very concerned that I should not have Picolax again, but I was very concerned that he could have a very good view of the entirety of the inside of my large colon. Something which was crucial for an accurate diagnosis and confirmation that I did not have an underlying cancer. I decided to be strict with myself and had a very low-fibre diet for three days. Then a fluid diet for a further 24 hours and a water-only diet for the next 48 hours. Fortunately, this did empty my bowel and MS was able to undertake a complete colonoscopy. He also took biopsies of small tissue samples around the area of the obstruction.
My colonoscopy
For the procedure he initially sedated me with some short-lasting intravenous drugs. I woke up about 5-10 minutes later and was able to watch the examination on a separate TV screen. Many readers may find this disconcerting, but as a doctor, it was reassuring. I was able to see exactly what the problem was and to see how thorough MS’s colonoscopy examination was.
MS phoned me a few days later to confirm that the colonoscopy had demonstrated only diverticulitis, and the biopsies demonstrated no evidence of any tumours or cancer.
