Hi everybody,

I have a pouch scope (under sedation) to be done by my new GI doc (through HMO) tomorrow!!!.. he has just one other j-pouch patient and his office keeps telling me to prepare like a colonoscopy.

I told them i have no colon and they didn't know what to do. I called the hospital imaging and they didn't know either (after telling them i had no colon they just say they don't see that very often).

So... how does one prepare for a pouch scope?

I have one pouch scope before by my surgeon but could not get a hold of him because he was on vacation. it has been a while but i think i had no food after 9 or 10p and a fleet enema in the morning that was about it.

my new GI wants me to drink 10 oz. of magnesium citrate tonight at least and no food for 24 hrs (clear liquids only).

any help on what your doc likes you to do to prepare? in the end, he just told me he doesn't want any stool in there, of course.

but i dont want to prep like i have a full colon to empty out.

thank you!

The prep sounds excessive for a pouch. All my surgeon requires for a scope and biopsy is an enema before the procedure.

Sue

Same here, nothing to eat past midnight, small enema in am before procedure. Prep has always been adaquate. I'd be a little nervous if he doesn't really know anything about pouches....your HMO should be able to approve an out of network doc if they don't have one in network that has experience.
LoriP

Jan, My Doc doesn't have me do any prep at all. I wouldn't take any of the magnesium products, I have seen what it does to people with normal anatomy. At most an enema or 24 hrs of clear liquids will do the trick. To be honest I eat dinner and am completely empty pooping bile by 10am if I don't eat anything. Also not to knock the place you are going but if they are so inexperienced with this procedure you may want to go somewhere else. We pouchers have anatomy very different that normal anatomy and I would want a skilled doc doing any important procedure on me. I hope you don't get mad or scared by my reply but this is my opinion, I try my best to give all the information I know. Good Luck, Scott Mc

I think i will eat a small dinner with no dyes and no dyed drinks and not eat anything after 9pm. The procedure is at 12Pm tomorrow .. so that is a lot of time passed with no food i would think, i empty out very quickly. I will do a fleet enema in the AM around 10.

I think that sounds more rational?...

p.s.
oh, yeah.. i dont think im going to drink that magnesium citrate. the last thing i want is to be exploding out the other side nothing but bile ?!

I have not had a pouch scope, but I have spoken to my GI doc regarding the prep if ever need be. He told me that nothing to eat after dinner and a fleet enema in the morning. I think you will be okay doing that.

I have just always done clear liquids the full day before the scope and nothing after midnight. Gets me totally cleaned out and no need for anything like laxatives or enemas.

I had a terrible experience having my first pouch-o-gram before take-down when I tried to have it done at the local hospital. I do believe they had no idea what they were doing, even though my doctor sent detailed instructions. I was miserable and just had to have the procedure repeated at the hospital connected to my surgeons office anyway!

Even if you are there, on the table and they are ready to begin, if you do not feel right about it, speak up!

I have yet to have any kind of prepping for the scoping my surgeon does in his office. He uses a rigid scope, but because the pouch is "right there" that is all I have ever needed. My GI, if I ever have to have him scope, will approach it like a colonoscopy. . . which seems excessive. I would have him dialogue with my surgeon before proceeding with a scope there.

My partner is usually with me when I get scoped . . . in fact, my surgeon has actually let her look into the scope once or twice to see what he is seeing! See if you can take someone with you just so you have a companion, a witness, and a driver if you feel uncomfortable for any reason in driving yourself home.

Ian337,
How did it go???

I have one once a year in the MD office. I have not had to be sedated. It has never hurt. I eat a regular diet, and use a fleet enema 2 hours before.
Jennifer

A RIGID sigmoidoscope?!! No thanks! I had one done at the student health clinic when I was first having symptoms of UC, and of course they had to call in a few residents so they, too, could see it for themselves. Not as comfortable or safe as a flexible sigmoidoscopy.

Even 10 years ago, I was scoped with no prep at all using a modern flexible sigmoidoscope, and remarkably clear images appeared on a monitor so I could see them squirt water to get a better view, and extend the biopsy snipper to grab a tissue sample at those interesting ulcerated patches. They can also save some images to keep with one's medical records.

I think a minor prep, like "nothing by mouth but water after 9 PM", is a good idea, since no one wants stool coming down from the small intestine during the examination.

thanks for the input all.. here's what went down...

i did a full fleet enema and went to the bathroom maybe 3 times after it and i was very clear. the scope was at 2-ish and i hadn't eaten since 9 the night before.

they knocked me out hard, in fact so hard i still have a bit of a hangover from it. and a very fuzzy memory of the events for a couple hours after.

i got some pictures he printed out and they said they saw some "ulcers", i wasn't told much more than that, and he took biopsies so i will have to wait for those results. he suspects pouchitis.

thanks,
Ian

I have had several flex sigs since takedown and all were clean except this last week's when I forgot to use an enema! I did drink only clear liquids the day before but I really should have done that enema! I never use meds/sedation for these exams because I like watching the procedure on the monitor. I even get to watch the removal of some polyps. Last week's involved a little more bleeding than usual and I needed cauterization. Strange to see "smoke" being manufactured inside you! My surgeon kept asking if I was okay! Wonder how he could tell the smoking gun was "getting to me"??? All is well. He called this evening to say the polypz were benign!

Flex sig yearly
NO prep at all
Breakfast and sometimes lunch
dr uses suction and never had sedation
20 years no problems

At Cleveland Clinic for pouch endoscopy they told me cleat liquids after mid-night, and I did a fleet enema about 20-25 minutes before the procedure. It does sound excessive for a full bowel prep for a pouch-endo.