Colonoscopy

[Robby nz]

There have been enquiries on this forum from time to time about a colonoscopy or examination of the colon.

I had this done last week at Phramongkutklao Hospital. This is the big army hospital near Victory monument where I have had treatment for rectal cancer, including an operation, for over a year.

Thought it may be of help to some TV members if I wrote a bit about the procedure.

In order that the colon can be examined it first needs to be cleaned and this is probably the worst part of the whole exercise. I was given a sachet of what was really a salt solution to mix with 2 ltrs of water and drink the night before. The term ‘to go through you like a dose of salts’ is very applicable and while drinking the stuff and a few hours after you don’t want to be more than a few steps from the correct hole in the ground.

The next morning before going to the hospital you have to do an enema for the final clean out, I didn’t find this to be any problem just a small bottle of liquid squirted up the rear end. I lay on the floor for this in order that the liquid could easily flow up the colon, hold it for a few minutes then back on the can to let it all go and preparations are complete. No eating of course from the day before.

At the hospital they have a dedicated colonoscopy room and after waiting my turn I was wheeled in and laid out on my side, had a needle inserted in my hand for an anesthetic and was attached to blood pressure and heart monitors. Next thing I knew I woke to see on the TV screen the camera being withdrawn and got a picture of a bit of my colon.

Then into the recovery room where heart and BP were again checked for about 20 min then out and get dressed again and go for a feed.

Didn’t time it but suppose the whole thing took about an hour and the total cost 3327Baht, this didn’t include the salts or enema as we got them about a week before and paid cash for them, I can’t find the receipt but it wasn’t much.

Had a meeting after with Doctor Sahaporn who has been my surgeon throughout and he told me everything was clear with nothing out of the ordinary, great.

I would recommend that hospital to anyone but there can be some drawbacks, it is a big hospital used mainly by Kohn Thai and is usually crowded so you have to wait your turn. The doctors seem to all speak English but most of the nurses do not. As it is a teaching hospital there are always a team of students around but this didn’t worry me.

They seem to have specialists for most things, the colorectal unit where I have been treated has 5 specialist surgeons and I know for a fact they are farmed out to some of the private hospitals who do not employ specialists for all disciplines.

If anyone wants to know more you can PM me.

Robby

[FBN]

Thanks for feedback; personal experience always adds loads of value to this forum.

Stay well!

[tuky]

Robby, sounds like you had a decent experience.

I had the procedure in Azerbaijan at a small hospital called Medi-Club.

I was given castor oil to clean me out the day before and when time came for the actual procedure I was given nothing.

It turned out to be one of the most painful experiences of my life, I could feel the scope through every inch of my colon, I could feel it poking around inside. At times it felt like it was going to bust out through my skin.

I was left with abrasions on my ring and I found walking hard for many hours afterwards.

It was horrible, the worst experince of my life.

Funny thing is never did find out the result. I just wanted to get out of there.

[FBN]

Robby, sounds like you had a decent experience.

I had the procedure in Azerbaijan at a small hospital called Medi-Club.

I was given castor oil to clean me out the day before and when time came for the actual procedure I was given nothing.

It turned out to be one of the most painful experiences of my life, I could feel the scope through every inch of my colon, I could feel it poking around inside. At times it felt like it was going to bust out through my skin.

I was left with abrasions on my ring and I found walking hard for many hours afterwards.

It was horrible, the worst experince of my life.

Funny thing is never did find out the result. I just wanted to get out of there.

... and the "surgeon" had a full set of gold capped teeth and wore a chef's hat!

Yes, have seen the same in Kazakhstan and the surgeon here did not even change his clothes and went straight to the theatre to do a brain op...

Never volunteer for any medical intervention in these countries! (any country that ends in --"stan".. is bad news!!)

[wpcoe]

I had a colonoscopy at BNH in Bangkok about six year ago. I was given a laxative to take the day (two days?) before the procedure. I was NOT anesthetized and felt NO pain, and only a minor discomfort when they inserted air bubbles (or whatever it was that they did to increase contrast, or some such thing?)

It makes me wonder if the bedside manner of the colonoscopy folks makes a difference. They were quite gentle and reassuring. I could feel nothing of the scope once it was past the sphincter. I was able to watch the monitor as they moved the scope around, but I didn't know what I was seeing, so didn't bother watching most of the time.

[zzdocxx]

This reminds me of something that I thought was kind of funny.

I am an anesthesiologist, and in the pre-op hold room one morning, I overheard a patient telling another anesthesiologist, "Just make me feel the way I felt when I had my colonoscopy".

I am sure he was referring to the sedation medications, but I had to chuckle at the other possible interpretation.

BTW I think FBN is making a fantastic contribution to this forum (-- I just noticed his "rating" is one star, which doesn't make sense to me).

[FBN]

It is quite likely that the chap in the Azerbaijan clinic used a rigid colonoscope. This is a metal tube not the newer flexible fibreoptic ones.

Went out of use in the early 70's but this is often still the case in the old Russian federation states.

The poor individual was physically skewered... Very traumatic and a very high risk of perforating the colon!

[phetaroi]

Another thing to consider is a virtual colonoscopy, which I had done about 5 years ago. The preparation for it is all the same. The difference, of course, is that nothing is stuck up in you.

A concern is the radiation, although it appears that if you have this done once, there is little risk; multiple sessions over a few years would clearly be a serious mistake. Some will say they miss about 30% of the polyps, which is true, but on the other hand the physical colonoscopy misses many polyps also. Interestingly, the two procedures miss different polyps.

One thing I liked was that it was part of a full body scan, which located a few other problems I had. Nothing serious in my case, but things to know about if certain health problems surfaced (for example, a benign cyst on one organ, which is common at my age, but should be looked at again if certain areas of pain developed.

There is a female gastroenterologist at a very famous Bangkok hospital who dwells on wanting patients to have a colonoscopy. She sees it as a "first resort"...wanted to do one on me before even doing a stool sample...for what another doctor there discovered was a pretty basic case of food poisoning.

[prodriver]

I was diagnosed with rectal cancer a few year's ago and I had two colonoscopy examinations. One at Siriraj hospital where I was put under a general anaesthetic for the procedure. Wonderful, didn't feel a thing and one at Thonburi private hospital where I was awake during the procedure. This was an extremely unpleasant experience. However, I don't think that I'll have to undergo this ever again as my anus is now sewn up and I wear a colostomy bag instead.

[Robby nz]

Had a temporary colostomy bag on the end of the small intestine for a couple of months while the OP healed and was glad I dont have to have it permanant.

First Dr (specialist) I saw siad I would have to have a permanent colostomy but went for a second opinion after a bit of research on the net and found I didnt need it.

Pays to shop around when faced with any medical procedure.

Thought for the day:

If some of the posters in the news clippings section had the back passage sewn up it there would be about half as many posts

[prodriver]

Had a temporary colostomy bag on the end of the small intestine for a couple of months while the OP healed and was glad I dont have to have it permanant.

First Dr (specialist) I saw siad I would have to have a permanent colostomy but went for a second opinion after a bit of research on the net and found I didnt need it.

Pays to shop around when faced with any medical procedure.

Thought for the day:

If some of the posters in the news clippings section had the back passage sewn up it there would be about half as many posts

Ha! Ha! You're probably right there!

My tumour was right near the exit so my bag is permanent, there being nothing to join up again.

[khundon]

I had a colonoscopy but they had to stop due to the pain (loopy colon) so I was given a barium enema which was also unsuccessful, as they missed the ascending colon section.

Then I was given another colonoscopy under general anaesthetic but nothing was found in the large colon but I was still suffering from anemia, so I was sent to a specialist cancer hospital where I was given a Capsuloscopy.

This involves fasting for 12 hours before swallowing a small camera with flashing lights and wearing a receiver around your waist and 8 sensor pickups stuck to your body.

The camera transits through your stomach, then through the small intestine and finally the colon, which takes about 9 hours and you can eat after 5 hours.

The camera takes around 55,000 pictures, which are transmitted to the receiver and are downloaded to a computer at the end of the test.

The gastroenterologist then runs the pics like a video, whilst the camera passes out the next day and is flushed away. I saw the pics which were crystal clear and show up any lesion/problem in the large and small bowels.

Easy peezy lemon squeezy.

Edited May 29, 2010 by khundon

[prodriver]

I had a colonoscopy but they had to stop due to the pain (loopy colon) so I was given a barium enema which was also unsuccessful, as they missed the ascending colon section.

Then I was given another colonoscopy under general anaesthetic but nothing was found in the large colon but I was still suffering from anemia, so I was sent to a specialist cancer hospital where I was given a Capsuloscopy.

This involves fasting for 12 hours before swallowing a small camera with flashing lights and wearing a receiver around your waist and 8 sensor pickups stuck to your body.

The camera transits through your stomach, then through the small intestine and finally the colon, which takes about 9 hours and you can eat after 5 hours.

The camera takes around 55,000 pictures, which are transmitted to the receiver and are downloaded to a computer at the end of the test.

The gastroenterologist then runs the pics like a video, whilst the camera passes out the next day and is flushed away. I saw the pics which were crystal clear and show up any lesion/problem in the large and small bowels.

Easy peezy lemon squeezy.

WOW!! Sounds fantastic. Was that done in Thailand though?

I have an ultrasound scan of my abdomen once a year during check-ups but with what you describe it would be possible to have that in my case if ever needed. The camera could work it's way through and exit through my stoma and straight into my bag. Job's a good 'un

[khundon]

Sorry prodriver, I forgot to mention, this was done in UK.

I don't know if this procedure can be obtained in Thailand, maybe someone out there will let you know. But I bet it won't be cheap.

The initial procedure (swallowing camera and fitting of the receiver and pads is a simple procedure) however, the downloading and interpretation of the film would require a cancer specialist.

This procedure would only pick up problems in the small bowel, a colonoscopy would be needed for the large bowel, as that requires the use of Picolax or similar to clear large bowel completely, whereas a capsuloscopy only requires 12 hours of fasting and no liquids, tablets or food for at least 5 hours after the camera is swallowed.

In my case, it was suspected I had cancer but it turned out to be Angiodysplasia, (google it) unfortunately it is virtually untreatable and definitely incurable but better than having cancer, so I'm not complaining as I've had that before.

In your case, it is bound to be more effective than an ultrasound test.

The beauty of this test (if available in BKK) is, it would only involve one day in BKK, pop the camera in at 8.30 am, go back at 4.30 pm to have the receiver removed and get results a few days later. You don't even have to stay in hospital whilst the test is running.

Edited May 31, 2010 by khundon

[Arkady]

I think general anaesthetic is a bit over the top for this procedure, as there is a risk involved in a general anaesthetic and the recovery time is not justified. However, it is rather uncomfortable, largely due to the air pumped into your bowels, and the best solution seems to be a tranquilizer which makes you doze off and on during the procedure and ;you don't notice much discomfort. I had the first one at BNH plus some biopsies and they advised an overnight stay and I think that was totally unnecessary but luckily my insurance picked up the massive B70k tab. The second time also at BNH I told them I would go home afterwards and this was quite OK an hour after the procedure, except of course it is inadvisable to drive yourself after the tranquilizer. I later had one in London without tranqulizer because I was due for surgery later that day and it was excruciating due to the air pumping. Finally my problem which BNH could not discover over two years of various tests was diagnosed within a few minutes of digital examination to be a very high anal fistula by a Harley St surgeon who operated a few days later. Now two years later all pain has gone. Thai hospitals have a lot of hi-tech equipment and staff but give me an experienced Harley St man any day of the week.

Definitely avoid having this procedure done at primitive hospitals in undeveloped countries. There is a slight risk of perforation of the intestines that can cause gangrene and a extremely painful death, if not repaired promptly. However, if the hospital and medical personnel are up to scratch the risk is less than the risk of not having your bowels checked for polyps or cancer every few years. Any polyps found is snipped or burned off during the procedure to ensure it will not turn cancerous.

Edited June 27, 2010 by Arkady