The colon, otherwise known as the large intestine is a important part of our digestive system. It is approximately 5 feet long in an adult. The colon is responsible for absorbing water, salt and some nutrients from the digested food, and what remains is fecal matter. This waste is stored in the last part of the colon, called the sigmoid colon and expelled through the anus via the rectum.
Colon cancer is quite common. Unfortunately, there are no statistics available for Grenada, but to give you an idea, colorectal cancer is the third leading cancer diagnosis in the United States, where there are approximately 97.000 new cases diagnosed annually.
One good thing is that cancer of the colon is practically preventable. Most cases of colon cancer start as clumps of precancerous cells, which can either be in the shape of a mushroom known as a polyp, or flat. If these cells are removed early enough, then full blown cancer will not develop.
Normally, it is recommended that people with average risk of colon cancer start to have screening tests for cancer at age 50. The usual screening test is called a colonoscopy. A specialist called a gastroenterologist inserts an instrument called an endoscope into the rectum and examines the entire colon from anus to caecum for signs of abnormalities on the mucosal surface of the colon.
Remember the colon is normally full of shit. In order to have a good test, you have to clean out the feces so that the doctor can see clearly. This is where my adventure began. I had to follow a strict 3 day regimen in order to clean out my colon completely so that the doctor would be able to visualize the mucosa clearly.
On the first day, I had to follow a low fiber diet, that did not sound too bad, until I read what a low fiber diet excluded; no whole wheat or multigrain products, no raw or dried fruits, no raw vegetables,no coconut, no nuts, no popcorn, no beans or peas. I am a lover of air popped popcorn. I especially enjoy eating this snack when I am watching a movie at home with my family. I really was wondering what on earth I would eat for the next 2 days! The permitted foods included white bread, white rice, pasta, meat, well cooked vegetables and canned fruit, fruit juice without pulp, cornflakes, yogurt and ice-cream.
One thing for sure is that we are definitely creatures of habit. It was easy to read what was allowed and disallowed, but it was another thing all together to follow the new diet. One vital thing that I did not see was chocolate, is it considered a low fiber food? I decided not to even check, but to voluntarily avoid it in a effort to cleanse my colon. While writing this blog post, however, I did check and for all of you who may need to follow a low fiber diet in the future, plain chocolate is considered a low fiber food!
I survived the 2 days of low fiber food, and increased water intake. It was quite a strange experience to eat all the foods I normally warn my patients to eliminate from their diets and to avoid the foods that I preach about eating regularly. I had to keep reminding myself that I was feeding myself these unhealthy foods for an ultimately good reason. I also did some research as to why it was advisable to eat low fiber foods in preparation for a colonoscopy , and found out that low fiber foods decrease the amount of feces produced in the large intestine, making cleaning out easier.
The next part was the least fun of this whole experience. On the second day of eating a low fiber diet, two hours after my last meal, I had to take one small bottle of phosphosoda. It is a saline laxative that tastes extremely salty, and purges you out within 40 to 60 minutes after drinking it. Immediately after drinking it, I had to drink 3 large glasses of water. I think I drank them too quickly, as I felt nauseous and bloated for almost one hour afterwards. Of course, the purge part was no fun, but thanks to the low fiber diet it was not too bad.
The next day, which was the day before the procedure, was the most difficult for me, because I was only allowed to have liquids. It was compounded by the fact that I was attending a medical conference and staying in a lovely hotel. When I went to breakfast to get tea and more tea, I had to pass by the heavenly smelling buffet. Every time I thought of eating food, I just drank more water and diluted apple juice. Luckily, I was allowed to suck on hard candy and so I was able to pop mints in my mouth intermittently. I was concerned about what I would be able to eat for lunch, and thankfully, the soup du jour was fish broth, so I helped myself to 2 large bowls of broth. I don't think I ate anything substantial for dinner as I knew that I had to have my second laxative. This time, I took the last bottle of phosphosoda earlier in the evening, and this time the purge was not as bad. I made sure to drink the water much slower afterwards, and this time I tolerated it much better.
I woke at 5 am the next day, showered, dressed and took a taxi to the hospital. I arrived at 6:30am and was registered and prepared to start my procedure at 8am. I was taken down by wheelchair, while dressed in my hospital cap and gown, to the procedure room. The last thing I remembered was the doctor telling me the names and amounts of the drugs she was injecting into my arm. I remember wondering if she did that for regular patients too, or was it just a courtesy for me as a physician, whom she knew may be wondering what was being injected into her veins.
The next thing I remember was feeling a gripe like pain in my lower abdomen and shifting myself to avoid the pain. In retrospect, I think I must have felt the endoscope being pulled around the corners on its way out of me. After that, I recall being wheeled back up to my room, where I was aroused and helped to slide off of the carrier and onto my bed. I felt woozy for quite some time afterwards.
The best part of this experience was that it was over and that I got a clean bill of colon health. There were no abnormalities seen and my doctor complimented me on my colon prep.
I guess in the name of health, all things can be tolerated.
Bottoms up to all my readers who are 50 or over who are due to have their own colons scoped!
Yours in health and wellness,