Colonoscopy after Esophagectomy

bingbing2009 said:

Colonoscopy
I had a colonoscopy last June, a little over 2 years after my esophagectomy. My GI doc had me do a 2-day prep, so I didn't have to drink the gallon of prep. I had 2 small bottles of magnesium citrate and took several Dulcolax tablets over the 2 days. It wasn't bad at all. It worked for me.

Melinda

DX October 2009: T3N1M0
November and December 2009: chemo (Cisplatin and 5 FU) and radiation
February 2010: Ivor Lewis surgery

FlorenceNightingale911 said:

JoAnn~Did U know there R alternatives~Mayo has one w/only pills!
Dear JoAnn:

Offhand, my first remark would be, “Surely your doctor jests?” Not being a medical person, but having consumed a gallon of “Golytely” in preparation for a colonoscopy recently myself, it is no easy task. As a matter of fact, had I researched different methods of prepping for a colonoscopy earlier, I would have chosen one of the alternative methods mentioned in this discussion.

Betcha’ if your doctor had to run a gallon of “Golytely” through his/her J-tube, and spend hours sitting on the commode, they would probably choose an option of only taking 2 litres (64 oz.) instead of the 128 oz. as called for in the Golytely prep.

I have read that the main difference is the cost difference. Believe me, I would opt to pay more to be able to drink less, or even better, no drink and all pills. (See the options I have read about only since pondering your question. As usual, not claiming to be a doctor, so consult your physician for any of the information mentioned here.)

Personally, I don’t think trying to run a gallon of the liquid through your J-tube would work best for you. You must remember that the preparation will begin to accomplish its designated purpose of emptying your colon long before you finish the “jug!” In other words, it will be difficult to be in the bathroom and being in the process of letting the liquid drip through your J-tube simultaneously. I’ve never heard of running a gallon of Golytely through one’s J-tube before. Wonder if you called the makers of that product and asked that question about putting it in your J-tube, what they might say. It wouldn't hurt to ask. Did someone with a medical degree tell you that it would be no problem to run the gallon of Golytely through the J-tube?

Remember the Golytely instructions are for drinking 64 ounces (1/2 gallon) at 15-min. intervals, till half the jug is consumed, together with being on a clear liquid diet. THEN the SECOND HALF GALLON is to be consumed just a few hours later. The solution must be used in 24 hours. Golytely instructions say to consume lots of liquid, preferably water in addition to the gallon of “Golytely”. That’s a tall order for one who has had an Esophagectomy.


Because of limited oral intake capacity of Esophageal Cancer patients who have had surgery, it would seem that Melinda’s doctor has the better option. If I were you, I would be calling my doctor now and inquiring about a “second option.”

Had I known about either of the two options listed below prior to my last “Golytely” experience, I would have opted for either of them. The Mayo Clinic has developed a new way of prepping for a colonoscopy without having to drink a gallon of liquid. It seems that there is something called a “Virtual Colonoscopy”, and there is no drinking involved. (See the link listed)

At the least, according to the doctor who wrote the “Colonoscopy Chronicles” blogspot listed below, the liquid prep can be reduced to half.

JoAnn, normally I would sign my name as “Flo”, but in this instance I will use my whole name. Hope you can arrange for an alternative and avoid the “Golytely gallon gig.” In the end, I hope everything comes out clean!

Sincerely,
Florence Nightingale911
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P.S. Here is the web link for the instructions for the “GOLYTELY PREPARATION.” (When I picked up my prescription for “Golytely”, it was a gallon jug with a powder substance in the bottom. It was to be mixed with one gallon of water! The instructions give explicit examples of medicines that should be avoided within a certain period of time prior to the Colonoscopy. Perhaps you have those instructions, but this is the “pdf” file my Gastroenterologist had me to print off the web.


• http://dlds.org/images/uploads/Golytely-Prep-06-12.pdf

A portion of that reads: “…DAY BEFORE YOUR PROCEDURE

AT 12:00 p.m. on the day of your clear liquid diet, reconstitute the Golytely powder with luke warm water. Shake several times to ensure ingredients are dissolved. Place in the refrigerator to chill prior to drinking. The solution must be used within 24 hours.

AT 4:00 P.M. begin drinking 8 oz of the solution every 15 minutes until you drink ½ of the solution. Place the solution back in the refrigerator to chill. Continue your clear liquid diet.

DAY OF YOUR PROCEDURE

5 hours prior to your scheduled arrival time begin drinking 8 oz of the solution every 15 minutes until it is finished. You must finish the entire remaining amount. Continue your clear liquid diet until 2 hours prior to your procedure. Nothing by mouth 2 hours prior to your procedure. This includes gum and hard candy. . . .”

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• http://www.everydayhealth.com/digestive-health/for-virtual-colonoscopy-you-can-lose-the-liquid-laxative.aspx

“For Virtual Colonoscopy, You Can Lose the Liquid Laxative ” - New Mayo Clinic protocol makes virtual colonoscopy prep easier to swallow, replacing liters of laxatives with four pills.”
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• http://colonoscopychronicles.blogspot.com/2007/12/laxative-cleanout-for-colonoscopy.html


Excerpt from above site:

“ . . .I’ll briefly review some of the PEG solutions available. The original PEG preps consisted of a four liter solution(almost 1 gallon). There are several of these that are still available, and are in common use today. These include: Golytely, Colyte, and NuLytely. The main advantage of the 4 liter solutions is price:they are about half the price of the 2 liter solutions. These cost in the $25-30 range.

Due to the fact that many people have trouble consuming 4 liters of a PEG solution over 4 hours, lower volume PEG solutions were developed. These include HalfLytely and MoviPrep.

The HalfLytley involved taking two laxative pills followed by 2 liters of PEG solution.

The MoviPrep consists of a one liter solution of PEG which is repeated as few hours later. The main disadvantage of these preps is the pricing, which is in the $50-60 range. . .”