I have been away for a while due to a poor bowel prep for a required colonoscopy. Penn Med Transplant recipient team states that the colonoscopy has to be successful in the prep and needs to rule out colon cancer. I have a tortuous colon which interferes with the procedure to begin with. I visited Penn Med to see my team recently and found out that they very much want to put me on the deceased kidney list. I am repeating the colonoscopy on April 16 following a more intensive laxative regimen. I hope it works. I am on hemodialysis now and so far, my fistula is working, except that I needed to have an angioplasty due to 80 % blockage in the access. I am having it checked in early April 2025. I wonder if anyone else has experienced the problems with colonoscopy prep and requiring an angioplasty for their access. Thanks for your response.
Kidney transplant list: I have been away for... - Kidney Disease
Kidney transplant list
This is what I found after my own failure:
Repeat colonoscopy--Prep
PATIENTS AND INTERVENTION:
Outpatients with inadequate preparation at an index colonoscopy were offered a repeat colonoscopy and instructed to follow an intensive preparation regimen consisting of a low-fiber diet for 72 hours, liquid diet for 48 hours, bisacodyl (10 mg) in the evening of the day before the colonoscopy, and a split dose of polyethylene glycol (1.5 L in the evening before and 1.5 L in the morning on the day of the colonoscopy).
Low-fiber diet for 72 hours
TYPE OF FOOD OR DRINK OK TO EAT THESE FOODS
Milk and dairy
OK to eat:
• Milk
• Cream
• Hot chocolate
• Buttermilk
• Cheese, including cottage cheese
• Yogurt
• Sour cream •
Bread and grains
OK to eat:
• Breads and grains made with refined white flour (including rolls, muffins, bagels, pasta)
• White rice
• Plain crackers, such as Saltines
• Low-fiber cereal (including puffed rice, cream of wheat, corn flakes) •
Meat
OK to eat:
• Chicken
• Turkey
• Lamb
• Lean pork
• Veal
• Fish and seafood
• Eggs
• Tofu
Fruits
OK to eat:
• Fruit juice without pulp
• Applesauce
• Ripe cantaloupe and honeydew
• Ripe, peeled apricots and peaches
• Canned or cooked fruit without seeds or skin •
Vegetables
OK for some if cooked or canned:
• Canned or cooked vegetables without skin or peel (includes peeled carrots, mushrooms, turnips, asparagus tips)
• Potatoes without skin
• Cucumbers without seeds or peel •
Nuts, nut butter, seeds
OK to eat:
• Creamy (smooth) peanut or almond butter •
Fats and oils
OK to eat:
• Butter
• Margarine
• Vegetable and other oils
• Mayonnaise
• Salad dressings made without seeds or nuts
Soups
OK to eat:
• Broth, bouillon, consomme, and strained soups
• Milk or cream-based soup, strained •
Desserts
OK to eat:
• Custard
• Plain pudding
• Ice cream
• Sherbet or sorbet
• Jell-O or gelatin without added fruit or red or purple dye
• Cookies or cake made with white flour, prepared without seeds, dried fruit, or nuts •
Drinks or beverages
OK to eat:
• Coffee
• Tea
• Hot chocolate or cocoa
• Clear fruit drinks (no pulp)
• Soda and other carbonated beverages
• Ensure, Boost, or Enlive without added fiber •
Other
OK to eat:
• Sugar
• Salt
• Jelly
• Honey
• Syrup
• Lemon juice •
Legumes-- None allowed
Stop supplements: Herbal, vitamins and oral iron supplements
Start low-fiber diet meal plan Foods allowed five days before the procedure:
• Enriched white bread, pasta and noodles, white rice, potatoes without skin
• Canned or well-cooked vegetables without seeds or skin
• Canned fruit or fresh fruit without skin or membranes
• Tender meat, chicken or fish
Foods to avoid five days before the procedure:
• Any food containing seeds, nuts or popcorn
• Raw vegetables with a skin, seeds, corn, broccoli, cabbage, dried beans or peas
• Whole grain bread or pasta, brown or wild rice, cereal such as oatmeal, shredded wheat and granola
• Fruit with skins
• Tough meat with gristle l Fatty foods
Suggested meal plan:
• FRIDAY (Five days before colonoscopy):
o Breakfast: eggs, white toast, jam
o Lunch: turkey sandwich on white bread with avocados, baked potato chips
o Dinner: grilled chicken thighs, sautéed mushrooms, white rice cooked in mushroom broth
• SATURDAY (Four days before colonoscopy):
o Breakfast: Greek yogurt with bananas and honey topping
o Lunch: tuna with olive oil and lemon juice on sour dough bread, honeydew melon cubes
o Dinner: cedar plank wild salmon (no coloring), sautéed spinach with garlic, Israeli couscous
• SUNDAY (Three days before colonoscopy):
o Breakfast: half cantaloupe with Greek yogurt and honey topping
o Lunch: turkey sandwich on sour dough bread, honeydew melon cubes
o Dinner: Orecchiette white pasta with cream sauce
Clear-liquid diet for colonoscopy preparation
Two days before — and the day of — your colonoscopy, you will be on a clear-liquid diet. The chart shows examples of drinks you can include, and what to avoid. Starting the day before your screening, don't eat any solid food until after your colonoscopy.
• Water
• Tea and black coffee without any milk, cream, or lightener
• Flavored water without red or purple dye
• Clear, light colored juices such as apple, white grape, lemonade without pulp, and white cranberry
• Clear broth including chicken, beef, or vegetable
• Soda
• Sports drinks such as Gatorade and Propel (light colors only)
• Popsicles without fruit or cream; no red or purple dye
• Jello-O or other gelatin without fruit; no red or purple dye
• Boost Breeze Tropical Juice drink •
Two Days Before the Colonoscopy:
o Monday
Stop any anti-inflammatory medications l Do not take Motrin, Advil, Ibuprofen l You may take Tylenol and Celebrex
Confirm that you have a driver who will come with you to the appointment
Complete all medical forms
List all medications you are on
Find insurance cards
Prepare first and last names with address of all doctors you want to receive a copy of your procedure
Determine product for preparation and flavors you prefer
Determine what you will be wearing
Comfortable, loose fitting clothing
Easy to step into l Tennis or flat shoes
Do not wear jewelry, watches or bring valuables
One Day Before the Colonoscopy
o Tuesday
No solid food or alcohol
Liquids you must avoid:
Milk, shakes, smoothies l Juices: orange, grapefruit, prune (no red or purple juices)
Clear liquids you may consume:
(no red or purple flavors/colors)
Gatorade, Powerade, Kool Aide
Juice: apple, white grape
Soda: ginger ale, orange, diet cola, cola, Sprite, 7Up
Coffee or tea (no cream)
Jello, popsicles
Clear soup, beef broth, chicken broth, bouillon
Hydrate: (once awake)
Drink eight ounces of Gatorade without prep product every hour while awake
Medications: (3:00 p.m.)
Make sure you take the prescribed medications one hour prior to drinking prep solutions so they can absorb Bowel Preparation:
My husband also has a "torturous colon". He was on peritoneal dialysis at the time and, like you, needed a colonoscopy to get on the transplant list. (He was 70 yrs old then and had to get it done during the pandemic when very few doctors were performing them.) My husband, who is never constipated, took the "golytely prep", managed to complete most of it, and presented "clean" on the table. We then learned, for the first time, that he had a "torturous colon" and, hence, the colonoscopy was incomplete, leaving a good portion unexamined. Upsetting news. His gastroenterologist doubted another colonoscopy would fix the matter, his scope would only get blocked again. So, the decision was made to use the Cologuard Kit - the one you mail in - to complete the colon evaluation. That result came in fine. The doctor then quickly completed and sent in his evaluation using information from both sources - the scope and the kit. Our transplant center accepted it, no questions asked. A few months later, we double-listed at another transplant center and it also accepted that evaluation. And, to our great surprise, my husband received his gift - a deceased donor kidney with a few issues - soon thereafter. It's performing well - almost 4 years later. If this is similar to your situation, this approach may work for you too - combining the kit and the colonoscopy. Where there's a will, there's a way. Sending you encouragement!
Thanks for your reply and congratulations on your husband's finding a kidney. Unfortunately, I have adenomas, which must be removed. Cologuard warns not to use it if one has adenomas.
My husband actually had an adenoma that was removed in the portion of his colon that the scope could see and access. We don't knows if there were others. In view that, it's interesting the two centers accepted the scope/cologuard evaluation. CKD-4 mentions getting around the torturous colon problem using a CT scan - see below. That might be an alternative solution, but that wouldn't be able to remove polyps either. I'll cross my fingers that that another colonoscopy will be successful for you. I'd truly love to see you get a transplant.
I like Darlenia's answer the best about taking the cologard test after the incomplete colonoscopy. With a tortuous colon, it may be impossible to get the instrument around all the bends. As for the angioplasty, I've had several and you will be under sedation during the procedure, so you won't feel it. It's best to get it done asap so the fistula doesn't completely block. I've had that kind, too, which required me to have a in chest catheter temporarily. I would suggest talking to the anesthesiologist before they do it so you can explain if you have any problems with anesthesia side effects. I have nausea and vomiting afterwards, so I insist they use Zofran in the IV line. They usually use Propofol on me for sedation. Good luck on both!
I am checking the success of the angioplasty in maintaining patency, the opening of the vessel and lack of blocking. That will occur April 3, 2025. The vascular surgeon used fentanyl as the anesthetic. I did not ask if it came from Canada or Mexico-hah hah. I appreciate your kind thoughts.
Once, I had a different vascular surgeon who did put in a stent in the upper part of my fistula which would repeatedly block. That worked very well. I began to think of balloon angioplasties as necessary routine maintenance for my fistula. I would have at least one per year for the four years I was on hemodialysis before I got my transplant.
Hi. I had the same problem and ended up having a CT colonoscopy.
Kidney transplant recipient 
The Kidney Project
Kidney Transplant
