Colonoscopy Prep and Heart Arrhythmia

Good morning all!

I am from the U.S. and read all the posts on here, though I rarely post myself. Everyone on here is aways so helpful and I have learned so much from all of you! I have had IBS for many, many years, but it has gotten much worse over the past 3 or so years. Gastro started me on Linzess and that has helped, as has keeping a diary of trigger foods (I eat plant based diet, so I'm already a bit limited, and that is frustrating!). But I do feel I'm making at least a little headway.

Here is the current issue that is most worrisome to me, however. She wants me to have a colonoscopy (in 2 weeks!) and has prescribed a drug called SuTab as the laxative to be used during the prep. It is pills that you take in two rounds, one the afternoon before and one in the wee hours the morning of your procedure. I have a heart arrhythmia/AFib, and I fear this will be too much for me, especially with not being able to eat during all that time (well, clear broth, jello, and popcycles notwithstanding I guess).

I also have some issues with hypoglycemia, so to me, this seems really scary and l worry that it will have massive effect on my palpitations and then set me into a panic. Am I just being a baby, or have any of you experienced issues from this?

Thank you in advance for your feedback!

[b1b1b1]

I have the same concerns as you, so I hope people will post some thoughts about this question. I am also due for a colonoscopy and have premature ventricular contractions, IBS, and blood sugar issues. The only thought I have is to go over all the issues carefully with your gastroenterologist.

[Hidden in reply to b1b1b1]

Thank you b1b1b1 ! I also have PVCs and SVTs, so yes, it is concerning! I have only seen the physician's assistant so far, never an "actual" gastro, though he will be the one to administer the colonoscopy the day of the procedure. The PA seemed completely unconcerned when I brought this up to her, but I do think I might send a message to my cardiologist to see if I can get a response back from him on it. I hope you will be able to get some answers too!! It shouldn't be this hard.

[b1b1b1 in reply to Hidden]

Good idea to talk to the cardiologist. I will do the same.

[Hidden in reply to b1b1b1]

Awesome! Let me know what you find out from yours if you can please! I called the office and found out my doctor is out of the office this week. But I now have a phone consult set for next week with him so I will let you know what I find out too! Also, hopefully some others on here will have some experiences to share...

[b1b1b1 in reply to Hidden]

I will not see my cardiologist until mid-February, but I will let you know then. My colonoscopy has not yet been scheduled but will probably be around March. x

[Hidden in reply to b1b1b1]

Oh, ok, no problem. My procedure is the 25th (of Jan) so too late for that, but it would be interesting to see how different (or not?) the answers will be from our cardiologists. I'll let you know what I am told. At least it's further out than I was first thinking - I had it in my mind that it was in 2 weeks! I have a little more time to prepare myself for it. Whew!

[xjrs]

In terms of the hypoglycemia, you could explain this and ask for the very first appointment of the morning and that you need something to eat as soon as the procedure is over. I think they give you something afterwards anyway.

I suffered from hypoglycemia for years. From a baby I was brought up on evaporated milk started by the hospital, which is loaded with sugar and a complete no no for babies. I became addicted to sugar and suffered badly from hypoglycemia as a child and a young adult. This lead to panic attacks like the ones you mention due to blood sugar dropping. Mid twenties I discovered the concept of the glycemic index (GI) of foods and tried to eat low GI from then onwards. It helped the hypoglycemia by eating complex/slow release carbohydrates, protein and healthy fats, which help to keep the blood sugar stable. This means that I can now go for much longer without food.

When eating high GI, processed foods (like white flour products) and high sugar foods, these don't exist in nature and your body thinks that you are eating a massive meal. It then pumps huge amounts of insulin into the blood stream. Initially you get the energy hit, but eventually the extra insulin eats this up and more, reducing the glucose content on the blood resulting in hypoglycemia and an energy crash. The symptoms can be a racing heart, nausea and a feeling of panic and dizziness since your brain isn't getting enough glucose. You might know all of this, but thought I'd mention it anyway.

Just to let you know that I had a colonoscopy many years ago when I hadn't yet recovered from the hypoglycemia, had an early appointment and I was fine. Good luck.

[Hidden in reply to xjrs]

Thank you!! I didn't think about asking for the first appointment but as it happens, I think I am may have gotten the first one anyway. It's a 7:45 arrival with procedure at 8:30 so if it's not the first it's pretty darn close. I think my hypoglycemia is something genetic. This is weird; both my brother and I, who are 5 years apart in age, were diagnosed with it when we turned 25. I'm 62 now so been dealing with it for quite a while now. Been a vegetarian since high school and plant based for about 5 years, so I don't eat a lot of sugar. I agree with everything you said and I do stick with whole grains stay away from refined/processed - anything! It definitely does help. It's a journey though, isn't it?

[xjrs in reply to Hidden]

Absolutely.

The appointment time sounds good for you. Good luck with it.

[Hidden in reply to xjrs]

Thank you!!

[meadfoot]

You are mirroring my experience. I too have Afib, SVT, PACs and PVCs plus heart pauses and lots of ectopic beats. I also have IBS, acid reflux slow gastric emptying and failed gastric peristalsis.

Nine weeks ago I had a colonoscopy and had the same concerns as you. Its not the first colonoscopy I have had while being a cardiac arrhythmia patient. The good news is that I havent had any big over concerning issues arrhythmia wise while taking the prep or from the stress of the anticipation or during the colonoscopy which to me is amazing given that I can flop into arrhythmia anytime anywhere without any seeming stressful or clear trigger.

Here is what I did to try to mitigate the issue during the prep and pre procedure. It seemed to work for me. (Initially the colonoscopy nurse specialist booked me into hospital the night before in order to take the prep under medical supervision due to my arrhythmia history, a bit over the top I thought, but in the event there wasnt any beds free so I took the prep at home as I had done before).

I ensured I was well hydrated the day of the prep which is key when having rhythm issues generally. I followed a strict diet given by the hospital in the run up to the colonoscopy. I armed myself with a variety of warm drinks not just water which I usually only drink, all of which were allowed according to the literature given to me. That way I managed to stay hydrated and keep the relevant electrolytes in balance which is a biggy for triggering arrhythmia especially while taking bowel prep as we are loosing them at a rate of knots with all the trips to the loo. I tried to keep myself calm and do deep breathing and mindfulness, not easy when flying to the loo every few minutes, but somehow I managed to keep on an even keel.

I took advantage of sedation at the hospital, no point in not doing and allowing arrhythmia to raise it head through stress, I also took advantage of gas and air. All was calm on the heart front. All was well. I wish you good luck for the procedure and outcome. Incidently I am convinced that my gastric and cardiac issues are interlinked in my case as my gastric issues can tip me into arrhythmia whenever gut plays up.

Are you on blood thinners due to your arrhythmia. I had to stop them in advance of the colonoscopy. My cardiologist was quite sanguine about the whole thing.

[Hidden in reply to meadfoot]

Thank you so much for your reply and this information, it is so helpful and reassuring!! May I ask though, when you say you "armed yourself with a variety of warm drinks", are you talking about coffee and tea I assume? I probably would have just drunk water and possibly gatorade (or other ectrolyte replacement drink) is why I ask. I hadn't thought about warm drinks being an important part to help in this, but perhaps the warmth does do something that helps with the gut, which we all know is connected with everything!! And maybe that works to calm things? I shall definitely give it a try! My SuTab says to give it under monitored administration (in a hospital/clinic setting) for people with arrythmias and that's why I was concerned, especially since the PA at the gastro was treating my concerns like she'd never heard of them before. It's good to know others have at least had the same concerns, but especially good to know they've been able to get through it all without issue! Thanks again for sharing your experiencing. Oh, and no, not on blood thinners, just the channel blocker (flecainide).

[meadfoot in reply to Hidden]

Ah good old flecainide, that should really help keep things calm. Its been my saviour over the years. I cant drink tea or coffee due to my arrhythmias and just dont fancy decaf stuff. My drink of choice is hot water generally but my bowel prep said not just water with it. I guess thats because there wasn't any electrolyte value as such in just water. I had vegetarian type oxo cube, do you have that in USA, tasty, warm and full of goodness. I also tried some clear fruit juice. I drank a fair amount of liquid to ensure not getting dehydrated. I found the warm drinks comforting.

I think I would call again about the prep. I am amazed about the different advice we get from medical people and their associates who dont often know the ins and outs of either our concerns or the meds given. Better safe than sorry. I wish you all the very best. I have no doubt you will be fine. Please let us know how you get on.

[Hidden in reply to meadfoot]

Good to know the flecainide will be helpful!! It really has made a huge difference for me. I have been on atenolol, sotolol and a couple other meds and this is the most beneficial for me by far. I'd never heard of OXO cubes so I looked them up. They are a European thing, but I can order them on Amazon. People are saying they do take some time to get here. Not sure if it would be as good but we have a similar product here that we use for vegetarian stock that I could try. Have some in the cupboard right now in fact. I've just never drank it by the cup - only used it for cooking. But I guess it's a soup too, right? Great idea, thank you!! I know what you mean, I'm stuck with decaf coffees and herbal teas, and it's hard to find ones I like. Teas are a bit easier but with decaf coffees I have to drink what my husband calls "fru fru coffees", because they have to have other things in them like almond milk and maybe a sugar free flavored syrup or maybe blended (frozen) into a frappachino (if you have those there, Starbucks?). I only drink those as a treat, but sometimes you gotta do what you gotta do, haha! Anyway, couldn't do that during the prep, so coffee is out. I will maybe drink some herbal tea and definitely the vegetable stock, and I can get some white apple juice or something too. THANK YOU! These are great ideas!

I too am flummoxed about the advice we are given from the medical community. I don't understand why it can't be more clear and concise, and why everyone doesn't seem to agree on anything, or why no one seems concerned about things WE are concerned about or takes our concerns seriously. But honestly I don't see that changing anytime soon. That's why I'm so grateful for sites like this where we can all talk to each other and find help and support this way. Thank you so much!

[meadfoot in reply to Hidden]

I am on atenolol too. Together with flecainide they have saved my heart and my sanity.

Bovril is another thing to consider to drink if you can get it instead if oxo.

I like the sound of your inventive coffee drinks. Wishing you a very happy healthy new year from up here in the glorious but frozen north of England.

[Hidden in reply to meadfoot]

Thank you, I will look into Bovril as well! 😘Wishing you a very happy and healthy New Year as well, from Indiana where we are just melting down after a blizzard over Christmas, lol. Literally, we went from 12" of snow over 2-3 days with gale force blizzard winds to nearly 50 degrees today. Mother Nature, SMH. Stay warm up there!

[meadfoot in reply to Hidden]

Thank you. Your weather does sound strange currently. Just want the seasons to do what they are meant to do, a bit like our gut lol. Keep safe.

[Hidden in reply to meadfoot]

LOL, too true!

[behj]

does your doc not use the conventional prep liquid? I have to prep for 2 or 3 days tho still use the liquid . You might ask him or her if the liquid is safer for you, best of luck beh

[Hidden in reply to behj]

I asked about the liquid when she prescribed the SuTab and she said they "have gone to this now because it's easier". Not sure who it's easier on or why, perhaps I should have pressed that issue further. Hmmm...

[eliz45]

Hi. I am 77 and am in the US also and have A-fib also. I usually take Xeralto for the A-fib. Last year I worked with a gastro and she scheduled a colonoscopy prepping with SuPrep, which is a liquid. You drink two bottles of it. So the late afternoon of the prep, I followed the directions and drank the prep. By 8:30 I was having extreme palpitations and did not know how i would be able to drink the other bottle. So I called the doctor's answering service and talked to the doctor on call. He said this happens a lot since you are changing the electrolyte balance in your system and also dehydrating yourself. He told me I could not have the procedure the next day because I would not be able to complete the drinks and if I showed up at the surgery center and they saw one strange heartbeat they would immediately stop anyways. I could not figure out how I would ever be able to have a colonoscopy. He told me that I could schedule it again, but this time start taking Metoprolol (blood pressure med) 3-4 days before the appt to slow my heart down. And I suggested to the doctor that perhaps there was another prep which would be easier for me to tolerate. She agreed and i went the next time and had no problems. So I guess I think maybe these pills might be better in the sense that you wont be drinking down tons of electrolyes that throw off your balance. And taking a blood pressure med for a few days before slowed my heart so I did not go into A-fib. You could possibly do that. The downside is that the blood pressure medication makes me pretty much useless, ready to go to bed all day. But it got the job done. I hope this is of some help.

[Hidden in reply to eliz45]

My goodness, how scary!! I'm SO sorry you had to go through this! But I'm glad you called and got help, and that they were able to figure a work-around so you could retry it. Honestly, after what you went through, I'm not sure I would be brave enough to try again! lol I am definitely talking to my cardiologist next week to see what he thinks about it all, and I'll be sure to mention to him the possibility of adding a blood pressure medication a few days prior. Being useless for a few days I can handle...going into AFib, not so much! 😆Thanks so much for sharing this, it really is helpful!

[eliz45]

I just reread your post and saw that it said that the pills need to be taken under supervision in a hospital /clinic since you have A-fib.. I would check with my doctor or PA before just taking them at home alone. This stuff can be so frustrating. Good luck.

[Hidden in reply to eliz45]

Frustrating indeed! Thank you, I'm definitely checking with my doctor. I'm quite concerned about the whole situation, even if the PA at the gastro office isn't.

[eliz45]

I have one PA who is great and one who should not be in medicine. You do need to be your own advocate.

[Hidden in reply to eliz45]

eliz45 I could not agree more!!

[annenic]

Morning from Scotland and Happy New Year to you. I have A.Fib and have had 2 colonoscopies without any problem. It's a good way of learning what's actually going on in there to cause all your problems. They found out on my first one I had Microscopic Colitis and on my 2nd one a few years later that I had diverticular disease. Hope this helps x

[Hidden in reply to annenic]

Hi annenic ! Thanks for your reply! Well I'm glad they were able to give you some answers as to what's going on with your gastric issues. Information is power, right? I hope I will be able to learn something. It's even better hearing that you were able to have TWO colonoscopies with no issues from your AFib! That truly gives me hope and some relief that I can do this! Thank you for the info and encouragement and a Happy New Year to you!