Colonoscopy prep and low weight - anyone?

[Chaucer89]

Hello folks,

So I’m going to be having a colonoscopy at some point soon (still on waiting list) because of an enlarged liver, high calprotectin and IBD symptoms. I am extremely underweight at 43kg (I’m 5’4”) and extremely nervous about doing the prep for the procedure. My consultant muttered something about how they do things a bit differently for patients under 40kg of weight and I’m wondering if that has applied to anyone on here or if you know someone it does. I’m curious if it means you don’t take as much prep or they do it a different way entirely etc so we don’t risk losing more weight. I feel like I want to know now before I keep building it up in my head waiting for the call.

I’m worried about just instantly throwing up the prep as I both have severe emetaphobia and I’m chronically nauseous (double whammy) and I’ve heard the mixture is revolting and bowel movements make me nauseous anyway never mind constant diarrhoea for hours and not eating. I’m restricted due to a heart condition on taking strong anti emetics and my liver can’t handle sugar well so drinking lots of sugary drinks and eating jelly babies all day isn’t going to be successful either. I’m also concerned about fainting as I’m very much not good without food considering I have no reserves at all (I did a very dramatic faint in the waiting room for my endoscopy and would like to avoid a repeat!). My GP discussed the option of doing the prep inpatient but doing all that stuck on an open gastro ward with an IV in sounds even more hell. At least at home I can just lay on the floor or my bed in between.

I also wanted to see if anyone’s done the prep using just pills rather than the liquid? I feel like I would tolerate this more but not sure if it’s a thing in the U.K. if anyone from the U.K. in particular sees this I’d love to know your experience, seems to differ worldwide.

Very aware I’m likely hugely building this up in my head but I have childhood related medical ptsd so I really struggle with not knowing what to expect so any reassurance would be greatly appreciated, TIA

[BabsyWabsy]

Hi Chaucer89, I had heard horror stories too. Like you, I cannot handle very much sugar. The prep was tedious, but not as bad as I expected. I am pretty sure it is made with artificial sweeteners. Stay hydrated too. Which sounds counterintuitive when you are drinking that volume of prep, but it is very important. Could you ask your GP or Consultant if there is an alternative method of prep? I found nappy cream quite helpful to counteract soreness.

[Chaucer89 in reply to BabsyWabsy]

Im told that when they book me in I can talk to nurse on the phone about my concerns and I’m really hoping they have multiple alternatives they can do like the tablets only and lots of water but I definitely don’t want to risk bad prep and having to do it all over again so reluctantly willing to be pretty miserable for 24 hours if I need to be..going to have to practice drinking enough water as with my nausea I’m rubbish with enough hydration standard nevermind like this. Nothing like drinking lots of water on top of an upset stomach. Thank you for replying 🙂

[Superzob]

I’m 20kg underweight for my height and was worried about losing too much with the prep, but the effect (3kg) was short-lived and I regained my “normal” weight very quickly. The main issue was, although I was hydrated, I didn’t take enough sugar afterwards; drinking too much water without accompanying salts tends to dilute the blood. If you’re worried about sugar intake I don’t think you need much; Diarolyte is quite acceptable and, if you can eat normally after the procedure, then that would be even better!

[Chaucer89 in reply to Superzob]

Gosh 3kg 😬 my issue is I can lose weight like no one’s business but it’s impossible to put it back on so I’m worried as im already having to fight off hospital admissions thanks to my weight but will have to just try extra hard to get some good caloried food in me now and after and hope my body will be kind to me. Definitely will look into diarolyte and thinking trying luzocade. I just need to get to the hospital and to the procedure room without falling flat on my face! Thank you for replying 🙂

[Superzob in reply to Chaucer89]

I was advised Lucozade Sport because it’s an isotonic liquid and has the salts you need. I was hesitant to suggest it initially because of your comment about sugar, but you might tolerate it better than the original Lucozade, which is pure glucose

[Chaucer89 in reply to Superzob]

Thank you very much, I’ll try them out before I do this so I know what I can tolerate. I’m already liking that it seems there is a non fizzy version.

[seas002]

Hello, this is a more general response about taking the preparation. Think about eating a very bland diet for 2-3 days before you take the meds. Mashed potato, white fish, white bread, chicken soup, basically low fibre. If you are able to eat fruit stick to easy to digest fruit like bananas and peeled apples so your body doesn't have to deal with skin or pips. On the day you take the meds put the water you'll need to mix up the preparation in the fridge as early as possible. Drinking it cold helps. I use a straw to get as much of it down as I can without alerting the taste buds! Try not to overthink it, if the people telling you about the meds took theirs more than 5 years ago they wouldn't recognize today's mixture, much less harsh in both taste and effect. As others have told you it's vital to stay hydrated, I tend to drink herbal tea and stay away from normal tea or coffee. Consider getting an audiobook and a nice scented candle so you can stay on the loo for a while and be entertained. Finally think about how great it will be to get some answers once your colonoscopy has been completed!

[Chaucer89 in reply to seas002]

Thank you for sharing your experience with me 🙂 Yes I’m trying to remember it could be worth doing it long term if they find something that can be treated. Though my brains focusing more on what if I do all this and they find nothing! But that’s very typical of my brain.

I definitely plan to do bland meals for few days before to make this easier on me, I can find enough to eat I think. I believe I can have my complan supplement drinks so I will use those to keep calories up. From what I’ve been seeing from others seems having a chaser drink helps get it down too so I’ll get straws, some strong lemon or apple juice I think and hold my nose, I’m so sensitive to tastes. I bet it’ll not be nearly as bad as I think it is, like most procedures I’ve done but the waiting list is making me go a bit stir crazy in overthinking! 🫣

[1Unicorn]

As a possible solution to general anxiety with taking the medications and emptaphobia > me too] look up EFT tapping therapy. I've recommended to others. It's free ( youtu.be videos) non-invasive and can be used for all manner of purposes. Basically it's a grounding and affirmation technique. Works for me.

[Chaucer89 in reply to 1Unicorn]

I’ve heard about this in the past, I’ll have to look it up again, willing to try most things for any relief from my anxiety, thank you 🙂

[MyStar86]

Unfortunately they don’t do it differently as I’ve been around 40kg and below for many many years due to bowel issues and I’m 5ft 6in so my bmi is very low. I have supplement drinks like fortisip and ensure etc to help prevent further weight loss. However I’ve done bowel prep hundreds of times and they still make me do the same prep as every one else but the most effective is moviprep it isn’t nice but I’ve gotten so used to it I’ve even done it whilst on a train to London before as I know how and when it kicks in for me. It does involve a lot of liquid but it’s the best and causes me the least issues and provides the cleanest bowel. There are tablets but they are not as effective and lots of people have to repeat due to ineffective bowel prep. Last time I had to do Picolax which was the worst experience of my life rhe cramping was horrific so I would never touch that again but moviprep isn’t that bad and you can ask your gp for anti sickness pills to take in advance and you have to take those at least an hour before starting the bowel prep to ensure you absorb them.

Definitely follow the white diet before hand and maybe ask your gp if you can be prescribed some supplement shakes as it sound like you need to build up and ok supposed you haven’t been referred to a dietitian if you are that low a weight as the doctors and anyone I see is all over my low bmi. I had surgery a couple of weeks ago and they nearly didn’t go ahead due to my weight but as I had only had surgery 4 months ago and didn’t die they decided it was ok to go ahead thankfully but I had to do bowel prep for that as well and again it wasn’t made any different for my low bmi.

Good luck but definitely do it properly or you will have to repeat xx

[Chaucer89 in reply to MyStar86]

I’ve had that moment with the surgery yes or no too, not fun. It does seem to come to the point where you just have to take the risks if it means making the life you have now more tolerable.

thank you for all this, really helpful to hear from someone in similar situation. I did think it was going to be hopeful thinking that there would be an easier way to do this but yeh I think I’m having to accept it’ll be the standard prep and get through it. I’m definitely thinking moviprep is the best one from all I’ve seen.

I’ve got complans already as supplements so can do those as meals aswell as the white foods plan and I’m seeing dietician again next week so can see if they can recommend anything aswell, my GP who is thankfully absolutely marvellous, is very much on guard with regards to my weight as it’s been affecting my heart so im being monitored very closely. She’s worried about me doing this as when I lose weight I really struggle to put it back on no matter what I do but if we find anything it could help me long term gut wise, will be worth doing.

thank you again ☺️

[Gianaa in reply to MyStar86]

Hi what kind of surgery did you have to do? What did they find with your bowels? Have to do a colonoscopy too and I am super small. Suprep is what my gi dr suggested have you had that one before? Thanks for answering

[Luisa22]

Hello Chaucer 89. I have never had to do a colonoscopy so far but feel for you in this situation as I am low weight too, and get skinnier if I just miss a proper dinner for one day! So long as I eat at regular times, I maintain my same weight.

But from what I have picked up(mostly on this forum) I .think there's a prep which is a much smaller amount to drink (200ml or something??) Unfortunately I can't remember what it's called. Hopefully someone who does may have some input here.

Tablets sound like an even better idea.

But I imagine you would also need to continually drink some fluids containg electrolytes through the prep. Mainly because the powerful laxative effect could leave you dehydrated and low on electrolytes, and that in itself can cause nasty symptoms and even faintness.

Is there an option of asking your doctor for some less brutal prep ideas?

[Chaucer89 in reply to Luisa22]

I’m definitely going to ask which is the less gross/painful/brutal. I really don’t want to lose too much weight with this, being this low is already exhausting. Like you I lose it quick and don’t gain. There seems to be wildly different preps, from drinking one drink to drinking an entire large jug full! I find it difficult to drink generally anyway so it’s going to be quite a mind over matter experience to get it all down, water included. I’m going to go with lucozade for electrolytes and sugar. One day I’m going to stop over thinking this and that will likely be the moment the procedures done! 🫣

Thank you for replying ☺️