Colonoscopy Preparation and Post-Procedure Concerns

Thank you for the doctor's response. I have some additional questions related to colonoscopy that I would like to ask. Thank you?

The previous issue was: On Friday, April 7th, around 5 AM, I felt some discomfort in my stomach, so I went to the restroom.
My bowel movements were normal, and I thought I could go back to sleep after that.
However, my stomach still felt uncomfortable, but it seemed to improve a bit after the bowel movement.
Around 6:30 AM, I suddenly felt the urge to go again, and this time it was diarrhea, but there was blood in it, which scared me because I had never experienced this before! I quickly went to the hospital to seek assistance.
I registered with the colorectal department, and the doctor performed a physical examination on the spot, confirming that there was indeed bleeding.
They scheduled a colonoscopy for a week later.
The doctor prescribed me an ointment, a 7-day suppository, and laxatives for the colonoscopy preparation.
After the visit, I felt much better.
In fact, on the way to the hospital and even after the visit, my stomach discomfort had subsided, and there was no pain, but I still had occasional urges to go, and each time I did, there was blood, mostly in watery diarrhea, but not much volume.
I was really scared.
I wanted to ask the doctor if it was okay to go to the restroom at home if I felt the urge, even if there was blood.
Also, are there any dietary restrictions I should be aware of? Additionally, I’ve seen many people mention the term "massive bleeding"; what does that mean? I’m not sure if my bleeding is considered severe or mild.
Thank you, doctor.
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The doctor's response was: Ans: In this situation, the likelihood of hemorrhoidal bleeding is higher.
As long as there is no further bleeding, it should be fine.
I recommend avoiding constipation during this period and minimizing the time spent on the toilet.
If you feel the urge, you can go; holding it in is not advisable.
Your diet should be light, with plenty of fruits and vegetables.
Warm sitz baths may also help alleviate symptoms.
You can purchase hemorrhoidal suppositories at the pharmacy.
It’s best not to take laxatives indiscriminately.
If bleeding persists, it’s advisable to consult a doctor.
As for what constitutes massive bleeding, it is generally considered significant if there is a large amount of bright red blood in the toilet that is opaque.
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I have some follow-up questions: Since the day I went to the hospital on April 7th until now, April 10th, my diarrhea has improved significantly, and my bowel movements have started to normalize, occurring once a day in the morning! It might be because I haven't eaten much, so the volume is low, but there is still some blood.
However, compared to the first day, it is getting better! (Is it normal to still have some blood?) Additionally, sometimes I feel a bit lightheaded and have a slight feverish sensation, but it doesn’t affect my daily activities.
Could these feelings be due to recovery? Regarding the colonoscopy, I have some specific questions I’d like to ask the doctor: (I am scheduled for the procedure on Friday, the 14th, in the afternoon.) 1.
Should I take the laxative at 6 AM on the day of the exam or the night before? Also, should I mix the powder with water and drink more than 2500 CC of water directly, or follow the instructions on the form to drink a certain proportion of water every 10-15 minutes? 2.
The laxative should only be mixed with water and not with other beverages, right? 3.
On the day of the exam, can I eat anything at all? Can I drink water? I have quite a few follow-up questions, and I may need to trouble Dr.
Ke for assistance in answering them.
Thank you very much!

ben, 30~39 year old female. Ask Date: 2017/04/10

Dr. Ke Fangxu reply Surgery

Since the bleeding from the hemorrhoids has improved, it is generally considered not a major issue.
Regarding the dizziness and fever, I am afraid I cannot provide professional advice as it is outside my area of expertise.

As for the colonoscopy preparation: it is better to drink in the afternoon to avoid drinking too late and affecting your sleep.
It is generally recommended to finish drinking within 2-4 hours.
I believe you cannot drink 2500cc of the laxative all at once.
You can mix it with clear liquids like sports drinks or pulp-free juices.
If anesthesia is involved, you really cannot eat anything.
If there is no anesthesia, drinking small amounts of water should be fine.

Reply Date: 2017/04/10

More Info

Understanding colonoscopy preparation and post-procedure concerns is crucial for ensuring a smooth experience and recovery. Based on your situation and the questions you've raised, let's break down the key aspects of colonoscopy, including preparation, potential risks, and post-procedure care.

Preparation for Colonoscopy
1. Dietary Restrictions: In the days leading up to your colonoscopy, you will need to follow a low-fiber diet to minimize residue in your intestines. This typically includes avoiding whole grains, nuts, seeds, and raw fruits and vegetables. Instead, focus on clear liquids, white bread, and lean proteins.

2. Bowel Cleansing: The day before your procedure, you will be required to take a bowel-cleansing agent (laxative). It's essential to follow the instructions provided by your healthcare provider. Generally, the laxative should be taken the evening before the procedure, but some protocols may recommend taking it early in the morning on the day of the colonoscopy. The goal is to ensure your colon is completely clear for the examination.

3. Hydration: You will need to drink a significant amount of clear liquids (usually around 2-3 liters) to stay hydrated and help with the cleansing process. It's important to follow the specific instructions regarding how to mix the laxative with water and how quickly to consume it. Drinking it over a period of time (e.g., 10-15 minutes) is often recommended to prevent nausea.

4. Restrictions on Food and Drink: On the day of the colonoscopy, you should not eat anything. However, you can usually drink clear liquids up until a few hours before the procedure. Always confirm with your healthcare provider about specific guidelines.

Risks Associated with Colonoscopy
Colonoscopy is generally considered safe, but like any medical procedure, it carries some risks. The overall risk of serious complications is low, estimated at about 1 in 1,700 procedures. Potential risks include:
- Perforation: This is a rare but serious complication where a hole is made in the wall of the colon. Individuals with a history of abdominal surgeries or adhesions may be at a slightly higher risk.

- Bleeding: This can occur, especially if polyps are removed during the procedure. Most bleeding is minor and can be managed, but significant bleeding may require further intervention.

- Infection: Although rare, there is a risk of infection following the procedure.

Post-Procedure Care
1. Monitoring Symptoms: After the colonoscopy, it’s normal to experience some cramping or discomfort. However, if you notice significant pain, heavy bleeding (more than a few tablespoons), or signs of infection (fever, chills), you should contact your healthcare provider immediately.

2. Diet: You may be advised to start with clear liquids and gradually reintroduce solid foods. Avoid high-fiber foods for the first day or two to allow your digestive system to recover.

3. Activity Level: Most people can return to their normal activities within a day. However, if you received sedation, you should avoid driving or operating heavy machinery for at least 24 hours.

4. Follow-Up: If biopsies were taken or polyps were removed, your doctor will discuss the results with you during a follow-up appointment.

Addressing Your Concerns
Regarding your specific concerns about seeing blood in your stool, it’s essential to monitor the situation. If the bleeding persists or worsens, you should seek medical attention. Light bleeding can be common, especially if you have hemorrhoids, but it’s crucial to rule out other potential causes.

As for the feelings of dizziness or mild fever, these could be related to your body’s response to the recent changes in your bowel habits and the stress of the situation. However, if these symptoms persist or worsen, it’s advisable to consult your healthcare provider.

In summary, preparing for a colonoscopy involves careful dietary management and bowel cleansing. While the procedure is generally safe, being aware of potential risks and knowing how to care for yourself afterward is essential for a smooth recovery. Always feel free to reach out to your healthcare provider with any questions or concerns you may have throughout this process.

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