What to expect during a flexible sigmoidoscopy.

Some of you may have seen that I underwent a flexible sigmoidoscopy yesterday. As well as gynaecology based struggles, I have also been struggling with my bowel, and so far have a supposed ‘IBS’ diagnosis. I say supposed as it’s just been a guess until we do more tests, but the level of pain I experience combined with the chronic diarrhoea at random, to me suggests otherwise… A flexible sigmoidoscopy is a little like a colonoscopy in which a thin camera is entered via the rectum (your bumhole) and looks within the first two feet of your lower intestine (makes me feel weird). I was sent no leaflet or information pack from my hospital, and therefore didn’t know what to expect and to be honest, I don’t think I really wanted to know the details! For any procedure in which your bowel is being entered, you will need to undertake ‘bowel prep’. This is usually in either a laxative form, or an enema (administered into the anus). Both make you experience diarrhoea violently, until your bowel is clean and I think it goes without saying that it is not enjoyable. I had to stop eating at 3pm, having followed a low fibre diet, and then had to drink the laxative solution named ‘Plenvu’ within two parts. Plenvu: Dose 1/Sachet 1 - The entire sachet mix had to be in a jug of which water then had to be added to make up 500ml. You then have to drink the whole thing within 30 minutes and this was at 6pm for me. Dose 2/Sachet A&B - For some reason the sachets are separate but you have to combine them both and again, fill with water to 500ml and drink over 30 minutes.

Stay hydrated, you’re going to need it…

TOP TIP: Plenvu and other laxative preps such as Moviprep, taste, DISGUSTING. It is so hard to drink. I did NOT finish it all, and i did NOT drink (the first one anyway) within half an hour. Do not rush yourself. It is also important to note that you may not need the whole thing! I for one, am a very petite female, and therefore only drinking one glass was PLENTY for me to get the effects. I definitely don’t think I would need anywhere near as much as a full grown man per say. I used a straw to drink it, and just did fairly large sips as often as I could to try to prevent nausea. You can add ice cubes however I didn’t want this to create even more liquid to drink so I just went for without. The first dose was the harder one for me to stomach, but I don’t think my nausea levels were that bad. It helped as I had been able to eat a light breakfast and lunch that day so there was already something in my tummy. I think it took about an hour and a half before I started to cramp up and low and behold, the first round of diarrhoea commenced. My first bowel movement was more solid, but from this point onwards it was literally water (ew). The leaflet for Plenvu had said that I would stop shitting about 2-3 hours after drinking. This is a fucking lie. I was using the toilet until 6am the next day, when it was time for round 2 of the vile mixture. For context, you are not allowed to eat anything whilst bowel prepping. Therefore when I woke up at 6am the next day to drink the next batch, it was a lot more sickening. On an empty stomach I managed to drink the last batch quicker (again only one glass) and honestly within about 5 minutes I was running for the toilet. I was then using the toilet about every half an hour all the way until around 3pm. It. Was. Not. Fun. TOP TIP: If you are unsure as to whether you have carried out the bowel prep correctly, take a peek in the loo. If you are passing pure water which is either yellow or pretty much clear in colour, with NO particles whatsoever - then bravo! You have completely cleaned your bowel. My mum drove me to the hospital and honestly the hardest part was the level of hunger I was experiencing. It had been 24 hours without food at this point and I just wanted to get it over with so that I could eat a Nandos. When I got to the hospital I made a point of telling the nurse that I struggle without eating (my blood sugar levels drop and I get mega shaky and faint) and therefore she bumped me up the list and allowed me to eat a glucose tablet (yay food). I am SO glad I mentioned this because when I was called through, I had to wait in another waiting room for AN HOUR AND A HALF. It was already way past my appointment time so god knows how long it would have been if I kept quiet (I would have passed out for sure!). When the procedure begins you have the initial consultation to ensure you understand the risks and sign paperwork, as well as the question of whether you would like sedation or not. I was then given a huge pair of pants with a hole around the bum (sexy) and of course, the classic hospital gown. I was still having to use the toilet at this point and had to ask if I was going to have an accident during the procedure...would it matter? Thankfully it did not, and I was only passing the smallest amounts of liquid, but the nurses explained that the tools used have a little suction pipe on them so any leftover liquid would be taken away anyway. I was taken into the procedure room and because I had opted for no sedation, I did start to feel a little nervous but the Nandos was the main concern in my mind. There is gas and air in the room as well, however I already felt so faint and dizzy from hunger I really didn’t want to worsen it and I just wanted to get out of there as soon as possible, knowing that the woozier you are, the longer it takes to be discharged. I got up onto the bed and you have to lie on your left hand side with your knees up towards your chest in a fetal like position. To start with, cold gel is applied and the doctor used his finger to examine the actual anus first. This was WEIRD AS HELL. Literally fingered up the bum by an old man but you’ve got to do what you’ve got to do. They then administered the camera and began the procedure and to be honest, I kind of blacked out from the pain at this point. The gut has no nerves and therefore can’t feel anything...but because you are pumped up with air to expand the gut - THIS caused excruciating cramps just like I experience in a flare up. I was deep breathing the entire time and it took longer for me because they explained my bowel was very loopy. (Like me then hehe) I had to move onto my back, my right, my front, my left again, all so he could try and reach the last corner of my bowel because for some reason my bowels were not playing game. It was so painful being prodded for that long that I started getting tears down my face and was literally face down into a pillow with my arse in the air trying my hardest not to scream. I think the doctors thought I was mad as they kept asking me ‘Are you sure you don’t want gas and air?’ and I was like ‘NO I JUST WANT A NANDOS’. You can see the camera during the procedure but I didn’t really want to look and I was too distracted by trying to breathe that I didn’t look at anything else. They had also taken several biopsies from the left side to send for testing because of my diarrhoea symptoms. When the procedure ended, I was escorted back to the toilet and told to sit there and let the air pass out of my bum. It was actually difficult for me, I was stuck in there a while and couldn’t get anything to pass, but I was soon getting dressed again and waiting to be discharged. The nurses came in to discharge me and offered me a packet of biscuits which I HOOVERED, before I was finally allowed to go and pick up my well deserved Nandos. Oh my god, it was the best Nandos of my life. My stomach was still messing around and the nurses had told me that the Plenvu may stay in my system for another 24 hours. When I got home, I was still having watery bowel movements and I was a little alarmed to notice that the first movement post op, was very bloody. This was normal because of the biopsies taken but it is VERY important to monitor this, and if you bleed heavily you MUST go to A&E. Thankfully, the blood seemed to lessen up and my bowels don’t seem to be watery anymore, but I think it could be some fair time until I do a normal poo. It is the perfect time to carry on drinking my Symprove shots every morning as now I am starting on a completely clean bowel! Recommendations:

  • Drink the laxative at your own pace and do not chug it. Drink as much as you can/what you think you need. If you are petite, you are unlikely to need the entire solution.

  • Use a hot water bottle during the stomach cramps

  • Keep drinking water

  • Get sedation or gas and air if you don’t have a high pain threshold. It was painful - however the pain was heightened at points and less so at other points, it wasn’t a solid 10 minutes of pain. If you want to get on with your day after I would try without and opt for the gas and air.

  • Bring food & spare pants to the appointment so that you can eat straight away, and in case of accidents

  • During the bowel prep I drank sugar free 7up. It was nice to drink something fizzy and it filled me up a little more whilst still abiding to the clear fluid rules.

  • If you struggle with hunger and/or are diabetic, tell the nurses!!!! You will be prioritised and shouldn’t have to wait as long.

  • Try and wash your bum after bowel movements instead of loo roll - it really started to hurt after a while


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