Hello. I was thinking about posting a question for the doctor but thought I'd post here first and see how many responses I get.
I'm getting ready to get a colonoscopy and endoscopy next month. They are pretty sure I have Crohns. Also, after getting an Upper GI done, the Gastro doc saw some thickening or irritation in my duedonum and wants to see what that is.
The only other time I had a colonoscopy was in a military hospital. I was referred to a Gastroenterologist off base and the procedure would be done in this clinic. I was assured they're board certified, etc. and that most procedures are done in clinics now because of insurance, etc. I will be given a conscious sedation, Versed and Fentynal. I'm a little nervous first off that this isn't being done in a hospital. Is this common practice? Also, I'm nervous about the endoscopy. I don't relish the idea of something being put down my throat. How will I breathe?
Also, is it common practice for the two procedures to be done together like that? They will do the endoscopy first and then the colonoscopy.
I looked up online and found that a capsule endoscopy can sometimes reveal Crohns with more accuracy than the standard endoscopy or colonoscopy. This certainly seems less intrusive. Has anybody out there ever had a capsule endoscopy? I asked about it at the clinic and they said I'd have to see if my insurance will cover it. They said most insurances want to see that you've had the standard procedures done first and we'd have to give them a reason for requesting the capsule endoscopy. I also have to have that approved by a physician before they can put it before my insurance.
What does everyone think? I'd really like to hear back from people who have had these procedures so I can know what to expect.
Both procedures at the same time is no big deal. It's often called an 'around the world'. As long as you are sedated you wont feel a thing. Capsule endoscopy is also not a big deal - you just have to swallow a large vitamin sized plastic pill.
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I've had them both done at the same time - and several times! Never had a problem with either one. Don't worry about the breathing issues either. The scope is placed in your esophogus (food pipe) and not in your breathing pipe. :-)
Capsule endoscopy can certainly do a good job of visualizing your entire digestive tract, but there are some drawbacks. One, it's very expensive and as you've discovered, not covered on many insurance policies. Even if you go that route, you may end up having to go back for the old fashioned scopes. Why? Because biopsies can be taken and sent to pathology using the typical procedures. Also, some problems like polyps can be removed and treated at the same time. With a possible Chrones diagnosis, your doctor is going to need a to biopsy the affected area anyway to confirm that Chrones really is your problem - or not. If you do the capsule route, you'll still have to go back to have the biopsy done.
Try not to worry about it too much. Since versed and fentanyl will be used for sedation, you shouldn't know a thing. I've had these procedures done in hospitals, and small surgical centers. It really doesn't matter where it's done as long as you're comfortable with your doctor and have all your questions answered to your satisfaction ahead of time. It also doesn't take long at all - about 15 to 20 minutes for each end. :-)
Thanks for your input, Jaybay. I had surgery three months ago to remove a mass from my small intestine and biopsied it. That's how they came up with the diagonosis of Crohns. They just were surprised because other than the one mass and ulcer, I didn't have any other sypmptoms of Crohns. So, yeah, I already did have one biopsy.
I guess I'm just tired of being poked and prodded. The capsule endoscopy sounded less intrusive. I may not have an option anyway because my insurance may not cover the capsule endoscopy. Well, actually I guess I do have an option. I don't have to get it done at all. It's tempting because since the surgery and recovery, I've been feeling great. He just wants to do this and then if everything checks out ok, he said we can just leave things alone unless I get more symptoms. Do you think I should go ahead and do this or just wait until I have more symptoms? Like I said, I'm just tired of being poked and prodded. I've had quite a bit this last few years.
Several years ago I underwent a total colectomy for torrential diverticular bleeding and, earlier this year, my surgeon recommended a colonoscopy + endoscopy just for a check-up. I was sedated (in fact to all intents I was unconscious) during the procedures. After "awakening" I rested for about two hours and then went home. Afterwards I felt no pain or discomfort. The only "intrusions" were the purgative to empty the bowels prior to the colonoscopy part and a 12 hour fasting so that the stomach was empty for the endoscopy part - oh yes - and the needle in the arm for the sedative!!
I think these examinations are the most comprehensive for discovery of anything amiss in the upper/lower intestines and they are well worthwhile.
I have both done together in the January 2007. Only found a mild reflux. It was done in the hospital. The Dr didn't want to do it in the centre because she afraid my heart will getting naughty. She said the centre didn't has any facility to cover the emergency.
The capsule endoscopy was done in March 2007 for small intestine. CT abdomen said I got multiple diverticulars and it affected most of my bowel. Colonoscopy said my colon was very clean and no biopsy required. Dr said she didn't see any diverticular!
HI i have had" the double" as its called three times along with several colonoscopies and i can assure you its no big deal,especially if you have sedation you will not remember much at all.
I have had rectal blood clots for over 18 months now and they can't find the cause. Am awaiting appointment for capsule endoscopy.Have had two polyps removed and various biopsies but they say I'm a mystery.
So do not worry but i would recommend making sure you have a good empty out so that you are well clean and that way they will be able to see clearly,and thats what you want.
Hey guys, thanks for all the support! I appreciate all the answers. :)
One more question. I was diagnosed with PVC's and PAC's about 7 months ago. They did a stress test and a couple of other tests and said it wasn't enough to worry about. I also had surgery three months ago. I did great, but I think they were being extra cautious with watching me. Will the sedation be ok for me, do you think? That's why I was a bit nervous to do it in a clinic rather than a hospital. Do I have any reason to be nervous do you think? Or am I just looking for things to worry about, lol. I do tend to be a worrier.
I concur with some of the previous writers - absolutely no big deal. I have experienced the dual procedures several times over the past few years searching for mysterious blood loss. Finally dr.s decided to correct gerd w/open nissen procedure and found large hiatal hernia while in. Problems are now cured but now have ventral hernia along incision which is to be repaired next march. Back to your concerns. No Sweat - I'm sure you will be thirsty and starving after though cause if you clean as you are supposd to I assure you that hunger will be your companion and concern more than the procedures. Good Luck and GBU. Olegoat
Well shoot - since you've already had the confirming biopsy, and this round is just for a look-see, I can understand your desire to go with the capsule. One argument that might sway the insurer is that capsule endoscopy will allow your docs to see your entire small intestine. That is impossible with the old endoscopy procedure.
I can also understand your reluctance to do anything at all since you're feeling so good right now. I certainly wouldn't attempt to sway your decision. You just need to have a very frank discussion with your doctor about your reasons for hesitation. Good luck!
hey Jaybay, would the capsule endoscopy be able to get a good look at the duedonum? That's why he wants to do the endoscopy. He said I have some thickening or irritation there that showed up in an Upper GI I just had done and he wants to see what it is.
Have you done the capsule endoscopy before?
Yes and no. The capsule can only see so much, but not every last bit of tissue it passes by. It will record everything from the time you swallow it until it is expelled, including the duodenum, but there are going to be some things it just can't see as it passes through.
I elected not to have the capsule endoscopy done because it was so terribly expensive, and even in Houston, found only one practice that offers it. The equipment is very expensive, so it's not yet commonly used in all gastro practices.
I too have PVC'S and PAC'S and had an endoscopy back in June of this year when I was FIRST diagnosed with the above. I was pretty nervous, but everything went well. I now have to get my gallbladder taken out and I REALLY nervous about that since it's not a 10-20 minute procedure like the endoscopy.
Pika I had a question for you, do you have heart issues is that why your doctor was concerned about doing the procedure. I am just curious as to why he thought your heart would act up?
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