A colonoscopy is a routine procedure designed to allow for visual inspection and evaluation of the interior lining of the colon (large intestine.) Most often, it is used to diagnose colon cancer, check for early warning signs of the disease, and inspect benign or precancerous growths, or polyps.

A video camera mounted on a thin, flexible tube, or colonoscope, is inserted into the rectum and guided through the colon by a gastroenterologist. The colon may be inflated with air prior to the procedure to make viewing and navigating the colon an easier process. A host of instruments can be deployed through the tube, including tools to sample and remove polyps.

Side Note: George W. Bush had a colonoscopy today, and temporarily transferred presidential power to Vice President Cheney for the duration of the procedure and recovery (7:09 to 9:24 a.m EST, 6/29/2002.) Y'know, there's nothing more egalitarian, nothing more noble, nothing more democratic than a president bending over like the rest of us poor saps and taking one for freedom and justice. God Bless the President, and God Bless America, and to the republic for which it stands: one nation, under god, indivisible, with liberty and justice for all!
         Note: This writeup can't help discussing certain private areas and the like.

Colonoscopy is an archetypical unpleasant medical procedure, the resort of bad stand-up comedians. It's safe, common and vital in diagnosing and examining a number of conditions, such as inflammatory diseases and - in particular - colon cancer with its notoriously high mortality rate, but still amounts to getting a tube stuck up your ass.

The preparations can be worse than the actual procedure. The intestine must be emptied with a strong (and normally oral) laxative. This is preceded by increasingly strict dietary requirements, culminating in a clear liquid diet that can last from a few hours to 1-2 days. The amount of the foul-tasting liquid to drink also varies, from a cupful of two to several litres (!). The instructions are unpleasant, but for crying out loud, follow them! My brief work as a medical transcriber was enough to learn that a number of people almost inexplicably choose to ignore doctors' orders. These people tend to come to regret it. Obeying serves to make the procedure as fast and easy as possible, and on the table this'll be exactly what you'll be wishing for.

After washing the taste from your mouth, stay in the house and wear sturdy, yet expendable underwear and pants. The purge will happen in several parts as you move to wet stool, then to liquid shit, then to fecal foam and ultimately to a fine mist of butt-spray. Please - while you're waiting for this to begin, try to remember what's going on before passing that fart. It's an easy mistake to make.

The colonoscopy itself is done on an examination table, wearing a pair of thin pants with a hole in the rear like some bizarre piece of kinky underwear. After a prudent application of lube to the sphincter, the performing gastroenterologist will engage splorch. Like a drip, it hurts initially but then fades to an annoyance. He'll guide the tube through the colon, up to two meters of it, monitoring the process from a large viewscreen. At the same time you'll get to discover an entirely new side of yourself, one somewhat similar to the works of H.R. Giger. An ordinary inspection can be expected to take 20-30 minutes, and the doctor can also take samples (biopsies) or perform more exotic things, such as cauterization, that I know little of. Navigation involves a certain amount of poking and bouncing, which is painless, and inflation to ease passage, which hurts like a fuck. Getting air pumped right into your intestine is agonizing to the point of shouting, though having it there is relatively bearable, so the procedure has a generally slowly mounting pain level with sharp sudden spikes.

Pain medication is available; conventions vary per practice and region. I've usually been given the choice of either going in raw, or getting an i.v. Alfentanil mixture that knocks the recipient into a semi-lucid state and shorts out his memory. If a tree falls on you in a forest, and you're not there to feel it, does it cause pain? Come accompanied - it may even be required. If you end up on sedatives, it means no driving for hours, and swallowing your pride is far preferable to swallowing a mouthful of windshield. Scopees are usually outpatients, and as such are released once any drugs wear off.

Finally, if you end up being left aware, bring a cell phone. Ask if you can keep it as an unobtrusive focus of attention. Turn the sound off. Calls are out, but non-reaction based games and especially text messages help. With your link to the outside world you can discuss ordinary things, receive moral support, terrorize your friends or treat your worried relatives and/or victims to something they have never seen before: Real-time updates of your status.

Up to the transverse part now, it looks fully normal, visibility's excellent but the view's grotesque, coping with the pain so far...

Just use discretion with the recipients. Not everyone can stomach the fruits of the information age.


Xwiz sees the obvious and notes that cell phones in hospitals are out of the question in the UK. They're also forbidden in many places here. D'oh!

kalen makes excellent points, but should turn them into a full write-up if he has anything to add:
  • "The only suggestion I would make is to stress even more than you have that people follow the pre-op proceedure STRICTLY. And to stress the safety of the i.v. knock-out. That's certainly the option I took. No memory. No pain! :)"
  • "You might also want to mention that the micro-hemmaroidal "burning" that almost everyone gets towards the end of the Fleet solution "bowel cleansing" is perfectly normal."
  • "One more thing! I think you should mention that you shouldn't mix your Fleet solution (or whatever lax you're given) into a drink that you expect to like the taste of afterwards. Tartare sauce syndrome may well kick in, and the association with the unpleasant over-taste of the solution, and the effects, may put you off your mixer and chaser for a long time. Go with water... :)

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