# Capsule Endoscopy and eating problem



## OppOnn (Jun 30, 2002)

My GI wants me to have a capsule endoscopy. He says he wants to be cautious and couldn't see everything when he did the colonoscopy and endoscopy last week. I had two days of rectal bleeding (that I know of, he says it can be hard to detect)...I'm hypoglacemic, must have something in my mouth every 3 hours. He says I can't eat or drink anything after midnight the night before, I'd have the camera pill at about 10 am (he says 9.30 but he always gets in late)and I won't be able to eat or drink anything until 11 am, when I can drink liquid but nothing solid until 1 pm. I can't wait that long. Had problems before when I had procedures and surgery and couldn'teat from midnight to 10.30 am, and that's earlier.Problems over the years:1. Bled thru bed after D&C2. Bled thru stitches after surgerysustaining some minor nerve damage3. Blood pressure went up to 104, stayed theretoo long.All of above happened when it was 10.30 without food and water.Oh, he says I can have one cup of yellow jello but that's not going to be enough, I know myself.I can't eat late near midnight because I can't lay down for at least 3 hours after eating anything because I gurgle too much if I do.What to do? Can I ask for an IV? Last year, he had told me the camera could get stuck and then one would have to have surgery to remove it, but he now says he thinks it will be safe. I guess after the colonoscopy he has decided I can take it. Hmmm.Any ideas anyone?O


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## NancyCat (Jul 16, 1999)

You certainly should be able to get an IV when you go for the test. They could run some D5W (sugar water). Make sure you tell them when you check in that you are hypoglycemic. My grandmother was hypogylcemic and also had IBS. She always had to carry some sort of food w/her when she went out.I never had the camera endoscopy so I cant help you w/that. I hope it goes well for you and yields some answers.


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## OppOnn (Jun 30, 2002)

Thanks, NancyCat.One can't know about it unless one has it, or been with someone who has and seen what happens. Even many doctors don't get it, and not sure mine does, not really.He says he can do it an hour earlier, but that's 8.30 and he always late!!!Still won't be able to eat until 12 noon.I asked about the IV and got no response. I'll try again.Water with sugar is an answer but that's not until 10 (if he does it at 8.30)and I start going haywire about that time without food.I'm going to ask again about the IV.O


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## NancyCat (Jul 16, 1999)

I think the sugar water iv fluid is called dextrose 5% in water or D 5 W. They should be able to easily give it to you when you check in (usually you need to be there early before a test, not sure about this one). Who diagnosed you w/hypoglycemia? If it was your primary doc maybe he/she can call the gastro's office and explain that you have special needs. If the gastro diagnosed it IMO he doesnt get it at all if he wont see that your needs are met. IMO he shouldn't have scared you about having the capsule getting stuck. I'm sure "anything" is possible but very unlikely. What does he think is "different" with/about you now? Makes me wonder if perhaps this test is now covered by your insurance and wasnt before? You'd be surprised how much money motivates some Dr's.Pardon my cynicism, I've had some rather interesting experiences navigating through the health care system over the years. Just curious what type of surgery you had that caused nerve damage. I had some major abdominal surgery 3 yrs ago and I'm numb from the incision down on the left side of my abdomen. I absolutely get it, my grandmother would be/feel incredibly sick or faint if she didnt eat regularly. If she was in a store and had left her food in the car she'd get panicky if there was a line at the checkout. When I was real little she would take me to a drug store in Irvington NJ (I grew up in NJ near NYC)where there was a soda fountain (this was 35+ yrs ago) where she'd get some sort of cherry drink. At the time I thought it was fun, it was only as I got older that I understood her medical condition/s and inherited some of them (IBS).


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## OppOnn (Jun 30, 2002)

My GI is wonderful - he's GI # 5 and I spent a lot of time researching to find him, very proactively.It's possible my insurance will pay whereas it didn't before (yes, I'm cynical about doctors, too) but I think he genuinely thinks I need it.I had a colonoscopy and endoscopy about 10 days ago after rectal bleeding - and he says he couldn't see everything with those 2 procedures and he could with the endo - in the interests of caution.I'm going to ask for an IV. I know one can't drink any liquids after midnight, not even water.Yes, you do absolutely get it about hypoglacemia. It's amazing how many doctors I've come across just do not. I think my GI will listen to me, because I know he usually does. Even for him to come in an hour early just for me is special for him. I really like him and think the feeling is muitual.It was diagnosed by Dr. Atkins (himself) - and it was he who told me how to control it, not to drink juices, be careful with the coffee, and to put anythilng in my mouth, even if a nut, every 3 hours. It really did change my life because I was always feeling faint or sick or irritable, even as a kid and certainly during work situations. I can't eat nuts or drink juices now anyway! When I first read all about hypoglacemia, it was a revelation to me. Thanks for your support.O


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## NancyCat (Jul 16, 1999)

I'm glad you like your gastro and that he is helping you. Finding a good dr who one likes is very difficult. Regarding a sugar/glucose iv; I believe you can get what is called a "heparin lock" type iv which is given to people who need iv infusions frequently. I think (I am a nursing school drop-out from the 70's, my husband is an RN) this type of iv has like a little stopper that can be inserted between infusions. Its used a lot for people who need to get say antibiotics iv over several days, you get the fluid and then put in the little stopper and you dont have to get "stuck" over and over again as the iv mechanism is already inserted. Sometimes people can even do their own treatments at home. Basically you walk around with an iv taped to your wrist, its easy to be mobile. Perhaps (I'm certainly not an iv authority)this type of iv (which is kept open)would be appropriate for you, cause sugar water solution could be given at 3 hr intervals so your hypoglycemia could be controlled while you need to be NPO (nothing by mouth). Just a thought, good luck


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## OppOnn (Jun 30, 2002)

Thanks, NancyCat.I sent GI an email this morning about having an IV, no reply yet. He typically replies around 8 pm unless he is doing something, I guess.But it is scheduled for Sept. 22 so I have time.I'll let you all know what happens. Just hope it's not another saga because I feel well, only bled for 2 days, no longer bleeding, and even my bms are a now a normal, lighter and consistent color.The prep really made me feel soooo much better, after. Maybe 18 months was too long to go without a clean out!!O


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## OppOnn (Jun 30, 2002)

Got an email back from GI. He says I can have sugar water or, if worst comes to worse, Seven Up. I never drink Seven Up!So, now, I think I can have sugar water, l cup yellow jello, suck on boiledhard candy (with sugar) but he's not answered all my questions yet so I sent another email saying I know I'm a pain, but could he answer my questions so I can have a comfort level in advance and quit worrying so (or something to that effect.)I've always lost it at 10.30 am before and for this I have to go at lea to 12 noon. If he's on time. I'm going to feel faint, lightheaded, even be sick, I hope not but...O


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## OppOnn (Jun 30, 2002)

It's 10.05 am on the day of the capsule endoscopy and the doctor turned up at 8.45 am (for an 8.30 appointment, which is v. good for someone always late who never usually gets in until at least 9.40 am)...He told me something I wish he'd told me before in such detail (I had asked him by email)...10.00 am I can have a cup of water with some sugar in it (which I just did)....10.45 some clear liquid (like tea or water)...plus see-thru hard boiled candy (I got some glacier mints) and l cup of lemon or clear jello...I can't eat solid or any food until 12.45. I hope I make it. Think I might with the mints and jello - if I don't get a little d. from the sugar I need which is also my worst enemy. I find time flies when I'm on the computer, so here I am.I'm sitting here wearing a HUGE black contraption on a very wide black belt - flashing, blue, green and yellow lights with black wires hanging down. The girl told me to wear something loose (only after I asked) but what I wore is not enough, although, thank goodness it was all black and stretched, but not enough and the lights showed thru, although it is quite a thick cotton. The contraption is so bulky, and it's going to be 84 degrees here today, so I placed a big black bag I fortunately had with me over my whole left side where the contraption sticks out, and got a taxi home as asap - hoping no one would arrest me thinking I'm a suicide bomber!I told the doctor he should give better written instructions, in advance and that he is a "naughty boy" for not doing so. He laughed but was listening.I tried on various clothes for a hot day and nothing works, so I guess I'll go back the same way I came. A loose, not long enough cotton cardigan thing, which stretches.Have to go back at 4 pm.Meanwhile, it's nothing. Although the pill swallowed was quite a number.Like a big vitamin, with flashing yellow lights. Hope it comes out the other end tomorrow. stay tuned...O


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## OppOnn (Jun 30, 2002)

By the way, the pill, like a big vitamin, was very easy to swallow. Had some plastic coating, was rounded, no hard edges, but it did have these blinking lights!I can't usually swallow big vits.O


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## NancyCat (Jul 16, 1999)

O-I'm glad that things are going well. You sound like you sure look wierd (lol) but from what you say your hypogylcemia isnt going to be as much of a hassle as it could be. Hopefully the test will yield some answers for you


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## OppOnn (Jun 30, 2002)

NancyCat: Yes, I do look weird, can't go out, have to get a taxi back since I seem to have no suitable clothes to cover the bulk and blinking lights on this hot day.It's now 11.30 am - I've had my water w/sugar, my cup of jello, one glacier mint and I think I'm going to be OK. Thought I was going to be sick in the taxi coming back (the movement always set me off when hungry) and I nearly got out and walked but thought better of it! The water w/sugar made me instantly better at 10 am. phew.As usual, I worried far too much, silly me.I hope it finds absolutely nothing. I already have bleeding ulcers and a diverticulum and an internal hemmoroid - all from my Crohn's, and I've had a colonoscopy and endoscopy 2 weeks ago, so I want them to find nothing else in this area apparently not reached with other procedures. As it is, I am resisting going on drugs because the bleeding stopped after 2 days, is not active, I have no d. or c. and feel well, except for a gurgle or two. I always resist any drugs but may have to succumb but, then, maybe not!O


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## OppOnn (Jun 30, 2002)

Well, I did have too much sugar because I could feel my stomach gurgling, just like I'd eaten too many grapes. Which is a shame since my stomach is good most of the time because I don't eat what I shouldn't, unless I make a mistake! And it will show on the film, I suspect.I go back on Monday at 9 am (fitted in, not that he'll arrive before 9.40 or so for his 9.30 appointment)...but you can imagine the build-up wait time later in the day so better to be first, and wait a bit! He said he gets the results to his computer and will download them on Sunday night. Isn't that amazing? And so fast. I do hope he finds nothing on Monday.It was big and unwieldly the device, but not so bad, esp. when I was told that it was big on both sides not just one side a year ago, when it was just bigger. I guess this is technology in progress, and soon it will be smaller.All in all, the best, easiest test.O


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## SpAsMaN* (May 11, 2002)

HI O.I would love to get this pill test.Which model did you have?There is one flashing on both side.







Try to keep the pill as a souvenir.


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## OppOnn (Jun 30, 2002)

> quote:Try to keep the pill as a souvenir.


Some souvenir. I just hope it comes out tomororw!!My GI didn't want to give me the capsule a year ago saying the pill could get stuck and then I'd need surgery to get it out. I guess he changed his mind after my colonoscopy/endoscopy 2 weeks ago, but it still leaves me somewhat apprehensive.I was surprised he could give me the capsule now. My insurance wouldn't pay before but I suspect it's because I had 2 days of bleeding and he made a case. I think the GI has to make a case. Is it in Canada/QuÃ©bec?I don't know the make. I did look in the mirror but, of course, the name was back to front, and then I forgot. Anyway, it flashed and the contraption was on one side only.Hope you can get it one day, if you want it. I suspect - and hope - this is a procedure which will improve and become more mainstream as time goes by. I know it used to take 2 weeks to get results and one had to stand for the several hours one was wearing it, and that wasn't so long ago. Maybe someone up there is on to our case with IBS/IBD etc.Let's hope so...O


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## SpAsMaN* (May 11, 2002)

I can have it but the cost is 2000$ and i have to verify if i could be reimburse.


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## SpAsMaN* (May 11, 2002)

There is a photo on my post on the IBS forum about the pill camera and their web site.


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## OppOnn (Jun 30, 2002)

Next morning.Had a bm at 8.45 am today.The camera pill did not come out.Slow panic.Thought it was supposed to venture out within 24 hours.Have emailed GI.On the way to make some porridge.Maybe I can induce another bm.I usually have only one a day.Anyone have any ideas?SpaMan - where's your post on IBS website, do you have link?Maybe they have words on it coming out!O


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## OppOnn (Jun 30, 2002)

10.30 am Friday, the day after.GI just emailed back saying it could take 4 days to come out.I should have known that, surely. No website says that.But if my GI says so, it is so.Not bad emailing back from about 9 am at 10.30...I am mostimpressed with that fast response.Stay tuned...O


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## Kathleen M. (Nov 16, 1999)

Normal transit time is usually said to be from 16-72 hours and I wouldn't expect the camera to go faster than everything else in there.K.


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## OppOnn (Jun 30, 2002)

Thanks, Kath M.Every website I saw said within 24 hours.I guess I didn't see the right ones.What a number!How space age!Amazing!O


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## SpAsMaN* (May 11, 2002)

http://ibsgroup.org/eve/forums/a/tpc/f/43110261/m/998100461


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## OppOnn (Jun 30, 2002)

Thank you, SpAsMaN.Very interesting.I just downloaded a patients brochure.Instructions seem to vary a lot on the internetand what my GI told me.Is he ahead or behind, I don't know.Don't know how old the internet stuff is and this is a fast-moving technology.Also just had a 2nd porridge induced very nice bm (at 5 pm today)but still no capsule!O


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## OppOnn (Jun 30, 2002)

Day 2. Later, had to wait because of induced-porridge bm at 5 pm yesterday and I only usually have one bm/day.Lovely bm, formed, perfect, but nothing there!!!!!Silly - I guess it looks like the pill, but not so white?The battery must have run out by now, so no flashing.I so wanted to see a flashing light in my poop.That only happens if one has a fast poop, I suspect.But now I just want to SEE it...there.Unless I missed it? But I don't think so.I poke around with a chopstick. Gross, sorry...Stay tuned...O


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## OppOnn (Jun 30, 2002)

For those really really interested in this subject, the link below is how I posted on the subject on my usual forum - the IBD (Crohn's and UC forum)...suggest you just skip my posts because they are the same, and read the rest.http://ibsgroup.org/eve/forums?a=tpc&s=500...08171#699108171


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## OppOnn (Jun 30, 2002)

Day 3Well, I'm just not sure.Had another lovely bm this morning and maybe I found it.But I'm not sure it was it!Seemed something harder than the rest, same length, butflat'ish, not round or white (!) and it disintegrated a bit when I touched it(with my chopstick)...No one told me what it should look like after Day 1, Day 2, etc.Would have been good to know.I kept it, wrapped up in the wrong thing, stuck it in an old pill tube, and I guess I'll takeit in to see the GI doctor for tomorrow's 9 am appointment, whichwill be Day 4, the longest it should take to come out, accordingto him. I feel good, no problems.By the way, since the scopes my bms have been lovely. By that,I mean, formed, just the right amount of soft. A change from thedaily variations I had before, and I feel better, too. Definitely goingto have to clean out at least once a year in future. I can reallytell the difference.Stay tuned...O


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## OppOnn (Jun 30, 2002)

Day 4.Ok, Phew! Had x-ray to try to find the capsule and it's not there! Amazing, because I poked about every day's bm and must have missed what the GI described as something looking just like the pill I swallowed, a capsule, but no longer white! How I could have missed it? I don't know.He gave me 8 selected photos from the camera each with a diagnosis of that area. He said it took him 45 minutes to go thru the lot, and it's like a video, you can fast forward but see everything you need to see. Again, I guess results depend on how caring the GI (or technician) is and I think I'm lucky to have a caring human being of a GI.Here's the details for those who care about these things:I have stomach erosions, duodenum normal, jejunum possible lipoma (for which I have to have another capsule endosocopy in a year because that could grow into something)... Ileum has distal erosions and small ulcers and the summary was "Mild Crohn's ileitis, gastric erosions" with recommendations to "Observe" - no meds, the lovely GI said, he agrees with me, he said, and I hadn't said a word this visit.From the colonoscopy report - I also have a hepatic flexure diverticulum, internal hemorroids (biopsies unremarkable) and when I had this (on Sept, 2, 2 days after 2 days of bleeding) I had multipe deep ulcers, no active bleeding, biopsies with inflammation. Cecum normal. Tranverse Colon: Normal...Descending Colon normal...Sigmoid Colon, normal.From the endoscopy, also on Sept 2 - GE Junction - normal, biopsies with mild inflammation...esophagus normal...duodenum, normal.So, all in all, I am very pleased. But will watch out if I bleed again and I won't be eating any more nuts, nut candy, natural peanut butter with bits of peanuts in it from the health food store or crisp duck skins. And I'll stick to my elimination diet.So that's it. Once again, I have worried too much, put my life on hold and wasted a little of it. As I always say to everyone, the glass is half full with these tests. Why didn't I listen to myself.Thank you all for your support.Hope some of this is useful.O


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## SpAsMaN* (May 11, 2002)

O,can you feel the erosions?


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## OppOnn (Jun 30, 2002)

In general, I feel very good. But when I obsess about my stomach, which is too often, especially when I am not active in the evening after dinner, then I can feel some activity down there...some gurgling.I definitely can't eat or drink lots of food and drinks. Too much sugar, which isn't that much, like over 6 grapes, can send my stomach in a tizz or even give me a d.O


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