Thursday, February 17, 2005


Colon cancer, the third leading cause of death from cancer in America, is paradoxically an easily treatable cancer if it is found early. That's why a colonoscopy is recommended starting at the age of 40 and then every 1 to 5 years depending upon the risk factors of the patient in question. The hospital I work at performs between 30 to 50 colonoscopies a day.

To have an adequate colonoscopy, the colon has to be cleared of stool. To accomplish this, patients are instructed to consume a wide variety of laxatives, the most commonly prescribed one being GoLytely.

GoLytely causes massive diarrhea by osmosis. Patients are instructed to drink four liters of this (yes, over a gallon) in a 2 hour period and just sit on the toilet as they "shit their brains out." (Quoted from a patient.) We tell patients that their preparation for their colonoscopy is complete when the fluid leaving their anus is see-through.

Naturally, this colonoscopy and its preparation generates a lot of anxiety and questions for any patient, and I got a call from a patient the other night that went like this:

Patient: [panicking] Doctor, I've followed the instructions on the sheet of paper about the colonoscopy and I've drank all of the GoLytely as instructed, but nothing is happening.

Me: [curious] What do you mean "nothing is happening?"

Patient: Well, I haven't had a single bowel movement yet.

Me: Are you passing any gas?

Patient: Yes. I hear my stomach gurgling, but I don't even have an urge.

Me: Did you mix the GoLytely correctly and drink it all in the 2 hours?

Patient: [panic building in her voice] Yes, Doctor. There's nothing coming out of my rectum. My gas smells a little funny, but there's nothing happening!

Me: Well, ...

Patient: [interrupts] I've even tried jumping up and down! Nothing is coming out!