Colonoscopy with Pico-Salax

I had my second colonoscopy on Monday. My first colonoscopy was a little more than two years ago. That post is one of the most popular posts on my blog, so I figured I’d write about this one too.


First off, I’m twenty-two years old, and I’m in my fourth year of university. I live in southern Ontario, Canada, and I was diagnosed with Crohn’s disease in December 2009, after a terrible year where I was very sick, and the doctors didn’t know what was wrong with me. I went to the hospital in December (thinking I had appendicitis) and had some tests done. They found that I had a perforated bowel, so I had a bowel resection. I had my first colonoscopy in February 2010. I wasn’t on any medication until June 2011, when I took Prednisone for a few months. That was a miracle, and I have been quite well ever since. This colonoscopy was just a precaution to make sure we aren’t sitting ducks for something bad to happen.

In a nutshell

So, to cut to the chase: everything went well! In fact, I was in a great mood most of Sunday (prep day) and all day Monday (procedure day). Considering the situation, that’s not what you would expect, but this colonoscopy was so different from my first one, and the prep went so much better, so I was very pleased. If your doctor gives you a nice prep like Pico-Salax, there’s nothing to worry about; Klean-Prep, however, sucks, but you will get through it.

Just a little tip for those taking Pico-Salax: when you’re getting together clear fluids to drink, trust me, you will not want anything citrus-y.

Prep day instructions

My instructions were to take four small Dulcolax laxative pills at about 2:00 pm the day before the procedure. At 5:00 pm, I was to take the first dose of Pico-Salax mixed with 150 ml of water, followed by four cups of any clear fluid. Then sometime before bed, I was to have another dose of Pico-Salax and four more cups of clear fluids. Then I would have the procedure on Monday morning.

It begins

The instructions suggested starting earlier if you have trouble drinking lots of fluid; I had had a bad experience with the massive amount of Klean-Prep I had to take last time, so I decided I would take the first dose of Pico-Salax three hours early, at 2:00 pm, right after the Dulcolax.

The laxative pills

Unfortunately, drinking large amounts of fluid is not my only problem. Yes, I’m twenty-two years old, and I still can’t swallow pills. The pharmacist said I would be able to do it with these ones (“they’re so small!”) My mom, who picked up the prescription, insisted that no, I wouldn’t be able to do it. We’ve been through this enough times, and I have tried every method; it’s just a psychological thing that I can’t seem to get past. But no problem; the pharmacist said we could crush the tablets up and mix them with a drink. So, we crushed them and put them in apple juice, and I had them down in one gulp. I didn’t even taste it. I even said, hey, I’ll put some more apple juice in here and take another drink just to make sure I got it all. I was pumped.

…for a few seconds.

The first dose of Pico-Salax

We mixed the Pico-Salax with the water; 150 ml is really not very much liquid, not even a full small glass. The orange flavour didn’t smell that bad. I took a mouthful and swallowed it back. It didn’t even taste that bad. It definitely wasn’t good, and I certainly don’t want to drink any more citrus flavoured things for a while though. Anyway, four or so more mouthfuls, and I was done. I had a glass of apple juice nearby to take in between mouthfuls of the prep and to wash it down with afterwards.

The Pico-Salax website says you can only mix it with water. I thought maybe I could mix it with something else to make it taste better, but I didn’t need to. It was really not that bad. (And I mean, if I can get this stuff down, anyone can; I am the pickiest eater/drinker ever.)

Four cups of clear fluid

Afterwards, I felt super anxious and uneasy. I felt like throwing up, but I didn’t.

I tried drinking some water, but it just made me feel like throwing up even more. I sucked on a light yellow Life Saver for a little while, since that always used to help me when I felt like throwing up back when I was very sick with Crohn’s. You’re aren’t technically supposed to have hard candy or gum, but people online say they’ve done it and were fine (and I guess you can add me to that list of people too). But unless you really need it, I would not suggest risking it. I had an orange Freezie as well, and since you’re allowed to have Popsicles and Jello (just nothing red or purple), I think Freezies should be okay too.

I held back on taking any more fluid until my stomach felt calmer. I had already had about a cup of apple juice right after I took the Pico-Salax, so later, a couple of bottles of water got me to my quota. I could have — and probably should have — taken more; “more is better” the instructions said.

To the bathroom

At about 3:30 pm, an hour and a half after taking the laxative and the first dose, I went to the bathroom. Very loose, brown stool, and quite a bit of it. Despite most people online saying that once it starts, you’re on the toilet the rest of the night, that didn’t happen to me. I only went to the bathroom a few more times before the next dose. Those times, it was more liquid-y, but still very brown.

After about two hours, I wasn’t feeling anxious any more. In fact, I felt pretty good, considering the circumstances.

The second dose of Pico-Salax

At around 7:00 pm, I decided to take the next dose. I had a bit more trouble getting this one down, I think because I was taking smaller mouthfuls, whereas the first time, I was chugging it. I considered using a straw, but I think that would make it worse. Taking big mouthfuls and chugging is the way to go.

I gagged and came very close to throwing up, but I didn’t. I also came close to giving up and not finishing it, but I finished it all. Another Life Saver, some more apple juice, and I was feeling better — even more better than after the first dose, because I knew there were no more awful things to drink.

Four more cups of clear fluid

I had already drank about a cup of apple juice right after the second dose, so between 7 pm and when I went to bed at about 11 pm, I drank a couple more bottles of water. I considered having some lemon-lime Gatorade and some Crystal Light lemonade, but I couldn’t take the citrus smell. I really only like the blue Gatorade anyway, but that’s off limits, since blue drinks will show up during the colonoscopy. I didn’t want to even look at the orange Gatorade.

The bathroom

I moved closer to the bathroom, since I was going a bit more frequently. I really just wanted to relax in my bed with a heating pad, but that didn’t happen for very long. The heating pad wasn’t for cramps, since I didn’t have any; I find the heating pad seems to calm my insides and helps me not “go” as often. By this point, my butt was also very sore, despite using baby wipes.

By now, when I went to the bathroom, there wasn’t as much. Sometimes, I couldn’t tell if I had gone and it was completely clear, or if I hadn’t gone at all. Mostly, there were just little flaky bits of stool, and they were still brown.

Going to sleep

I went to the bathroom at around 11 pm, and then I went to sleep. I slept normally through the night, and I didn’t get up to go to the bathroom at all.

The morning

I woke up at 7:30 am, which is later than I normally wake up, since I only needed to get dressed; no breakfast or any more drinks. I went to the bathroom a few more times, and the stool was the same as the night before. I was a little worried, because I thought it should be clear or white by now (I think that’s what happened with the Klean-Prep, but I’m not sure how it’s supposed to work with Pico-Salax). I know lots of people found my last colonoscopy post because they had the same problem, so (not that you can really do anything about it if it’s an hour before the procedure, but) if you’re still going to the bathroom at his point, and there’s still brown stuff, you should be okay, so long as it’s not a lot, and it’s not the explosive diarrhea type stuff you got the first time you went after the laxative.

The hospital

My mom took me to the hospital. We were only the second people there, so it looked like I wouldn’t have to wait long. My first time, we waited several hours. I took a number, sat down and waited. They called my number, I gave the woman at the desk my health card, and she asked a few questions: my birth date, address, do I have diabetes, any allergies, am I taking any medication? She printed out a bunch of papers and put some stickers on them.

She then took me to another room which was for patients only. She gave me two hospital gowns in a plastic bag and told me to take off all my clothes except for socks and shoes, and then put the first gown on so it opens in the back, and the other gown on so it opens in the front. I put on the gowns and went to the bathroom again. One thing I haven’t mentioned is how LOUD it is when you’re going to the bathroom. That’s normal I think. I hope no one in the waiting room heard me, although I’m sure they would understand, since they were presumably all there for the same thing.

I waited in the patient waiting room with everyone else in their gowns. After a while, a nurse called my name and took me to a small room. She asked me some questions, mostly the same as the woman at the reception desk did. Then she said she was going to put the IV in. I told her I tend to get woozy with things like this, so she took me around to another room where I laid down on a bed, and she put the IV in my left hand. I think I’m actually used to people sticking needles and IVs into me by now, but better safe than passed out. And besides, I got to lie down while waiting for the procedure rather than sitting in the waiting room, so that was nice.

The procedure

I’m not sure how long I waited, but I think it was probably about 9:30 am when a nurse came to take me away. My appointment was for 8:30 am, so this was pretty good time. I was wheeled down some halls on the bed, and soon, I saw my gastro doctor. She said hello and helped wheel me into the room. She asked if I was still doing well, and I said I was.

Pretty soon, they must have hooked up the IV, because I was suddenly… wooo woooo woooooooooo. I was awake for the entire procedure (which you are supposed to be), but sedated, or whatever the IV is supposed to do to you. It was a sort of a surreal, thrilling, a little scary, a little funny feeling. Kind of like being suddenly dizzy? I can’t actually remember too well. They had me bend my knees and move upwards so they could lift the hospital gown out of the way. Then they told me to lie on my left side and bring my knees up towards my chest. And then they go in. You probably don’t want to hear details of that, and I couldn’t even tell you any if I wanted to (and I do love going into detail about gross Crohn’s related things). I kept my eyes closed most of the time I think. The video screen was behind me, so I couldn’t see what was going on.

At one point, I felt a bit of pain. It was kind of like a lot of pressure. I felt like they were at the farthest point up in there, or maybe they were taking a biopsy. I don’t know if I made any noise, but I think I might have considered groaning a bit, and I was thinking “STOP!” but I decided against making any noise because I didn’t want anything to go wrong. The feeling passed quickly anyway.

Soon, the nurse was saying, “Not much longer”, and my gastro doc was saying, “Almost done”, and then they were out. I think they asked how I was doing, and I said, “Alright”. My doctor told me there was some inflammation and that they took some biopsies. She said that at my follow-up appointment next month, we would talk about getting me back on some medication. I got the feeling overall though that things were not terrible. Then I guess they wheeled me off to the recovery room.


I can’t remember too much that was going on then (but this is probably partly because I’ve waited too long to write it all down). Anyway, there was a nurse there who told me to lie on my left side and try to get all the gas out so that I wouldn’t feel so uncomfortable. He asked who was with me, and I said my mom, and he said he would get her in a few minutes, but first, he would let me expel my gas in private. Well, not completely private, because he was coming and going checking my chart, and I think there were patients on either side of me behind curtains. I expelled a fair bit of gas and made a fair bit of noise, but there’s no sense being embarrassed about these things.

Then the nurse must have had me sit up, and he took the IV out and told me to hold a cotton ball to my hand so it wouldn’t get bruised. Then another nurse went to get my mom, and I heard her say “I can see my slippers” (which I was wearing). My mom sat with me for a bit while I tried to regain full awareness, consciousness, whatever. My mom told me that one of the nurses had said I was “cute as a button”. After a while, I put on my clothes, sat for a while more, and then we left, very slowly. The nurse stopped us as we were leaving for something, maybe to tell us where to go to get out.

Going home

I don’t remember much after that, but we must have gone to the elevators and down to parking. There was a candy vending machine outside the elevators, so I asked my mom to get me an Aero bar. I think that helped me feel a bit better. Off to the car and off home.

My mom made a bed for me on the couch, and I laid down on my left and expelled some more gas. Oh, and I had some nice toast with butter and jam and chocolate milk. This jerk on Coronation Street the day before was eating toast while I was fasting, and it made me so jealous. After eating and lying down for a bit, I was feeling pretty good. So good that I even did some homework! And I was still in a great mood because everything went well and it was all done. I was still a bit tired all day, but otherwise, it was a great colonoscopy. You don’t hear that often, do you?

They said there might be some blood in my stool for a while after, since they took some biopsies, and as long as it wasn’t a lot, it would be okay. I had quite a bit of blood the first time I went after I got home, and then progressively less during the week. So I think all is well, and we’ll see how it went for sure at my follow up appointment.

So in all, I guess I want people to know a colonoscopy is not really a big deal. The prep day is the worst part, and even that can go quite well if you take a good prep solution like Pico-Salax. There are lots of things you might worry about, like still having brown stool, still going to the bathroom in the morning, and not going all night, but you will likely be fine if you’ve followed the instructions. Good luck to anyone who’s having the procedure done. :)