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General Inquiry,

My present doctor wants to prep me as a colonoscopy patient with "Clenpiq" for my pouchoscopy.   Never was prepped with such a heavy hitting cleanup.  Have persuaded the doctor to accept that I will have soup the night before and some prune juice.  The next morning will have a warm water enema with no food or drink.  This is my usual prep and other attending physicians have always been ok with that.  My present doctor counters that that will be acceptable but he may have to reschedule if there is any stool in the way.  Have any of you ever had this full prep before?  Concerned it would lead to inflammation, bleeding and dry heaving.  I am going to go with my prep but am curious if any of you have encountered this preparation before. 


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The heavier preps that are sometimes ordered might be justified if the scope is intended to be passed well into the ileum, or if an extended, delicate procedure is to be performed. I worry, though, that it’s more often a sign of carelessness (not bothering to create a pouch-specific prep) or inexperience with pouchoscopies.

@MJFMJF posted:

My present doctor counters that that will be acceptable but he may have to reschedule if there is any stool in the way.

Not sure how many pouch patients this doctor has but once, after being IV'd and prepped in the pre-procedure room, I was asked to wait in the Yale endoscopy recovery room while my Pouch specialist was dealing with a patient emergency and was over an hour late for our scheduled pouchoscopy.  It's a large endoscopy center but mostly colonoscopies.  I heard numerous patients (not visible to me because curtains were drawn) being scolded by their doctors because stool had prevented a clean scope. I even heard one guy being told, in a state of groggy sedation, judging from his mumbled and slurred responses, that he had numerous polyps but his doctor "could not even tell how many or get clear visuals because the bowel was full of stool."  He ordered a re-test in disgust.  My paralegal even admitted to me once she could not do the full prep, "failed the exam", was told to reschedule and then never did, because she was charged $1000 or whatever and it went against her deductible.

It's true that pouch patients often get "one size fits all" colonoscopy prep instructions, and it's also true that doctors not used to doing many pouch patients tend to overprep for reasons stated in paragraph 1.  Fortunately me and my doctors have good communication skills and we have always been on the same prep page.  In the last year my doctor did adjust the laxative component of my prep, which had been Magnesium Citrate 1 10 ounce bottle.  Instead, I take 4 tablespoons Milk of Magnesia.  The prep is otherwise the same: clear liquids after noon the day before exam, Milk of Magnesia 8 pm night before, warm water enemas the morning of 2 hours before.  It is pretty easy and I have never "failed" my exam or had a doctor scold me for having stool in my bowel. You cannot drink certain colors especially anything red like cranberry juice or with red dyes in it.

The best part of the exam is afterwards.  The endoscopy center I go to now is right next door to a great Asian fusion restaurant, Thai, Chinese and Japanese, and they do all 3 cuisines well. I usually go there with my Dad after the procedure, order takeout and then go home and rest.  My Dad really likes their miso soup and sushi, and I like their dumplings and noodles.

Last edited by CTBarrister

Had my 1st pouchoscopy last month by the Cleveland Clinic surgeon who did the 3 stage operations for j-pouch. There were no instructions for cleaning out the j-pouch other than not eating past midnight. Contacted the office and they confirmed no prep is necessary.

Apparently, when I was under sedation they used air to view the pouch. They never told me this was going to be done.

Hours later my stomach was extremely swollen, painful, until I was able to pass large amounts of gas. I would prefer to prep similar to colonoscopy than what they did.

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