Flexible Sigmoidoscopy during pregnancy?

[Txarmywife]

Saw the GI today for the first time (in a few yrs) and she wants to do a flex simoidoscopy. I'm currently 18 wks pregnant so she wants me to get permission from my OB. I've never had this scope (just the traditional endo/colon) so not only do I not really know what it is I dont know if it's safe for my baby. Any experience? The GI wasn't much help because I'm pregnant...didn't want to prescribe me anything and so I left in tears still barely able to walk to the car

 

[2thFairy]

It's usually done in the GI office and requires no anesthetic or sedation. It only takes a few minutes. The contraption is similar to a colonoscope but does not go very far into the colon at all. I don't know if you will need to do any sort of clean out before hand or not, as when I had one it was after I already had a stoma and there was no stool going in that direction and I was already clean. I had a little bit of pain only from the anus, but I was still healing from surgery.

P.S. I was not pregnant.

 

[Rebecca85]

I think for a flex sig you normally have some sort of enema rather than drinking the prep like a colonoscopy, since they are only looking at the end of the large bowel.

Personally (I am 16 weeks pregnant by the way) I would want to know why she wants to do the scope, can it not wait 6 months, and what does she expect to see that won't have shown up on colonoscopy? How will it affect her treatment of you?

And of course what the potential risks are. Like with a colonoscopy there is a teeny chance of perforation or the prep might make you ill, what are the specific risks for the flex sig?

Then I guess you will have to weigh up her answers, do the potential benefits outweigh the potential risks?

Good luck deciding!

 

[Txarmywife]

The reasoning for the flex sig would be its one of the few tests they feel comfortable with doing while I'm pregnant. I'm desperate for something to help me...this flare is pretty severe. I've already had 3 surgeries this pregnancy (also have kidney stones) but they used a spinal which does not effect the baby. They said they couldn't do a spinal and would prob have to do light sedation. The issues I'm having which make me so desperate are severe left upper quadrant pain, puking blood, 10-20 D some with blood all pretty mucusy. The did a bunch of blood work so I'm hoping maybe that will show them something so the flex sig won't be needed but I'm not very hopeful. I've never shown markers even during flares.

 

[SarahD]

Sorry you're not doing too well, it must be a great worry to go through all this whilst pregnant.

I had a flexi sig a few years ago and asked to be sedated for it (it's not standard in the UK to sedate for this examination, but since it was my first I asked for sedation and I'm quite glad I did, though I think without sedation it would be tolerable). I found it to be very much the same as a colonoscopy except that it was far quicker. I had a bit of discomfort with the air they use to expand the bowel but I didn't find it too awful. I had to give myself an enema a few hours beforehand whilst at home, which was easier said than done, and I also wasn't allowed to eat for several hours beforehand too. There was no yucky prep to drink.

One of the main differences between the colonoscopy and sigmoidoscopy is the distance they go into the bowel. The sigmoidoscopy only goes into the first part of the large intestines so I think in that respect it might be safer than a colonoscopy during pregnancy, but if your disease is further up then I'm not sure it would be much help. I recall reading that it was safe to perform a flexi sig during pregnancy but I'm afraid I can't remember where I read that. There will be risks with any procedure but you have to weigh up the risks and benefits.

Good luck and I hope you manage to get some answers soon.

Sarah

 

[Rebecca85]

Just had a thought- I had an ultrasound of my abdominal organs whilst in hospital, which first raised the red flag for some sort of intestinal problem. Could you ask if that is a possibility for you? Am I right in thinking you were diagnosed with undeterminate IBD, in which case you only need to show that your disease is active to get some treatment, it's not like they need to take biopsies to diagnose you.

(And to be honest, I think it sucks that it's taking you this long to get some help when you already have a diagnosis, after I came off the pred and still wasn't feeling right they put me straight on e aza, I didn't need to go through the rigmarole of proving my disease was still active, I had a diagnosis so they went on symptoms alone)

 

[Txarmywife]

Just had a thought- I had an ultrasound of my abdominal organs whilst in hospital, which first raised the red flag for some sort of intestinal problem. Could you ask if that is a possibility for you? Am I right in thinking you were diagnosed with undeterminate IBD, in which case you only need to show that your disease is active to get some treatment, it's not like they need to take biopsies to diagnose you.

(And to be honest, I think it sucks that it's taking you this long to get some help when you already have a diagnosis, after I came off the pred and still wasn't feeling right they put me straight on e aza, I didn't need to go through the rigmarole of proving my disease was still active, I had a diagnosis so they went on symptoms alone)

Thanks for your input. I do have an IBD Undeterminate Type DX which I feel everyone I've come into contact recently isnt taking too seriously. I guess because it's not one or the other? Anyways when I went to the ER last week for the severe pain they did a bedside ultrasound (meaning by the ER doc not a radiologist) but I think it was for more training purposes for the Resident and to look at baby. They also checked my kidney but I'm not sure if they looked at anything else...if they did they didn't mention. But I thought the intestines can't really be seen on the ultrasound because of gas and stuff? The GI did think out loud wondering if they checked my pancreas or gall bladder. *sigh* I hate this waiting game while I'm left feeling lousey

 

[Rebecca85]

The intestines can be seen- like I said, I had an ultrasound which showed up intestines that looked 'like sausages'. I have no idea what the tech meant by that, but that was enough evidence to get me a CT scan of my intestines, which then got me a probable Crohn's diagnosis, which was confirmed via colonoscopy (they did the ultrasound because they wanted to check all my abdo organs, and were concerned about doing a CT for that length of time, once they had seen a problem with my intestines they then just did a CT of those).

 

[SarahD]

This may be a stupid question, but can the intestines still be seen behind the foetus on an ultrasound scan?

I too had an ultrasound and they could see thickening in my bowel wall.

 

[Rebecca85]

I think so- looking at pics of internal organs during pregnancy the intestines kind of go up and over rather than behind baby picture here

 

[Txarmywife]

Hmm I think I'll ask about that then. I'd much rather an ultrasound than this flex sig. I believe the ultrasound tech can turn the probe to control what they're viewing. I've had several renal ultrasounds while pregnant and they were able to see my bladder, ureter, kidney etc even with baby in the way. So if the GI organs can be viewed by ultrasound I'd imagine it'd be the same way even with my lil baby and not so little uterus in the way.

I want to do what's safe for baby but I also want relief. Right now I'm having to take pain pills just to stay out the ER...I don't want a little pill head baby but I need relief! I hate this my first pregnancy put me in remission...this one I'm in the worst flare of my life I think. Just craziness

 

[sararay]

I think you should just keep bugging them for answers. This sounds serious.

Last year I had a fistula to the bladder. It took them FOUR MONTHS to diagnose this even though they knew I had crohns and I was having severe bladder pain and chronic bladder infections. All it took was a CT scan (which I know you can't do while pregnant but I'm getting to my point) to diagnose which I asked for to begin with but nobody listened to me. My point is you have to be the squeaky wheel. Bug them. Call them every day. Don't go to the ER because they really just find the quick diagnosis to get you out of there. (I was discharged with IBD... REALLY?? DUH!! but I went in for BLADDER PAIN! They had the nerve to tell me that it is hard for patients to really determine where the pain is in their abdomen.)

Ask for a second opinion from a different GI. Ask to get tested for pancreatitis and gall bladder problems. Once you ask, if they deny you the test they are liable for negligence, so at least you can get more blood tests or whatever. Just keep bugging them.

I hope you get an answer soon.

 

[Txarmywife]

Thanks for your input. I'm feeling slightly better (not like I'm dying). The OB approved the flex sig so I plan to ask more questions at the GI follow up. My hubby has training in the upcoming months though so I don't see when I'd be able to get the test done anytime soon. I'm still having problems so who knows what the plan will be. This is all so frustrating