Congested Mucosa – Could This Help Solve My Abdominal Pain Mystery?

In the quest to discover the root of at least one of my physical problems, I had a colonoscopy yesterday, Tuesday. Monday, prep day, was my birthday. Worst birthday since the day I was born, since I almost died of pneumonia that day. But since my abdominal pain ended up not being my ovaries, I’ve been seeking gastroenterological care and hitting dead ends with the CT scans, the ultrasounds, and the x-rays – I said sure, let’s do another colonoscopy.

It was my third colonoscopy. and I just turned 36. (Never had GI problems before I had my kid. I love them so much, but they sure messed up my innards.) My previous colonoscopy was only two years ago, but the NP at my primary doc’s office told me her husband has a colonoscopy every year, and they always find new polyps when they go in.

But before I get to my results, let me regale the story of the night of my birthday.

I’d spent close to a week avoiding beef, iron supplements, nuts, seeds, fruits, vegetables, and other “high residue” foods – namely, all of the high-fiber foods I’ve been subsisting on since trying to overhaul my diet. I’d been excited at first that the only foods I was allowed to eat were the ones that aren’t good for me. (Candy! Brownies! Mashed potatoes! Fried chicken! Macaroni and cheese!) But I was feeling pretty gross by Sunday night. So yesterday, Monday, I was already feeling pretty bad when I started my 24-hour diet of nothing but “clear liquids.” And nothing red to drink, except for cranberry juice. Surprisingly, cranberry juice is allowed because it’s naturally red, and it’s only the artificial red coloring that can stain the GI tract and look like blood, tainting the results of the colonoscopy. So I did enjoy some cranberry juice on my birthday.

But I also had hunger pains until about 5:00, when I had to start taking my generic GoLytely. I should have been able to finish drinking it in a few hours, despite the size of the jug. I’m not entirely sure of the capacity, but the instructions mentioned that it usually takes “at least 3 liters” to work properly, and my two Brita pitchers full of filtered water were insufficient to reach the fill line on the jug. But the generic version’s “lemon” flavor packet did nothing as far as making it more palatable. My gag reflex wouldn’t let me gulp it down. Apple juice made it potable, but I was running out of apple juice. The cranberry juice was actually a last-minute Walmart run that my husband made for me.

Cranberry is a much more powerful flavor, so it worked really well. (My saint of a husband put a cup of cranberry juice in the freezer so it would get cold quickly for me.) It also increased the volume of liquid I had to consume by at least 33%. I still should have been able to finish drinking it in just a few hours, but the intense stomach cramps – almost as bad as the pain that sent me to the ER multiple times, the whole reason I was doing this – made me take a break from drinking the nasty stuff. I’ll spare you the gory details, but I drank my last cupful shortly after midnight. I wasn’t able to go to bed until after 2:00, and I was in some serious pain.

The dehydration caused by the prep kit triggered my other pain issues. All of my skin was tender to the touch. It literally hurt to lie in bed, because anywhere my body touched the mattress and pillow felt like someone poking deep bruises all over my skin. But since all of my bedtime medication is supposed to be taken with food, and I was completely cleaned out, it didn’t take long for me to fall asleep.

When I woke up, most of the pain had dissipated, except for my arms. My upper arms continued to hurt for the entire day, so badly that it hurt when they took my blood pressure at the doctor’s office. And the tourniquet the nurse used to aid in finding a vein for my IV was a special kind of torture. I’d described the pain as 3-4 to the nurse when we were just doing my paperwork… it was definitely 7-8 with the tourniquet on. Just short of me whimpering and crying. At least it was only a minute or so before she found the vein, and the IV didn’t continue to hurt – like it did the last time I was at the ER. (I should have blogged about that, but because of the timing, I didn’t because I didn’t want to cause undue distress to a few people who would have been horrified about it all.) But they did bring me warm blankets. Warm blankets are the second best part of getting a colonoscopy. (First on the list is the Demerol that leaves me blissfully unaware of the doctor poking around in my backside.)

If you’ve never had a colonoscopy before, you tend to get very cold. When you don’t have food to burn in your body, and you’re voiding any liquid calories you may have consumed, you have a harder time generating body heat. And I already have temperature regulation issues. I’d been shivering, my lips partially blue, while taking the prep the night before. So the warm blankets were pretty awesome. I ended up under three blankets by the time the doctor came in and they injected my anesthesia. (Demerol, Versed, and Propofol with Lidocaine.) When I woke up again, I was in the recovery area. I had a delicious can of cranberry juice once the nurse was convinced I’d, um, let enough gas out. They called my husband in from the waiting room, and after a little while, the nurse pulled the curtain for me so I could get dressed while I waited for the doctor to come out and talk to me. He was busy with another patient’s colon. I asked my husband to take a picture of me in my nest of blankets once I was fully clothed again.

It took forever for Dr. M to make his way over to me, but he was basically just confirming his findings, which I’d been able to read on the paperwork the nurse gave me. I had two 3 mm polyps removed: one at the hepatic flexure, and one in the rectum. I had to look up the first one; I knew what the second one was. My earlier CT scans had suggested something going on with my ascending colon, and the hepatic flexure is what connects that with my transverse colon. I had internal and external hemorrhoids; I promise you I didn’t have anything external before I took my prep the night before. I can’t imagine anyone who has this procedure wouldn’t have hemorrhoids after prep like that.

The term that I’d never heard before was congested mucosa. I had congested mucosa found and biopsied at the ileocecal valve and in the cecum, both of which were biopsied. I also had no idea where these locations were and had to look them up. More proof that the right side of my abdomen has something detectable going on!

Dr. Google suggests things like inflammatory bowel disease (IBD), and specifically ulcerative colitis. Dr. M had told me there was no evidence of Crohn’s disease, so that’s one potential IBD off the list. Now, IBD is not something I’d like to have, but if it’s what I have then, that means the docs will know how to treat me so that I don’t have to deal with crippling abdominal pain again. Having a diagnosis helps. Having clinical evidence from the colonoscopy from hell helps. I’ll find out what Dr. M thinks when I see him on December 1. I have real hope that I will get answers from him at my appointment. AMEN!

Read my Big Fat Medical Update for more details.