Questions and Answers with Crohn's Disease Patient Ruth Nugent

By Clara Caslin

Ruth Nugent studied Geomatics (surveying and mapping) in the Dublin Institute of Technology in Dublin. She graduated in 2016 with a second class honours BSc, which she says was one of her best achievements to date. She was in one of her worst flare up of her Crohn's at the time. Ruth left university qualified in land surveying. She currently works for ESB Networks where she is following a career in mapping. She also competes in motorsport in her spare time.

Ruth Nugent

When did Crohn's symptoms start for you?  

My Crohn's Disease symptoms started when I was around 14/15 years old but during the years of 18 to 20 years old, they got progressively worse. I had a vitamin B12 deficiency and some food intolerances from the age of 15 but it wasn't until I was in college that things started to get worse. That was when I decided to start seeing a gastroenterologist for tests to see if there was anything wrong. 

How old were you when you were diagnosed?  

I had just turned 21 and was in my third year in college when I was diagnosed with Crohn's Disease. I had never heard of it before and was terrified. I was put on a course of steroids and wasn't given any more information so it was a tough time trying to come to terms with the diagnosis. I joined the ISCC (Irish Society for Colitis and Crohns Disease) and met other patients and IBD nurses through meet ups and that was when I started to see that there were so many other young people and younger as well as older that had Crohn's or Colitis. 

I met people who had Crohn's since they were a baby, some who had colostomy bags, some who were newly diagnosed like me and even family members who wanted to learn more about the disease. The ISCC helped me a lot with coming to terms with living with Crohn's and I'll always be incredibly grateful for them. I also had huge support from my parents who were willing to go anywhere and do anything to help me physically and mentally. 

What were your symptoms?

My symptoms vary but at my worst stages in the disease my most common and debilitating symptoms included needing the toilet between 4-8 times a day including loss of blood, severe stomach pain, extreme fatigue, mouth ulcers, very bad acid reflux and a variety of other symptoms linked to malabsorption issues. 

How active has the disease been since you were diagnosed?  

I had a few bad flare ups but during 2018, it seemed to get worse very fast. It was my first year in motor racing and I had a few other big things going on in my life so it may have been triggered by stress. I had been trying to manage it through diet and the odd course of steroids until late 2018. I was put on a harsh course of steroids because I was too sick and they made no change whatsoever to the symptoms. This was when my consultant decided to back track through all my blood tests and colonoscopy results over the previous three years to decide a proactive route of treatment. 

It was around this point that it was starting to affect my daily life. I was losing my appetite, limited to what I could eat, losing blood daily and fed up of being in pain and exhausted all the time. I was missing more days in work and found myself more self conscious around people and worst of all trying to explain to anyone what was going on with me.  

What is it like living with Crohn's?

I can't really remember what it's like to not live with Crohn's Disease even though it's only been a few years. The diagnosis completely changed my perspective on a lot of things and changed my outlook on life a little, as dramatic as that sounds! Every day, I deal with one symptom if not a few. On very bad days it can be hard not to let it mess with my mood and sometimes feel a little "why me?".  I have had to have the odd cry, I don't think there's any shame in admitting it. Sometimes, I celebrate achieving things in every day life that may seem small to others because I would have had to push myself to get through it whether it's marshalling at a race, going out on the bike, racing the car when I'm unwell or sometimes simply going to work and getting through the day. 

It can be extremely tough mentally, as well as physically, because all I want to do is keep going and to stay busy and happy but sometimes my body can't keep up. I have learned a lot from other patients lives and following some badass people living with Crohns on social media who are living their best lives! The support my family and friends or even strangers online have given me has influenced me to keep pushing to live as normal as a life as I can and most of the time it is just that. Just add in the mini pharmacy on me everywhere I go and the mental map of where every toilet is at every venue!

What would you say to someone who has just been diagnosed? 

Your diagnosis/illness DOES NOT DEFINE YOU. This is what I firstly had to learn because automatically I felt I was going to be labelled the girl with Crohn's and to some I may be! To me, Crohn's is just a small element of my life that I've learned to use to shape me for the better. I would say not to panic, that there are so many treatments available, not to be embarrassed - you have NOTHING to be embarrassed about. You're a bad ass person who yes, has a bowel disease but you are still you. Find your own way of describing Crohn's disease so you're comfortable to tell whoever you may need or want to tell. Sometimes words like "bowel" or "disease" may make even you cringe so you can always use other words like "digestive illness" or "autoimmune or chronic illness". Please, please, please talk to people about how you're feeling. The diagnosis can be very daunting and you're allowed to feel confused, scared, lonely or absolutely anything you want to feel!

Have you had surgery? 

No, I have been one of the very lucky Crohn's patients who has not had to have surgery yet and hopefully never will. I am friends with a good few patients who have however had surgery and thanks to them, if I was to every face that road, I feel like I could face it with knowledge and support. Everyone I know who has had surgery has said it has either changed their lives for the better or in fact saved their lives so I definitely don't see it as a negative thing!

Have you had to change treatment because it stopped working?

Yes, I stopped responding to any form of steroid treatment so I am now on biologic therapy, which I receive every eight weeks through infusions. It is an artificial antibody drug that is used to treat autoimmune diseases. I'm now four months on this treatment and I'm the closest to feeling "normal" than I've ever been in about eight years! 

Questions and Answers with Dietician Aoife McDonald

By Clara Caslin

Aoife McDonald is a dietician, who has set up her own clinic called The Digestive Health Clinic. It is located in Cork, Ireland and is launching in the Summer of 2019. Aoife studied BSc. Nutritional Science at University College Cork (UCC) and then went on to do a Postgraduate Diploma in Nutrition and Dietetics at the University of Chester, UK. She has three years experience working in the NHS and has a special interest in gastroenterology. A digestive health programme has been designed by Aoife to help people with Inflammatory Bowel Disease and Irritable Bowel Syndrome to manage their symptoms through diet and lifestyle changes.

What types of food do you recommend for people with Inflammatory Bowel Disease (IBD)? 

There are no foods that are specifically recommended for those with IBD, therefore it is advised that people with this condition aim to follow the dietary guidelines for the general public. These guidelines are based on the principles of a Mediterranean diet, which is largely based on high-fibre plant-based foods such as wholegrains, nuts and seeds, fruits and vegetables, legumes, and olive oil. It also encompasses plenty of seafood such as oily fish, moderate amounts of eggs, moderate intakes of poultry and dairy products (cheese and yoghurt) and low quantities of red meat. 

What types of food do you not recommend?

There is no one particular food that all those with IBD should avoid completely, as sensitivities can vary from person to person. If you have IBD and suffer from digestive discomfort when in remission, I would recommend keeping a strict food and symptom diary to help you to identify any problematic foods. 

Studies have shown that the incidence of IBD is higher in countries where a 'Western Diet' is consumed. This dietary pattern is characterised by refined carbohydrates, high intakes of red meat and regular consumption of processed foods, which often contain additives such as emulsifiers and sweeteners. Adhering to a Mediterranean diet as outlined above may be beneficial to those with IBD, as it inherently limits intake of these types of foods.

What portion sizes should people with IBD eat?

People with IBD should eat 'normal' portions, but 'normal' can mean different things to different people! A good rule of thumb is to fill half your dinner plate with vegetables or salad, one quarter with a wholegrain such as brown rice or quinoa, and the other quarter with a protein source such as lean meat, fish, eggs or legumes. Take a look at the Healthy Ireland guidelines for further advice on portion sizes http://www.healthyireland.ie/health-initiatives/heg/

You may wish to have smaller portions when in a flare-up, or if you experience IBS-like symptoms when in remission, reducing your portion sizes can help with symptom management.

Should IBD patients stay away from fibre?

In general, patients with IBD do not need to avoid fibre, and should aim to have at least 30 grams per day. However, tolerance to fibre can vary significantly from person to person. If you are planning on increasing your fibre intake, always do so slowly, and ensure you are drinking plenty of water too.

Many people with IBD consume low fibre foods when in a flare-up as these are easier to digest, and can reduce the frequency of bowel movements. Once symptoms have improved, patients can slowly begin to reintroduce fibre to their diet, up to their personal level of tolerance. The one exception is in those with stricturing Crohn's Disease, where a low fibre diet may be recommended long term to reduce the risk of bowel obstruction.

Apparently, dairy is bad for IBD. Is that true?

No, dairy is not bad for IBD. Some people may experience transient lactose intolerance if their IBD affects the small bowel, as this is where the enzyme needed to break down lactose is found. When their IBD is back under control and their bowel has had time to heal, these patients are normally able to reintroduce dairy foods back into their diet.

However, if you find that dairy does not suit you,  always ensure that you are replacing these foods with non-dairy alternatives such as fortified soya or almond milk, and soya or coconut yoghurt. Other foods such as tinned fish, green leafy vegetables, beans, soya products, figs, oranges, seeds and some nuts are also good dietary sources of calcium. IBD patients have an increased risk of developing osteoporosis, therefore adequate calcium and vitamin D intake is particularly important.

Would IBD patients benefit from a gluten free diet?

A gluten free diet is generally only recommended for people with Coeliac disease, which affects about 1% of the population. In saying this, many people with IBD find that removing gluten-containing foods from their diet makes them feel better.

If you find that gluten does not suit you, consider the types foods you are eating. For example, pizza and cake contain gluten, but these foods are also highly processed and high in fat, so it may be these components of the foods that are causing discomfort rather than the gluten.

In the 30% of people with IBD who also suffer from Irritable Bowel Syndrome (IBS), removing gluten containing foods from the diet may help to improve digestive discomfort. Foods such as bread and pasta are high in FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) which can cause symptoms in those with a sensitive gut. In this case, the reduction in FODMAPs rather than gluten can lead to symptom improvement. Your dietitian may take you through the Low FODMAP Diet process if you also have IBS. 

Should IBD patients avoid alcohol and caffeine?

Patients with IBD do not need to avoid alcohol and caffeine, unless an individual finds that it triggers symptoms for them. Reducing caffeine intake can be useful if you have persistent loose stools as caffeine acts as a stimulant. 

Overall, there are no specific guidelines for caffeine and alcohol consumption among IBD patients, therefore I would recommend adjusting caffeine and alcohol intake on a individual basis. The alcohol guidelines for the general population can be found at www.alcoholireland.ie

What are common problems that you see coming up with your IBD clients?

In clinic, one of the common problems that comes up is Irritable Bowel Syndrome (IBS).  I help patients to manage their functional gut symptoms through diet and lifestyle changes, as well as therapeutic diets such as the Low FODMAP Diet. This diet involves reducing intake of FODMAPs (poorly absorbed carbohydrates) for 4-6 weeks, followed by a systematic reintroduction process. About 60% of IBD patients with IBS achieve clinically significant symptom improvements on a Low FODMAP Diet. For accurate results, this therapeutic diet should only be carried out with patients who are in remission, and under the guidance of their dietitian.  

Other patients I see in clinic may not be able to manage solid foods when in a flare-up. These patients sometimes require exclusive enteral nutrition (liquid diets) followed by a slow reintroduction process called the LOFFLEX diet (Low Fat/Fibre Limited Exclusion diet), which is used when patients are transitioning from a liquid diet back to solid foods. This diet helps patients to identify foods they are sensitive to, and therefore may need to avoid long-term.

On the wards, I see patients who require parenteral nutrition, which is a type of nutrition that is given intravenously. This is normally only needed short-term until the patient can safely eat and drink again.  I also provide dietary advice to patients following surgery who have a new colostomy or ileostomy. 

You can contact Aoife by email:

thedigestivehealthclinic@gmail.com

Instagram: @digestivehealthclinic

Website: www.thedigestivehealthclinic.com

Disclaimer: The information provided is not intended to replace medical advice or diagnosis from a physician or other medical provider. Please speak with your IBD team/dietitian if you are planning on making changes to your diet. 

Questions and Answers with Consultant Gastroenterologist Professor Stephen Patchett

By Clara Caslin

Professor Stephen Patchett is a Consultant Gastroenterologist who works in Beaumont Hospital in Dublin. He also works in The Bon Secours hospitals and is an Associate Clinical Professor in the Royal College of Surgeons Dublin. He graduated from UCD and began his training in Dublin before moving to London to train in St Bartholomew's and The Royal London Hospitals. 

He was a Senior Lecturer in St Barts in 1996 and then returned to Ireland to take up his current position in Beaumont in November 1998. He has a focus on diagnostic and therapeutic gastrointestinal endoscopy and therapeutics of inflammatory bowel disease. He is the clinical lead for endoscopy services in Beaumont and The Bon Secours. He is currently the chair of the working group for the national QA programme in endoscopy and represents the College of Physicians on the QA Steering group and the Conjoint Endoscopy Curriculum development group. 

Professor Stephen Patchett

What is your role?

Consultant Gastroenterologist.

When did you realise that being a Gastroenterologist was what you wanted to do? 

When I was a second year junior doctor and started working with a very influential gastroenterologist who subsequently became my mentor.

How many IBD patients do you treat (estimate)? 

1000.

What age group are the patients you treat? 

17-85.

Are all cases different or do you see a lot of similar ones? 

Whilst there are similarities, every patient is different both in the manifestation of their disease and their approach to dealing with their illness.

What do you think people can do to help their IBD?  

Look after themselves physically and emotionally. Eat well, exercise, don’t smoke. Learn as much as they can about their disease through interaction with others and IBD societies.

Do you ever think there will ever be a cure? 

I think ultimately yes but this will be some way off. However our ability to control the disease is improving rapidly and living with IBD will not be the challenge that it use to be.

What sort of lifestyle do you tell patients is best for them? 

Important to stay active and eat well (as we all should). This is the same advice that we would give to the general population.

Do you think IBD is one of the hardest diseases to live with? 

Difficult question as there are many difficult diseases. It really depends on the severity of an individual’s disease.

What would you say to someone who was newly diagnosed? 

Apart from explaining the nature of the disease and its treatment, I would stress that in the vast majority of cases, treatment is very successful and that a very fulfilling and active life is possible. I think a positive outlook is very important.

Image Credit: beaumont.ie

Questions and Answers with Inflammatory Bowel Disease Nurse Angela Mullen

By Clara Caslin

Angela Mullen is an Inflammatory Bowel Disease specialist nurse in the Mater Misericordiae University Hospital in Dublin. She began her nursing in Mercy Hospital, School of Nursing in Cork and then attended the Royal College of Surgeons in Dublin.

Angela Mullen at a photo call for a campaign for IBD nurses to be doubled in  2018.

What is your role?

My role is an IBD specialist nurse. I manage the IBD service, which includes inpatient and outpatient support education and advice. Most of my patients are managed at home. I run an advice email and telephone service, attend outpatient clinics and arrange urgent clinical review and also coordinate all Biological, immunosuppression therapies and educate re all medical treatments.

How many patients do you have?

I have over 1500 patients and growing rapidly.

Are you the only IBD nurse in the Mater?

I am the only IBD nurse.

Do you see more cases of Crohns or Colitis?

We see a little more Colitis than Crohn's patients (but not much).

What symptoms do people with IBD have?

Symptoms vary, classically its frequency of bowel motions worse in the mornings or at night with watery diarrhoea bleeding urgency and mucus. Sometimes just pain with altered bowel habit either constipation or diarrhoea not always with blood or mucus.

Do you think we need more IBD nurses in Ireland?

We definitely need more IBD Nurses, the patient’s with IBD need access to care (sometimes rapid) and unfortunately in some practices they don’t have that.

 How severe can some cases be?

 The severest of cases can be life threatening.

Do you think more people are having surgery or is medication able to "fix" a bad flare?

Medications can certainly treat a bad flare but with the unpredictability of the disease this sometime is not enough and surgery might be the only option totally dependent on the case.

Have you seen an increase in cases of IBD over the years?

Definitely an increase and more aggressive.

How young and old have you seen patients been diagnosed?

I work in adult services but have diagnosed patients at 16-17 and at the other end in their 70’s.

Is every case different?

No two cases really are the same everyone is different. We follow international guidelines on managements and escalations of treatments but every case is individual .

Photo Credit: Fingal Independent

Questions and Answers with Professor of Biochemistry Luke O'Neill

By Clara Caslin

Luke O’Neill is a professor of Biochemistry in the School of Biochemistry and Immunology at Trinity College Dublin. He was educated there where he was awarded an undergraduate degree in Natural Sciences (Biochemistry) in 1985. He completed his postgraduate study at the University of London where he was awarded a PhD in Pharmacology. His research investigates inflammation. For largely unknown reasons it can flare up and cause a range of inflammatory diseases, like Inflammatory Bowel Disease, which remain difficult to treat. I asked him some questions about his studies and the information that he found about Inflammatory Bowel Disease.

Luke O'Neill

What is your title?

Professor of Biochemistry.

How long have you been in your field?

 30 years.

Where did your interest start in it?

In my final undergraduate year in TCD – a project on Crohn’s disease.

What can you tell me about genetics in Crohn’s and Ulcerative Colitis?

Lots of genes have been implicated in inflammatory bowel disease affecting multiple inflammatory pathways. 2 of particular interest to my own research are NOD2 and IRGM. NOD2 is a bacterial sensor, implicating bacteria in disease pathogenesis. IRGM is an inhibitor of an inflammatory pathway involving the NLRP3 inflammasome, which a company I co-founded called Inflazome is developing inhibitors of.

Is there any trends that you have noticed in these diseases?

Both are obviously inflammatory in nature, and most likely involve a disturbance in the gut bacteria. 

Is there anything in your studies that you have noticed leads to shifts of the intestinal bacterial composition in Inflammatory Bowel Disease patients?

No.

Do you think that diet has a lot to do with these diseases? 

Limited evidence of dietary involvement.

What do you think would cause there to be a disrupted immunological response to gut microbiota in genetically susceptible individuals? 

Clearly it is a disease where there is a dysfunction in the how the gut handles bacteria. This then provokes inflammation and the inflammatory process becomes unresolving – a wound that won’t heal.

What causes chronic inflammation in the gut?

Unknown – likely to be a combination of genetics and aberrant handling of gut bacteria, or some yet to be uncovered cause.

What change can be seen when patients are treated with immunosuppressant’s? 

Current therapies show some benefits (eg anti-TNF and mesalamine) but there is a desperate need for new medicines which will limit the inflammatory process locally and promote a healing response.

Losing My Dad As A Teenager

Yesterday, it was nine years since my Dad passed away. When you’re younger, you never think that you’re going to have such a short time with a parent. You imagine your Dad being there for your birthdays, graduating from school, starting and graduating college, walking you down the aisle and being there when your children are born. I only had 15 years with my Dad. What I want to talk about in this post is the importance of dealing with a parents passing. Before I get into that I’m going to give some background into what happened.

I remember the morning that he died like it was yesterday but it also feels like a lifetime ago. My Dad never drank or smoked so it came as a huge shock to find out in April 2009 that he had terminal cancer. He was diagnosed with an extremely rare cancer that one in a million people are diagnosed with that had spread from his stomach to his liver, lungs and esophagus. His symptoms had started around Christmas time in 2008 when he was suffering with a lot of indigestion and he couldn’t eat much so in turn he lost a lot of weight. 

We were all so concerned because this huge character in our home had become quiet and withdrawn. My Mam pleaded with my Dad to go to the doctor but he was afraid of going. Eventually, he had to give in and go. The doctor sent him to the hospital the same day for an endoscope and blood tests, which came back the same day with the result that nobody was prepared for, cancer. 

I remember my Nana collected my brother and me from school that day and it was very quiet, I could tell by the atmosphere that something serious was going on. The way I found out about the cancer diagnosis wasn’t ideal. I was being nosey and had a look at my Mams phone where I saw the words, “John has cancer”. I remember nearly collapsing in the kitchen and running into my mam and nana saying “Does dad have cancer, tell me now”. After it was confirmed, I went up the stairs to my Dad who was resting in their bed. I lay down beside him and he gave me a cuddle. I started crying but I was trying to hide the fact that I was because I didn’t want him to feel worse than he already did, if that was even possible. 

He comforted me even though he was going through every person’s worst nightmare. That was the last time my Dad and I shared a cuddle. He had to go to the hospital for a week and even then when he was so weak, he was making jokes to the nurses about where the gym was and walking to meet my brother and I at the ward doors. He came home at the very end of April. The next week was spent making sure he was comfortable and being there for anything he wanted. He couldn’t talk very much because of the cancer in his lungs so his breathing was very bad.

The Tuesday night, which was the 5th of May, was the last time he was able to come down the stairs. The doctor came on Wednesday because his breathing was really bad. I tried to get him to eat some beans but he wasn’t able so I left him alone after that to rest. The next morning, we were woken early and he passed away surrounded by my Mam, Brother and me at home where he wanted to be.

We rushed to the hospital and I remember just being in shock. Family came to the hospital and I remember from the moment we left I switched into this mode where tears didn’t exist. I wanted to be there for everyone else but disappear so I wouldn’t have to have any sort of conversation about it. I use to dread when people would ask me about how I was feeling and now I realise it was because I was in some sort of denial. Family tried and tried to get me to talk about my Dad but I would shut the conversation down or leave the room. I was just too heart-broken to talk about it and to process the feelings that I was feeling deep down, so I shut them out. I got extremely sick in 2011-2012 and spent a lot of time in the hospital (which you can read about here) where I only started talking about my Dad. 

There was a night in May 2012 around his anniversary were I was closing a window in my room and I looked out and saw the room where my Dad had stayed in the hospital and from then I opened up more and more. Whatever it was about that and being so sick, it was being so vulnerable that it made me talk about him a lot. It was really a healing. Now, I speak about him everyday. We say at home that it’s just like he’s in a different room. It’s so important to speak about the passing of a parent because if you don’t, it just shuts you away from people and your true emotions. 

A lot of my family thinks that I got sick from the suppression of my emotions. I definitely agree that your health can deteriorate but I don’t think it’s what caused me to have Crohns. I know what it’s like to watch people with their dads and wanting to cry because you can’t do that or someone’s dad ringing them and knowing my dad will never ring me again or that he never got to see me grow into an adult or that I’ll never see him come home or give me a goodnight kiss and cuddle ever again. 

My advice to anyone going through the death of a parent as a teenager or any age is to talk about it. You don’t have to always be so strong for everyone else. Don’t be embarrassed about your feelings. It’s ok to cry – you’ll feel a lot better after letting it out. Don’t feel like talking about it is looking for attention just because your friends haven’t been through the same thing as you. Your friends will want to be there to support you and of course your family will always be there to support you and if you don’t want to speak to family or friends there is plenty of other support out there for you so there’s always an option. 

For anyone lucky enough to still have their parents hug them tighter, call them more, spend as much time with them as you can and tell them you love them everyday. It only takes a second for everything to change. 

My Experience Of Having A Colonoscopy!

Hi everyone,

If you read my blog then you'll know that I was diagnosed with Crohn's Disease just over four years ago. In August, I was in the hospital for a routine check-up and met a new doctor on the team. We were chatting about my case for a while and all seemed ok. Two weeks later, I received a letter in the post informing me that I had an appointment to have a colonoscopy done two days later! I had an appointment the day that it was scheduled so I had to reschedule it. I received another letter a few days later from the doctor that I met telling me that the team had discussed my case and wanted me to have a couple of tests done quite urgently. 

For anyone that doesn't know what a colonoscopy is, it's a test where they place a camera up your you know what so that they can see your rectum and entire colon. It can also reach the last part of the small intestine called the ileum. I've dodged having a colonoscopy done for years but this doctor wasn't letting me away with it! Everyone always thinks it's so strange when they find out that I've never had one done before but the reason I didn't have one done was because there was too much inflammation in my intestines when I was sick and they didn't want to chance that any perforation would occur during the procedure. 

My appointment date came and it was scheduled for last Tuesday which was the day before I started in Dublin City University (DCU). I was quite anxious about it because I didn't know how I would be after the test and I didn't want to miss my first day of a new college. I'm sorry for what I'm about to say to anyone who is going to have a colonoscopy done but I'm going to be completely honest. KLEAN PREP IS THE MOST VILE THING THAT I HAVE EVER HAD TO GO THROUGH. Your preparation starts a week before you have to go for the colonoscopy. You have to avoid certain foods which was grand and then at 3pm the day before the test you have to start drinking Klean Prep. 

You have four sachets that you dilute with a litre of water each and you're supposed to drink 250ml every ten minutes so that your bowel is clear for the procedure the next day. The only way to describe the taste is like swallowing vanilla scented salt water. You can dilute it with mi wadi but I ended up having to drink straight mi wadi before I could take a taste and then I washed it down with more straight mi wadi. I started at 3 15pm and I was still up at 3am finishing it and by finishing it I mean that I got through two and a half sachets in 12 hours!! 

I was annoyed at myself for struggling so much with it but it literally reduced me to tears after half a glass at the thought that I was going to have to struggle through four litres of this crap. Once the Klean Prep starts working, I advise you to stay very close to a bathroom! I gave up at 3am after the two and a half sachets because things were clear (if you get me) and I was really tired too. I wasn't scared about having the colonoscopy, I was more anxious that they would find anything! 

I was in chatting with some women in the dressing room when a nurse came looking for me. I went out and was brought into a room to have the cannula put into my arm and sat up on a bed. It was only after around five minutes of chatting to the nurse that I realised I was in the procedure room! A few minutes later, the doctor put some sedation in the cannula and I felt a bit relaxed but I was still completely aware of what was going on. The colonoscopy began and I watched everything that was being done on a screen and asked about 1,0000 questions (the poor doctor)! There were a few moments of cramping and discomfort but they didn't really bother me as they passed after a few seconds.

My biopsies won't be back for a few weeks but there were no signs of any inflammation anywhere which I was delighted about! That was my experience of having a colonoscopy. In short, Klean Prep is evil and the colonoscopy is absolutely nothing to be worried about! 

Clara