Please note this information is from my experience only; I am not a healthcare professional so there are likely to be some inaccuracies.
For me, one of the most embarrassing and scary things about having a rectal prolapse was all of the tests that I had to have. The tests came in all different shapes and sizes and (it turns out) weren’t actually that scary at all. I thought I’d share my experiences of the different bum tests in case anyone who is about to have one is wondering what it is actually like…
The initial consultation (the finger exam)
If I could have a gold star for every time that a medical professional had put their finger in my bottom I would definitely be on to a winner by now. It has happened so many times that I can’t count and it feels completely normal these days.
I do remember, however, how scary it felt to be going in there the first time and actually showing someone my obscenities; being told to take my trousers off and lay sideways on the bed with my knees up; getting ready for the doctor’s investigation…
But the important thing to remember is that the doctors and consultants see this kind of thing all of the time. Colorectal surgeons look at people’s bumholes literally every day (pretty legendary actually if you think about it!) and have seen all kinds of weird protrusions and strange lumps and bumps.
The doctors, consultants, and nurses all know what they are talking about and are there to help you, they will never laugh at you, they will never stop trying to remedy your symptoms, and they will always welcome you with a smile. You are in good hands (and if you find yourself in an unfortunate circumstance where you are not in good hands then you can choose to go somewhere else).
Flexible endoscopy (a camera in your bottom)
A flexible endoscopy is when the consultant uses a camera on the end of a flexible rod inside your anus and up into the lower parts of your colon (that’s your intestines) to check if there is anything abnormal going on in there.
For me, by far the worst part of having a endoscopy (or sigmoidoscopy to be exact) was the necessary preparations… I was sent a harmless looking package in the post that contained a few sachets of white powder. I was told to dissolve this powder in water and drink it over the evening before the procedure. I was also told not to eat anything and to stop drinking a few hours before I went in.
The white powder was there to clean out my bowels. Drinking it lead to the most amazing watery diarrhoea that I have ever experienced. My bowels have never been so clean! Pretty disgusting but also pretty darn well amazing.
The procedure itself was painless and very short. I changed into a hospital gown and was lead into a room full of clever looking equipment. I was asked to lie sideways on a bed, a quick ‘Are you ready?’ from the consultant and a little ‘Yes’ from me and the camera went in. It felt strange, very strange. And was perhaps made even stranger by the fact that during this the nurse started asking me about me job (while some one was putting a camera inside my anus!). Very strange. But very quick and completely painless.
Also, one of the coolest things about this was that I was able to watch the output of the camera on the screen. I have seen the inside of my colon, not many of my friends can say that!
Proctogram or defecography (my favourite!)
This is the strangest test of them all – an x-ray is taken while you defecate into a special x-ray toilet. Woop!
So this test is incredibly important because it lets the consultants see what is going inside of you when you push down and strain when excreting things from your bottom. Though some prolapses are very obvious from the outside (i.e. external prolapses), others are completely invisible and this x-ray allows the consultants to get the full story of what is going on.
Obviously x-rays are usually for looking at bones and they aren’t very good for looking at soft tissue. This means that prior to the proctogram I was given a barium paste beverage to drink. This barium travels into your upper colon and makes it show up on the x-ray. It tasted a lot better than I thought it would, quite surprising actually.
A little while after my barium appetiser I was invited to wear another lovely hospital gown and then chaperoned to a room filled with fancy looking hospital equipment. Though the barium paste had made some of my insides visible to an x-ray, other parts needed some work. The nurse chatted pleasantly to me about my work while the doctor inserted some barium paste into my rectum (again, incredibly surreal!). I had the task of inserting some into my vagina and then I was ready…
I was directed to a toilet in the middle of the room and there the doctor gave me the instructions; I was to hold my pelvic floor muscles up, then release, then go to the toilet, and then push down and strain as hard as I could. She pulled a curtain around me and a few seconds later directed me to do as she had told me. This is by far the weirdest hospital experience that I have ever had; very strange but again very quick and completely painless. Easy Squeezey.
Ano-rectal physiology and ultrasound
I had these tests done to test the function of the muscles in my pelvic floor prior to surgery. Recovering from prolapse surgery can be hindered if your muscles aren’t working properly and these tests are done to check if anything special needs to be done during or after the surgery to help with recovery.
First thing first, I had to take my panties off. Then the smiley nurse described to me what was about to happen.
The nurse inserted a small probe into my bottom and then asked me to squeeze it a few times for different lengths of time. This was to test the strength of my sphincter muscles.
Next the nurse put a small balloon into my bottom in order to test the sensitivity of my bottom. She slowly inflated the balloon and asked me to tell her when it felt like I need to go to the toilet. She then slowly inflated it a bit more and asked me when it felt like I would have to run to the toilet…
Lastly she inserted an ultrasound probe into my anus to take some pictures of my ano-rectal tissues. This ultrasound probe took some pictures which were used to show the consultant if there were any problems with the surrounding muscles.
Again all very strange but all very quick and completely painless.
Examination under anaesthetic (EUA)
I had this test done a few months after surgery. I was still having problems defecating so they decided to have a look and see if there were any residual problems with my anatomy that could be hindering my recovery.
This test is done under general anaesthetic so obviously I don’t remember anything about it. I do remember wearing an attractive hospital gown and delightful slipper socks. I also remember my friend smiling at me as I fell asleep from the anaesthetic (it is great to have amazing friends with you when you go through these things!).
I was asleep for about 30 mins and when I woke up I felt fine, wouldn’t even have known they had done anything except that my bottom was slightly numb… Definitely the easiest and most stress-free test I have had 🙂