Medications for rheumatoid arthritis can be hard on your stomach. Between heartburn, acid reflux, gas, GERD and other gastrointestinal shenanigans, chances are that sooner or later your doctor will suggest you get scoped. Even if you have the sound gastrointestinal constitution of a camel, there comes a time in your life where it just makes good sense to screen for other health conditions, such as colon cancer. Colonoscopies and endoscopies aren't the most fun at the best of times, but can be more difficult with RA - today's post looks at how to work around these challenges. I spoke to Dr. Cindy Haines, who gave me excellent tips for further research. Also thanks to Hanna T. Hanna of Main Drug Mart in Toronto for information regarding colonoscopy prep.
Let's start at the top.
Endoscopy is a name for the type of procedure that looks inside the body using a flexible tube (or endoscope) with a light and a TV camera on one end and an eye piece on the other end. When laypeople talk about this, they usually mean what's called an upper endoscopy, in which a doctor examines the esophagus, stomach and top part of the small intestine, looking for abnormalities or damage. Your doctor may order an upper endoscopies if you have acid reflux, stomach pains or as a way to diagnose GERD.
During an upper endoscopy, a small brace placed between the teeth to keep the mouth open and the endoscope is threaded through this brace into your stomach. The tube is 1/3 of an inch wide or less (8-11 mm). Before you panic, it's important to know that you'll receive sedation through an IV before the procedure and probably not remember what happened. The procedure itself lasts no more than 30 minutes. Preparing for an upper endoscopy usually involves fasting for about 12 hours.
If you have RA in your jaw joints, opening your mouth may be difficult. Having your mouth open for up to 30 minutes, even though you're sedated, might strain your jaws, potentially causing a longer-term flare or pain. The good news is that there are options.
An alternative to the regular upper endoscopy is one where the doctor uses a smaller caliber scope, inserting it through the nose instead of the mouth. This eliminates the need for your mouth to be open for an extended time and reduces strain on the jaw joints. Another, significantly more high-tech, option is wireless capsule endoscopy or the "video pill." This is the stuff of science fiction, my friends!
In a capsule endoscopy, you swallow a capsule the size of a large pill. Within the pill is a small camera that takes pictures of your gastrointestinal system as it travels through your G.I. tract, transmitting it to a data recorder you wear for about 8 hours. These pictures become a sort of movie of your insides (see video here). It can be especially helpful to investigate the small intestine which can't be reached by upper endoscopy or colonoscopy. Preparing for a capsule endoscopy also requires fasting and you might need to do a bowel prep/cleansing (see colonoscopy below).