I offered to prescribe him a laxative regimen that could help him purge the existing stones and debris over time. I told him that I could envision a time when there would be so many rocks and stones that he could develop a blockage or tear in his bowels - which would likely require emergency surgery - or that he could get some sort of infection from such objects that clearly did not belong in his digestive system.įrankly, Jasper was lucky that his symptoms were so minor, given how much material was in his colon. It certainly seemed to me that we had identified the cause of the heavy sensation he was experiencing in his right lower quadrant, where his rock-filled cecum was located. Then it was my turn to be astonished, as he went so far as to ask if I had put them there during the procedure! Jasper told me that he had no idea how the stones and pebbles had gotten there. His wife likewise stared at me with a mix of puzzlement and shock on her face. The patient met most of my questions with a look that could only be described as astonishment. I asked him if he could tell me anything about this. I reviewed the findings of the examination and showed him the photos of the rocks, pebbles, sand and mud in his bowel. I printed the images and incorporated them into the procedure note itself.Īfter the effects of the sedatives had some time to wear off, I met with Jasper and his wife. Using the camera built into the colonoscope, I quickly captured several color pictures of my findings and then completed the rest of the examination, which was otherwise unremarkable. It was immediately obvious that there were too many stones to remove with the colonoscope. The entire collection would have filled a small cup and would probably have weighed a couple of ounces. There were at least a dozen stones the size of marbles, and well over 100 pebbles amid a heap of what can only be described as sand and mud. I don’t mean gallstones or kidney stones, or some other unusual calcification created by the human body itself, but actual geologic rocks from the earth. When I advanced the colonoscope into the patient’s cecum, I encountered a profoundly unusual sight - a large collection of what were undoubtedly stones. The cecum marks the beginning of the colon, and it sits just below the very end of the small intestine. After obtaining his informed consent for the procedure, he was sedated, and we began his colonoscopy.Ī complete colonoscopy involves inserting the colonoscope to a depth of about 5 feet, all the way into the cecum, a chamberlike region in the right lower quadrant of the abdomen. On questioning him, he reported no other troubles beyond those that he mentioned to his primary care physician.

When Jasper arrived in the endoscopy unit, he looked quite robust and healthy. Given these facts, and because a colonoscopy is also part of the standard workup of lower abdominal pain, I scheduled him for the procedure. As Jasper had never had a screening colonoscopy (and was well overdue to have one - most patients need their first screening colonoscopy at age 50 and every few years thereafter), he was referred to me for an evaluation. The symptoms had been present for some time and were mentioned only to his primary care doctor in response to some standard questions about his overall health. The patient in question, let’s call him Jasper, was a 55-year-old man who had developed some intermittent abdominal discomfort and a feeling of heaviness in the right lower quadrant of his belly. Sometimes when we look into the colon, however, we find the unexpected. A big part of gastroenterology involves performing screening colonoscopies to look for and remove colon polyps that could develop into cancer. The nitty-gritty of GI doctors’ work may not make for good party talk, but gastroenterology does afford its practitioners the opportunity to take care of a wide range of patients - young and old, male and female, and with a diverse set of problems ranging from heartburn to colon cancer. Most gastroenterologists don’t choose their subspecialty based on its inherent glamour.

Pica syndrome first discover