Well, in fairness, the teriyaki sauce makes that much tastier, and it takes a lot of spiders to make a decent meal!
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Ummm - have you ever had a colonoscopy or endoscopy? It is unimaginable to me that the one-inch cockroach could be introduced during the procedure.
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Plus, the man wasn’t having a colonoscopy, which wouldn’t go anywhere near the upper GI tract (the small intestine). The story is bizarre. I have a hard time imagining that a cockroach could survive the acidity of the stomach, but maybe if this guy’s stomach acidity was reduced somehow?
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Well, cockroaches are tough - and I can imagine it hitting the stomach and its acid, going ‘nope’, and heading off down the small intestine.
But IANADoctor so … (I expect one will be along to tell us this may not be plausible.)
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A doctor has already spoken here and he didn’t say it wasn’t possible.
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The insect wasn’t necessarily on the endoscope itself, but potentially in the air used to inflate the small intestine. (Roaches are very good at squeezing into small spaces - a 1/10 of an inch crack for an inch-long specimen is sufficient for entry.) Either way, it’s a hell of a lot more likely than an insect surviving being digested - if that happened, that would suggest a seriously dysfunctional digestive system and a bug in his guts was the least of his GI issues (and would have been a lot more obvious than an insect in his intestine)*.
*And even then, the lack of oxygen in the digestive tract would have killed a roach well within an hour. There’s really no plausible scenario in which the guy swallowed a roach, went to the doctor, got a colonoscopy and that roach was still alive in his intestine. Which means the roach went in the other way, and not long before it was detected in the colonoscopy.
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Oh, boy. I know that feeling. (In the large intestine. Balloon colonoscopies are such fun.)
I guess that is plausible. As @docosc said, if so, there is a real issue in that hospital.
And if so, then still no explanation for all the stomach problems the patient was experiencing beforehand, that necessitated a tube down the throat to start with, if the bug was introduced during that procedure.
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Although it wasn’t a colonoscopy, as I assumed, but an upper GI endoscopy, and I don’t know that anything got inflated in that process (which makes it a lot less likely they introduced it), but the quotes from the doctors also doesn’t say it was found alive, but “intact.” (It looks very dead in the provided picture, taken in the gut.) So it could have been swallowed - but it’s also pretty clearly not the cause of his bloating and discomfort, either.
He’d been having problems for three days, and the bug couldn’t possibly have been in there that long - it was just a series of coincidences that the guy had GI issues, and he swallowed a roach and they happened to find the roach when they did the endoscopy.
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Over the years, if i have learned anything, it’s to never say never. Bodies are weird, act unpredictability and react in ways they should not. IOW, there ain’t no rules. Hypothesis time, then. Was he on PPIs? Take out the stomach acids and survival for parasites goes way up. No clue how that works for roaches, i seriously doubt there is any data on that. But roaches are exceptionally hardy critters. 
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A roach isn’t an internal parasite - even completely absent stomach acid, the lack of air would kill a roach pretty quickly. Given that the quotes from the doctors say nothing about the roach actually being alive (and the in situ photo shows it clearly dead), I assume it wasn’t, which makes ingestion far more likely. (Given that he had GI problems for three days, it also means the roach wasn’t the cause.) The headline here is just incredibly misleading.
