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It's a design constraint

This theory is supported by the discovery of adrenal atrophy upon autopsy ( CAI in PWS is not well understood, as studies have reported varying results (ranging from 0% to 60%) using different dynamic tests, such as the insulin tolerance test (ITT), metyrapone test (MT), glucagon test (GT), and the currently most used low-dose and standard dose Synacthen stimulation test (LDSST and SDSST) ( Table 1 ) ( Table 1 Summary of the studies with stimulation tests for central adrenal insufficiency in PWS

The colonoscope contains a tube that pumps air, carbon dioxide, or water into your colon