painful colonoscopy

I checked this discussion because I had done extensive reading about colonoscopy procedure - all aspects - including without sedation. 

I did this because I was scheduled for a colonoscopy to investigate colorectal bleeding + anaemia. I had the procedure this morning and wanted to feedback on my experience, because I know how anxious it can feel doing research before the first time you experience the procedure.

I too, thankfully, can report that I had a painless colonoscopy which was completed fully and without sedation. I write this to offer another experience - but in no way do I discredit the true accounts that othe's have testified to here and elsewhere. My motive is to let others know that it is possible for some.

Even though I went in already decided against sedation - I asked the prep. nurse what she'd recommend from her experience witnessing patients having the procedure. She said some feel pain with the sedative and some dont - she also said that this is also the case for those who don't have any sedative - some do have pain some don't.

I wondered how it is that the medical profession state 'some discomfort' yet there are so many testimonies of 'the worse pain ever!' My conclusions were that if sedative is not going to prevent pain, why have it? So I focused on the 'pain' exclusively in my options for the procedure. I did not want to be 'out of it' and confused and forgetful, whilst at the mercy of the medics, allowing rushed and unconsidered actions.

Focusing on pain, I asked if I could receive fentonyl, which is an alalgysic (pain releiver), without the sedative (versed, medazolam or any other benzodiazepan). They said yes they could do so - and did. I did not use gas and air or anything else (except Boscopan, to relax the colon itself)

Women have longer colons which means this procedure can be difficult, especially if they have had a hysterectomy. In my case I have Uterine Fibroids and mentioned this to the Dr before doing the procedure and he said it may make it a little harder to get around if things are obstructed. I am also a small woman, 5ft and 9 stone & I have had 3 children; I am now 50 yrs old.

I had 75 micrograms of Fentonyl and 10mg of Boscopan immediiately before the procedure started.

The Dr (Consultant) got all the way to the first bend before I felt any discomfort - then I felt him infrate air and was a little anxious because I know this is where other say the pain intensifies. The colonoscopist (Dr) asked if I was OK - he could see me tense, I said yes and the baloon effect of pumping air was a little uncomfortable, but not excessive. After that point he managed to get all the way to the appendix without me feeling any more discomfort. He told me that was the worst part over and that I was doing very well - I thought, no you are! The he said the next part was to remove it and double check for any abnormalities or areas of concern (polyps etc)

On coming back out, he took 6 biopsy's - no polyps found and everything normal. He did see a slight hemeroid on withdrawal (anal) on the way out. I felt only a slight tugging on one of the biopsy's.

I can ony offer my own experience in order to inform others who may be having the procedure and wonder what to expect - I myself nearly frightened myself out of the procedure after all that I had read. I was referred for the colonoscopy due to rectal bleeding, dark red & mixed in wih stools + anaemia, so was obviously concerned about possible colorectal cancer (no polyps, results of biopsy soon - but basically given the all clear in terms of suspected colon malignancy). 

Main points for consideration

- I specifically asked for painkiller (Fentanyl)

- No sedation, so I could be aware and part of decisions to proceed etc.

- Researched the person doing the procedure - opted for a Consultant who does frequent colonoscopy procedures (Asked who was scheduled to do it, researched his name on NHS Choices, list of consultants). Modesty made me want to choose a woman - but his credentials outweighed, and it was minimum pain and skill that I focused on. I did have a choice depending on hospital and date - was on a fast track 2 week referral list, due to symptoms.

My humble advice would be to

a) focus on skill (the colonoscopist) - to minimise pain & the chance of missing polyps etc.

b) Focus on pain relief medication instead of sedative. This way you are fully aware to work with the Dr and to be considered every step of the way. You will remember all the images of your colon and be reassured that you were treated with consideration and due care. 

c) Just a thought - but I also wondered whether some of the pain reported may be related to the conditions people present with crohns, diverticulitis, previous bowel surgery etc. I'm no expert, but I wonder if this should be considered when deciding the type of painkiller or sedative options? We're not all the same and possibly this may also affect the pain experienced.

If you are really worried about this procedure - I hope this helps. If you have suffered painful colonosopies in the past, I hope this helps going forward too. I really appreciate all of the feedback each person here has given - it helped inform my own choices. I was glad to have had only mild discomfort at one point, but I know that was not guaranteed.

All the best in your individual journey  

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109467/