Colonoscopy Without Sedation

I had a colonoscopy today without sedation.  The default is sedation, but I didn't want it.  The proctologist said that's fine, but if I had pain, let him know and he'd add sedation.  I watched the procedure on the screen.  They inserted the scope all the way through the colon and into the small intestine (you can see villi), looking for polyps mostly on the way out.  The probe insertion wasn't painful.  They inflated the colon with air, however, and at some points there was some discomfort with that, completely analogous to gas pain, because that's what it is. Interesting because certain locations were uncomfortable in exactly the sensation I've had in the past, and now I could see the spot corresponding to the sensation.  They found one polyp that was lassoed and excised.  There's no pain with that.  No nerve endings there.  Afterwards, I had to pass the air out of the intestine before I was comfortable enough to stand and leave, but that would have been true with or without sedation.  All in all, the discomfort was modest to moderate, and I'd certainly do it again with no sedation.  They can have it at the ready if there's too much discomfort, but I'm sure I could handle it so long as they don't inflate me to the size of a zeppelin.  The prep was certainly more unpleasant than the procedure. 

I'm a 52 yr old male. Family history of colon cancer and polyps was my driving factor to overcome my resistance to a colonoscopy. My father was told by his physicians to have all four of his sons to not delay having the procedure until age 50. That was 12 years ago. I was 40 yrs old at that time. I've delayed the procedure due to high anxiety about medical professionals in general. I believe the majority of men delay or reject medical procedures for many reasons. One being this type of procedure, by being placed in a vulnerable position and most likely lack of the medical professionals lack of respect for male modesty are common concerns.

I chose to have my colonoscopy unsedated. My gastroenterologist is highly recommended and respected in the field. He had no issue with my request for no sedation. We had an in depth discussion of the sedation options. The high probability of adverse reactions, lung and heart issues while under sedation, outweighed the possible discomfort. Also the mind altering twilight drugs, offer no pain relief, only amnesia to the procedure. Never consent to these meds. They have adverse reactions on well over 10% of patients. My opinion, these meds should be outlawed. Similar to date rape drugs.

Great staff on my arrival at the clinic. I was asked repeatedly from check in, consent form signing, pre-op to procedure room by four different nurse staff, "are you sure you don't want sedation". Followed by the roll of eyes and "well everyone gets sedition". This became a little unnerving, as there's a bit of anxiety going into this procedure anyway. I stood by my decision. I had to agree to an IV in the event of emergency need for life sustaining drugs should something happen during the procedure.

The Doc was great. Within in seconds he had the tube inserted for the scope. I was anticipating discomfort immediately. But honestly only felt a mild sensation to relieve my bowel. I watched the screen as he looked in my rectum first, all clear and onto the colon. As he scoped forward, irrigated with water. I only felt a little internal pressure at the first turn. I asked " Doc, was that the first turn"? He said "yes". I said jokingly "you could give me a heads up" which brought laughter to Doc and the staff in the room. Doc said "I forgot for a minute you're fully awake"

There is no feeling of the scope inside the colon. Honestly watching the screen, I couldn't place any sensations with what was going on inside. The Doc said I shouldn't feel anything. That's the way the colon is. The nurse had to press on my stomach to flatten out the colon for one section for the scope to advance. Once arrived at the cecum (small intestine) I felt some pressure like i had gas in my bowel. No cramping, just feeling of bloating. I asked if he was pumping in air? Yes, he said.

He backed out the colon and talked thru what he saw. All looked great and healthy until right before exiting the colon. One small polyp. He said looked like no worries from appearance, and I watched as he clamped to it with a claw tooth instrument, pulled out away from the colon wall and snipped it off. I couldn't even feel the removal. One small drop of blood appeared. He said, got it all and we'll send it off for testing.

All in all, was in me total of 17 minutes. Total time from IV start to walking out of the clinic of my own accord was 55 minutes. I'll tell you, the prep the day before wasn't awful. Didn't taste great tho. But No cramping, just have to stay close to the bathroom. The most discomfort is relieving the air pumped in during the procedure. I had mild cramps and the air didn't fully discharge until late in the night.

I would highly recommend unsedated!! No reason for any meds. An easy procedure and honestly can not feel the scope inside. Only slight pressure from the air being pumped into the colon for the Doc to see all of it. I felt respected and realized it's not about the bum where my initial anxiety rested, it's about getting into the colon to check you out.

Talk to your Doc about the options of unsedated. No need to put unnecessary stress on your body and unknown possible side affects from truly unneeded meds.

I have not (and NEVER will have) a colonoscopy, but I had a screening sigmoidoscopy some 16 years ago. I am glad your experience went ok.  Mine  .... was far from tolerable.  Since all the sigmoidoscopy was done behind my back, I have no real idea what was inserted in me, but my imagination tells me that they forced up a small rodent up my bum, and that rodent scurried around inside around and around and around with its sharp little claws for what seemed like the better part of a day before it found its way out.  NEVER AGAIN!

Hi All, I just want to write a quick review regarding my recent colonoscopy and fear of 'sedation'. I am a 26 year old practice nurse and I yesterday went my first colposcopy  in London - I had  been anxious for leading up to this, not because of the procedure but because of going under 'sedation'. I would advise anyone who is having this procedure and has a fear to request 'Fentanyl and gas and air only' you will be fully aware of the procedure and your surrounding and it will not  knock you out or cause any disorientation  - just relive any pain/discomfort.. My procedure was a bliss and with a positive outcome. Hope this helps and good luck to you all.

Just had mine done this morning.  Was not given a choice about sedation but was told would be ok to go home later on my own.  I remember when the sedation was given feeling myself relaxing, however I also remember loads of really bad pain and being told to move on my front my back etc I also remember moaning and asking for it to stop due to the pain, it was really unpleasant.  I was given fentanyl and not sure if it was enough.  Anyway the pain was compensated by being able to go home 4 hours later.  YAY  

I had s colonoscopy yesterday. I did have sedation but it was wasn't the sedation I've had before that knocks you out. I was wide awake and aware of everything - best way to describe it was like having a glass of wine. The nurse they give you just just enough to relax you. I thought sedation knocked you out so you didn't remember anything

I used gas and air for the first 30 seconds I'd say which was really only the uncomfortable bit - when they first push the scope in and put the air in. As soon as the gas and it kicked in I didn't feel anything at all and was watching on the tv screen the whole time. It was quite interesting to watch - very weird looking too. You can feel the air going in and building up at times but I think if you stay as relaxed as possible it just comes back out naturally. The only other uncomfortable bit was when she was taking the scope back out again and I think going round a corner - as I could see that on the screen.

You have to move a few times - you start on your left side, then move to your back, then to your right side.

All of this said, thank fully all was fine with me and nothing at all found. I'm sure it could be very different if you have a bowel condition or inflammation which could make the test more painful.

While what I have to say doesn't have to do with the colonoscopy itself, but the prep. I'm 25 and I have to get s colonoscopy Monday due to bad lower stomach pain which GI thinks is just IBS but my first time meeting with him was yesterday and he wants to do a colonoscopy because my father passed from colon cancer. So where my worry sets in is with the prep. Having so called ibs, I'm worried that the prep will hurt my stomsch. You know, the sharp and crippling pain.. have you had that expiernece at all?

2017 - Replying long after original post, but, as this still comes up in Google Searches, I do feel it's important.  I just had a successful, pain-free (Ok maybe a 2-3 for eight seconds) colonoscopy.  I searched online SO MUCH and feel I basically wasted a lot of time worrying over nothing.  It was a breeze.  If you have EVER had a bought of gas (aka painful gas bubble) then that gas bubble was far, far WORSE than your colonoscopy will be.  Honestly, I read everything... including the fact that women may have a more twisted, windy, tortous colon and so I read men's reports with a bit of a grain of salt.  As a woman, I can tell you, it was almost embarrassing how worried I was.... there was little to no pain.  I did have a first dose of fentanyl (which does not put you to sleep and is NOT related to the scary Versed stuff) but, I don't really believe that did much..... gas bubbles, or gas pains are not exactly the kinds of pains you would take an advil, tylenol or even vicodin for, right?  So, same idea. I think the fentanyl was reassuring but don't think it did much.   

That said.  Details I was most worried about: Will the scope hurt being threaded up my bum? Nope. Barely felt it. The doctor does do a quick finger sweep, and that was minor uncomfortable....  and that was WAY worse than the scope.  Not sure why, but, I was shocked that I never had any discomfort in my anus regarding the scope itself. None.  I had worried that after a day long bought with self imposed diarrhea, I'd be in agony... but, not in the least.  First, the prep isn't even related to a bought of diarrhea. Not the same.  No nausea or 'sick' feeling. It's more 'matter of fact' if that makes sense.  Yes, you have a runny, pure water output, but, it's' just streaming out forcefully as expected, not coming out because you feel sick..   so, I didn't wake up 'sore' like you might expect after having actual diarrhea.  Totally different experience.  To my relief! 

So, day of the procedure -- I kept having to REMIND the nurses and staff that I wasn't planning to be sedated. It's so unusual, and so so standard to give Versed, that they kept assuming I was having it.  

This was one of the most painless medical procedures I've ever had.  Honestly.  Just some gas bloating for about 5 seconds at one "turn".  The most surprising part????  Unlike actual gas pains, your doctor has control of the air he or she pumps in..... if you feel too much agony, they can quite quickly and EASILY suck it back out, give you a minute to breathe and start again.  That happened to me for like 3 seconds.  He sucked the gas out... I was.. like... oh, ok!!! And he started again and it didnt even hurt.  

I watched people who had been sedated recovering next to me gagging, vomiting, crying, acting crazy... and I was chatting politely with my nurse.  When I left the hospital, I went out with my husband for a lovely late afternoon lunch!!!! 

Just do it.  You have nothing to lose. If you can't get through it, they'll stop, and you can try again.   But, as a 50 year old female undergoing the basic screening, I was very very thankful I opted OUT of Versed. 

2017 - Replying long after original post, but, as this still comes up in Google Searches, I do feel it's important.  I just had a successful, pain-free (Ok maybe a 2-3 for eight seconds) colonoscopy.  I searched online SO MUCH and feel I basically wasted a lot of time worrying over nothing.  It was a breeze.  If you have EVER had a bout of gas (aka painful gas bubble) then that gas bubble was far, far WORSE than your colonoscopy will be.  Honestly, I read everything... including the fact that women may have a more twisted, windy, tortous colon and so I read men's reports with a bit of a grain of salt.  As a woman, I can tell you, it was almost embarrassing how worried I was.... there was little to no pain.  I did have a first dose of fentanyl (which does not put you to sleep and is NOT related to the scary Versed stuff) but, I don't really believe that did much..... gas bubbles, or gas pains are not exactly the kinds of pains you would take an advil, tylenol or even vicodin for, right?  So, same idea. I think the fentanyl was reassuring but don't think it did much.   

That said.  Details I was most worried about: Will the scope hurt being threaded up my bum? Nope. Barely felt it. The doctor does do a quick finger sweep, and that was minor uncomfortable....  and that was WAY worse than the scope.  Not sure why, but, I was shocked that I never had any discomfort in my anus regarding the scope itself. None.  I had worried that after a day long bought with self imposed diarrhea, I'd be in agony... but, not in the least.  First, the prep isn't even related to a bought of diarrhea. Not the same.  No nausea or 'sick' feeling. It's more 'matter of fact' if that makes sense.  Yes, you have a runny, pure water output, but, it's' just streaming out forcefully as expected, not coming out because you feel sick..   so, I didn't wake up 'sore' like you might expect after having actual diarrhea.  Totally different experience.  To my relief! 

So, day of the procedure -- I kept having to REMIND the nurses and staff that I wasn't planning to be sedated. It's so unusual, and so so standard to give Versed, that they kept assuming I was having it.  

This was one of the most painless medical procedures I've ever had.  Honestly.  Just some gas bloating for about 5 seconds at one "turn".  The most surprising part????  Unlike actual gas pains, your doctor has control of the air he or she pumps in..... if you feel too much agony, they can quite quickly and EASILY suck it back out, give you a minute to breathe and start again.  That happened to me for like 3 seconds.  He sucked the gas out... I was.. like... oh, ok!!! And he started again and it didnt even hurt.  

I watched people who had been sedated recovering next to me gagging, vomiting, crying, acting crazy... and I was chatting politely with my nurse.  When I left the hospital, I went out with my husband for a lovely late afternoon lunch!!!! 

Just do it.  You have nothing to lose. If you can't get through it, they'll stop, and you can try again.   But, as a 50 year old female undergoing the basic screening, I was very very thankful I opted OUT of Versed. 

So glad you had a good experience,

Many of these comments were helpful for me, and I decided to write about my own experience of having a colonoscopy without sedation, just yesterday.

First, I'm a 63 year old male, and not a medical professional, although I have read a lot about medicine, including issues involving the colon since a few decades ago, I had a minor one-foot inflammation of the colon called Ulcerative Proctitis, which is not as serious as Ulcerative Colitis, and I recovered quickly after taking a non-steroidal medication. I had two sigmoidoscopies then, and a colonoscopy then with Versed. As it was, I bled from the colon too much for a month, all because my GP should have upped the dose of the simple suppository medication I was taking. The gastroenterologist doubled the dose and I was cured within a few days. 

Incidentally, I think I developed the inflammation and bleeding (which was quite bad) from wiping out my healthy colon bacteria using a tincture of the herb goldenseal, which I was taking to overcome a cold. I took too much of it and it is a very strong anti-bacterial. There are many herbs which are relatively harmless. Goldenseal isn't one of them. It's very powerful.

I got the colonoscopy yesterday, not because I was having any problems, but because both my parents had colon cancer (and major surgery), and my older brother recently had one cancerous polyp removed from his colon during a colonoscopy. His was large (20+mm), and his bowel comfort and performance improved considerably after having it removed. He was having cramps during elimination, and having this one large polyp removed stopped those completely.

My brother did not get anesthesia for his colonoscopy, because he wanted to avoid any possible side effects of Versed and/or gas, on the 10% chance (this I read on the Internet) that an experience with anesthesia can leave more than an hour or day of adverse effects, such as brain fog, memory loss, or depression, although most of the time these things may happen in much older people who are not in as good health as my brother.

For my brother, the pain of the colonoscopy, as the doctor tries tries to get around corners while going in, while getting air injected to expand the colon, was pretty bad about a dozen times. But it was tolerable, but still a very awful pain.

I thought my experience would be similar to my brother's, and it was. I had an unconnected IV put in my arm, in case I wanted the Versed during the procedure. As it turned out, I didn't use it. At least six times, the pain was so bad I groaned and broke into a sweat. So, I don't think this level of stress would be good for an older person with a heart condition, for example. 

Watch videos on colonoscopy and you will learn that first, the colonoscope is threaded all the way to the cecum (terminus of the large intestine) and then the search for polyps begins on the way out. I experienced only one minor pain on the way out, and I had only one small (4mm) polyp removed, which is now at the lab to see if it is cancer or benign, which will help me determine how often I should get colonoscopies in the future. If it is benign, I may go another 10 years before I get a colonoscopy, as long as my colon feels and works as fine as it does now. 

For me, watching on the screen was one of the greatest rewards of getting this procedure without sedation. I found it fascinating, and I was amazed at the rapidity with which the doctor was able to snare the polyp with the wire loop (which comes out of the colonoscope when needed), snip/cauterize the polyp, and that it was just a tiny dark red spot and no bleeding after it is removed. That, incidentally, is painless. Peering into one's own body, even if it's just the colon, was an experience I've never had before, and awe inspiring for me.

At one point, the nurse assisted with pushing on my stomach quite hard, to help the colonoscope get around a difficult corner on the way in near the top. The pushing didn't hurt. At another point on the way in near the top, I was asked by the doctor to shift from my left side to my back, again, to get the colonoscope around a difficult corner. On my back, it worked so well, I wonder if doing that might have helped with some earlier moments of intense pain.

Anyway, it seems like development of a thinner, more flexible and perhaps self-propelled colonoscope would go a long way to making this procedure a snap without sedation for nearly everyone. Again, the drawing of it out, which is when the doctor does the careful search for polyps (benign or cancerous) or developed neoplasms (cancer) begins, and so you know that if you can make it to getting the scope going all the way in, the painful part is over. I had only one relatively smaller pain on the way out.

If your colon is working and feeling fine, you have no history of anyone in your family having colon cancer, I can see how someone might want to avoid a colonoscopy completely. But then again, at age 82, my father's colon had been working/feeling great until cancer was discovered, and he needed a serious three stage operation, with chemo follow-up. Believe me, the more serious the operation you have to have, the bigger chances things can go wrong. My father died from something related to his bowel cancer ordeal, and it was really stupid and unnecessary. And when you have colon surgery, they want to do as many as three colonoscopies. The center forgot to give my father prep instructions for a colonoscopy after the first stage of his colon surgery, so one time we went in, and we told them we hadn't gotten any instructions for a prep, and the doctor did the colonoscopy anyway, couldn't see a thing, and my father had to endure ANOTHER colonoscopy the following week. After he died, we found out his insurance wouldn't pay for the second one.

So, the ability to have polyps removed during a colonoscopy, and thereby avoid ever needing major cancer surgery on the bowel, which often includes chemo after the surgery, is one of the great revolutions in modern medicine.

Back to me, me me...After the colonoscopy was over, I was elated, and was happy I got it without sedation, and happy to have the one polyp removed. I had Versed for a cataract surgery only a year ago, and while I had no long-term adverse reaction, I did feel a little other-worldly, a little spacey, for the day after surgery. My mind feels really sharp now, and I want to preserve that feeling into my 70s and beyond, as much as I can. 

Even though you may have done fine on a certain sedation in the past, as time goes on and you get older, you never know when the sedation for one procedure will knock you into the twilight zone, as happened to a friend of mine in her mid 70s. It took her over a year to recover from the sedation, after having a small breast lump removed. This was devastating for her, because her mind had been totally clear and fine before this procedure, and then she was left in a fog for a year. The likelihood of that happening from Versed is probably smaller, but it is a possibility.  

Lastly, I read comments of a few people who had excruciating pain, one who said it was the worst in their life. As bad as my pain was during the colonoscopy, it was not like that. It's different when you expect it and it is "normal," and it is not the type of pain which would leave me psychologically traumatized.

I was in a cycling accident years ago where I landed on my face. The trauma of the accident, that I was responsible for doing something dumb which led to it, would often come back to me at odd moments, or just while daydreaming.

So the pain I had during the colonoscopy I can forget, and the satisfaction of getting rid of my one polyp and knowing my colon is healthy is well worth the peace of mind at this point in my life. 

 

I just had a colonoscopy with no sedation and NO PAIN.   The idea that one needs to be sedated for this procedure is ridiculous and a waste of money.   There is discomfort, the same kind I experienced drinking the laxatives, bloating sensation and cramping, but certainly NOT painful.  Uncomfortable is how I would describe it, but only for a few seconds at certain points while going up.    The cramping comes during the first few minutes on the way up, but most of the procedure is backing the camera out and there is no discomfort there at all and certainly no pain.  I asked the doctor to pause once so I could take a breath and let the cramp pass but it was not painful, just uncomfortable, like passing gas.   When done, everyone else who were having the procedure were knocked out and waiting for someone to drive them home.  I bolted up and got in my car and drove to Dodger Stadium for the World Series. I was literally in and out in less than an hour.    

 

It was cool to watch the images on the computer with the doctor explained everything to me as it went along which was very educational and cool.

NOTE:  I had to fight the doctors to do the procedure without sedation but I'm glad I did.

 

NOTE:  If someone has a collapsed colon or some real problems it could be more uncomfortable, that’s what the Doctor told me.  She’s had other people do it with no sedation and told me those patients said there was no real pain, just discomfort.     

 

If you have regular bowel movements and are not constipated, then I’m confident telling you a colonoscopy won’t hurt. 

In my case, I get colonic hydrotherapy once a year and eat a vegetarian diet and have regular bowel movements so I was confident this would be easy and it was.   I also had three colonics leading up to the colonoscopy but the doctor says that doesn’t make any difference.  I felt the colonics did help prepare, but again, this is NOT a painful procedure.  You can use colonics instead of drinking all those laxatives but you have to do three in a row leading up to the procedure and not eat for three days.  It might be easier to just do the laxatives but that’s another discussion.

~Rob