Painful colonoscopy

Ken7on -- I'm pleased for you, and had a similar experience several times before my last bad one. Other relatives, and my wife, also had perfectly acceptable experiences. However the expression "a little bit of discomfort or pain" is not what I, and others, experienced. For me it was one of the most painful experiences of my life. I had to be pinned to the side of the cage by staff. As for the comment that the pain the pain 'avoids' perforating the bowel (a very real risk during this procedure) I, and I am sure the others here, who experienced this pain would have expected the doctor to stop the procedure if pain is a sign of potential harm. I was certainly never asked whether I wanted to stop and while I was screaming in pain I remember one of the staff making comments like 'not much further...nearly there now....".

Certainly not all colonoscopies are a problem. Are the painful ones due to the patient being unsuitable for the procedure, the doctor being incompetent, too little analgesic, or what?

To anyone nervous about having a colonoscopy, reading this thread, I'd suggest that you contact the doctor before presenting for the procedure - in writing if necessary - to confirm that the doctor will cease the procedure if you ask him to, or if you are visibly distressed, or if the pain indicates an increased risk of bowel perforation (very nasty indeed). I'd bet you'll get more pethidine; midazolam isn't the painkiller and shouldn't really need more to mask pain though the dose does depend on your body mass and whether you've had similar drugs before - and how often.

Hi tom, Have read that some drs refuse to have Midazolam if needing proceedure re pain. Can understand its use now. Thanks for info.

I had a combined Gastroscopy and Colonoscopy last Thursday afternoon.When the unsmiling nurse took me into the treatment room the examining doctor was sat at the desk on the phone with his back to me and stayed like that until the nurses had got me ready for the exams.He never gave me any pep talk before starting or any words of comfort or encouragement,I was never told 'if it gets too painful tell me and I'll stop.He gave me all the meds at once,needless to say I awoke during the Gastroscopy with the scope pressing into my throat causing pain and me gagging til he'd finished.Onto the Colonoscopy which was agony,I was given some Buscopan 20mg while he was trying to find the polyp he'd lost after spotting it but it made no difference.I also was shouting out and groaning in agony during this procedure and the only encouraging words said to me was'concentrate on your breathing'---very helpful.The doctor never found the polyp again and gave up and told me I will have to go back in 6 months time---oh yea,and I remember everything.One of the nurses afterwards asked me how much I remebered and I told all of it,she was amazed.This doctor was not my own consultant,I was transferred to him as they suspected coeliac disease and I'm waiting for results but I don't feel I can ever go near another doctor ever again,I've lost my trust.Maybe if they had been kinder and more sympathetic and understanding I would have had a different outlook but I felt the staff were cold and unfeeling and seemed amazed when I told them beforehand that I was super petrified of the tests., I do think the endoscopistsrely on patients not remembering what happens---they are WRONG.-

hel5zt -- So sorry to hear of your dreadful experience. As you've seen from other posts the pain happens to a lot of people but the cavalier and uncaring attitude of your doctor was simply unforgivable. Were it me, I would write a letter of complaint to the hospital concerned - tell them you want to make a formal complaint. As for the 'forgetting' it's usually midazolam that causes that though it doesn't of itself act as painkiller. Gastroscopies are quite routinely carried out without any midazolam - a local anaesthetic in the form of a throat spray is used, then a pause for that to take effect. The gagging usually stops as soon as the head is into the oesophagus and if you've had midazolam you shouldn't remember it (it's not actually painful but it is distressing). The colonoscopy is a different matter and routinely pethidine is given (that's the painkiller often used in labour) and if enough is given it should work. However, as you've seen, not always. In your case you should consider complaining and I suggest that you ask specifically for a statement of what medication was given. So many milligrams of midazolam and so many milligrams of pethidine (or whatever). You are entitled to see your records but these days the NHS make this a Data Protection Act search which costs around £50 and takes some weeks. But if you complain to the hospital manager you might find the answer comes free and quickly...hopefully with an apology and an explanation. Good luck and let us know how you get on.

Thankyou Tom for answering to my post .The meds I was given was for the Gastroscopy : Midazolam 2mg IV,Fentanyl 50 ugm IV and Lignocaine spray but I got only 2 quick sprays----this doctor was in a hurry.For the Colonoscopy I had Midazolam 4mg IV ,Fentanyl 100 ugm IV and Buscopan 20mg--this was given towards the end of this procedure when the doctor was trying to find the polyp--my bowl had contracted so probably this drug was given to relax the muscle not to ease my pain.But apart from the Buscopan all the other drugs were given before the start of the Gastroscopy and the reason I woke during this procedure was because of the pain of the scope tubing pressing into my throat and it was pain not just discomfort of something being there,it felt like I had Tonsilitis for a couple of days after.Before these procedures the one I most dreaded was the Gastro one so I was really shocked and unprepared for the amount of pain I got during the Colonoscopy.I never had Pethadin and am wondering why not.I had a late afternoon appointment and had the impression everyone was anxious to get home,but my point is that the last patient of the day should be treated as if they were the first patient of the day.I shall write to the hospital to complain but which manager is best to write to : would it be the senior clinician of Gastroenterology or the hospital manager.

I forgot to say that one of the nurses held me down at one stage during the colonoscopy---is this right??

hel5zt -- The lignocaine is good and for many is all that's needed; it's not so much 'how many sprays' but they have to be in the right place and given time to work. It's just a topical, local anaesthetic. Most people find the sensation of gagging with the endoscope uncomfortable; some more than others. Midazolam does give a measure of retrograde amnesia and also makes people feel more relaxed. If you're really relaxed, you tend not to gag, there is little pain, and no problem... Not rocket science. However, to have a hard object forced down your gullet is not pleasant if they are rough with you...and it sounds as if they were. Unnecessary and disgraceful, in my view.

As for the colonoscopy, Fentanyl is a perfectly appropriate drug but like all opiates is is less effective if you've had to use it often in the past. For example, even if you've only been using over the counter codeine with paracetamol, your tolerance to opiates will be surprisingly increased...so if it's needed again, and if you have a past history of needing benzodiazepines and opioids you need to share that with the doctor who hopefully will compensate.

To be fair to them, they have two constraints other than keeping the patient comfortable. First is safety. Second is speed. After all, these are quick in/out routine procedures - sure, not quick and easy for you and me, but the staff, procedure room and equipment all need to be kept in use to keep costs under control.

None of that excuses, in my opinion, the sort of experience that you, I or others here have reported. I was also held down and I consider that to be verging on assault. I've not taken action. Certainly it is not 'right'. What you choose to do is your business but if you fear that you might need a similar procedure in the future and you make too much fuss about this one.....eh?

Given that like me you've come through it and out the other side, the best counsel is to make it VERY clear to the staff and the doctor next time that you want better handling. Wait till you're in the procedure room, or they might just find they haven't got time to handle a difficult patient. If you see what I mean?

I fully understand and share your anger and frustration but in this case I think you are wisest to keep your complaints to yourself. Good luck, and I hope this has been a helpful and constructive reply

Thanks Tom,I was kind of worried in complaining and knowing I have to go in again to have another procedure done in 6 months time,so I will consider things,although if they don't know whats wrong about the service they cannot put things right and give patients confidence,but at this stage I'm not even sure if I want to go back again although it is the sensible option,so I'm pondering but thankyou so much for your correspondence it has helped me feel un-alone in my upset-----if you know what I mean,If there's a next time I will be more assertive.Thanks again,good luck to you too.

I had my first colonoscopy today and yes it was agony. The first part was sort of painful, but bearable. I was on the Entonox which I think did little or nothing. However, as he started to go round the first bend the pain was intolerable. I could hardly speak and my hands were clenched. I was told to stop holding my breath and to try to relax. How do you relax when you are in such pain.

Anyway,, I asked them to stop but they explained if they couldn't get the scope all the way I would have to have it done again, so they then decided on a sedative, Fentanyl and midrozapam (spelling). I felt a little lightheaded, but can honestly say it did nothing for the pain. I was then turned on my back and the nurse pressed on my stomach. They managed to get it to the end and finally it was over.

Never, ever again.

I should also add that I have a large haematoma on my hand where they put the line in.

Last but not least, the reason for my colonoscopy was episodes of diverticulitis and IBS. My report after the exam today was severe diverticular disase in sigmoid colon wit a few others further up. I was told that the reason it was painful was because the diverticular sacs cause the colon to be irregular in shape. Also, as my colon flares up regularly, I wonder if the Colon cleanse that has to be done inflames my bowel and caused this terrible pain.

Oh Dear jeanlyon,I'm sorry to hear of yet another patient suffering agonies with this procedures---it's the stuff of nightmares I think.The meds did nothing for me either,they found at least 1 diverticula in the colon and I think this has been causing me problems for a few years but yours sounds awful and no wonder you had so much pain.I was sent for tests because I'm anaemic with no obvious cause.Unfortunately they also found a polyp for which I've got to go back to have a sigmoidoscopy and have it out--and I'm not looking forward to that.I really think a gen anaesthetic is needed for a colonoscopy and I wish the doctors were more sympathetic to the suffering patients endure during it.Hope you recover from your illness soon and the trauma of the 'procedure'fades.PS Lots of people suffer a lot of pain during a colonoscopy when there is nothing wrong and yet I know of 2 friends who slept through the whole thing---I'd like to know why some suffer and others don't.

I lived in Canada for a couple of years and have two friends still there. they have colonoscopies routinely and don't even remember them. Can't imagine why they can't do them here.

Why didn't they remove your polyp when you had the c'scope? surely that's the whole point. My husband just had one and they removed 8!! His was painless of course :-)

Well I was recommended by another consultant to have a combined Gastroscopy and Colonoscopy to discover if there was a bleeding point in my digestive system.However I was transferred to another Gastro-enterologist for the procedures because he dealt with Coeliac disease and upper gastric cancer.After doing the Gastroscop(he took duodenal biopsies)y he started on the Colonoscopy found a polyp and the diverticula but when he came to remove the polyp he lost it and after several painful attempts ( on my part) he gave up and told me I'd have to go back in 6 months--in order for it to grow they said.My 2 friends who slept through the procedure both had small polyps too and they were removed with no trouble----so I'm not a happy bunny.The report I was given afterwards said the bowel wall collapsed(probably from pain I should think) making the polyp disappear.The whole thing seemed sloppy to me the staff being more interested in going home and the report made no mention of the diverticula.