Perforation from colonoscopy?

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Hi, I'm having a colonoscopy this week and I'm just doing some research beforehand. I will be having conscious sedation for the procedure. I have heard that although it is rare, colonoscopies can cause bowel perforations. Does this happen during the procedure and do you feel symptoms of this immediately? Or is it something you will start to feel hours or days later? How is it diagnosed? How is it treated? Does anyone have experience of this? Thank you

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  • Posted

    It is very rare and particularly so if you have a competent specialist. The signs to look out for to do with bleeding that doesn't stop (some blood spotting is quite normal) will be on the fact sheet they should give you. Even on this site where naturally people talk about any difficulties they have encountered, it is incredibly rarely mentioned so just read your fact sheet and really don't worry about this. There's enough to be anxious about without adding in stuff that won't happen.

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    • Posted

      Try not to worry about the complications as they are very rare, I was so scared when I had one but it was all ok and there was no real pain, only very slight discomfort but more in my tummy area, it's really nothing to worry about, try to relax and it will be easier. I found the prep the worst part. Good Luck!

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  • Posted

    As already replied to the prep is the worst part!. As for perforation i would think the specialist would realise during the exam if this happens,,,or possibly there would be symptoms of heavy bleeding during the following couple of days. However let me put your mind at rest having had 6 colonoscopies. I have never had any bleeding or pain during or after the exam even when polyp were removed. As for perforation it is extremely rare....in fact about 1 in 500/800. When i had my last colonoscopy i asked the doctor who gave me my immediaete results if he had ever known of a perforation. He said he had been in that department for 8 years and had never heard of even just one. Maybe he wouldn`t tell me anyway but i tended to believe him .Also there is a risk to every medical procedure,,,,even minor ones. You will be ok.
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  • Posted

    A Colonoscopy operator would likely see it happen immediately during the procedure.    I have problems with the drugs used in conscious sedation so I opted for a drug-free Colonoscopy.   As a result I could see the procedure on the monitor.  That way both of us would see a perforation immediately if it happens.

    I found that in a four month study of colonoscopies in North East Thames, West Midlands, and East Anglia, the rate of perforations from a Colonoscopy was 1 out of 769.   No one thinks that rate is optimal but I would take that risk without hesistation.  The risk is further reduced if you are not elderly and have a competent and experienced Colonoscopy operator.

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  • Posted

    I have read a number of studies on the incidence of perforation.  The use of the colonoscopy occurs in a number of situations.  Some people have colonoscopies because of the presence of an inflammatory bowel disease (IBD).  Naturally, the existence of IBD likely will make the bowel more compromised, leading to a higher risk of perforation.  Then again, an otherwise healthy individual under the age of 60 will not have as great a risk of having a perforation.

    The reports I have read reveal a perforation rate of some1200where in the 1/1000 to 1/1200 range.  Reports that I have read related to colonoscopies done in Europe reveal a lower rate, than these numbers in the US.  I suspect that since the US system generally pushes for the use of many drugs like versed and/or propofol for this procedure, that the rate may be higher in the US because more alert people will verbalize the existence of pain.  Those who are highly medicated will be too "out of it" to even be aware of any such pain.  Pain is the body's way of warning us of something that may be harmful, and a perforation is definitely harmful.

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    • Posted

      That is very interesting. I think there may also be a difference between the level of doctor required for the procedure. Colonoscopy procedure requires knowledge, experience and dexterity. But clearly some conditions or situations will also be more prone to perforation. I have a friend who had never had any internal procedures who already had a perforation from infection and not surprisingly the colonoscopy was very painful and indeed they withdrew pretty quickly.
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  • Posted

    Hello.   I am not a doctor, but just using a little common sense here I have noticed most people write a response and actually fail to answer this persons questions.  I see this a lot with forums where people want to "feel" like they are helping yet fail to answer a persons questions. 

       The initial posting asked what symptoms a person could expect if they were perforated.   How about more answers along this line and less about not worrying?   Obviously perforations do happen, so this persons concerns are REAL.   

       Thanks for reading and hopefully hearing.  

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  • Posted

    It's in the sheet they give you. Excessive bleeding, sometimes abdominal pain, and sometimes fever. It's very rare and even the few cases that do happen are usually when there is surgery  and the surgery is very difficult for some reason. It's natural to think of worst case scenarios but compared with a lot of surgical interventions these ones are rare and usually even rarer than the bare statistic shows. My colonoscopist is completely upfront about the number of his procedures that went wrong in any way (and they are very few) but in each case there was a severely complicating feature so it was a rare risk which came to pass in extremely rare circumstances. That's very rare. 

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