Fellow readers: Do not be afraid of a colonoscopy. Do not avoid it-- in fact, look forward to it. They are easy and painless. Waking up from the anesthesia I felt more relaxed than I ever have in my life. Also, the prep of clearing your system will reset your digestive system and you'll feel like a new person. I think the prep cleared out whatever it was that was causing us to investigate my digestive system in the first place.
The night before mine, I googled to see if I could find anything that would make me feel less anxious and uncomfortable and I couldn't. Well, fellow reader, I hope this comment and the article put you at rest when it comes to doing this important and necessary procedure.
Recommend anyone considering this to ask your doctor about using a sedative instead of general anesthesias.
As best I can tell general anesthesia for colonoscopy for low risk appears to be a cultural custom especially prevalent in the northeastern USA.
Anesthesia has many more possible side effects than sedatives and ought to be avoided unless needed (this applies to any unneeded treatment).
Plus if you’re awake you can actually watch the scope going, it’s cool! Not painful at all. Agree there is no reason to fear colonoscopy but there is also no reason to undergo general anesthesias for it either in most cases
I had a colonoscopy five years ago here in the UK without any anesthesia and it was perfectly fine. Walked into the theatre wearing a gown and a pair of shorts with a flap at the back, and hopped up onto the bed. Somewhat embarrassing with a half dozen nurses standing around various bits of kit and more monitors than NASA.
They asked me if I wanted to watch, then angled one of the monitors so I could see what they were doing. Laid on side, knees up and relax. Blimely is my bum really that hairy? Don't normally get to see if from that angle.
It feels weird and a little uncomfortable at times, but certainly not painful - even when they found a polyp and removed it with a remote lasso tool of some kind. This later turned out to be harmless.
As is normal for Brits, there was a lot of humour, with the women discussing the latest TV soap opera whilest doing their thing with the "dynorod" tool. As they pump in a gas of some kind to keep the bowl inflated while they work, they tell me it's okay to fart whenever I need. Boy, I think I've got a bad job sometimes. Whatever the nurse with the pointy end gets paid - it's not enough.
It's not exactly pleasant, but necessary and quite interesting to watch inside your own body (not as interesting as watching surgeons put stents into my heart, but that's another story).
Totally agree with Graeme, nothing to fear and massive win if they find things before it's too late. Don't hesitate!
Same. Had one under light sedation a few years ago (switched to biannual stool screening for occult blood subsequently) and I'd say the discomfort was similar level to having a tooth filled under local anaesthesia. Not fun, occasional moments of mild discomfort, outweighed by the novelty/this is cool factor of getting to see the inside of my own guts.
I will note that general anaesthesia generates lots of extra billable hours (anaesthetist! extra nurse/assistant anaesthetists!), which might be why US hospitals are so keen on it and NHS hospitals are less so.
I had one a few years back and it was amazingly painful. Nonetheless I would choose it over getting knocked out.
This may sound like a strange sentiment, but years ago I broke a bone on a weekend and they put my arm in a sling at the emergency room. I got to see a doctor on monday and he said - you have to move your arm. "Move it every day, otherwise you will lose your range of motion. Let pain be your guide".
Completely different advice than I expected (I expected to keep it immobilized as much as possible until fully healed)
So I wonder if I was knocked out - would they damage something while they're looking around without my hints?
Good point. I could say “whoa that’s uncomfy” and the doctor would react.
There are risks to colonoscopy, primarily in older patients. You can get a perforated bowel.
Quite plausible that where sedation is warranted this reduces the risk. But that would depend upon whether the cause of this perforation is even amenable to patient/doctor feedback.
The doctor's experience matters a lot here. Try to find one who has done several thousand colonoscopies. Going around the corners in your colon is a potential source of pain, and more experienced doctors do this best.
We badly over-use general anesthesia. Next to antibiotics it might be the most over-used thing in medicine. When you scratch the surface of the neuroscience of general anesthesia you will never want to experience it in your life if you can help it. It's effectively a controlled coma, and though we can control it, we don't know the precise mechanism of action. (Like so many things with the central nervous system it was discovered by trial-and-error.)
If you're having a medical procedure and the physician mentions general anesthesia, always ask if IV sedation works as an alternative.
Meanwhile, up here in Norway you have to beg and grovel and almost pretend to have a panic attack in order to get a one-off benzodiazepine-based IV sedative while taking a gastroscope down your throat.
An acquaintance of mine with Down's syndrome, no less, couldn't do a gastroscopy to investigate a quality-of-life issue that was assumed to be benign, due to this. Boggles my mind, honestly.
General anesthesia might be over-used, but some healthcare systems go too far in the other direction too.
I always had issues with gastroscopy (I guess mostly panic and uncontrollable reflexes), but recently I discovered that there’s an option to do it through nose instead of mouth (of course, with a thinner tube) — highly recommend it for people like me!
Socialized healthcare systems often have room for a private sector, so you can have both.
You can also go to other doctors in a socialized one, if their treatment (style) does not fit your cause.
Also, in my experience there's lots of choice in most socialized health care systems.
I had a gastroscopy in Austria, the Doctor asked me if I'd like a general anesthesia or rather a local, nerve blocker - mostly to avoid the gag reflex.
He said that it may not be as pleasant without the anesthesia, but I still opted for it and am really glad I did. While it really was not pleasant, I was up and going again in about half an hour.
Nah... that has more to do with how medicine is practiced versus how it's paid for. I'd bet you'd have troubling finding any doctor willing to sedate for an endoscopy in that country.
It's just "how it's done". Just like the US has it's own unique methods that seem odd to Europe.
Oh, you can do it privately instead. Costs $500 or so, but there's as much choice as the market allows for. My description was how it's normally done in the public system.
I had shoulder surgery a few years ago, and I had to argue with the doctor to get him to do a nerve block instead of general anesthesia. He never suggested it - I researched the options myself and found that patients who did the nerve block recovered faster and better, and yet right up until I rolled into surgery, the doctor was trying to convince me to do anesthesia. Sadly, I think the reason is that anesthesia makes patients easier to manage during surgery, which makes the doc’s job easier even if it is ultimately worse for the patient.
Some of that is just inertia. Things are done a certain way and everyone is comfortable with it. Throw in a new method and everyone gets nervous. You might even have trouble finding an anesthesiologist who has done enough nerve blocks to be comfortable with it. And even if you do, your doctor has maybe never worked with them before.
Don't it just turn on the chlorine tap on a neuron to open so that the voltage is now much lower and it will inhibit the signaling ???.
It is the natural mechanism of a neuron so I don't see what side effects there could be - it is like pulling a jumper wire from one pin to another pin on a board to get a voltage right.
Great point and I see that commenters above are suggesting conscious sedation (benzos) instead of general, which would probably be propofol in this case. Both benzos and propofol act at the same chloride channel...
I’m an emergency physician and we use all of the above medications with the exception of general anesthesia.
Benzodiazepines are considerate anxiolytics whereas propofol would be considered moderate sedation. Neither of these require airway control (intubation) because people tend to keep breathing on their own and we really would much prefer that.
With general anesthesia, you cannot protect your airway whatsoever and will need some form of airway control via either endotracheal intubation or LMA.
Thank you for the knowledge. I'm an M3 who hasn't had surgery, EM, or anesthesia rotations yet. Probably should have thought about the airway though...
In most procedures I've observed (or experienced first-hand), a combo of Versed (a benzo) and a small amount of Propofol for the "milk of amnesia" effect is lumped under the term "conscious sedation".
The patient is aware, can breathe on their own, and can respond to basic commands, but is relaxed, with a much higher pain threshold, and has no memory of the event.
I'm not sure what you're trying to argue here. We don't know the "precise mechanism of action" of ANYTHING related to consciousness or subjective sensations. We don't even know why Tylenol works. That's not a reason to avoid it.
For the overwhelming majority of patients, you simply fall asleep, avoid discomfort, and then go on with your life. Weighing that against the risks of a traumatic or very painful wakeful experience is not trivial.
> Plus if you’re awake you can actually watch the scope going, it’s cool! Not painful at all.
For sure! My first colonoscopy I was sedated and enjoyed watching the screen. In fact, I remember I was making HILARIOUS jokes the entire time. I could not remember them afterwards though. My second colonoscopy my doctor sedated me again, but put me further under for reasons that remain a mystery.
Also, a year ago we buried my brother-in-law at age 53. He was diagnosed stage 4 at age 48. DO NOT DELAY your colonoscopy. I think 50 is too late to wait.
> For sure! My first colonoscopy I was sedated and enjoyed watching the screen. In fact, I remember I was making HILARIOUS jokes the entire time. I could not remember them afterwards though. My second colonoscopy my doctor sedated me again, but put me further under for reasons that remain a mystery.
It was the 15th time that week he'd heard the "rectum, damn near killed them" joke and he didn't feel he needed another aspiring comedian on the operating table.
I remember asking my doctor (I was sedated, but not 100% asleep) to look for the iPod I lost about 10 years ago....
I must admit, the experience wasn't awful. It was like getting an intestinal reset. Getting completely cleared out from the fast and prep. I felt like a new man, and very well rested after the "twilight" sedation.
I only wish they could have given me a copy of the video of the procedure for my YouTube channel.
> In fact, I remember I was making HILARIOUS jokes the entire time. I could not remember them afterwards though.
This is the primary purpose of the "sedative".
I had samples taken from the interior of my stomach via a machine that went down my throat. It was an intensely unpleasant experience; you're trying to vomit for most of the time the cable is there.
Anesthesia was not even recommended, but they really wanted me to take something that would inhibit memory formation. I asked if people who took the drug struggled or retched any less. "No." (I declined to take it.)
This is also how women were drugged for childbirth in the mid-20th century. No anesthesia, but memory inhibitors so they couldn't remember what had happened. That was eventually "discovered" by the press and became a huge scandal. I don't get how the approach persists elsewhere.
If I recall correctly, "general anesthesia" is actually a combination of multiple drugs with different purposes; some that inhibit memory formation, another to put you to sleep, and another to I guess relax the muscles etc?
Not sure about the drugs, but during anesthesia, you will be completely unconscious, and inhibiting memory formation is a side-effect of that. Sedation is when you are still (more or less) conscious, but relaxed. But between these two terms there are several levels: https://en.wikipedia.org/wiki/Sedation#Levels_of_sedation
> during anesthesia, you will be completely unconscious, and inhibiting memory formation is a side-effect of that. Sedation is when you are still (more or less) conscious, but relaxed.
The concept of anesthesia is that you don't feel pain, not that you're unconscious. If you're unconscious, it's "general anesthesia"; if you're not, it's "local anesthesia".
Colonoscopies are much more pleasent that having a probe sent to your stomach. Going up from behind, you are sedated, for the stomach you have to stay awake to "swallow" the probe. ut hey, I guess it still beats surgery, chemo therapy and potential fatal cancer down the road.
>Also, a year ago we buried my brother-in-law at age 53. He was diagnosed stage 4 at age 48. DO NOT DELAY your colonoscopy. I think 50 is too late to wait.
The rate of new colorectal cancer diagnoses has been increasing for those under 50 years old, despite the rate falling for the older population. I don't know if they've narrowed down a major cause. My pet theory is obesity.
The usual recommendation to start screening at 50 is for asymptomatic people with no increased risk. If you have symptoms, family history of colorectal cancer, or enough other risk factors[0], bring up screening with your doctor. As somebody else mentioned, you could do fecal occult blood tests (FOBT) or other non-invasive tests if you're worried about colonoscopies.
Second this. There is evidence that anesthesia causes brain damage. This shows up in the data most for babies and small children, and the elderly, where you can see it on IQ tests and chance of dementia. It's more pronounced with multiple surgeries. It may be that it's damaging everyone's brains, but it's just not as noticeable for adults. One study with twins showed about a 1.5 point IQ loss from a major surgery.
Of course, 1.5 IQ points is not likely to dramatically change the course of your life, but I would absolutely not get it if the procedure could be done under sedation.
I'm up to about 30 hours of general anesthesia after a near fatal snowboarding accident left me with a spinal cord injury. I like to think how smart I'd be if I hadn't needed it!
On top of this, IIRC, we (meaning doctors and medical science) have basically no idea how anesthetics actually work. For instance, xenon gas has anesthetic properties. Xenon. Gas. How's that for weird?
Oh yes... I remember the aftermath of getting emergency surgery for an appendicectomy: after breezing through a major Calculus exam before that, I struggled for months waiting for the cloud of confusion and forgetfulness to lift. And to this day I’m not sure it ever did
Its such a weird thing. After a while, you begin to wonder if you just learned to work around it. I too bad a similar experience, just s/snowboad/motorcycle/.
I'd love to see the study for this and how they controlled for the fact that being sick enough to require general at a young age probably will ding your IQ a couple points. I'm guessing they didn't do a randomized controlled trial.
One of the studies I saw was from Sweden and it looked specifically at twins where one had been injured. This is probably about as close to an RCT as you can get. That said, it doesn't separate the anesthesia from damage due to the injury itself, or the trauma of the surgery.
Still, getting anesthesia for something like a colonoscopy or a root canal strikes me as a very disproportionate risk given the evidence.
AGAIN, these data points apply to using something like a fluorinated gas, which is what you'll get for major surgery, not Propofol, which is what they'll give you for a colonoscopy.
It takes 10-15 minutes for a regular colonoscopy, for such short time, does the side effect of anesthesia actually comparable to the "major surgery" that can easily last 5-10 hours you mentioned?
I always get the same stuff Michael Jackson was using. You fall deeply asleep for the duration, wake up pretty refreshed, only downside is that I am usually besides myself for the rest of the day. Good thing you aren't allowed to drive for the next 24 hours.
Could you post any resources that discuss this? I don't doubt that you could be correct. After a quick search I wasn't able to find any material online that really supported this claim. There is the well-known condition of 'Postoperative cognitive dysfunction', however that doesn't quite line up with the kind of brain damage you're describing.
No. That's local anesthesia. It's called a "nerve block". The anesthetic is injected right next to a nerve. If you imagine pain as starting somewhere, then, "travelling" upstream to your brain, the anesthesia basically interrupts signals from the point where the injection takes place.
I think local anesthesia does not lead to these effects (as far as we know), I also would be surprised if it does. One thing I remember when you also use N20 (laughing gas) you should either check or just take vitamin B supplements (it seems to deplete your vitamin B storages)
I once had an endoscopy without any sedatives or anesthesia and that really sucked. The doc stuck a large tube down my throat and had me gagging for what felt like an eternity. After the procedure I needed a few minutes to wipe the tears that started forming from my eyes and gain some composure. This was done in Poland. If a colonoscopy is anything like that then not sure I'd want to be doing them regularly.
I was offered anesthesia for the endoscopy as well and I was glad I refused. The whole thing was over in 10 minutes, the actual endoscopy was about 2 minutes of serious discomfort. I gagged a couple time, the rest of the time I held steady, but the nurses also complimented me for powering through so I don't think it's expected to be easy. It was a weird and humbling experience.
If you feel like you're relaxed enough to be calm when someone does something to you that your body will tell you is going to kill you, then it's not so bad. They sedate your throat to kill the gag reflex, but it doesn't work 100%.
The upside for me was that it was over so quickly, and I could go on with my day, was allowed to drive, etc.
Yeah, I didn't have my throat sedated, that might have helped. I was able to go on with my day shortly after the procedure as well but the 5-10 minutes it lasted wasn't the most pleasant for sure.
My wife took no sedation when she had one, so I was shamed into doing the same when I had one a couple of years later. It was unpleasant, but not actually painful, and over quite quickly. Would opt for no sedation if I had to get it again
I went for no sedation during a colonoscopy too, but after a while it got too painful and I asked for some
I've got it done without sedatives 10 years. It was quite a ride. They went only half way and I had enough. It was literally a gut-wrenching experience.
Funny, I am considered high risk and have had it done annually for about 15 years. None of my doctors ever mentioned a sedative as an option, let alone anesthesia. And it has never been a big deal. The risk associated with anesthesia is way too high to justify it for this kind of procedure.
Once every few years they find a suspicious polyp and snip it of / cauterize the wound, all with just local numbing. Still nothing worse than stubbing a toe, and certainly not worth the risk of using sedatives.
I got mine done three years back at 36 (I've had gastric issues, and my mom has colorectal cancer) - didn't use sedatives or anesthesia. Pain tolerance is relative, so my own experience wouldn't carry over.
I can understand if some people want sedatives, but anesthesia is pretty high risk like you were saying.
Its not my responsibility to look for evidence if you're making the claim.
If you want to come into a thread telling people that are already apprehensive about a procedure "please don't do X its dangerous!" when an _actual_ first google will give you a Mayo Clinic saying its perfectly fine, then you need to provide some fucking evidence.
Your evidence is unconvincing, but good job being condescending.
I have ulcerative colitis so have had many many colonoscopies. General anaesthetic is never used in UK but twilight sedation is normal. I refuse this as (after an unpleasant gastroscopy) I can't stand having tubes stuck up my orifices while I'm unable to fully intellectualise what's happening. They're usually happy to give a bit of fentanyl instead.
My experience is that GI doctors enjoy chatting during the procedure but specialist nurses (who often perform minor endoscopies) are usually not very communicative.
They regularly use Propofol which is not the same as general anesthesia. I've waken up (in pain) on Propofol. Pretty much impossible with a GA fluorinated gas. General Anesthesia is a very monitored situation as it's potentially very dangerous (you have to be put on a ventilator).
This is something I've been wondering for a while, perhaps someone here knows. I've had two colonoscopies, and my understanding was that what they used was a sedative, but I was definitely totally unconscious. What's the line between sedation and general anaesthesia?
Medically, anaesthesia is a "balanced triad" of three elements: analgesia (pain relief), narcosis (sleepiness), and muscle relaxation. It's a spectrum: we talk about having various "planes" of anaesthesia that are in principle relatively woolily defined but in practice oddly specific. An example would be the difference between a "light" form of general anaesthesia for a relatively non-invasive procedure -- such as a broncoscopy, which can be performed under heavy sedation; and something where unexpected movement can have catastrophic effects, such as surgery on the spine. It is rare, but not terribly so, for some surgical stimuli to cause local responses or motion, even when the patient is "completely under", ignoring local reflex arcs which may (or may not!) be affected by the anaesthetic agent.
A good, modern anaesthetist in a western hospital has access to an incredible array of information about their patient, ranging from their complete physiological state to the partial pressures of anaesthetic gasses going into, and out of, their lungs (and thus in their blood stream). This largely means that the horror stories of the past about people "waking up and being unable to move" -- the triad becoming unbalanced and muscle relaxation ± analgesia being (barely) adequate, but narcosis clearly not -- remain in the past.
I've probably waffled incoherently enough, but it's worth reiterating that anaesthesia is a _field of medicine_ in its own right. There are literally thousands of approaches, drug combinations, and "gotchas" to deal with, in all sorts of situations -- right the way from the straightforward and simple to patients with massive facial injuries where it is very difficult to know how to intubate them without causing further damage. Drug combinations are prescribed on the basis of the patient, the indication, and local rules and availability (including toxicity to the operator and cost -- many anaesthetic gasses are carcinogenic if you're exposed to them for a long period of time in trace amounts, which occasionally becomes an issue).
Re: the content of this article --- if you have blood in your stool, see your doctor. (S)he won't be embarrassed about shoving a finger up your arse, and the outcomes range from "eat more fruit", or "don't have anal sex for a little while" to lifesaving surgery.
Thanks, that's very interesting! And yes, I definitely agree about seeing your doctor. We're often unreasonably embarrassed about things like this, but a good doctor will have no problems putting people at ease. And obviously the outcome can be really bad if something serious goes undetected.
100% agree. I've had several colonoscopies without anesthesia. This does not make me a badass (npi). It merely reflects that the fear of this procedure is completely out of proportion to the reality. It's a little bit uncomfortable in the same way that being gassy after a big meal is uncomfortable, but it's less painful than a flu shot.
Colonoscopies aren't quite general anesthesia in the US (generally, I'm sure there are exceptions). General anesthesia as being completely unresponsive to external stimuli and potentially needing supportive measures to make sure you maintain your airway.
What they tend to do is "conscious sedation". Basically load you up with a sedative and painkiller - midazolam and fentanyl as an example. You're not completely out of it, you can breath on your own and will show some response to stimuli. But you won't remember any of it due to the amnesia from the sedative.
Very good advice. It seems that it is difficult to ensure sufficient oxygen to the brain under anaesthesia, and the effects are more noticeable in older patients.
They're different drugs. You'll definitely want the pain relief Fentanyl provides if you're getting cut open, such as for endoscopic surgery.
(Fentanyl gets a bad rap because it's very dangerous as a street drug. In a healthcare setting it's a wonder drug, superior in almost every way to morphine.)
Is propofol not a general anaesthetic? That's what I was given for my colonoscopy. Totally knocked out, and when I opened my eyes again it was all over.
Side note: I was never warned about a particular effect of propofol. They started pumping it in and told me to count down from 10. At about 5, I suddenly felt this horrible searing, burning pain in my IV-connected arm that I felt spreading throughout my body. Thinking something was terribly wrong, I opened my mouth to say I'm feeling awful pain, but by then I was already falling unconscious. So I only consciously felt the pain for a few seconds, feeling totally fine (besides grogginess) when I woke up, but it was panic-inducing and some of the worst pain I've felt.
Apparently it's pretty common for propofol. I think they might have told me I might feel a little discomfort, but they didn't mention the possibility of sudden, dramatic pain, for some reason. I could've grit my teeth through those seconds if I knew it was possibly going to happen, but I feared that I was having an unexpected severe allergic reaction or something, so I spent those few seconds absolutely terrified.
Propofol is definitely used as one of probably a cocktail of drugs required for various levels of sedation (AKA “general anesthesia” in this case).
I’ve experienced the exact same pain you’re talking about but with IV antibiotics. No nurse or doctor could actually explain why it was happening to me, other than to say the IV had “gone bad.” Because I was in the hospital for so long, they eventually switched me to a PICC line. Absolutely zero pain with that.
My own experiences with propofol involved either the PICC line, or maybe some kind of arterial line or something (I was unconscious when I was first sedated during this incident).
Probably local phlebitis. Propofol is a milky emulsion and is very lipid soluble (that's what makes it a good, blood-brain-barrier crossing agent!) but occasionally does cause side effects [1] --- I understand, particularly if it gets outside of the vessel at all.
There can be a number of things covered by the phrase "gone bad", ranging from phlebitis (inflammation of the vein) to infiltration (where the catheter becomes dislodged from the vein (or pokes through it)) and the IV fluid leaks into the surrounding tissue.
At my first, I was offered the option of minimal sedation, which I took. Then my doc offered to put up an extra monitor so I could take the tour, as it were. It was fascinating.
By now, I've had 9 colonoscopies. My brother had colon cancer, hence the maybe higher frequency than usual. They've all been either non-events or pretty interesting.
If you have any symptoms at all, get the procedure done. Immediately.
If in doubt, take it. better be safe than sorry, especailly since colon cancer usually takes time to became really bad and can be treated rather easily when caught early. Also agree that 50 is too late. Case in point, I had colon cancer when I was 28. Turned out well, but 6 months of chemo therapy is nothing I want to repeat, and I had the easy therapy.
I just had a colonoscopy a few weeks ago because of some minor bleeding. Ended up just being hemorrhoids and a small polyp. Definitely worth having the peace of mind.
The worst part or the prep was not sleeping much that night because I was up until 3am. Watching TV most of the night was relaxing, though. After the procedure I took it easy all day while the propofol effects wore off.
Don’t wait to have a colonoscopy. The prep isn’t that difficult!
I’ve got Crohn’s so I’ve had my share of colonoscopies, completely agree that the procedure is a breeze. And now that propofol is the standard it’s that much better, the older versed/morphine combo really hammered you. The prep is the worst bit and it’s better if you prep well for the prep; wet wipes, bidet, water bottle anything, some good reading material and a good even free from other disruptions (you’ll be disrupted enough...)
Fellow sufferer here. My doctor ordered one for me when it wasn't really called for (MD, not gastro). I'd had one recently and kind of rolled my eyes. Did I really need it? They found high dysplasia tissue (cancer precursor). Now I have a permanent ileostomy but I'm still walking around being a father and what not. If you have Crohn's, do not avoid these!
I had a colonoscopy almost two weeks ago (a 3-year follow-up on having a large not-quite-cancerous-yet polyp removed), and got in a lot of Factorio the night before.
So in a sense it wasn't that different than a regular night of staying up till four in the morning playing Factorio, except that I had to drink a gallon of stuff that tastes like diluted seawater. I had forgotten how gross that stuff is, but in the end that was the worst part.
Here in the UK you just get pain relief, and are generally conscious for the procedure - though gas and air is available if it is uncomfortable.
It caused me no pain at all, was quick and easy and I'm pleased I went ahead with it.
My father found he had bowel cancer from a routine fecal occult test they were sending to all men above 65 in my area. He took some convincing to do the test, but found he had cancer and was swiftly operated on. My older brother found he had it far younger, about 52 and his was far more advanced when it was discovered, and 5 years of treatment later it won't be something they can cure. So it is pure chance my father's was caught so early and was so successful.
After speaking to my gp they agreed to start my colonoscopy cycle at 40 - with one every 5 years until I hit 55 and then likely more frequently.
I was a little nervous but it was totally fine and I feel freed that it is one worry that is if not behind me, that is controlled.
Top tip is to follow the instructions of the laxatives well and eat nothing except a broth or miso soup, and it will be far easier on your gut.
By far the worst part is what they refer to as the “bowel prep” i.e. strong laxatives. A top tip is to coat the affected area with Vaseline before starting!
That and the sedation depends on whether you’re getting a “flexible sigmoidoscopy” or a full colonoscopy. The latter is the full 1.5-2 metre insertion to inspect all the way to where the small intestine starts, which typically involves sedation (though conscious). The former is usually preceded by a home enema rather than laxatives and done with pain relief only.
My suggestion is to only wipe your butt the first two times during the prep. After that, use a shower nozzle (or a bidet) for the other dozen bowel movements...
> Here in the UK you just get pain relief, and are generally conscious for the procedure - though gas and air is available if it is uncomfortable. It caused me no pain at all, was quick and easy and I'm pleased I went ahead with it.
Not necessarily, you can get the Good Stuff that knocks you out during the procedure in the UK (I have), but I'm not sure what the criteria are for getting it, if any.
> Entonox pain relief should be available at all sites where bowel scope screening is provided, as the procedure will be performed without sedation, unless a decision was made and documented at a best interest meeting about the appropriateness of performing the test with reasonable adjustments.
Thanks for that comment. I once, out of nowhere, had a bad bout of panic attacks and subsequent health anxiety. Every symptom(which were themselves manifesting) led me to believe I was dying. Literally the only thing that helped was googling the symptom + "anxiety.". I felt like an idiot googling 'random pinching pain anxiety', but found all kinds of accounts. After reading hundreds of poor folks in my shoes describe everything I was going through, the symptom faded, and I felt peace. Really weird time for me for sure. But just know people reading random comments can really put minds at ease.
Cannot confirm; my girlfriend had a sigmoidoscopy (similar) and she experienced it as traumatizing and violating. I don't believe she got any anesthetics admitted; pretty sure it's not standard.
Please don't romanticize invasive diagnostics. If you want to advocate for the occasional bowel purge or using anesthetics to sleep have at it though. But also, general anesthesia should be avoided as much as possible, it's not a trivial matter.
In the UK it's uncommon to be anaesthetised for for endoscopies or colonoscopy. I've been offered either midazolam or gas & air for colonoscopies and pretty sure my last couple of endoscopies were done without anything.
The movicol prep stuff they give you isn't ideal either; you've got to drink a lot of odd tasting fluids that then give you basically explosive diorama which can be awful in itself. It also causes some people to explosively vomit as well (it's designed to make your body want to eject it asap) which really isn't fun when it's trying to escape both ends at once.
The actual procedure isn't amazing either. A camera down either end is uncomfortable at best ranging to extremely painful (short term) as they try and get round the corners in your bowel. There's also the potential it to go wrong in some nasty ways or for odd side effects, and at absolute best, you're still stuck on a table trying to make polite conversation with 2m of camera tube stuck up your bum.
Can confirm your refusal to confirm; none of it's a thrilling or trivial experience.
I'm in the UK and I had a good level of sedation for mine. I wasn't even asked, just told that was standard.
I wasn't knocked out but I might as well have been as I didn't feel any pain and kept kind of drifting off half to sleep. It was completely fine and I'd not worry at all about getting it done again.
Just to calm your nerves. I had mine done today and, despite the intermittent choking and gag reflex, it was actually completely fine. Turns out I have Barrett’s esophagus, maybe caused from acid reflux and stress I've had since a kid. Slight increased cancer risk so I'll be getting this procedure more often from now I guess.
Hope yours all goes well!
Yes, this, totally this. Even the bowel prep [was] easy and painless [for me -- added this edit]. It's a good excuse to just binge a show, too.
I think the traditional guidance has been to go for your first colonoscopy around age 50. My doc mentioned that they're recommending that move down to 45, because they're seeing more and more young people with issues. You should bring this up with you doc if you have any similar symptoms or if there's any family history of colon cancer.
Bullshit. I've got Crohn's, and have had more colonoscopies than I can count since age 13. About 75% of the time, I'm throwing up due to the prep. The prep is the WORST part.
It has gotten better over the years. If you go for one, do NOT let them give you the jug full of powder. I've had much better luck with prep-o-pik.
The other PITA is they generally won't let you go for the procedure by yourself, since you're under anesthetic and don't trust you to get home OK. That means you have to find a friend who is willing to wait 2+ hours for you.
Yeah, drinking a gallon of anything that fast is no fun, but the laxative they gave me was terrible. The worst part was that I tried drinking it cold, which made it sit in my stomach and build up, so I ran out of space to drink more. I heated it up, which got things moving again, but made it taste even worse.
I will say though, after having the colonoscopy, my general bowel symptoms(never ending gas, mostly) improved dramatically. I'm thinking about doing a chemical cleanse every year just to keep things working fine.
You reset your microbiome; I think this is what the colon cleanse people are trying to achieve. I usually try to take good probiotics and eat right (avoid processed foods, especially sugar) after to try to establish good gut bacteria.
I've tried all kinds of probiotics, different kinds of fiber, I regularly eat yogurt and kefir, even prebiotics. I've had normal diets, and low-carb diets(not keto). Nothing ever made a significant difference until I did the cleanse. It wasn't even a natural cleanse. It was 2 gallons of chemicals.
My doc. said he always uses the pills with water to prep for his own colonoscopies. I did the same (I believe the pills were named OsmoPrep) - 4 pills every 15 min with 8 oz of lukewarm water. Not pleasant but quite tolerable for me, and I will again ask for pills the next time.
Good advice, and I've edited my comment above to clarify. I've only had to two rounds of bowel prep so far - albeit on two different types of prep stuff. Had the jug the first time. I'm sorry to hear about your experience with it.
After a while, its like your system realizes what you're putting into it and just eventually rejects it. Its not a squeamish thing. I can always swallow all of it. Its just that it comes back up some time (~1 hour) after drinking when I'm near the end of the prep.
They usually are, for most people. But for me the first time I did it was the most painful experience ever. So painful in fact that they had to abort it and book me for another time and that time I went under.
That was before my surgery and when my intestines were all over the place. That being said, after my surgery in which they corrected the placement of my intestines, it was painless. That time, the last time I did it, I chit chatted with the doctor and nurse and it was funnily a pretty relaxing experience since I'd gotten some mild drugs before because I was nervous it would hurt as it did the fist time.
Absolutely agree. I got one a few weeks back, the colonoscopy itself was painless, the prep is the worst part. They found some benign polyps, which were removed. Yes, people, if you have a history of colon cancer please talk to a gastroenterologist ( my dad was diagnosed with colon cancer in early Feb and I had to get it asap since it's hereditary)
Colon cancer is the most common type of cancer and recent guidelines have changed the age of getting a colonoscopy from 50 to 45.
In US, if I have no symptoms, can I just get it done as a preventive care? I doubt that wothout a referral. Has anyone done that? I m approaching 40 and wondering
Maybe? I think they're recommended for everyone at 50 years, but for anyone else I don't think they would normally recommend getting one unless you have some symptom or family history of cancer.
Getting a genetic test might be another option if cancer is what you're worried about. Not as accurate as a colonoscopy, though.
Colonoscopy is absolutely painless. However, in my case, when I woke up, they took forever to tell me the results (about 30 mins), so expected the worst. I'm an incredible patient person, but in this case I got up of bed and screamed to the nurses: "can you just tell me news now? I can handle it." I later realized they were just having a printer problem, and the doctor had left and they couldn't reach him to speak to me, but everything had come out ok. But I hope people are told the news immediately after they wake up (whether good or bad); some of us have been contemplating impending death since being referred for colonoscopy. They were the longest 30 mins of my life. I've never screamed at somebody, and I wonder whether the anesthesia had anything to do with it.
I would take 5 colonoscopies instead of gastroscopy any day... It really is not a big deal. I was a quite high but I managed to actually watched the camera feed during procedure. The only problem later on was that I had trouble of putting my clothes on and do anything that needed little effort for at least one hour, because of the wonderful drugs.
It isn't that common in america but most of the world does colonoscopies without anesthesia. Without complicating conditions there is little more than minor discomfort and without anesthesia are very quick and much less expensive. With a little searching you should be able to find a doctor who will do the procedure that way.
Interestingly, colonoscopies here in DK are mostly without anesthesia. I prepared by looking at mostly-American sites where some doctors said 90% of patients prefer full anesthesia, and the rest some other sedative drugs.
The procedure was 20 minutes, painless and slightly uncomfortable where the nurse had to push on my stomach to help the probe round the guts, that was like some brief constipation. You get to your appendix from the inside and physically realize how much the colon takes up in your body.
BTW, in Denmark, a 40+ yo patient with rectal bleeding that cannot be physically confirmed as hemorrhoids by the GP would likely be referred to the emergency cancer track, with I think, 2 weeks before all the tests have to be finished.
It's uncomfortable but not painful really. I've had a few as I have celiac disease. Let's say that you don't have to worry about choking like with a gastroscopy, which I "luckily" had booked for the same day as the colonoscopy. I've never been sedated or had any anesthesia for either, it's really only the air afterwards that's painful, but that's not worse than when your stomach is upset during a flu or something.
It isn’t. Considered better too do it under a milder sedative in most cases I think as there are fewer side effects.
I checked and general anesthesia seems to he a custom used in some regions of America. I’ve had 3 colonoscopies and been awake for each one. They aren’t painful in the slightest and you get to watch them on screen! Anyone who gets one should talk to their doctor about sedation options.
I don't think it's a matter of being painful necessarily (though it might be, depending on what they do), but rather most people just don't want to be awake for what is at best a socially awkward experience. I've had several, and I'm grateful to have been unconscious. (They had to wheel me back in once without sedation to take another look around a biopsy site to make sure I wasn't bleeding too much. It was kind of interesting, but not terribly pleasant.)
They do pain research on people getting colonoscopies because it varies so much. A lot of people do find it unbearably painful. It's a relatively small fraction though.
> They are easy and painless. Waking up from the anesthesia I felt more relaxed than I ever have in my life.
Alternatively, you can opt for no anesthesia/sedative, if like me your major concern is lingering after effects (and a fear of going under). I had a colonoscopy and an EGD in the same visit, really wasn’t a big deal. Also quite fun to see your insides on the monitor — gave me peace of mind to see perfectly uniform pink healthy flesh, as opposed to some of the craziness you can find on YouTube.
The prep juice tastes so nasty but you are right about feeling refreshed. After the colonoscopy I had intense cravings for a cheeseburger and milkshake, but let me tell you that was a mistake! It gave me the worst acid reflux. Keep in mind your insides are virgin again after the prep juice. It causes you to shed the lining of your stomach, I'll be smarter next time.
>Also, the prep of clearing your system will reset your digestive system and you'll feel like a new person. I think the prep cleared out whatever it was that was causing us to investigate my digestive system in the first place.
I had the exact same feeling afterwards. The issue has disappeared since, and that was 2 years ago.
As a data point: I met a service technician for colonoscopy equipment (in good spirits) and he said he wouldn't recommend one.
From my past experience, I'd recommend MRI over anything else (especially CT scans), though it's apparently not as useful in diagnosing bowel stuff as colonoscopies.
These are almost lateral approaches and very different from each other though, with MRI being more like a sonar scan and colonoscopies more like sending a submarine equipped with a camera into the depths.
Both can be very useful and helpful in aiding diagnosis with more data points.
Case in point, I have had an MRI (which showed nothing), several CT scans (which showed temporary blockage) and both methods have not really led to a conclusive diagnosis.
I have a family history of colon cancer, so get them done periodically. The procedure isn't terrible, but the prep is worse. Pretty sure I need seat belts for the toilet for that day. Otherwise... meh. Beats dying.
I second this - I've had about 10 colonoscopies/endoscopies in my life (due to a medical condition) and it went well each time, no pain as steve said. The prep is also an opportunity for cleansing of the digestive system.
I'm in the US, and have had one colonoscopy at age 33 (to rule out cancer, I had rectal bleeding). It was hemorrhoids, but will have another any month now because of family history of polyps and colon cancer. And I'll have one every 5 years even if I have zero symptoms.
For example in Germany you can get a colonoscopy paid by the health insurance without any specific reason every 5 years from the age of 50. You can always get one at any age for no reason if you simply pay yourself.
Most insurance policies won't cover a colonoscopy without symptoms or family history, and most gastroenterologists won't recommend one in that situation anyways.
The day before the colonoscopy, patients are asked to drink a laxative solution that's generally some combination of magnesium citrate or another compound. The taste is generally pretty bad, but you can mix it with some kind of non-colored drink or flavoring powder (or just hold your nose and chug)
Never had this issue, sure, your hand gets warm and then just dose of. Quite pleasant actually, the rest of the day kind of sucks for me, so. But I do get why people take for non-medical reasons, no idea how you will be able to fall asleep without so, if you use it that way to often.
Bracing for a passel of autointoxication links to bubble to the top of Hackernews, accompanied by anecdata of the form "I started giving myself coffee enemas and my chronic headache/gout/acne simply vanished".
The night before mine, I googled to see if I could find anything that would make me feel less anxious and uncomfortable and I couldn't. Well, fellow reader, I hope this comment and the article put you at rest when it comes to doing this important and necessary procedure.