recent colonoscopy experience

jeanart · Apr 9, 2010

Thanks for your reply. It makes me feel a little better. I just am nervous because I may have a male anesthesiologist and don't like the idea of having the procedure done in front of anyone, let alone a man. I hate being put "under" and not knowing what will be done to me. I wish I would have talked to my doctor more about sedation choices because her standard is to use propofol and I feel like that will put me entirely under. I would rather be aware of what is being done to me but the doctor will not do the procedure unsedated. Thanks again.

CrohnieToo · Apr 9, 2010

You will LOVE propofol. You are awake and aware almost immediately after they stop administering it unlike Versed or Valum where you take awhile in recovery to wake up and be able to stay aware and you sure aren't alert for quite some time afterwards!!! If I remember correctly whilst you are laying on your left side the anesthesiologist is standing more to the left as well so I don't think he ever gets a peek at your rear end even if he was interested in it. :jester:

jeanart · Apr 9, 2010

I know I am being overly curious but I have so many questions and my doctor didn't spend any time with me before having me scheduled. I will be having biopsies and stool studies done because of symptoms. I am wondering how and when they do stool studies during the procedure?? If your colon is cleaned out how can they get a sample? It all just seems so embarrassing. It almost makes me just not want to do it. Do most people have "overflow" or soiling from leftover colon prep or does the doctor remove it while scoping so that it doesn't expel from the rectum? Any experience with this?

CrohnieToo · Apr 9, 2010

Bite me on the stool studies bit. Unless it has been more than 6 hours (I think it is 6 hours anyway) since your last dose of the prep you colon should be squeaky clean. There "might" be some small clumps of yellow "slime" called chyme here and there thru out the colon. This is suctioned out thru the scope to enhance the visual field in the colon. As our food is digested in the small intestine nutrients are absorbed and waste collects as this slime they call chyme. The chyme enters the colon at the ileocecal valve into the cecum which is the beginning of the colon. Maybe this chyme is what they will be doing the stoo studies on.

One seldom has "leaks" during or after the procedure unless the procedure is done very close to the last dose of prep (w/in 2 hours, I think it is). I don't know of anyone that has happened to. That doesn't mean it hasn't happened but it would be very unlikely.

Mjeff · May 20, 2011

I just had my first colonoscopy yesterday and it was a nightmare. They gave me a sedative(not sure what it was) and it had a slight effect on me. Unfortunately not enough of an effect because I was in pain from the word go. They got through the descending colon and across the transverse with me barely able to stand it. When they started to make the turn into the ascending colon the pain was so excruciating they had to stop. They said they gave me enough sedative that should not have even been aware of what was happening but it barely had any effect on me whatsoever. SO, now I have to go through it again fully anesthetized. Not a happy camper to say the least.

CrohnieToo · May 20, 2011

Was this "just" a routine colon cancer screening or have you had something going on that indicated a scope would be in order?

The major source of pain during a colonoscopy is due to the flexible scope shaft looping back on itself and stretching the walls of the colon. Another source is an "air-happy" scopist inflating the colon so that the walls are stretched. A skilled scopist willing to take the time will not cause a patient much pain or even much discomfort even w/o sedation.

Of course, if someone has something like active Ulcerative colitis or Crohn's disease going on at the time that could account for some pain during a scope.

More than likely this first time they used Versed, possibly Valium. This next time they will most likely use Propofol (diprivan) as these are the most commonly used for scopes.

This may be of interest to you:

Endoscopy 2002 Jun;34(6):435-40

Patient pain during colonoscopy: an analysis using real-time magnetic endoscope imaging.

Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP. Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, London, United Kingdom.

BACKGROUND AND STUDY AIMS: Colonoscopy is generally perceived as being a painful procedure. Contributory factors are: stretching of the colonic wall and mesenteric attachments from looping of the instrument shaft, overinsufflation, the degree of torque or force applied to the colonoscope shaft, and patient pain threshold. The aim of this study was to determine the frequency of pain episodes experienced during diagnostic colonoscopy and the corresponding colonoscope configuration, utilizing real-time magnetic endoscope imaging (MEI).

PATIENTS AND METHODS: Consecutive outpatients undergoing colonoscopy were studied. Patients with previous colonic resections were excluded. Procedures were commenced with antispasmodics only, and patient sedation was self-administered whenever significant discomfort was experienced, using a patient-controlled analgesia (PCA) syringe pump. All "demands" were correlated with the MEI record, which was subsequently analysed.

RESULTS: A total of 650 demands were recorded in 102 patients. Seventy-seven percent of all demands occurred with the colonoscope tip in the sigmoid colon, 7 % in the descending colon, 6 % at the splenic flexure, 5 % in the transverse colon, and 4 % in the proximal colon. Ninety percent of all pain episodes coincided with either looping (79 %) or straightening of the colonoscope shaft (11 %); presumed overinsufflation being an infrequent cause of pain (9 %). Of the loops encountered during colonoscopy, the N-sigmoid spiral loop was associated with the majority of pain episodes (56 %). Looping was both more frequent ( P = 0.0002) and less well tolerated in women than in men ( P = 0.0140).

CONCLUSIONS: This study is the first to document pain at colonoscopy accurately. Looping, particularly in the variable anatomy of the sigmoid colon, is the major cause of pain, especially in women. Use of MEI may improve pain control by facilitating the straightening of loops within the sigmoid colon, and by enabling the endoscopist to target patient analgesia.

PMID: 12048623 [PubMed - indexed for MEDLINE]

Mjeff · May 20, 2011

It was due to recurring and increasing pain in the digestive system.

swift125 · Jun 3, 2011

Skip the Versed and be sure to write: "I'm not consenting to midazolam" on the consent. Midazolam (Versed) is given to cause amnesia, has no effect on pain and is seriously implicated in long-term memory loss/PTSD even at low doses given for colonoscopy. Check out askapatient.com for versed horror stories. Versed is not given to: "relax you" it's a cover their **s drug that causes tempory amnesia (until the patient gets out the door)..then the fun starts..this drug is patient abuse.

Dadeus · Sep 6, 2011

I am 52 and had my first colonoscopy Friday. I read all your posts and prepared for a horrendous procedure. My experience was to the contrary- it was about as routine as I could make it. Monday, I started my low-residue diet. Thursday morning I started the liquid diet which I chose to ignore in favor of plain water. I drank two quarts during the day, took two bisocodyl tablets at noon and started the golytely solution at 3:30pm. The golytely solution was a little salty, but had no odor, bad aftertaste or weird consistency. It was just like cold water. I drank 8-9 oz every 10 minutes all at once (around 4-5 swallows) without stopping. I would not heat this with chicken broth because I think I might be inclined to sip it. Because of the low residue, bowel evacuation didn't require any pushing at all, since you are just going to fill back up anyway. Reports of anal and lady partsl hemmorhoids are totally avoidable. Same with irritation. I didn't need vaseline or baby wipes. On the day of the procedure I asked the nurse to cut way back on the memory drug and the outcome was that I propped my head up on a pillow and watched (and remembered) the whole thing. The doctor gave me a small heads up when the scope turned the corner that there would be a little discomfort, but all in all it was very routine. When I left I was fully alert and didn't feel any after affects. I credit my doctor with being very skilled. Don't be afraid of this.

Dadeus · Sep 6, 2011

As a follow up, my procedure was not due to any symptoms, but just because I am over 50. My colon looked clean and in good shape. The doc found two polyps which he removed. I can see how there could be pain if I had problems prior to the procedure. I also have a very straight forward outlook to medical procedures and have found that if the personnel are professional (which they always are) I don't have a problem with who sees what.

tewdles, RN · Sep 6, 2011

I had my first colonoscopy last Friday. I am 46 and my mother has had two surgeries for colon CA, so I felt pretty good about being so responsible. I went to every website I could find and researched all aspects of the procedure (patient teaching, videos of colonoscopies, personal experiences, etc.) I also spoke to several people who had gone through the procedure recently including my husband and my OB/GYN. I felt very well informed and more than educated about what would happen, what I would see on the screen, and how it would feel.
I was given Versed 2 mg and Demerol 50 mg IVP and the doctor waited until I assured him that I was groggy. Everythiing went just as I expected until just after insertion when air was instilled into my colon. I experienced some of the worst pain I have ever felt. The doctor immediately instructed the nurse to give me "25 more" which I assumed meant more Demerol. He continued the exam with me moaning in pain. I felt every mm. of my colon being blown up and navigated. I tried to watch the screen because I was really interested to see my own colon after viewing so many others in my preparation for the procedure. The pain was practically unbearable. Since then, I have had trouble concentrating and sleeping because I keep reliving this scene. I feel so duped and betrayed. All of the instructions and testimonials I read stated that there is little dicomfort and the Versed gives the patient amnesia to any discomfort that may occur. I have lamazed three children and had I known ahead of time, I would have gotten into a breathing pattern and anticipated the pain. I will know better next time. And as a nurse, I will return in 5 years because of my FH.
I guess what I want from you guys is some validation that indeed this does occur occasionally and that I'm not alone in this experience.
Thanks for your input. Sorry about the length of this, but I needed to vent!

I recently had a colonscopy prior to my colectomy. I had propofol and it was the best. Not only was the procedure comfortable, but my recovery time was amazingly fast. ASK for PROPOFOL.

eCCU · Oct 8, 2011

So sorry you had this experience! i am not sure how your vitals and co morbidities relate to the administration of more pain medication. However, perharps next time you should definitely ask for "monitored anaethesia care' where the anesthesiologist adminsters propofol and any other deemed necessary medications during the procedure while monitoring your airway and cardiac status. Good luck.