UOAA Discussion Board

Has anyone had a routine colonoscopy with no sedation? I have a parastomal hernia and not sure if that will be a issue in regards to any additional discomfort to the procedure. I've been doing some research and other then a little discomfort and maybe a quick short sharp pain and then they were good to go. No having to wait till the sedation wears off. My doctor just says its up to me since everyone is different.

Mine were done in the late 50s and early 60s while I suffered from ulcerative colitis. I probably had it done on the order of 10 times within several different hospitals and medical centers any preparation. Although I can speak only for myself, I believe that no sedation was common in those days. I had discomfort but no pain. I recall that the first time I had it done I told the surgeon who was doing it that I had an intense urge to move my bowels and he explained that it was just because of the pressure of the instrument and that this was normal. Fast forward to a few months ago. I've had problems with pain from intestinal adhesions for years and my gastroenterologist performed an ileoscopy to see what might be happening on the inside (mucosa) of my ileum. As soon as the instrument entered through my stoma, I felt sharp, "yelling out" pain with spasms that continued up through my small intestine. My gastroenterologist was at first surprised because "this was not supposed to happen". After he thought about it, he explained that when the ileoscope was in the ileum and expanding it, the adhesions attached to the outside of the small intestine were being pulled and were causing the pain (over the years I had 3 surgeries in this area so there were lots of chances for adhesions to have developed). (As a side note, he found inflammation of the small intestine as far up as he could look. So he started me on a drug, Budesonide, by mouth. This is a corticosteroid designed to "cool" inflammations but which acts only on the inside of the intestine, so that very little gets into the blood to cause the systemic problems associated with long-term use of normal steroids.)

I had a female primary care physician at Mayo. This was about 25 years ago. She told me that it was time for a sigmoidoscopy, which they did without any sedation. I refused. Next time I saw her we went through the same routine. She asked me why I wouldn’t do it. I told her that it hurt me a ton when I had had one done before. Her comment: “Well, there is a bit of discomfort.” Before she got the words out of her mouth I asked her if she had ever had it done. “No.” Of course not. The following year she asked me if I would be willing to do this new thing that was done under sedation - colonoscopy. Sure.

About six years ago, again at Mayo, I was to have a drain placed in an abscess. There was a nurse who told me that she would take me through the whole thing, explaining what was to occur, etc. She actually went into the procedure room, explaining everything as we went, and did everything but hold my hand. So, she was true to her word on that part of it. I just about went through the roof when they stuck the needle in, and missed, and had to stick it in again, then had to re-position it. Afterwards, she told me that she could have requested sedation for me, but felt that it would not be needed. She had never even asked me what my preference was! And I had no idea that sedation was an option. I asked her if she had ever had the procedure done. “No.”

As far as I am concerned, the moral of the story is to take the sedation and get an Uber ride home. Do NOT believe what medical staff tell you about “a little uncomfortable”, or what not. If anybody tells you this, ask them if they have ever had it done to themselves. I can just about guarantee that the answer to the question will be, “no”. These practitioners mostly have no first-hand knowledge as to how what they are doing feels to the patient. And what if they find something and have to rummage around further, and spend more time? Are you ready to deal with that sort of scenario in the event that you don’t get sedation? I don’t think about how good it can go. I think more in terms of what can go wrong.

I had my first one with Valium. No help whatsoever. It was painful. Every corner and bend and the inflation to expand could be felt. The Dr even said I could watch on the monitor if I wanted. I told him it hurts. He said it shouldn't. Ha. He wasn't the one getting it done.
Didn't know any better. Thought they were all done without sedation.
I went for a second one a while later. Same Dr. I could hear patients in other rooms having procedures. I got up and left. I found a gastro that did it with sedation and have had ten to twelve scopes. No problem. I wouldn't do it without sedation. Period. Once was enough.
Being as sick as I was and having to do it without sedation was miserable.
Now I have had two sids without sedation. They were quick. Still no fun. But now I have no colon and don't have to do it anymore.
But.
If they have to go in my stoma any distance. I want sedation. But I don't see that happening anytime soon.
The sedation medication wears off pretty quick. I was given propofal. Doesn't last long. But you still need a ride.
Richard.

As with all things ostomy, this is going to be unique to each person.

Since I got my colostomy, I have had 4 colonoscopies. 3 were done by my surgeon who gave me the option. One was done closer to my home, and they didn't give me the option...they were going to sedate me whether I wanted to be or not. No big deal, I do fine with sedation. However, I prefer to have them done without the sedation, and I have a hernia. The only discomfort I've had, felt like gas in the bowels. No sharp pains, no "OMG, what was that!" kind of pain. I was able to watch the monitor as he progressed, with him discussing where we were inside the bowel....and we usually discuss Razorback athletics during the procedure! And, I can drive myself home, even though my wife always comes with me.
Again, do what is comfortable for you. Folks tolerate/perceive pain/discomfort differently than each other. You just need to decide for yourself what you are capable of handling.
On a side note, the first colonoscopy that I had done after the colostomy, there was an anesthesiologist standing by in case I needed to be sedated. Maybe that is an option you can discuss with your doctor if you don't think you can handle it without the sedation.

David