Facing the prospects of having a colonoscopy done can cause anxiety and distress over every aspect. For many people the dread can stem from the prospect of being put under sedation. In the United States it is common practice to be administered some type of anesthesia or pain relief for the procedure, but if your gastroenterologist is willing and experienced, you may be able to request that it be done with no drugs at all. I did it (3 days ago in fact) and will tell you it can be done!
The prep:
This is the part I had read so many dreadful things about while Googling away. Honestly, it was weird, strange, odd, but not painful or even unpleasant per se. I was prescribed MoviPrep which is a total of 2 liters of prep and 32 additional ounces of water. I ate up until 11:30 pm the night before I needed to start the prep (2 days prior to the colonoscopy). Being on a liquid diet the day of the prep I drank as much as I could stand knowing that I would likely become weak and dehydrated if I didn’t. Constant liquid intake also helped stave off the pangs of hunger that were roaring around my stomach. Seven minutes prior to prep start I was ready to chicken out again (I had already been a no show on the procedure once). I went ahead and drank it. It wasn’t as I had read about- there was no wanting to vomit or gagging at every swallow or even feeling overfilled with fluid. I didn’t cramp or have any pain and it wasn’t like anything I’ve ever experienced in the way of the prep working either. I kept hearing my stomach roar like the prep was on a water slide through me and it felt like a hose being turned on and off. A tad over an hour and the whole thing was done until 8:30pm when round 2 started which was the same deal. I slept fine- no insomno-riah as I’d often read about. In fact I only stirred a couple times because my stomach was growing so loud from hunger that it woke my half starved body.
I had already discussed with my doctor that I did not want drugs of any form. Why you ask? Perhaps I’m a glutton for pain? Nope. Truth is I hate the groggy after affect of narcotics and I was/am still nursing my baby and so I wanted to try without any chemical interventions. The anesthesiologist came and met with me. He was down-right rude and hostile. He sounded like the colonoscopy would be up there with labor pain and that I was making the doctor’s job near impossible by not being shot up with his loopy liquids. I was administered an IV in case there was an emergency need and also for a fine dose of fluids (which was great because once you haven’t drank since midnight and eaten in two days thirst is one of the foremost thoughts- right after party sized deli sandwich!). They wheeled my little bed into the procedure room and had me lay on my side. There were 3 nurses in the room, 1 anesthesiologist (just because you aren’t getting any drugs doesn’t mean they don’t need to be in the room- if some quick action were needed it’s good that they are at your bedside) and my doctor of course. The nurses were chatting with me and talking about how few people they’d seen do the colonoscopy without sedation and that generally women (especially who had been through childbirth) tend to do better than men with it. The doctor also mentioned mental preparedness which I wholeheartedly agree with. If you are going to choose to do it without drugs practice relaxing your muscles completely and breathing in through your nose and exhaling through your mouth.
Having had a Sigmoidoscopy I was a bit scared of the air. The Sigmoid was terribly painful for me but only because of the air used to inflate the lower colon. This is where having a great doctor also comes in to play. During my colonoscopy the air didn’t bother me a bit. The doctor was considerate that I was fully aware of sensations and regulated the air to a very tolerable point. The feeling of the scope is strange. You can literally feel it threading back and forth through twists and turns as you watch it on a television screen. I even got to see my appendix. The doctor was great as he make me aware when a turn was coming and that I would experience discomfort. Several biopsies were taken. That doesn’t hurt but it is a strange feelings – sort of a ‘click-click’ or ‘tap-tap’ in the location the tissue is being sampled from. During my procedure the scope going in was more uncomfortable than coming out (but on the removal is when the biopsies were taken). I concentrated through the whole thing on relaxing my muscles- this is not only important for the patient but also so the doctor has little resistance and can easily maneuver the scope. When I would encounter short bursts of discomfort I would use relaxation breathing techniques. My doctor also made me aware on the parts where the discomfort would be longer and I would count in my head to ten slowly. There was one point when it was mildly painful but it was very short lived. Was it uncomfortable to have a colonoscopy without drugs? Sure, a bit… but painful? No. It was over really fast. The whole thing lasted maybe 10 or 15 minutes total and then they wheeled me out and gave me a drink. My IV got removed, I got dressed and went about my day not feeling even groggy. I was starving though and I could hear the deli sandwich chanting my name. For a few days after I’ve had the feeling that my muscles were overworked from the prep and the biopsies but all in all I’m very thrilled I made the decision to not be anesthetized. I was coherent and understood completely my diagnosis and had no after effects to speak of. When I need to have it done again I will choose the same route of drug-free.
