Unsedated Colonoscopy

I’ve done it without any sedation countless times (I have to have very frequent ones because Lynch syndrome, which is a genetic condition that, among other things, increases your risk of developing colon cancer, as well as many other cancers, too, at a much younger age than they typically occur). I had to be almost dragged to get my first colonoscopy over 11 years ago, and I had it with sedation because it was what I had been recommended by the doctor given my anxiety levels. I believe that only Propofol was used and I have no recollection whatsoever about it but I do remember feeling out of it for a number of hours afterwards. My fiancé, who I was living with at the time, and who made me see a doctor in the first place (probably saving my life) was the one who suggested that I try and get it without any sedation. He came with me to the following pre-test appointment and we had worked out a bunch of questions for the doctor to make me feel as comfortable as possible (I was not terribly fond of the idea of having a few feet of scope inside me in front of strangers; I was never shy with my fiancé sliding just about everything imaginable up my butt, including his fist, but I knew that the same comfort levels would never be achieved with any healthcare provider, no matter how professional and skilled, and I have been very lucky in that regard). The doctor agreed to do the procedure without me having any sedation and explained that it was still necessary to have an IV access placed in case I changed my mind about being awake and because it was hospital policy in general, should a patient require emergency meds given IV. It was not a problem for me, and it eased my concerns about the whole thing.

Over a decade later, this has become a familiar ritual for every colonoscopy and just about any other procedure of the same type (upper GI scoping without sedation is very hard for me and I hate the feeling of being just about to vomit for the duration of the test).

I’ve had the same doctor for a number of years now and it has helped me become more comfortable with all of these rather invasive experiences that I have to deal with solo, after my fiancé passed away.

Some scope days are better than others and some are quite difficult, but it’s because of the amount of inflammation and tension that I have in my lower GI tract (not Lynch related, but IBS related… I won the organ lottery for this nice combo 🤦🏻‍♀️). Getting a colonoscopy when I have a flare up hurts, but I dislike the feeling of the anesthesia aftermath worse and I like not having to have a ride home every time, which is required at my hospital if you are put under. I can’t say that with certainty but it is probably the case in most hospitals and clinics and definitely something to consider/inquire about.

I would suggest that you talk to your doctor about your concerns and see what they say. Communication is key and you will hopefully have a great healthcare team that can make you feel better about the procedure in its entirety (the prep is way worse, and many options are available, so ask about it; that is something that you have to be awake for, barring very serious circumstances). Feel free to message me if you like, I am more than happy to answer questions if I can, since it is a daunting process and I would have not been able to get through it without the support of others who, from time to time, have been online strangers who shared the same diagnosis or had the same distaste for anesthesia.

Best of luck,

B x

@TheBriannaYouCrave,

You are very brave to undergo an EGD without any sedation. I absolutely couldn’t do it.

@Fawkes, thank you. Not one of my favorite things in the universe, that’s for sure. You can do it -if I could, so can you- but there’s very few reasons why you should. It’s positively awful 😣

@TheBriannaYouCrave Tough experiences! My wife did an endoscope half awake on Valium that I got to observe. I remember lots of gagging. The doc was pointing things out as he did the procedure, pointing out the pyloric (?) valve. She didn’t remember much, but she definitely was not “out” for the procedure. Others were always sedated with no after effects.

@TheBriannaYouCrave,

You are very brave to undergo an EGD without any sedation. I absolutely couldn’t do it.

@Fawkes I agree with you, THAT'S something I would absolutely not do without sedation! 😳

@Rigel, your description is pretty accurate and matches mine (side note: it’s pretty neat that you were able to observe your wife’s procedure, and I hope that she was/is okay; my fiancé was able to be with me for a few of those tests but it was not the norm then and it is pretty much unheard of now, unless you are hospital staff). Lots of gagging indeed. Valium would not do anything for me and I don’t like the brain fog it gives me. I will occasionally take my PRN Xanax (and of course let my doctor know) if I’m having a really bad flare up, because I do not dig the anxiety attacks AND the pain that I know is coming. Unfortunately, my options are somewhat limited and getting these checkups is not something that I can take chances and skip, with Lynch and my family history of colon cancer, and my very own, too.

Versed (midazolam) is more commonly used than Valium and Xanax since it is a benzodiazepine but will also give you amnesia. Benzodiazepines don’t do anything for the pain and the discomfort, but will calm you down and help you relax a little, but I don’t want to not remember being in pain. It’s easier to process what you can remember, and “own” and feel in a little bit more control of by being awake and alert (it’s an illusion, but it is really all I have since nothing about this medical saga feels one is in control of much, if anything at all). A lot of people find the Versed helpful, or so I have been told. My very limited experience with it was when I was under general anesthesia and had no saying in the choice of medication (I just politely asked to be given something, anything, really, for the nausea, imo one of the least desirable things ever, far worse than the infamous awake upper GI endoscopy, as the gagging and the extreme discomfort are very short lived compared to the side effects of general anesthesia).

But my situation is not what most people have to deal and live with. I had already pretty bad IBS and UC by the time I got my first colonoscopy and had probably had both for years, so I can’t really say how a “normal” scope day feels like. I’m still here, though, and I am still well enough to chronicle my experiences, and lift and have a physically demanding job, and all of my organs where they belong. I’ll take it over the alternative, you know?

We are pretty resilient when we are cornered 🖤

@mike45 😜 how about not getting it done at all? That would have been my first choice, had it been available. I was not suggesting that it was anything short of yucky, and I am not too proud to get sedation, but the logistics of my lifestyle and my job demands do not make it a viable option, as if my personal preference/“pick your poison” were to be set aside (and they could, but having to have a ride to and from the place and, ideally, for a number of hours after the procedure is over and the anesthesia wears off… that is not something that I would comfortably ask anyone to do for me at this stage in my life and with how frequent the “trips” are). My doctor had to be persuaded to do everything possible without me having sedation and there is always the anesthesia people on standby, or at least the drugs. My upper GI endoscopies are also much less frequent than my lower GI ones.

@mike45 😜 how about not getting it done at all? That would have been my first choice, had it been available. I was not suggesting that it was anything short of yucky, and I am not too proud to get sedation, but the logistics of my lifestyle and my job demands do not make it a viable option, as if my personal preference/“pick your poison” were to be set aside (and they could, but having to have a ride to and from the place and, ideally, for a number of hours after the procedure is over and the anesthesia wears off… that is not something that I would comfortably ask anyone to do for me at this stage in my life and with how frequent the “trips” are). My doctor had to be persuaded to do everything possible without me having sedation and there is always the anesthesia people on standby, or at least the drugs. My upper GI endoscopies are also much less frequent than my lower GI ones.

@TheBriannaYouCrave Well I've never had one and hope not to. Hope you recover from your health issues. 🌹

Sincerely, Mike 😃

Link for Lynch syndrome for those wondering what it is.

https://en.m.wikipedia.org/wiki/Hereditary_nonpolyposis_colorectal_cancer

Dont do it they suck when you have to have polips removed . SO tell them to KO you First.

You don't feel it when a polyp is snipped. I've needed that for two of my four unsedated colonoscopies.

You don't feel it when a polyp is snipped. I've needed that for two of my four unsedated colonoscopies.

He snared 3 polyps for my unsedated colonoscopy and didn't feel a thing.

The lining of the colon can only sense distention. Unlike the nerves in your hand, there are no nerve endings in the colon that can sense temperature, touch, or pain. Air is instilled during colonoscopy to distend the bowel anmd can produce the sensation of abdominal pressure. The distension can be uncomfortable - but as far as feeling pain when a polyp is nipped (or however they do it) doesn't happen. Maybe they pump a bit more air in to extend the colon for better access when they find a polyp - and that distension may be uncomrtable.

I was lightly sedated when he snared a polyp on me.

I watched it on the screen. I was fascinated. Didn't feel a thing.

Its down to each persons pain threshold i guess, i did it no probs but others may not be able to handle it.

I had a very uncomfortable barium enema years ago in my 20s, so when I had my first colonoscopy, I let them give me light sedation, and I’ve had three the same way with no problems. Any fear I might’ve had was unfounded. The sedation wears off quickly after the procedure, although they insisted that someone would drive me home.

I had a very uncomfortable barium enema years ago in my 20s, so when I had my first colonoscopy, I let them give me light sedation, and I’ve had three the same way with no problems. Any fear I might’ve had was unfounded. The sedation wears off quickly after the procedure, although they insisted that someone would drive me home.

That's why I tried it unsedated, so I didn't have to screw anybody else's day up.

I read somewhere that many hospitals require that an IV be placed during a colonoscopy regardless if you are going to be sedated or not. Just in case you can't tolerate it (they don't want to have to stop the procedure) - or in case something goes wrong (very rare) and they have to react to that or give you any kind of drug during the procedure. The IV itself wouldn't prevent you from driving home. So even if you go unsedated, you might need to have a back up on call for the ride home.

I read somewhere that many hospitals require that an IV be placed dujring a colonoscopy regardless if you are going to be sedated or not. Just in case you can't tolerate it (they don't want to have to stop the procedure) - or in case something goes wrong (very rare) and they have to react to that or give you any kind of drug during the procedure. The IV itself wouldn't prevent you from driving home. So even if you go unsedated, you might need to have a back ujp on call for the ride home.

I DID have a IV in just for that reason, if it got too uncomfortable, they could give me something to get through it. I did have my sister take me just in case.

I have one scheduled next month. I practically had to beg to forego the sedation, as I've had it done before without, and find it not necessary.

One thing they mentioned at this particular clinic was that there will not be an anesthesiologist present if I elect this method. So - in for a penny in for a pound.

One thing they mentioned at this particular clinic was that there will not be an anesthesiologist present if I elect this method. So - in for a penny in for a pound.

That sounds crazy - what if something goes wrong?? I know it's low probability.....but geez, if it did! From a liability standpoint, I bet there’s one close by.

I’m waiting on someone from GI to call me back to talk about the colonoscopy/EGD I have scheduled in a few months. I’m planning on telling them no sedation. I want it known and agreed upon before I prep and show up only to walk out that I won’t accept sedation.

I’m waiting on someone from GI to call me back to talk about the colonoscopy/EGD I have scheduled in a few months. I’m planning on telling them no sedation. I want it known and agreed upon before I prep and show up only to walk out that I won’t accept sedation.

@Exam90,

Colonoscopy completely awake, no big deal. Yes please! For the EGD without any sedation, good luck on that!!! I’ve had many countless EGD’s, corrosive esophagitis with large nasty hiatal hernia and esophageal stricture’s. Would I do an EGD without any sedation??? HFN, HELL FUCKING NO!!! Bring on the twilight with propofol.

What was the EGD like for you?

Sedation does nothing but kinda relax you and it induces amnesia preventing you from remembering what you’ve experienced. Analgesics must be added to block pain. Imo sedation is only used so they can do whatever they want to you and you won’t remember.

They can numb my throat topically, use the smallest scope available and I’ll take oral Xanax upon arrival.

What was the EGD like for you?

Sedation does nothing but kinda relax you and it induces amnesia preventing you from remembering what you’ve experienced. Analgesics must be added to block pain. Imo sedation is only used so they can do whatever they want to you and you won’t remember.

They can numb my throat topically, use the smallest scope available and I’ll take oral Xanax upon arrival.

@Exam90

WOW!🤦🏼‍♀️🙄

My wife has had several esophageal constrictions. The first EGD was with Valium and I got to watch. LOTS of gagging. Follow ons were always sedated.

My colonoscopies (3) were all sedated. Just get it over with!

It’s been almost 30 years since my first colonoscopy, and it was done with a very light anesthetic-I have no idea what it was. It was memorable, as I was well acquainted with the nurse, we had grown up together— she kept up an interesting conversation going, asking me at times to respond and verify some of the stories she was telling the doctor. I must have been lucid enough to do that. However the following procedures were done under much more anesthesia, and I remember very little about them. The first one resulted in the removal of three polyps- nothing removed since then, even lightly sedated I didn’t feel any pain or discomfort.

My first colonoscopy was ludicrously painful, and clear of issues. I was really hoping to pass out from the pain, but it didn't happen. This is definitely one of those "Your Mileage May Vary" things. Further colonoscopies I hope to be on something other than versed and demerol accidentally injected intramuscular instead of IV.

@Rigel the distension is nothing, compared to the barium enemas I have had. Sometimes I thought I was going to pop.

@gogglestars I wish you the best of luck. If you can still remember your procedure after being administered Versed, I suspect something went “wrong”. I don’t respond to most pain meds (which Versed is not, but I’m using it as an example). No point in taking them because they won’t help. I hate the feeling of having “lost” hours of my life when I am given Versed though.

I hate every single medical procedure with the fury of 1000 burning suns, I find each and every one of them violating (even if I know it’s something I need to stay as healthy as possible and I have extremely professional doctors - I just hate the fact that I have to have these things inside me and I don’t even care about the pain, I care about how lonely and vulnerable I feel while it’s happening… but that’s just me). Either way, I’d rather experience the whole thing than not knowing what happened. But tell your physician and your anesthesiologists /CRNA that the Versed dose you were given didn’t have the desired effect.