Question Colonoscopy without Anesthesia?

[Akimbo]

I have to get a colonoscopy late this year and have read that a few people refuse anesthesia. This will my 4th colonoscopy. It would be nice not to have driving restrictions after the procedure since I live hours away and will be 75 years old. I recently read that some people have the procedure without anesthesia and it's not "that" uncomfortable. I have had a two bone marrow and two prostate biopsies without anesthesia and was fine with them so seem to be reasonably pain tolerant.

Comments and suggestions?

Ping: @rsingler and @Compressor

 

[1fspeed]

Unfortunately I had a positive FIT test, they found a "precancerous" polyp on my last colonoscopy, and my father's brother died of colon cancer so I don't qualify.

I have no doubt that genome-based detection, like Cologaurd, will be the norm one day for most cancers. They have the capacity to be so sensitive that they can't currently differentiate between contained cancers and those that are growing and dangerous.

In any case, this will likely be my last one unless they find some really advanced polyps because 75 is the typical age cutoff for Medicare.

Ya, guess a scope makes sense... Fingers crossed they find that polyp remains "precancerous" and won't be a problem for at least another 20 years... at which point it won't be a problem. Best of luck good sir

 

[Bigbella]

Colonoscopy without Anesthesia?​

Like an audit from the IRS?

 

[cyclingman]

I’ve had one colonoscopy so far, no sedation or anesthesia. My experience was that it felt poke-y and cramp-y, but no acute pain. Also, all the discomfort is at the start, when the scope is being inserted. As I understand it, the exam is done while the scope is being withdrawn, and that part was fine for me. I drove myself home.

 

[-JD-]

Unfortunately I had a positive FIT test, they found a "precancerous" polyp on my last colonoscopy, and my father's brother died of colon cancer so I don't qualify.

I have no doubt that genome-based detection, like Cologaurd, will be the norm one day for most cancers. They have the capacity to be so sensitive that they can't currently differentiate between contained cancers and those that are growing and dangerous.

In any case, this will likely be my last one unless they find some really advanced polyps because 75 is the typical age cutoff for Medicare.

My Mom is highly drug-sensitive and has had at least 2 colonoscopies without drugs. FWIW, she also has dental work without drugs . I have a complicated pain-tolerance profile - last filling required 4 rounds of novacaine to not feel like my head was exploding, but I had also recently dealt with a ruptured disc with minimal meds. Mine colonoscopy was my first at 55, so I wasn't going in expecting issues, despite my maternal grandmother dying of colon cancer. Got a clean bill and told not to come back until 65.

With your history and detection background, I would probably choose the drugs to give them full freedom to explore and remediate as thoroughly as they need to. Knowing that things would likely need clipping would have changed my calculus.

 

[cyclingman]

For reference, I asked my gastroenterologist if my not using anesthesia might compromise the quality of his exam. He said no - that the only issue would be if I yelled out, because that would disturb the other patients in the clinic.

 

[MntryDvr]

I've had the procedure both ways and MUCH prefer sedation. Non-sedated is of course an option, but never again for me, though it is not nearly so uncomfortable as an non-sedated bronchoscopy....

 

[tridacna]

 

[kinoons]

It will be interesting to see how this falls out across the board. My (very limited) understanding is that colo without anesthesia is much more common in Europe, but fairly rare in the US. It is worth noting that the complication rate in Europe is less than in the US (not that it’s that high in the US) and one school of thought is that a patient won’t let you perforate their colon when awake.

Consider skipping it altogether and do a FIT or Cologaurd test instead. Bowel perforations are high mortality complications and there's a lack of quality evidence demonstrating the superiority of colonoscopy compared to other screening methods. Every other country I am aware of conducts a colonoscopy only in the presence of a positive fecal test result.

Actually, the only two tests with randomized control evidence to support colon cancer screening is flexible, sigmoidoscopy, and fecal occult blood testing.

There is no randomized evidence that colonoscopy, FIT, or cologuard save lives.

 

[Akimbo]

There is no randomized evidence that colonoscopy

It would be pretty hard to do placebo controlled randomized studies on colonoscopies. I suppose you could sedate all patients in both groups and not do the colonoscopy in the "placebo" group, but there may be some serious ethics problems getting the study approved. There is also the problem of people in the placebo group developing advanced cancer — sounds like a trial lawyer's wet dream.

Some people, like my wife, remember the whole procedure in detail so would have to be take off study.

 

[lexvil]

Go all the way and DIY