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

 

[tridacna]

I’d get my basement plumbed for Propofol if I could. Not sure why anyone would opt out. Best part of the procedure IMHO.

 

[rsingler]

Sorry, @Akimbo
Honestly wouldn't recommend going without.
Your muscular responses might influence the ability of the GI doc to give you a complete exam, especially when the scope has to get all the way to the cecum. A good exam is most important. You might be one of the 10-20% that seem to require almost no sedative, but trying to minimize sedative drug use is counterproductive. The typical patient with too little sedation will just get disinhibited (like a drunk in a bar), and thrash about upon minimal stimulus, even though the discomfort is insignificant.

 

[Joneill]

Sorry, @Akimbo
Honestly wouldn't recommend going without.
Your muscular responses might influence the ability of the GI doc to give you a complete exam, especially when the scope has to get all the way to the cecum. A good exam is most important. You might be one of the 10-20% that seem to require almost no sedative, but trying to minimize sedative drug use is counterproductive. The typical patient will too little sedation will just get disinhibited (like a drunk in a bar), and thrash about upon minimal stimulus, even though the discomfort is minimal.

This!! I don’t get why anyone would even consider forgoing sedation unless there was some underlying medical condition that might indicate that route. If driving is an issue, get a family member/friend to drive you or use Uber/taxi/car service. To each, their own though…

 

[dorsal]

Just my opinion. I’ve had this procedure a few times now. I would never consider it without being out cold.

 

[lowwall]

I've had 2 with anesthesia. My only bad memories are of the prep. I wouldn't want it any other way.

 

[therookie]

This would have made a great poll . Put me in the "give me drugs" camp - it was the best nap I had that entire year. Definitely will go that route the next time - and as alluded to above I wish I could have been drugged for the prep as well.

 

[MB NZ]

Obviously, I wouldn't speak for the OP who has a practical reason for not wanting sedation/general anaesthesia, but I do meet a small proportion of patients who do not like the idea of losing consciousness for various psychological reasons related to previous trauma. Others, I can only describe as control freaks (for want of a better description) who want to stay in control of their body. I try to accommodate their wishes, but sometimes it just isn't possible and they have a choice to make. I can only give advice and the "drugs" if they want them.

 

[1fspeed]

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.

 

[tridacna]

If driving is an issue, get a family member/friend to drive you or use Uber/taxi/car service. To each, their own though…

My gastro’s office won’t accept an Uber. Must be friend or family. I’ve stopped arguing with them about it.

 

[Akimbo]

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.

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.