by request:
We use the same drugs for colonoscopys that we do for EGDs. Since the test lasts more like 30 minutes including sedating and waking abit you usually get a bit more medication though.
In addition the scope will be passed around the 2 bends in the colon. This can cause pressure and cramping. Also the doctor will inject air into the colon. Since the colon is naturally flat this allows him to see better. While we could remove polyps forever and the colon wouldn't care, it does react to be stretched from the air by causing cramps. You may remember none of this in the procedure room. Some people do remember bits and pieces of it being painful, and again some may be awake for the same reasons as the EGD. We use 2 nurses in the room, a RN monitoring and giving the meds and an LPN assisting the md. If you start to get uncomfortable listen to them. They are trying to help you relax because the more tense you are, the harder the scope is to do. They may also have you change positions. While we try to remove all the air during the procedure, some may remain. It is important that in recovery if you feel that gas cramping that you just pass it. It is just the air. In addition if you are having difficulty passing it let your nurse know. Usually placing you on your left side will allow it to pass and you will feel much better!!!
While I don't normally add this next part when I admit patients, sometimes I do afterward when patients have had problems. Sometimes we can't complete the scope because the patient is too painful and they ask us to quit. It's really interesting in that sometimes the patients don't remember this at all, but it is dangerous to continue if the patient is in to much pain and fighting the scope. Usually it is because they may have a really twisty colon, adhesions, or the drugs are not working for them because they are already on similar meds. This does not happen very often!!!!! Also some have problems passing air afterward, this is more important than it seems because it may also drop your bloodpressure. Some people are just darn uncomfortable till they pass it....Yes indeed my job includes encouraging people to pass gas!!!
Again most of my patients come in very, very nervous about their procedure. The vast majority leave amazed at how easy it all seemed. They remember nothing or very little about what happened. Most don't even remember how they got in our lazy boy chairs!! While the meds have alot to do with it, so does the skill of your MD. Some just are wizards with those scopes!!!
You can also have the scope done in surgery with a more general anethesia or with much stronger drugs. This requires an anethsiologist and you may have to be intubated with all the increased risks involved. This is done much more rarely, and is usually done for those that simply can not tolerate it any other way.
And if you don't tolerate it one time it doesn't mean that next time won't go much more smoothly.
Just one more thought and I will stop. In the last 3 weeks I have recovered 2 patients that were in their 50s that came in for their routine scopes, one because their insurance was making them. One had a large rectal cancer, the other a huge cancer almost obstructing her colon. Neither one had any symptoms beyond occasional bleeding they attributed to hemrroids (we all have em, whether we know it or not, if we walk upright). Anyway hopefully we found them early enough while they are still in the more easily treated stage. Of course if those polyps were removed before they became cancerous..........
Enough soapbox...hope this helps....
Colon cancer the 3rd leading cancer in women (had to throw that in)
