You Aren’t Crazy to Want A Sedation-Free Colonoscopy

colonoscopyWhy would you want to be doped up with a sedative during a colonoscopy?    For that matter, why would you want to have a colonoscopy at all?

As to the latter, you pretty much don’t have a choice after turning 50.   Intestinal tract cancer rates are growing and they are very serious ailments.   The survival rates for such cancers are low — and late treated cancers result in almost sure, and painful, deaths.   The same is true for bowel and colon cancers.    53% of peopole who undergo a colonoscopy are less likely to die from intestinal cancers.

But there is a way to undergo this procedure without the drugs.  It’s actually quite easy.  The bottom line:  it is faster, easier, safer and is actually preferred by doctors.  We’ll explain how, below:

Colonoscopies Save Lives

Putting off a colonoscopy exposes you to a very painful and costly death/disablement.  If every person age 50 and older had a colonoscopy, 64% of people with colorectal cancer would have never developed the disease.  In light of the 6% risk of developing intestinal cancers, the risk far outweighs the inconvenience of a colonoscopy , which generally is a relatively common and safe procedure.

Sedatives Are Unnecessary and, in many parts of the world, are Not Used

However, the procedure gets a bit more complicated when sedatives or anesthesia are used.    And here’s the interesting part — in other countries, sedation is not used for colonoscopies.   In Europe, less than half of all colonoscopies use sedation. Yet, in the U.S.,  it is almost universally used.    This author recommends that when you have your colonoscopy, you should seriously consider going drug-free.

In the U.S., doctors frequently use a “conscious sedation” which is a brew of drugs that relax you while also blocking pain.   Patients are semi-conscious during the procedure but have little, if any, memory of what transpired.  Recovery from conscious sedation takes between 30 minutes to a few hours, although the effects of the sedation can take up to a few days to wear off fully.    Increasingly, MDs are using full anesthesia for the procedure — Propofol is the sedative of choice — arguably because conscious sedation doesn’t work well on patients who are obese or use painkillers.   However, there are a number of reasons for the use of sedation, including the fact that insurers reimburse for it,  doctors have more control over the process and because patients fear that the procedure is painful and they don’t want to experience pain.  The dirty little secret is that it is not a painful procedure; there are few nerves in the intestinal tract so one feels only pressure, not pain.

The Use of Sedatives in Colonoscopies Is Dangerous, To Boot

The dangers of sedation are not in your imagination;  there are definite risks involved with sedation.  In fact, it is probably the highest risk of complication during the procedure, according to the Weill Cornell Medical College, New York-Presbyterian Hospital.  Risks include an allergic reaction or respiratory problems.  There’s also a correlation of anesthesia with loss of memory later in life.   Actually, here’s how the Society of Gastroenterology Nurses and Associates describe it:

“A retrospective review, by Sharma VK et al, of 324,737 endoscopic procedures performed under conscious sedation was accomplished using the Clinical Outcomes Research Initiative (CORI) database.  Several factors related to cardiopulmonary unplanned events (CUE) during GI endoscopy were identified including chest pain; arrhythmia; bradycardia; tachycardia; wheezing; hypotension; hypertension; transient hypoxia; prolonged hypoxia; respiratory distress; pulmonary edema; vasovagal reaction; tracheal compression; death; and O2 saturation less than 95%.”

This is pretty serious stuff and it is entirely unnecessary.  Colonoscopies can be performed safely and with almost no pain.  But you’ve got to request it. American doctors do not offer sedation-free colonoscopies routinely.  The procedure is beautifully described by David Holzman in a blog;  it is mandatory reading if you plan to go sedation-free.  He describes the discomfort as minimal — hitting maybe 3-max out of 10 on the pain-meter for seconds at a time here and there, and otherwise never going beyond 2 out of 10, comparable, perhaps, to a very mild cramp. And added plus:  he could drive himself to and from the hospital, and he’d be able to work when he got home. Another knowledgeable blogger, Laura Johannes, offered a similar experience to that of Holzman.

How To Do A Drug-Free Colonoscopy……easily!

IMG_20141229_074225This author has undergone two sedation-free procedures in the last five years.  The first sedation-free colonoscopy was performed on December 29, 2014.  The second on February 7, 2019.   They were both 30-minute long procedures in which I had a number of small polyps removed.   The staff at Sharp Rees-Stealy in San Diego were very familiar with non-sedation colonoscopies, reporting that many health professionals and patients with high-level security clearances request them.  Essentially, they were not uncommon and were the preferred method among those in the business who understood the colonoscopy process.  Moreover, most all of the staff with whom I spoke actually preferred the drug-free patients because the process was less complicated and had they had very brief recovery periods.   The staff viewed sedation as a convenience to their patients, not due to medical necessity.  (By the way, the Sharp staff that conducted this procedure couldn’t have been nicer folks.  Pleasant and very competent.)

My procedures were somewhat long  (average ones last 15-20 minutes), yet there was minimal discomfort; largely just gas pains from the air pushed into the colon by the scope.   At no point did I feel any pain at all, even when the doctor was removing the polyps.  Recovery took less than five minutes — just the time needed to remove the monitoring equipment and IV tube used to keep me hydrated.   The doctors were skillful, but seemed to feel that the lack of sedation did not make their task any more difficult.

The Doctors’ Point of View About Sedation-Free Colonoscopies

Both doctors we interviewed agreed that not using sedation makes the process safer and easier for the doctors.  The primary reason they use sedation is that most patients are extremely nervous about the procedure and are pain-averse.   Moreover, the procedure is faster.  The patient is not required to stay in a recovery room for an hour after a drug-free procedure.   The doctors can explain their findings during the process and, further, don’t have to visit the patient after the sedation wears off.

For patients who are unsure about going drug-free, they will set up an IV tube and, if the discomfort is too much for the patient, they can quickly administer the sedatives and the pain disappears.

Other Tips for Drug-Free Colonoscopies

My experiences appear to be a fairly common among those who have shared their stories: no pain, minimal discomfort, no recovery needed.  I drove home after it was completed — I did not require a driver to stay at the clinic for 2 hours. But anecdotal evidence aside, please understand that you are taking unnecessary risks and substantial post-procedure discomfort when you rely upon sedatives to help you through a thoroughly non-traumatic procedure.  Think twice before using sedation — it just isn’t needed!

  • About four days before your colonoscopy, avoid fried and high-fat foods. Use olive oil and mashed avocado for fats.  Eat lots of baked or steamed vegetables. Avoid salads and limit raw vegetables to one or two small servings per day.  Also avoid corn, nuts, berries and legumes as they can sometimes linger in the bowel. Whole grains, such as brown rice, are fine.  Also, cut out any foods with dyes as well as beets, which can discolor your bowel wall.
  • Many people think that they can drink the prep one to two days before the procedure and then drink nothing but clear fluids (such as Gatorade, apple juice or water) until the day of the colonoscopy. But even during the prep, the small intestine (the section of bowel after the stomach and before the colon) continues to produce chyme, a thick, mucousy secretion that sticks to the walls of the ascending colon—so that seven to eight hours after drinking the prep the colon is no longer completely clean.   Many doctors recommend a split prep, with half the prep ingested the day before the procedure and half ingested four to five hours before (the middle of the night when the colonoscopy is scheduled for the morning…or the morning when the colonoscopy is scheduled for the afternoon).
  • Chill the prep liquid and then use a straw to drink it, followed by a swallow of  ginger ale or another better-tasting clear liquid. Suck on a clear menthol lozenge after you drink the prep. And if you throw up the prep, wait 30 minutes (until you feel less nauseated) and then continue drinking the prep as instructed—it can still work.  Studies have found that eating a fiber-free diet all or part of the day prior to colonoscopy also allows for better cleansing of the colon.
  • We use a different pre-procedure diet.  We use a 4-day clear liquid diet that consists solely of juices, broth and white wine.  (The wine makes the process quite tolerable by dulling the appetite and lifting your spirits).   This diet not only cleans out the colon so that the doctor can spot polyps, it also makes the day-before prep far more effective.  Moreover, you don’t need to drink all of that prep liquid.

50 thoughts on “You Aren’t Crazy to Want A Sedation-Free Colonoscopy”

  1. Since this was written, there is now a state of art method that uses warm water instead of air. It’s far far more comfortable than the old air inflation method. Not only is it more comfortable, (98% of colonoscopies using this WAC method are completed to the end,) it’s far better at detecting polyps and cancers. The water cleanses the intestinal wall as the camera moves along giving a perfectly clean view. And yes, I think it’s crazy for most people to use these heavy duty Cii narcotics for such a simple and fast procedure. I think any doctor who gives resistance to someone refusing them is being unethical. I would complain to the state medical board if that happened to me.

  2. I cannot metabolize any type of sedative – causes memory lapses for over 72 hours afterwards – with propofol being the worst. I had a sedative-free colonoscopy last week and it was no big deal. It took me a while to find a doctor in my area that was 1) willing to do the procedure sedation-free and 2) had the experience. The doctor I found does most of his colonoscopies without sedation, used a pediatric-scope (I am a very slender woman) and used carbon dioxide rather than air to expand the colon as he moved through it. I experienced 2 episodes of cramping but I was forewarned and they only lasted a couple of seconds. The procedure was fascinating to watch and the doctor explained where he was in the process and what he was seeing. I did have a 2 cm flat polyp of “benign appearance”, which was completely removed and I experienced absolutely no bleeding afterwards. When I need to do this again, I will definitely use that doctor!

    I also did a low-fluid split prep, which was very tolerable and had minimal restrictions (no seeds or nuts( in my diet for the 5 days prior to the procedure day.

  3. I am a fit female who is 5’3″ and 118 lbs who has never had any abdominal surgery so I don’t have any adhesions. I had a sedation-free colonoscopy yesterday. It hurt the most going in around the bend of sigmoid which is pretty well at the start of the procedure. The corners were the most painful part but each time it only took about 5 seconds so I took a deep breath and let it out and we were onto another straightway. (And anyway they didn’t hurt as much as the first one.) Every time it started being uncomfortable, I just pushed out some of the excess air and it helped at lot.Once the scope has reached the end of the colon and starts back, it is just a bit of cramping from too much air but it is completely manageable because of the view on the monitor. Even cutting out the polyps was pain free. I’m glad I didn’t take sedation as I got to watch the procedure and then the rest of my day didn’t involve recovering from the sedation. I will elect to go sedation free on my future. colonoscopy.

  4. Thanks so very much for this website! It helped me get my colonoscopy without any sedation today, and it went perfectly! Stats: I am in my 30’s, have no previous surgeries and had active ulcerative colitis at the time of the exam. The gastroenterologist was reluctant at first to do the exam without sedation. He has done colonoscopies before without sedation and some of them have gone perfect while others had to be aborted before completion because the patient was in too much pain. He said that I might be fine, but I might not, and that he didn’t want to risk having an incomplete exam because I opted to not be sedated. I informed him that I was willing to give it a try, and that if worst came to worst, and I couldn’t do it without sedation, I’d gladly admit I was wrong and come back in a few months for an exam with anesthesia. After about 10 minutes of back and forth arguments, he finally agreed to let me give it a try without sedation. There were several seconds of pain, and fairly intense pain while the scope was going around the curves of the intestines, and some weird sensations (felt like intestines were writhing), but the pain did not last beyond a few seconds giving a chance to breath and relax in between. You do also have to be able to resist the urge to push when you feel pressure and mild pain at your rectum. It certainly was much easier than giving birth to my two children! Pain was much more short-lived than contraction pain. I don’t think an exam without sedation is for everyone. If you are on the fence, or have reasons why the exam might be made more painful like adhesions from abdominal surgeries, it might be better to take the exam with sedation. If you are totally committed to a sedation free colonoscopy though than go for it and don’t let anyone including your gastroenterologist try to talk you out of it! Worst that happens, as I got my gastroenterologist to admit, is the exam has to be aborted and you have to come back another day with sedation. Not so bad of a worst case scenario in my opinion. If like me, your fear of being groggy and confused from anesthetics for even a few minutes or your fear of suffering long-term cognitive defects from anesthetic use way surpasses your fear of any degree of pain, then an anesthesia-free colonoscopy will most likely work for you too. I definitely plan to do my every three year follow-up colonoscopy exams anesthesia free after my experience today! I hope more patients will stumble upon this website and be fully informed about their options. If you are reading this, you are totally empowered to do whatever works best for you when getting your colonoscopy whether than be anesthesia or no anesthesia!

  5. I have my colonoscopy with no sedation on 6 Jun 2019.
    The pain actually came from abdomen cramp. Air is pump in to inflate the intestine. This caused abdomen cramp.
    I won’t say that the abdomen cramp is mild. It can be quite intense. But it came in short blast.
    So, I told myself – take it like a soldier. It is bearable, even for an 53 years old man like me.
    I heard the cramp is similar to giving birth. But I believe it is nothing close to that.
    I will go for future colonoscopy with no sedation.

  6. I had my first colonoscopy in the U.S., in California, when I was 17 years old. I also did both upper and lower GI series in two separate procedures. NONE of these three procedures required any sedation at all. And I had over 100 bleeding ulcers in my colon at the time.

    Think about that.

    Now, I cannot get a doctor to do this simple procedure 40 years later without the threat or what the physician calls “his right to knock me out if he deems it necessary during the procedure” in my way. In other words, no doctor will do this without endangering my life.

    This is a simple procedure. But since the doctors in my country refuse to learn how to do it properly and they will not offer sedation-free colonoscopies or GI series, I will be busy signing a lot of A.M.A. (Against Medical Advice) sheets for REFUSING (like I’m really refusing? no, they are, but I’m the one that has to sign it) to do their expensive, and far riskier knock out drugs on me.

    Sorry, not going there. Besides, don’t they know, at least a few of us wonder what they are trying to hide from the patient?

  7. I recently had my colonoscopy without sedation. I don’t have a fear or any adverse medical reactions to any of the sedating drugs they use. I am more curious to see and ask questions of the actual procedure being performed. I did have feelings ranging from mild discomfort to pain (4 out of 10 on my scale) . I found the whole procedure very gratifying – to see and ask questions and just the wonder of my own ‘innards’ . My fathered died a prolonged death from colon cancer: thank goodness and modern medicine, I probably won’t!

  8. Hi. Thanks for that great article. It helped a lot motivational wise. I’m a German guy who had his colonoscopy today w/o sedation. In contrast to what you read it on the internet, it is not common practice in Europe to offer colonoscopies w/o sedation, I can judge for Germany at least. My GI and his nurses asked me many times if I’m serious about this, the suggestion really was the opposite of the article’s subject: You are crazy trying. It turned out the procedure itself was not that hard. Pressure from the inside and occasional pain in the curves. Nothing compared to a stomach flue e.g. The doc said that only 0,5% of his patients do it w/o. He said my bowel was quite curvy and narrow and that I had quite a high level of pain tolerance. The truth is: I don’t usually. I tried a bit of breathing meditation and positive visualization. And it was over real fast. Information is really crucial on that one, it’s the only power we have as consumers/patients. I’m glad the internet exists. I guess the reason it is used so commonly in practice is often: More revenue for the doctor (easy application, charging a lot more), easier to handle for the doctor (needs less skill/attention, doesn’t need to talk to patient) and general misinformation. I would highly recommend everybody to try it w/o sedation unless it is a very urgent case and rescheduling in case of an abortion of the procedure is not possible. I felt quite energetic afterwards. The black coffee that I was offered kicked in immediately and I was clear in my head. I spoke to other people who looked like they will have a sleepy/blurry day. When you have a 24h prep already, why straining your body with more chemicals if really not necessary? Also seeing the bowel from the inside was super interesting as well. Good experience for me! 🙂 Doc himself said he did it w/o 😉

  9. I’m a 50 yo female, and with nearly 10 years of vegan eating, I knew my tract would likely be clean. I have horrific nausea and vomiting response to anesthesia and wanted to avoid it if possible. The anesthesiologist said he’d been doing these for 30 years and no patient has asked for sedation-free. I told him I’d be his first. Mild discomfort, more from the air pumped in than the scope itself. My final two turns were a little tricky, the last being the worst. If you combine both the tricky turns, I weathered about 5 seconds of intense discomfort, the rest was just bloaty-feeling. Though the doctor, anesthesiologist, and nurse were all skeptical and my tract is longer than most, I sailed thru in 20 minutes – the same time as most fully sedated procedures. I hope in 10 years science gives us a more comfortable option but if not, I would absolutely do it sed-free again.

  10. I have had multiple colonoscopies and by far the worst part was the sedation which was promised to make the procedure tolerable. Not true for me; conscious sedation was terrible then “anesthesia” with propofol was much worse. So I did my next colonoscopy unsedated with no drugs. It was easy and free of the sedation/anesthesia risks and side-effects. I recently moved and tried to schedule a repeat colonoscopy but was repeatedly refused drug.

  11. Recently, I underwent this screening procedure because my twin brother was diagnosed with four poorly differentiated adenomatous polyps in his terminal ileum. At 43, I was hoping to stave off this screening for at least another seven years. But given his diagnosis, I knew I needed to get this done.

    Everyone, from family to friend to health care provider told me I was insane when I opted to go drug-free. Unbelievable pain and complete discomfort coupled with the heightened risk of a bowel perforation if I moved too much were among some the scare tactics presented to me. The truth is the anesthetic drugs scared me the most. I didn’t want to lose consciousness or forget important details the nurses and gastroenterologist may communicate to me before or after the procedure. More importantly, I wanted to maintain awareness. A connection to my surroundings and maintain, within reason, all my decision-making capabilities.

    Last Friday was the day. All prepped, which wasn’t as bad as I had anticipated, I took an Uber to the hospital, registered, and replaced my clothing with a skimpy hospital gown that exposed all my vulnerabilities. My baseball cap remained in place. I was nervous as evidenced by my heart rate of 120 and blood pressure of 161/95. The nurses placed an IV into my arm and performed their typical intake duties, all the time assuring me that “rescue” anesthesia services would be available. The primary intake nurse was very calming and expressed her belief that I would be successful at my lofty endeavor. My gastroenterologist met me in the holding area, we spoke briefly and exchanged important details about what I was going to experience. He was blunt and honest. He warned be that we might have to abort the procedure if I was too uncomfortable or there was threat to my health. Not wanting to have to return because of an aborted procedure, I agreed (conditionally) to come IV fentanyl, a powerful opioid, only if I was remarkably uncomfortable and after consultation with me during the procedure. With that, he left to wash his hands – presumably.

    The nurses wheeled my gurney into the procedure room. The team conducted a “timeout” (correct patient, procedure, allergies, etc…). I was turned onto my left side, knees bent towards my chest, and my buttocks was exposed. I could feel the draft. I faced the cardiac monitor and a large screen that would soon display the inside of my colon. Anxious, I took a couple of deep breaths and said “let’s go!” The insertion was painless. I felt him snake the scope up and around the bends of the left colon. The proceduralist said he my bowel prep was excellent. I felt some moderately intense pressure from the distention of the colon as he insufflated the area with carbon dioxide, but it was not the grueling pain I had anticipated. The irrigation was chilly, but not too cold. For thirty seconds, no more, I thought to myself – can I tolerate this? Is going to get worse or better? I told myself, “you can do this!” And then I heard, “okay that is the worse part of it. We are already past the hepatic flexure”, which means they were entering into my right colon and the terminal ileum (the finish line) was only inches away. The pressure and discomfort dissipated almost immediately. I was breathing normal and I could see my heart rate was starting to come down. I stared in awe at the screen as he continued to advance the scope. This was the inside of my body. I was blown away. As strange as it sounds, I thought how lucky am I to be able to look, live, and experience what I am experiencing. Not many people can say they have had that type of experience. I was fascinated.

    Once he reached the terminal ileum he poked through the cecal valve and snapped a picture of my still intact appendix. He withdrew the camera, noted some irritation along the mucosal lining consistent with NSAID therapy (I had been taking lots of ibuprofen because of a recent foot surgery, which I was wide awake for, but that’s another story). On his way out, he found two diminutive polyps, which were biopsied with cold forceps, nothing too suspicious. As he was nearly done, he retroflexed the scope to view the rectal area, which produced some mild discomfort, – normal findings and withdrew the scope completely. Jokingly, I said may be I should have some fentanyl now. The room chuckled and congratulated me as though I had just completed a marathon. The doctor said I was surprisingly tough. But the truth is, it wasn’t that bad.

    The nurses wheeled me to the advanced stepdown area. One set of vital signs and the IV came out of my arm. I dressed and awaited the discharge instructions along with doctor’s procedure notes. They politely offered me a wheelchair, but I refused. I walked out of recovery area with a Cheshire cat smile. On my way out, I met the lovely preop nurse and thanked and hugged her for her support. I told her it wasn’t as bad as everyone said it would be. She congratulated me and wished me a happy holiday.

    In conclusion, the procedure, albeit uncomfortable for a fleeting moment or two, was not the horrific torture I had anticipated. I am happier knowing the results and living the lived experience. I worked with my gastroenterologist, and he with me. It was a true partnership. While it may not be for everyone, for many different, respectul reasons, it was the right choice for me. And it is an option that I wish more providers would offer upfront rather than having to have the patient plead. I understand there are patient safety concerns and comfort is an overarching objective, but there is also a business model. GI doctors working with anesthesiologists to perform quick, necessary screenings while collecting some hefty insurance payments. But honestly, does every patient need an anesthetic or sedative to accompany a procedure? As an anesthesia provider myself, I say no. Listen to the patient and let them guide their own care. Some people, understandably, choose to be sound asleep. I respect that and those individuals should not be shamed by making that decision. It is right for them. However, others should be presented with a drug free option as long as they understand the risks, benefits, and alternatives.

  12. I had a colonoscopy in my 20s and am in my 50s now. I was supposed to go back every year for follow up because of ” areas of concern”. I had conscious sedation and remember moaning and struggling in pain. The meds let me remember but not really control myself. The doctor yelled at me and l was held down. I later awakened while being cleaned up and extubated after another surgery. I don’t stay under. I can’t move or speak coherently but I am aware. The terror of being held down and hurt has kept me from going back. No doctor will agree to put me all the way out assuring me I won’t remember it. Maybe I should give up and try it awake.

  13. Do not use sedation! I had my first Colonoscopy at the age of 51 and it was a piece of cake! The prep was the worst part and I didn’t drink all of it. I weigh 122 pounds and my body didn’t need all of the medicine to flush my system out. The key is when you start peeing orange out your butt, you’re clean! The procedure was not bad at all. I talked to the dr and nurses the entire time and it took 8 minutes! It hurt a little like a quick side ache but it was over so fast. I would do it again with out sedation. I got up and drove home!

    • Yes! I did it!! I had to make a lot of calls and visit one doctor who wouldn’t go for it. I called the nearest teaching hospital, to see if they might be doing a study, and one of their docs, who trained in Canada, was fine with it. Everyone was very nice, but every single person said, Are you sure? One nurse was very encouraging. The anaesthesiologist did ask why not (see post from 2016 on nausea and vomiting) and was gently clear that if I chose this, they couldn’t leave another patient if I changed my mind. So, a little scary to know there was no turning back, but the doctor used a paediatric scope and the nurse helped me breathe through the 2-3 painful moments (less than 10 seconds each). He reached the caecum in 6 minutes and did the back up and out in 8. All good!! Then *afterwards* most people said some variation of “That seemed easier than a sedated one…wow. You can go home right away, and your vitals are great! We’re not used to seeing people like this.” I will say the Golytely prep was awful!!! I had a split prep, and I almost threw up the morning portion after half of it. The toilet time wasn’t too bad—have baby wipes and ointment. Next time, I’m asking for a different prep. So, I’m all about choices—I’m glad sedation is there for those who want it, but there should be options for those who don’t, also, without a fuss.

  14. I need frequent colonoscopies due to being high risk for colon cancet and I have had terrible life-threatening reactions to sedation. I have had my last several colonoscopies unsedated and they were easy, safe and comfortable. I recently relocated and scheduled my repeat colonoscopy with a new endo centet and I was told that they could do it unsedated.,…..but when I reported for the exam I was told that I had to consent to sedation or not have the exam. Nobody cared that sedation almost killed me in the past or that my last 4 unsedated exams were fine. They only want to do sedated patients because they can do sedated exams faster and they just don’t care about patient safety.

  15. Has anyone with blood in stool, inflammation, cancer findings done a sedation free colonoscopy..Just wondering if all of these didn’t hurt much becuz nothing was wrong?

  16. I’ve just turned 60 and have never had a colonoscopy out of fear of anesthesia. Oddly enough I had an abdominal hysterectomy earlier this year and went into respiratory distress due to the anesthetics while in the PACU. i was fine once I got to my hospital room and did not use the PCA pump at all for pain. But yet I am afraid to have a colonoscopy. I would opt out of andsthesia due to my adverse reaction.

  17. This article comes up as # 1 when I searched: san diego endoscopy no sedation. I mentioned sedation-free colonoscopy at Sharp in San Diego yesterday and got confused reactions and strange faces from people. Its almost humorous how little people in the medical profession know about their own profession, but us lay people are aware of the:

    (1) Risk of short term side effects
    (2) The long term dementia/memory loss risk increase
    (3) The fact that few people in Europe get sedated for this
    (4) The fact that its totally not necessary

  18. Having had 2 colonoscopies with BAD reactions to sedation, I am opting for no sedation for the next one. Because of my previous experiences, I have not had one in 9 years and I am 59 years old. Having to rely on other people to drive you to the GI lab and bring you home (I’m single) is not for me and inconvenient for them. I want to be able to drive myself home and not lose a day due to sedation/anesthesia. I have no problem with bowel prep since i tend to have diarrhea anyway. Being worked up for IBD and diverticulosis/diverticulitis.

    I called my GI’s office and asked to have a non-sedation colonoscopy. She (the nurse) “warned” me that it would be extremely uncomfortable. I told her that I’d done my research (have a 4-year medical degree) and this is what I wanted. She acquiesced and I’m good to go when I schedule. Have to have a CT first.

  19. I am getting scheduled for a colonoscopy to find out about irritable bowel disease…my levels have shown high in my blood work, etc. Being that I am so “inflamed” inside, I’m afraid that without sedation it may be painful, however still want to go without sedation. Can anyone tell me if you have had a colonoscopy while being inflamed, and still had no pain?

      • Hi Ann – Sorry that wasn’t so clear. They are checking me for inflammatory bowel disease, most likely ulcerative colitis. High levels of inflammation were found in my lab work.

    • I am reading all these comments about folks going for colonoscopies and other tests without anaesthesia and I must ask. WHY? When was the last time you had anesthesiaa? It is so much improved. First of all the nurses or who ever administers it are such experts they make it almost imperceptible. Really, I have waited to feel a needle in my arm and I cannot feel anything usually. Secondly, you wake up as if you’ve had a nap, no nausea, no dizziness, nothing. So…why be brave, what are people afraid of. BTW, I have had it three times in the last 13 months at different locations, including a colonoscopy. Unless it is to save money on a co-pay or something, I don’t see the point.

      • Far too many people have shared experiences that diverge wildly from yours. One of the key benefits of sedative-free colonoscopies is that people have no “sedative hangovers”. They can proceed with their day with no concerns that they’ll be “out of it”. Sedatives may not present any side effects for you. However, for those who have residual effects, sedative-free procedures are hugely important options.

      • Christine, I’m interested because my colonoscopy had to be aborted due to me becoming hypoxic during the exam with 4 mg. Versed, 75 mcg. Fentanyl, and 50 mg. IV Benadryl. Now, the doctors want to use Propofol and a tube down my throat for oxygen! I definitely don’t want this after reading how easily Propofol can cause respiratory arrest. And there is no reversal agent for Propofol. Scary. I’ve been doing research and am so glad I found this site and everyone’s comments on their experiences.

      • Hi,

        For me, the standard ‘sedation’ drugs make me incredibly sick. I would like to stress this is a personal choice, and if you want sedation, that’s your decision. For me, though, Versed has caused breathing issues, and the Fentanyl/Propofol combination causes relentless nausea and vomiting. I recognize the importance of screening, but it’s not worth it to me to either suffer respiratory distress and/post-op nausea vomiting. It has nothing to do with being brave or masochistic–it has to do with documented medical concerns from prior procedures that caused problems. Last surgery was 6 months ago–took 10 minutes to find a good IV vein (mine are tiny and deep), and then I spent 6 hours after surgery with my face in a toilet. No, thank you!

      • For me, even if the anesthesia works perfectly fine with no side effects, I don’t like the feeling of lost time. When I’m asleep, in normal function, my brain dreams and I definitely know I’ve been asleep. With anesthesia in general, this doesn’t happen. This is because anesthesia is not sleeping, it’s unconsciousness. The drugs block the neurotransmitters that provide for consciousness. Sleep is a normal state where the body is doing reparation on the body and it is a function that is supposed to be there. Anesthesia is a state that is closer to what your brain would do in death. No thanks. I have enough to worry about with simulating what it is like not to exist. To think that even in perfect conditions people die simply from anesthesia administration, it should be terrifying. For me, it is a claustrophobia reaction and when I wake up, it takes YEARS to recover from the PTSD. I’ve had it once for a tonsillectomy and I swore never again unless there is certain death for me to not have the procedure. This is on top of the side effects that some genuinely have.

        • I hope people don’t read these stories and put off a life -saving colonoscopy. I went in a couple of weeks ago. Without too much prompting I did a low residual diet for 2 days…(low fiber, NO nuts, pickles, olives, popcorn, corn ) In fact I ate baked potatoes and white bread and such because fibrous foods stick to the colon, and they have to examine anomalies. So just stop for a couple of days. (hardest part.) I also did the prep you buy without a prescription. No problems. Cleaned out in two sessions. I did take the day before off and sleep a lot. Got a little hungry. Followed the directions to perfection. Went in the morning. Got checked by the nurse and anesthesiologist. Wheeled in and got the anesthesia, administered by the anesthesia nurse. Woke up like I had never been asleep. All over. I was clean. Dr. said I did great with the anesthesia. It was nothing. After being wheeled in, I was lying on my side and then i woke up lying on my side and I was wide awake with no side effects. Could have driven, but didn’t due to rules could not and my better half was there to take me home. No after affects. Please don’t scare people! Both the prep and the anesthesia experience were just almost nothing. (and I was scared.) ** exception- Might be different if you have colon problems, Mine was a screening, no problems but I am in my late 50s. Don’t be afraid. It wasn’t even unpleasant and it could save your life to find a polyp 10-20 years in advance.

  20. I had a sedation free colonoscopy this morning. It went absolutely smoothly. There were a few moments when there was brief pain – more like crampy gas pains, otherwise there was just some pressure now and again. The nurse was right there next to me and saw me wince once or twice and just told me to take deep breaths. I think the doctor actually enjoyed it lol. He was pointing out all sorts of interesting facts about the colon and giving me a biology lesson as I watched the video screen long with him. At the end he said I was a champ and two nurses both old me after that when their time comes they’re going to opt for no sedation based on my experience and how well I did. In no way to I want to say this was fun, but it wasn’t bad at all, really didn’t hurt per se, and hey it only lasts 20 minutes. Believe me – it’s way better than having drugs pumped in to you for a 20 minute procedure and being all loopy for 12 hours.

  21. I am scheduled (in a week) for my first colonoscopy . I am a 58 year old male. No serious problems to my knowledge. I am opting for no anesthesia. I have read the many posts regarding this option. The pain issue seems acceptable. What I have not read discussed is the possibility of finding a severe cancer polyp, and how the patient would respond to this during the procedure. The after-procedure disclosure of having cancer must be rough enough, imagine seeing your own colon in real time with advanced tumors! So it seems to me that bracing for pain is not the only issue. I have already discussed this with the physician, and I am going with the sedation-free option.

    • Thanks for your thoughts, Chris. Just so you know, doctors can’t determine whether polyps are cancerous without extracting and testing them. So there are few, if any, scenarios where a clearly cancerous polyp will be identified during a colonoscopy. Glad to hear that you are going with the sedation-free option. Let us all know how it went.

  22. Ten years ago I woke up in the middle of a colonoscopy in a G.I. outpatient unit, under “conscious sedation” by an RN. The pain was excruciating. I returned the next day to see the nursing supervisor. The procedure record showed an acute elevation in heart rate and blood pressure during the procedure which coincided with missed doses of fentanyl (pain med).
    Since that nightmare, I’ve been given propofol for the 20-30 minute colonoscopies I’m required to take every few years. A good anesthesiologist does not knock your socks off with propofol. You wake up alert and feel great.

    • Sorry to hear about your experience, Terri. But we strongly urge our readers to avoid the use of propofol. As described in depth by Consumer Reports, the use of that particular sedative is unnecessarily risky and 20% more expensive. Propofol is attributed to the deaths of a large number of people, including Joan Rivers and Michael Jackson.

      • How could you compare the death of Michael Jackson for a reason not to take concious medication , Propranol, for a colonoscopy! This drug is very safe if given properly, not like Mr Jackson did. Of course people do die on the OR table for reasons other than the anesthesia, that being cardiac and pulmonary issues which they had going in to the proceedure.
        It was irresponsible to say that taking anesthesia for a colonoscopy is dangerous and people have died from it, when it is simply not true. People, on the other hand, do die from colon cancer , which is easily prevented.

  23. I really would like to get it done I wonder if anyone on this site knows any drs in NYC whom are compassionate enough to help certain people who want this done

    • It turns out that almost every doctor who performs colonoscopies knows how to do them without sedation. First thing we recommend is ask your doctor if they have any problem performing one — in all likelihood, they’ll agree to do so. Especially in New York.

  24. I am so grateful that you pointed me in the direction of NO ANESTHESIA !!!

    It was AWESOME 😀

    Yes, there were areas were it hurt, but I kept breathing and imagining that having a child would hurt so much more, and that I can get through it by visualizing peaceful images. And it worked. I was surprised though that my blood pressure was much higher than normal (even without the drip solution). My oxygenation was 100% since they did give me oxygen through the tubes on my nose to breath in. The staff was somewhat bewildered about no anesthesia, however, they went with it. My doctor, who does 1000 colonoscopies/year, told me that about 1% of his patients now are requesting NO anesthesia for the colonoscopy procedure.

    The particular nurse, who accompanied the doctor doing the colonoscopy, told me that I was her first patient that did it without anesthesia. And she approved of it after she saw how it went. Three nurses came in to congratulate me afterwards and as we all talked they were all in agreement that the anesthesia is not good for the body and mind.

    I was able to walk out immediately after the procedure and resume a “normal” day. Well… I say “normal” since I did not sleep the night before while having the runs and taking the fluids, I was soooooo tired… so I went home and went to catch up on my well deserved sleep! Thank you once more for bringing it up. I will spread the word !!! Halleluia !!!

  25. I was asked by the nurse when on the table if I wanted to try pain medication and sedation free. I talked to her about it. I did not realize that was an option. I had not done any research about this. My body does not react well to drugs. She told me that she had done it and about 20% of the patients at Loma Linda Hospital select pain medication/sedation free colonoscopy. I thought, if you did it, I can do it. I was thrilled that I would not be sedated and could watch the entire procedure and ask the doc questions. I am 69, and this was my first colonoscopy (ya, the docs have been after me for years). The nurse readied my arm for pain medication if I told her I needed it during the procedure. I agree with Robin in the above post. You need the ability to tolerate the feeling having to go poo really bad — like, “Doc, get out of the way and let me blast whatever is in me out.” But, then you realize that you are clean inside, and that the feeling is just the discomfort of the camera tube entering. So, it was creepy feeling with pain when the doc said, “We’re going around a corner now.” The last corner (third) was the hardest, and the nurse said, “Breathe deeply,” and I did, and was fine. It felt like a baby kicking inside of me. I love learning, so I consider this the experience of a lifetime: camera tube goes in rather fast, then the doc checks the colon tunnel when backing out. The doc said, “We’re at the end. There is your pancreas (small dark shadow).” When the doc started backing out, the little tube has a camera, a squirt hose, and a vaccuum on the end. The doc would spray any small debri, suck it up, and look at the pink tunnel. He kept going south, so to speak, exiting as he sprayed, vacummed, and looked; until the tube was out, and procedure was over! I was able to ask questions about the pink tunnel on the trip out. When he was done, I asked, “Nothing?” He said, “All is well.” I was amazed. I felt fantastic. I got dressed, walked out to meet my sister after one hour, 15 minutes. I went home, got into my swimsuit, and was able to attend my water aerobics class and have a hearty lunch afterwards. The prep was no problem. The day’s liquid fast had cleaned me out, but I hear that vegetarians have an easier time cleaning out than non-vegetarians. The prep only caused watery stools. I would say that a pain medication/sediation free colonoscopy is not for everyone — only the brave, curious, and those with relaxed colons and able to relax their muscles under creepy conditions. My sister could not finish her colonoscopy because her colon was too small and twisted. She was sent for some type of x-ray instead (with prep the day before, and drink that lighted up her colon for the x-ray). I am so happy that I was able to experience the pain medication/sedation free colonscopy!

  26. I had a colonoscopy this morning and after much Internet research, I elected to do it without sedation. I am a 29 year old female in good health. I was getting the colonoscopy to find the cause of rectal pain and bleeding. It didn’t turn out to be much.

    I signed the anesthesia consent form but beside my name wrote “Will try without sedation”. They made me amend it to say “But I do consent if I ask for it”.

    Two nurses tried to warn me that most people who have it done without sedation usually end up asking for it halfway through. The doctor had done patients who didn’t want to be sedated before but said he elected to be sedated for his own personal exams. He said there was no way he’d have one without it. He did tell me however that most patients did alright if they’d made their mind up prior to coming that they didn’t want to be sedated. He said the patients who were on the fence about it were the ones who ended up not handling it well. I told him let’s get this thing started. I was horribly anxious the whole day before and during. I did not take any anxiety medicine because I assumed I wasn’t allowed to but they said it would have been fine.

    We got started and it was definitely uncomfortable but I didn’t experience anything that I would consider horrible pain. I have a very low pain tolerance but apparently my fear of sedation outweighs my fear of pain. You don’t feel much except for when they are pushing through the turns of your colon. It is a bizarre, uncomfortable, pressure feeling but bearable. I started sweating and sweated through the whole procedure but it wasn’t profusely or anything, mostly my head and neck. I was wearing a sweatshirt because I was cold before it started. My vital signs stayed fine throughout the procedure so I was able to stay awake during the whole thing. I asked the nurse probably every two or three minutes my vitals were still ok and she would always assure me I was doing great. I made a little small talk with the doctor and nurses about my colon on the screen during the procedure. I was able to keep my mind off the pain by focusing on my breathing so that I didn’t hyperventilate due to pain or fear, and also by watching the video which was kind of fascinating. When I found myself clenching my legs or anything, I would remind myself to relax them. One nurse rubbed my back and reassured my throughout the procedure and the doctor used a pediatric scope which I think is a little smaller.

    Sorry for the graphic details, but the worst part BY FAR was definitely at my anus or the opening of my hole. It was kind of raw from the prep the night before and also part of the reason I was having the procedure done. I could feel the scope rubbing it as it was pushed through my colon and that’s definitely the worst pain I felt. The whole thing was over very quickly and probably only lasted about 15 or 20 minutes. Afterwards, in the recovery room, they gave me some Sprite because I hadn’t drank anything in about twelve hours and took my blood pressure once. Then, I walked out with no restrictions. It’s been about four hours and my bum-hole is still sore but nothing a few tylenol, Epsom salt bath and lidocaine cream hasn’t helped.

    If you’re leaning towards doing it unsedated, I say go for it! I’ll always do it this way.

  27. I had my first colonoscopy today and I told them I wanted to go sedation-free. Well… it was so painful that I screamed for them to STOP!! They did have the IV hooked up so I was given the smallest possible dosage of a pain killer. They said they give us 2 drugs usually, one to kill pain and one to make us forget what happened. I didn’t get that last one… I just got the pain killer and the smallest dosage they could do and it went fine. Nothing to recover from. They do look at your appendix, but don’t go into it. 🙂

    • Thanks Marilyn. Given that there are no nerve endings in the colon, it sounds like they may have pressed up against another organ when conducting the scope. Having the IV hooked up is not unusual — exactly for the reason you described. It gives the patient the ability to dictate what s/he needs.

  28. I just had a sedation-free colonoscopy this morning and agree: sedation-free is the way to go. It was an amazing experience to tour my colon and even a portion of my small intestine. It’s really not painful, and there were only a few seconds of intense pressure. Nothing to fear. A few deep breaths got me easily through them. Even when biopsy samples were taken it wasn’t painful. When I have to have another one, I am going sedation-free again.

  29. I recently had a colonoscopy at the Veterans Administration in West Los Angeles. I did it without sedation and it was a piece of cake. The doctor went through my colon and into my appendix. There was almost no discomfort and no pain at all.One I was done I walked out, got on my scooter and went to eat. It was amazing to watch the procedure on the big color screen. I would not hesitate to do it again without sedation. They hooked me up to sedation just in case I wanted it, and that was reassuring enough for me to try it. Once the procedure began until its conclusion, I never considered using it. Just got for it! 🙂 Why get sedated and put out of commission for twenty-four hours for nothing?

  30. I have had terrible reactions to the “sedation” for colonoscopies..I’m high-rish for colon cancer and would never get another colonoscopy with sedation. It’s dangerous and unecessary. Properly done colonoscopy is NOT a painful procedure; if your gastro insists on sedation (patient control drugs and forced amnesia-sometimes for a long time)..skip the exam and find another doctor. Sedation for colonoscopy with propofol is no simple “sedation” it can become general anesthesia in seconds. If you get propofol insist that an anesthesiologist administer it (not a nurse/crna)..if you want to be safe.


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