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Avatar universal

Colonoscopy without sedation

I'm 54 and have beeh having dark blood in the stool as well as recent onset change in bowel habits (alternating constipation/diarrhea) as well as a bad family history of colon cancer.  Since I'm a nurse, it seems like a no-brainer that I should get a colonoscopy, althought my doc said not to worry (she's making me feel like a pest for asking) and told me to take metamucil.  I can self-refer fo rthe test, but I want to have it without sedation; after recommending this test to hundreds of patients and seeing a number of them performed, I just won't do the "conscious sedation"; I have seen too many people with long-term memory impairment from Versed to consent to this.  About 10% of these exams are done without sedation (and most other countries don't use sedation), but when I try to schedule one, they "insist" on sedation.  Oh, and of course I'm allergic to eggs, so propofol is out, ut even if I wasn't I would not do the sedation.  Should I keep trying or give up?  What's the big deal with doing the exam without sedation?  I know it's uncomfortable; heck, I have seen a number of patients literally scream for the doc to stop the colonoscopy and this was with Versed; they rely on the amnesia effects to stupify the patient.  What bothers me, is that I see a lot of patients who have a PTSD-type reaction later when they start to remember how they were treated. I would rather experience and remember the discomfort.  My doc says that she would never get this exam, drugs or not........thanks
41 Responses
Avatar universal
Well, you may wish to have a CAT scan, or a barium enema, there are several diagnostic tests that can be done besides colonoscopy, particularly if you have a mass in the small intestine... colonoscopy would be useless in that case, and instead they'd do an endoscopy.  As for the colonoscopy, you are within your rights to ask for no sedation, or you could go for general anesthesia in an operating room, or you can ask to have only LOCAL anesthetics and analgesis, or you could specifically ask that they not put Versed or any other amnesia drug into the mix, and instead just inject Demerol for pain.

Docs don't want to do a colonoscopy without sedation because the patient might suddenly move in pain and thus cause injury, or because the patient who experiences overwhelming discomfort might end the exam before it is completed.  

I think it is perfectly okay to choose any alternative exam or variation on the way an exam is done, if you want, and if a doc is too stubborn to respond to your request, obviously go to another group, and another, until you get what you want.  There are docs and hospitals who are doing tests of nonsedation colonoscopies, to see if this is an option that should be offered to the general public.  There are plenty of people out there that don't want twilight sedation, period, and there are docs who will respond to that request, particularly when the patient has had a bad reaction to Versed, which can indeed cause some instances of pretty dramatic and negative amnesia experiences.
Avatar universal
Thanks for the info, local anesthetic for colonoscopy wouldn't work and GA would be dangerous overkill; I don't even think that the sedation part is a good idea, but some people seem to want it. the choice seems to be: risk receiving a drug that you have a know bad reaction to, or skip the exam.   I would  never do conscious sedation again and only consent to GA if I was dying.
Avatar universal
I would never get sedation after watching 2 coloncopies where one patient screamed her head off; they ignored her hoping that the temporary amnesia from Versed would get her out the door....I very possibly have colon cancer and need a colonoscopy-can't find anyone to do it without sedation.....therefore will not have it done
168348 tn?1379360675
We started out with my colonoscopy without sedation and then some sedation and I do vividly recall I was moving about too much and they were concerned I could get hurt by the movement and they asked my consent before administering more sedation.

They found an atypical polyp ........I am overdo for my followup exam by 2yrs worth .... really foolish on my end I know .... but due to the dehydration and a kidney stone problem/history I have, I am scared to get it again ..I had a major kidney stone attack 8 hrs after I got home and almost ended up in the ER that night.  Some have suggested 23hr procedure and stay there with IV bags of fluid for quite awhile before I go home vs. in and out.

915277 tn?1252576713
I worked for gastroenterologists for over 10 yrs and have seen many colonoscopies and egd's and I have never see anyone scream their heads off...I have had 6 colonoscopies myself and have been awake for a couple of them and had polyps removed and I felt absolutely no discomfort at all.  The reason they give you versed and fentanyl is to put you in a twilight sleep so that if they ask you to move slightly, you can and do follow those orders,  and to relax you.  As far as long term memory impairment from the meds, in 10 yrs, that never happened with any of our patients.  And your doc says she would never get this test??  Colonoscopies save lives everyday by the early detection of colon and rectal cancer and the removal of precancerous polyps and for a physician to say they would never have this test goes against the first tenant in the Hypocratic oath...First do no harm!!  Unfortunately, stories like this one are what scare people so badly that they put their health in jeopardy rather than have a simple 15 minute test.  I am surprised that you, as a part of the medical profession, would perpetuate such horror stories, which in turn could indirectly jeopardize another's heath, and possibly a life...
915277 tn?1252576713
You make it sound as if the doctor doing these tests mistreated their patients while they are under the effects of the meds, if that was the case did you report said doctor??  If you saw mistreatment of a patient and did not report it, then you are just as culpable as the doctor!  I don't fully understand why an NP would be coming to laypeople for answers, when surely you have colleagues to consult with on this issue...  
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