Let me first assure the reader that I definitely do not consider myself as having a high pain threshold and would be horrified at the prospect of having stitches, which I have refused in the past. Thank God for \"Steristrips\".
After reading many disturbing reports of colonoscopy procedures, I opted for a barium enema followed by a sigmoidoscopy, which I still wasn't exactly looking forward to but was persuaded as being necessary for a more accurate assessment. However, I ended up having an almost full colonoscopy; bearing in mind that colonoscopies are often incomplete. I was quite prepared to continue with a full colonoscopy but the clinician, having seen the barium results, considered it unnecessary.
Having changed an appointment for the barium enema (BE), which one apparently undergoes a couple of weeks before the sigmoidoscopy, I received a new appointment together with two more sachets of bowl prep (Picolax in my case - it tastes quite refreshing if you're partial to fizzy lemon juice). As I did not find this prep particularly uncomfortable before the BE, I decided to undergo the prep again for the sigmoidoscopy rather than merely have the prescribed phosphate enema at the hospital immediately prior to the procedure. My reasoning was that, firstly, if I was going to be pumped up with air during the procedure, any escaping air would be more wholesome for the staff and therefore less embarrassing for me. Secondly, if the clinician considered that exploration beyond the descending colon was necessary, they would have the opportunity to investigate further along the colon.
I attended a NHS hospital where neither sedation nor analgesic is generally given for a sigmoidoscopy, although I was offered the choice on arrival. I particularly did not want sedation (i.e. one is conscious throughout the procedure and, at best, merely forgets the procedure on recovery - somewhat like inebriation) because I like to take control of my situation and felt that more care might be taken if I were in a position to moderate or stop the procedure; I also considered that staff would be more appreciative of my not occupying a recovery bed afterwards.
I was more than surprised that, within a few minutes, the clinician had intubated the colonoscope up to the Splenic Flexure (junction of the descending colon and transverse colon) without my hardly feeling anything; as far as I understand, this constitutes a complete sigmoidoscopy. As I was experiencing no discomfort whatsoever, I advised that I was quite happy that he proceeded into the transverse colon. During this part of the procedure, he told me that he was trying to get loops out of the endoscope but all I could feel was a mild stomach. He continued on to the Hepatic Flexure (junction between the transverse colon and ascending colon) and decided that no further exploration was necessary. During all this time I could see the visual display and the progress of the colonoscope through the colon.
I accept that people experience things differently and that the practical experience of the clinician plays a large part in making the procedure as comfortable as possible. However, I believe that a relatively pain free colonoscopy can be achieved by becoming involved and interested in the subject to the point where you can discuss the finer details with the clinician during the procedure and not place yourself in an inebriated and, therefore, defenceless position unable to control the proceedings. I am sure that the clinician performing your procedure will have far greater respect for you, and therefore treat you, your fears and your discomfort (if any) with far greater consideration. Remember, if your partially zonked out you won't be able to stop the procedure even though you may desperately wish to and the clinician may not take anywhere near the care (even though you may be moaning and groaning on the table); he/she is only human and needs to get on with the next patient.
Good luck; although I don't really think you'll need it.
