Pain During Colonoscopy

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Veteran Member

Date Joined May 2003
Total Posts : 9448
   Posted 7/9/2009 3:25 PM (GMT -6)   
I've posted this abstract from PubMed before but its been a couple of years.
Endoscopy 2002 Jun;34(6):435-40

Patient pain during colonoscopy: an analysis using real-time magnetic endoscope imaging.

Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP.
Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, London, United Kingdom.

BACKGROUND AND STUDY AIMS: Colonoscopy is generally perceived as being a painful procedure. Contributory factors are: stretching of the colonic wall and mesenteric attachments from looping of the instrument shaft, overinsufflation, the degree of torque or force applied to the colonoscope shaft, and patient pain threshold. The aim of this study was to determine the frequency of pain episodes experienced during diagnostic colonoscopy and the corresponding colonoscope configuration, utilizing real-time magnetic endoscope imaging (MEI).

PATIENTS AND METHODS: Consecutive outpatients undergoing colonoscopy were studied. Patients with previous colonic resections were excluded. Procedures were commenced with antispasmodics only, and patient sedation was self-administered whenever significant discomfort was experienced, using a patient-controlled analgesia (PCA) syringe pump. All "demands" were correlated with the MEI record, which was subsequently analysed.

RESULTS: A total of 650 demands were recorded in 102 patients. Seventy-seven percent of all demands occurred with the colonoscope tip in the sigmoid colon, 7 % in the descending colon, 6 % at the splenic flexure, 5 % in the transverse colon, and 4 % in the proximal colon. Ninety percent of all pain episodes coincided with either looping (79 %) or straightening of the colonoscope shaft (11 %); presumed overinsufflation being an infrequent cause of pain (9 %). Of the loops encountered during colonoscopy, the N-sigmoid spiral loop was associated with the majority of pain episodes (56 %). Looping was both more frequent ( P = 0.0002) and less well tolerated in women than in men ( P = 0.0140).

CONCLUSIONS: This study is the first to document pain at colonoscopy accurately. Looping, particularly in the variable anatomy of the sigmoid colon, is the major cause of pain, especially in women. Use of MEI may improve pain control by facilitating the straightening of loops within the sigmoid colon, and by enabling the endoscopist to target patient analgesia.

PMID: 12048623 [PubMed - indexed for MEDLINE]

Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

Regular Member

Date Joined Jul 2009
Total Posts : 83
   Posted 7/9/2009 3:32 PM (GMT -6)   
I've never had pain during a colonoscopy -- the demerol/versed combination knocks me out just right and when I wake up there's no memory of it whatsoever.
**Diagnosed with ulcerative colitis in 2001; diagnosis changed to Crohn's disease in 2009 (but still only impacts colon)
**Asacol (4800 mg daily), 6-MP (100 mg daily -- recently switched from Imuran), Prednisone (8 mg daily...for a few more weeks), Flagyl (250 mg every other day), Nexium (40 mg daily)
GOAL of one day being immunosuppressant free...still working on my doctor on this one but I am a world traveler who desperately wants to go to Africa one day!

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