I've had an upper endoscopy w/and w/o "sedation". I prefer w/o so I can watch the monitor and see for myself - but - I have a strong gag reflex and the gagging does make the upper scope MUCH WORSE than the lower scope w/o sedation. The gagging can bring tears to my eyes. No pain but boy I gag starting in my toes!!! Retching actually!
I'm always so dry that they can't start the IVs soon enough to suit me! BUT - w/o the sedation, just the fluids. I'm fortunate to have a great gastro when it comes to doing scopes. She is slicker than snot on a door knob w/that scope.
Go to PubMed and check out these two abstracts:
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.
PMID: 12048623 [PubMed - indexed for MEDLINE]
Gastrointest Endosc 1996 Feb;43(2 Pt 1):124-6
Why is colonoscopy more difficult in women?
Saunders BP, Fukumoto M, Halligan S, Jobling C, Moussa ME, Bartram CI, Williams CB.
Department of Endoscopy, St. Mark's Hospital, London, England.
PMID: 8635705 [PubMed - indexed for MEDLINE]
The pain during colonoscopy is caused by the over enthusiastic induction of air stretching the walls of the intestine like a balloon and/or by the looping of the scope shaft back onto itself which also stretches the wall of the intestine. The interior of the colon doesn't have nerves to sense pain, you feel NOTHING when they take a biopsy or remove a polyp. But stretch the wall of the colon and yeah, you feel discomfort to pain depending on how much distention. Most gastros don't want to take the extra time necessary to do a scope w/o sedation. (And all conscious sedation is in an amnesiac - you FEEL any pain, you just don't remember it - I RESENT that!). Try threading a small string thru a straw. Not much different than advancing the colonoscope. It takes more time to use less air and to withdraw the scope a short way to straighten it and then proceed until the next time the shaft loops back on itself.
The ONLY colonoscopies that I had discomfort in the abdomen afterwards were the two done w/sedation. Both times it was the bruised like feeling of having been kicked in the stomach for 1-2 days.
A caring, considerate gastro will respect your wishes to have your colonscopy w/o sedation. He/she will suggest that you allow the IV set just in case and for fluids to be administered, maybe even suggest a little demerol or fentanyl for comfort (analgesiacs, NOT amnesiacs). He/she will use air sparingly, advance the scope carefully, w/draw it a bit when it loops, IF you do change your mind and ask for a littel sedation he'll take the time to let the sedation take effect before proceeding any further, including if necessary removing the scope and leaving the room briefly whilst the sedation takes effect. He/she will also be conscientious about
removing as much air and fluid as possible when withdrawing the scope and finishing.
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.