1/ What is a Colonoscopy?
A colonoscopy is a method that uses a flexible scope with an attached light and camera to visualize images inside the digestive tract. For esophago-gastro-duodenoscopy (EGD), the scope is inserted through the mouth or nose, passing through the throat to the duodenum; whereas for colonoscopy-rectoscopy, it is performed via the anus to the cecum.
Through a colonoscopy, doctors can identify the cause of symptoms such as chronic constipation and diarrhea, abdominal pain, bloody mucus in stools, and other intestinal problems. It can also detect colorectal cancer and precancerous lesions like ulcerative colitis, Crohn’s disease, and polyps.
Currently, two common methods of colonoscopy are used: conventional colonoscopy (patient is awake) and sedated colonoscopy (painless colonoscopy)
2/ Advantages of Painless Colonoscopy
Colonoscopy is an important method for diagnosing colorectal diseases, including colon cancer.
Colon cancer is one of the most common types of cancer. Colon cancer is treatable and has a better prognosis compared to other gastrointestinal cancers. However, most people with colon cancer are diagnosed at an advanced stage. The reason is that early-stage cancer often has few symptoms or can be easily confused with other common digestive ailments, leading patients to overlook it.
Although colon cancer screening has become much easier and extremely effective thanks to colonoscopy, a major barrier that prevents many people from getting screened is the “fear” of colonoscopy, believing it to be a painful and uncomfortable procedure.
In reality, depending on each person’s pain threshold, some may only feel uncomfortable during a colonoscopy, while others experience significant pain and discomfort. Some even develop fear or phobia associated with this procedure.
To overcome this issue, a method called painless colonoscopy has been adopted. This technique uses a small amount of sedative medication to help the patient “sleep” throughout the procedure. This eliminates patient anxiety and fear, as well as feelings of pain, discomfort, and abdominal distension.
Compared to conventional colonoscopy, painless colonoscopy is safer and more effective. With conventional colonoscopy, if the patient is too frightened and struggles vigorously, the scope could injure the colon wall, also making it difficult for the doctor to observe. Sometimes, due to patient non-cooperation, the doctor may have to end the colonoscopy prematurely, and some small lesions might be missed. The sedated colonoscopy method completely overcomes these problems.
Furthermore, in cases where interventional procedures like polyp removal or biopsy are needed, the doctor can perform them more conveniently and easily, and the patient experiences no pain.
3/ How is a Painless Colonoscopy Performed?
Not everyone is eligible for sedated colonoscopy. Therefore, before the procedure, the doctor will conduct a health examination to ensure the patient meets the conditions for sedation.
Subsequently, the colonoscopy procedure proceeds as follows:
The patient lies in the correct position, on one side, with knees bent.
Sedative medication is administered intravenously.
The doctor inserts the colonoscope into the colorectum via the anus.
A camera at the tip of the scope transmits images to a computer.
During this process, if any issues requiring intervention are found, the doctor can perform them simultaneously. For example, the doctor can remove polyps using a wire threaded inside the scope.
Once the examination is complete, the doctor withdraws the colonoscope.
The patient will wake up quickly but needs to remain in the recovery room for about 20-30 minutes for rest, relaxation, and monitoring.
The colonoscopy procedure can last 30-60 minutes, depending on each individual’s condition.
After the colonoscopy, if the results are normal, the patient may not need another colonoscopy for about 5-10 years. Patients should adhere to a healthy diet and lifestyle to prevent gastrointestinal diseases.
If the colonoscopy results are abnormal, the doctor will recommend appropriate follow-up appointments, interventions, or treatments depending on the diagnosis.
4/ When is a Painless Colonoscopy Needed?
Colonoscopy is indicated by a doctor when a patient has suspected colorectal disease symptoms. Additionally, it is the gold standard for colorectal cancer screening.
Everyone aged 45 and above should undergo regular colonoscopy for cancer screening. Individuals with risk factors for cancer should be screened earlier. The risk factors for colon cancer include:
Family history of polyps or colorectal cancer.
Having Crohn’s disease, irritable bowel syndrome (IBS), colorectal polyps, ulcerative colitis, or ulcerative proctitis.
Carrying genes that increase cancer risk, such as familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome, or Gardner syndrome.
Having undergone partial colon resection surgery.
A diet high in meat and animal fat, low in fiber, deficient in vitamins and calcium; consuming foods containing benzopyrene and nitrosamines.
Detecting precancerous lesions and early-stage cancer improves treatment effectiveness, increases the chance of complete cure, saves costs, and extends patients’ lifespans.
To help patients reduce pain and discomfort during colonoscopy and to facilitate a smoother procedure, doctors often recommend painless colonoscopy with sedation.
5/ Notes for Painless Colonoscopy?
1-2 days before the colonoscopy, patients should eat soft foods, drink plenty of water, avoid hard or solid foods, and refrain from alcohol. For sedated colonoscopy, fasting for 12 hours is required, with only plain water allowed.
If the patient has a history of adverse reactions to sedatives, they must inform the doctor.
The sedative used in colonoscopy is a low-dose medication, causing sedation only for a short period. Some people may experience headaches or nausea after taking the medication. Most people usually feel drowsy, so patients should not drive after the colonoscopy. When undergoing sedated colonoscopy, patients need to be accompanied by a family member.
After a sedated colonoscopy, patients may experience some symptoms such as:
Drowsiness for the rest of that day.
Bloating and abdominal distension.
Minor bleeding if a biopsy was performed.
These symptoms usually subside within a few hours to a day. Seek medical attention if you experience any of the following symptoms: fever above 38 degrees Celsius (100.4°F), severe or persistent abdominal pain, bleeding lasting more than 24 hours (in case of biopsy), weakness, persistent nausea, or fainting.
