Q&A: Pain management during colonoscopy

August 31, 2018 by From Mayo Clinic News Network, Mayo Clinic News Network

Dear Mayo Clinic: I just turned 50, and my health care provider recommends that I get a colonoscopy to screen for colon cancer. I want to have the test done, but as a recovering addict, I don't want pain medication. Is this possible, or would the pain be too much? What are my other options?

A: For people in your situation, there are several alternatives to choose from when considering a colonoscopy. In addition to the option of forgoing pain medication completely, you could have the procedure with nonnarcotic medication, or you may be able to opt for a noninvasive colorectal cancer screening test instead of a colonoscopy.

A colonoscopy is an exam used to detect changes or abnormalities in the colon and rectum. This test often is recommended as a screening exam for colon cancer, beginning at age 50, for people who have no colon cancer risk factors other than age. During a colonoscopy, a long, flexible tube, called a colonoscope, is inserted into the rectum. A tiny video camera at the tip of the tube enables your health care provider to view the inside of the entire colon.

Although sedatives and pain medications may be used to minimize discomfort during a colonoscopy, it is possible to have a colonoscopy without pain medication or sedatives. That is often the way a colonoscopy is performed outside the U.S.

When patients want to try colonoscopy without pain medication or sedation, they usually have the option for an IV line to be placed before the procedure starts. That way, the care team can give medication promptly through the IV if the procedure becomes intolerable. The medication you receive in that case could be one that doesn't contain a narcotic. This would avoid your addiction concerns.

It is also possible to have a colonoscopy performed under monitored anesthesia care. In that setting, a nurse anesthetist administers only sedation medication during the procedure. Here, too, you can request that the medication you receive not include a narcotic.

Another option would be a noninvasive colorectal cancer screening test, such as the stool DNA test (Cologuard). That test looks for abnormal DNA associated with colon cancer or colon polyps. The test also detects hidden blood in the stool, which can indicate the presence of cancer. This test is intended for colon cancer screening in people who don't have symptoms. It's not a viable option if a colonoscopy is being ordered to evaluate symptoms or for people who have a strong family history of colon cancer, particularly a history that suggests a hereditary pattern. It also should be noted that if the stool DNA test is positive, a colonoscopy would be required to check for polyps or colon cancer.

An additional noninvasive option is a virtual colonoscopy, sometimes called a screening CT colonography. Unlike a traditional colonoscopy, a virtual colonoscopy uses a CT scan instead of a colonoscope to produce images of your abdominal organs. The images are combined and digitally manipulated to provide a detailed view of the inside of the colon and rectum. Sedation and pain medications aren't necessary for this test. Be aware, though, that not all health insurance providers pay for virtual colonoscopy for colon cancer screening. Check with your insurance provider before having this procedure to find out if it's covered.

In addition to the tests discussed here, you may have other choices for colon cancer screening, too, depending on your situation. Talk to your health care provider about your options. There are ways to comply with your preference for avoiding narcotic pain medications while still obtaining this important cancer screening.

Explore further: Technology advances help to prevent, lessen impact of colon cancer


Related Stories

Technology advances help to prevent, lessen impact of colon cancer

March 14, 2017
Approximately 140,000 people are diagnosed with colorectal cancer in the U.S. each year. March is Colorectal Cancer Awareness Month.

Small study supports new stool-based colon cancer test

April 19, 2016
(HealthDay)—A new, but small, study finds more evidence that a recently approved, stool-based colon cancer test may be effective for certain patients.

Study: Colonoscopy after 75 may not be worth it

September 26, 2016
(HealthDay)—A colonoscopy can find and remove cancerous growths in the colon, but it may not provide much cancer prevention benefit after the age of 75, a new study suggests.

Study to determine which stool test is best for colorectal cancer detection

January 22, 2018
No one wants a colonoscopy. But there's no getting around the lifesaving procedure—the gold standard for colon cancer detection.

Nurse navigators may aid colon cancer screening follow-up

November 10, 2014
Group Health patients with a positive screening test for colon cancer (a stool test or sigmoidoscopy) tended to be more likely to get the recommended follow-up test, a diagnostic colonoscopy, if nurse navigators contacted ...

Virtual reality helping to improve healthcare

January 29, 2018
A virtual reality colonoscopy developed by researchers at the University of Sheffield could help clinicians to detect abnormalities in the digestive system.

Recommended for you

Researchers find adult stem cell characteristics in aggressive cancers from different tissues

September 19, 2018
UCLA researchers have discovered genetic similarities between the adult stem cells responsible for maintaining and repairing epithelial tissues—which line all of the organs and cavities inside the body—and the cells that ...

Ketogenic diet reduces body fat in women with ovarian or endometrial cancer

September 19, 2018
Women with ovarian or endometrial cancer who followed the ketogenic diet for 12 weeks lost more body fat and had lower insulin levels compared to those who followed the low-fat diet recommended by the American Cancer Society, ...

Eating foods with low nutritional quality ratings linked to cancer risk in large European cohort

September 18, 2018
The consumption of foods with higher scores on the British Food Standards Agency nutrient profiling system (FSAm-NPS), reflecting a lower nutritional quality, is associated with an increased risk of developing cancer, according ...

Could the zika virus fight the brain cancer that killed john McCain?

September 18, 2018
(HealthDay)—Preliminary research in mice suggests that the Zika virus might be turned from foe into friend—enlisted to curb deadly glioblastoma brain tumors.

CRISPR screen reveals new targets in more than half of all squamous cell carcinomas

September 18, 2018
A little p63 goes a long way in embryonic development—and flaws in p63 can result in birth defects like cleft palette, fused fingers or even missing limbs. But once this early work is done, p63 goes silent, sitting quietly ...

Enlarged genotype-phenotype correlation for a three-base pair deletion in neurofibromatosis type 1

September 18, 2018
International collaborative research led by Ludwine Messiaen, Ph.D., shows that while a three-base pair, in-frame deletion called p.Met992del in the NF1 gene has a mild phenotype for people with the genetic disorder neurofibromatosis ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.