Pain
Colonoscopy is certainly not one of the pleasant examinations. The insertion of the approx. 1 cm thick examination tube leads to pulling on various structures in the abdomen from which the intestine is suspended and the insertion itself is also felt.
This is not pleasant for the person being examined and can also cause pain. However, the pain usually does not come through the intestine itself, because its inner side has no sensitive fibres that can trigger pain. The pain only lasts until the examination tube has passed the bowel loop and straightened it.
Due to the directed air, slight abdominal pain can also occur after a colonoscopy. In addition to the mechanical triggers mentioned above, the large amounts of air or CO2 pumped into the intestine during the examination can also cause pain. This pain is caused by the stretching and pressing of other organs in the abdominal cavity and feels similar to extreme flatulence.
However, this should disappear within 1-2 days after the colonoscopy when the air or CO2 is absorbed by the intestinal wall and the distension of the intestine decreases. Due to the meanwhile very soft and bendable materials of the tubes and the ever smaller cameras, the pulling on the ligaments and the pushing forward can be made more and more comfortable for the patient and is only painful in individual cases. Patients who have already had operations in the abdominal cavity are often plagued by these side effects and pain, because after abdominal operations, adhesions usually form on which traction can then be applied very easily and which then cause more pain than the rather loose suspension bands.
Depending on whether one has decided in advance for an anaesthetic, an anaesthetic can be started even now if the patient feels the procedure is too unpleasant during the examination. The painkillers described under anaesthesia during the anaesthetic always relieve the pain sufficiently so that the examination is not unnecessarily unpleasant. Nevertheless, there are also many patients who describe the treatment as unpleasant but bearable even without medication. Much more unpleasant than pain are most patients who remember the unpleasant laxatives.
Duration of the procedure
As a rule, the laxative procedure for a colonoscopy is started in the afternoon of the previous day. Eating should be stopped about 24 hours before the procedure begins. The duration of the pure colonoscopy depends on the examined length of the intestine and the anaesthesia.
In the case of an examination of the large intestine, 30 minutes should be expected. If there is an anaesthetic, the process takes a little longer. If a tissue sample is taken, only short delays can usually be expected.
When can you eat again afterwards?
After the end of a colonoscopy, the patient may eat directly. Drinking directly after the end is also unproblematic. It is not necessary to pay attention to a special diet afterwards.
Sometimes, however, nausea or other similar symptoms may occur after a long time without food. It is therefore advisable to start with a light diet. Since the feeling of a tube in the body is not one of the pleasant feelings, it is possible to have the examinations carried out under anaesthetic.
In contrast to major operations, colonoscopy is not performed under general anaesthesia, so no ventilation will be necessary, but you will continue to breathe independently the whole time. All that is needed is an indwelling venous cannula, a small plastic tube that is placed in a vein of the arm in the crook of the elbow or on the back of the hand and through which the medication can be administered directly into the blood. This requires a small puncture through the skin, comparable to the vaccination.
Depending on the patient’s wishes or the standard of the clinic or practice, in addition to an analgesic, either a strong sedative can be administered or a strong sleeping pill, which, unlike the sedative, causes complete isolation from what is happening and transports the patient into a twilight or sleeping state within 30 seconds. Both types of anaesthesia are monitored continuously by doctors and nurses, who measure pulse and oxygen saturation. Patients who already have problems with their heart or circulation, e.g. who have already had a heart attack, are usually additionally equipped with ECG and blood pressure monitoring.
A positive aspect of the sedatives is that it causes forgetfulness and in the best case, after the examination, one cannot remember the examination. You should ask your health insurance company beforehand about the conditions for cost coverage. Some practices that perform colonoscopies cooperate with anaesthetic practices for such cases, which then perform the anaesthesia during the examination.
The internist who performs the colonoscopy usually only performs the more superficial anaesthesia described above himself. After the anaesthesia, one should stay in the rest rooms or recovery rooms of the practice until the doctor releases one into the care of an accompanying person. However, anyone who decides to use anaesthesia should be aware that 50% of the complications associated with the examination are related to the anaesthesia.
These include, above all, problems with circulation and breathing, up to and including allergic reactions to the anaesthetics. An anaesthetic should be carefully considered, especially in the case of patients with previous illnesses. It is also possible to start the examination without anaesthesia and, if symptoms or discomfort occur, to induce anaesthesia during the examination to make it as comfortable as possible for the patient.
Nor does anaesthesia prevent the pain caused by flatulence after the procedure. It is important to note that the patient should rest as much as possible after an anaesthetic for that day and should not drive any vehicles or the like, so the way home should be secured. Furthermore, one is not able to operate machines or to make bigger deals.
Depending on the profession, it may be necessary to be absent from work even on the day after the examination, e.g. bus driver. This time is regulated by law and cannot be shortened by a lower dose of medication.
