Is a Colonoscopy Painful?

A colonoscopy is a screening and diagnostic tool used to catch early signs of colon cancer. During a colonoscopy, the patient lies on his or her side, while the doctor passes a colonoscope, a flexible tube with a camera on the end, into the colon through the rectum. Although colonoscopy is the best defense against colorectal cancer, many people are nervous about the discomfort or the possibility of pain during the procedure, but fear of pain should not deter you from getting a colonoscopy. The majority of colonoscopies in the US are performed under deep sedation, meaning that patients are asleep for the procedure and don’t feel any pain.

Most Colonoscopies in the US are Performed Under Sedation

If you’re nervous about feeling pain during a colonoscopy, consider this: approximately 99 percent of colonoscopies in the United States are performed under sedation or general anesthesia. It’s possible to request a colonoscopy without sedation or general anesthesia. Some patients may prefer this option so they can drive themselves home after the procedure, but they’re more likely to experience discomfort and possibly pain. Only about two percent of colonoscopies performed in the US are performed without any sedation or anesthesia.

There are a few options for the use of sedation during a colonoscopy, including:

  • Light: The patient is relaxed and sleepy, but most likely awake. The patient can respond to the doctor, follow any instructions, and may feel pain or discomfort.
  • Moderate: The patient is drowsy and may go in and out of sleep. The patient most likely will not remember the procedure.
  • Deep: The patient is asleep, does not feel any pain, and does not remember the procedure. The patient will likely awaken feeling groggy.
  • General anesthesia: The patient is unconscious and unaware of the procedure. When under general anesthesia, patients do not feel any pain or discomfort.

Colonoscopies Can Be More Difficult to Perform in Women, but Are Painless When Done Under Sedation or Anesthesia

Colonoscopies are the gold standard of care for both men and women. However, the technical aspects of the procedure differ between the two genders — colonoscopies can be more difficult to perform in women. One reason for this may be because, on average, women’s colons are longer than men’s colons, making the procedure more technically difficult. Moreover, colonoscopies have been shown to be more painful in women compared to men, and more specifically in women who have had a hysterectomy. An interview published in Gastroenterology & Hepatology reveals that women who have had a hysterectomy are more likely to experience pain and difficulty during a colonoscopy.

Although it may require more technical skill to perform a colonoscopy in women, with sedation or general anesthesia, women should not feel any pain or discomfort from a colonoscopy.

What to Expect After a Colonoscopy

The most common complaint following a colonoscopy is abdominal discomfort or pain caused by cramping or bloating. This occurs because, in order to perform the colonoscopy, your doctor uses air to inflate the colon and maneuver the colonoscope. After the procedure, you’ll need some time for the gas to work its way out of your colon, which can be a little bit uncomfortable.

Immediately following a colonoscopy, avoid foods that are hard to digest, such as high-fiber, greasy, heavy, and spicy foods. If your doctor removed a polyp during your procedure, you’ll receive additional dietary instructions. It’s important to drink plenty of liquids to rehydrate — the preparation process for a colonoscopy can leave patients dehydrated.

We recommend planning to take the rest of the day off work and relaxing at home until you’re feeling well again. Remember that any side effects you feel are temporary, and the long-term benefits of having regular colonoscopies far outweigh the slight discomfort you’ll feel after the procedure.