Sedation during colonoscopy

Dear Dr. Roach: I have seen two of your columns in which I thought I read an implication that the decision to be sedated or not during colonoscopy was a fairly straightforward choice. I need to point out that for many of us, an unsedated colonoscopy would be agony. It does not feel like much of a choice.

I was sexually abused as a child, and I am one of the many for whom colonoscopies are traumatic even while sedated. My gastroenterologist said that she needs to sedate enough to not be in acute discomfort and stress, but not so much that the disinhibition increases agitation.

On top of that, many of us with PTSD have pain and inflammatory syndromes like fibromyalgia. It is hard for me to even convey how much more acutely sensitive my body is. I wish this were different, but after 63 years in this body I have learned to respect it and the underpinnings of it.

My father had colonoscopies in the days before routine sedation. He told me that these were some of the most agonizing procedures he had ever endured. This from a man who survived the Spanish flu and rheumatic fever, faced starvation during the Depression, and fought in the Pacific in World War II. — Anon.

Colonoscopy without sedation is not for everyone. The range of experiences with unsedated colonoscopy is dramatic: Some report no discomfort at all save some “gas pains.” I am publishing your letter to validate that there are people who have very different experiences and have much greater sensitivity to pain, especially visceral pain (from your internal organs).

I am not ashamed at all to say that when I have a colonoscopy, I am sedated, and have been very happy with the experience.