Endoscopy & Colonoscopy - terrified

[faeriesandelves]

Hi I’m having both procedures done one after the other on the same day in a couple of weeks to test for coeliac disease. I’m terrified. I have asked the consultant to be “put out” and he said yes and I reminded him on the way out of the consultation and he said yes oh I’ll give you morphine. Is this sedation or a general anaesthetic? I want to go to sleep then it’s all done and then I wake up. I’ve contacted clinic for clarification but wondered if you all know?

I’ve heard horror stories from people about being held down for the endoscopy even when sedated. I’m going private - if that makes a difference.

thanks.

I had an endoscopy recently. I opted for sedation. They call it conscious sedation, but I was completely out, and woke up back in the recovery room, only a short time later. I felt fine for the rest of the day, had a nap in the afternoon, but otherwise felt almost my normal self. It was NHS.

I think it depends on each setting, I'm having the same as you next month. I've had an endoscopy 3 times before (different places), 1st time they didn't give me any sedation, 2nd time I asked them at the time to give me the max dose possible and I was quite out of it, 3rd time I asked and she told me she'd give me their limit but it wasnt as much as the previous one.

I don't think you would usually have a general anesthetic, but they can give you a large amount of sedative which means that you really don't care about what you are experiencing. But saying that DM had the procedures under sedation and she pretty much woke up when it had all finished.

So what I'm trying to say it depends on the setting. I'm going private too next time and I'm hoping to get as much sedative as possible.

I've had 2 with sedation. It really was fine and believe me I am a baby. Don't think u can go home unaccompanied though- double- check this, I might be wrong.

You can't get a general anaesthetic because you need to swallow.

Honestly its not that bad. Sedation will help and you'll literally remember nothing about it

The worst thing about both procedures is the prep for the colonoscopy

You'll be fine

The endoscopy is so so quick...I was dreading it...before I knew it all done.

My mum did as they couldn't do it with sedation so had to go back for GA

Thanks all that’s reassuring. I’ll ask for as much sedative as possible then. Husband will drive me home later on - yes I’m not allowed to drive.

No the sedation they usually give does not put you out.

It is just a sedative and painkiller. It also makes you not remember so you think you were asleep.

It didn’t work well enough on me (despite my specifically telling them I needed stronger than this level of sedation they ignored me).

You need propofol sedation if you actually want to be asleep. That is what I had the second time - with a better consultant.

No but you can have very close to it with propofol and an anaesthetist.

Do not let these people lie you you like I did.

I’ve had endoscopy’s both with and without sedation and I’d always now go for the sedation. The last one was a few weeks ago. I had some sedation and the doctor asked how I felt. I said “too awake!”. He gave me some more sedation and it was fine after that. Don’t be afraid to ask for a higher dose if you need it.

Morphine is a painkiller - it would be a slightly unusual choice for the procedure, but if they have a protocol that works well for them I wouldn't dismiss it. Sedation on 'non anaesthetist' lists will usually be a combo of a strong painkiller and a benzodiazepine (often fentanyl and midazolam, but other combos are available) - the aim is usually to have you comfortable but roughly aware of what's going on. There is some evidence that deep sedation is associated with more procedural complications than lighter sedation. They can also use local anaesthetic spray for the throat to make the top end more comfortable and some places will have gas and air to make for the colonoscopy part. The IV drug protocols are pretty fixed for fairly obvious reasons on lists that don't have an anaesthetist. If there is an anaesthetist then propofol +/- an opioid is more likely to be used. Propofol/benzos will achieve the same amnesic effect given at the right doses, but each have their own side effects (propofol is much more likely to cause apnoea and cardiovascular changes, hence the need for an anaesthetist..... a large dose of benzo will take forever to wear off). There are pros and cons to each way of doing things and those may be different for different patients and depending on what the endoscopist is expecting to find. GA can be used where either sedation fails/is contraindicated, but it usually takes more planning. Hopefully they'll be able to explain the rationale behind their choices and reassure that they'll respond appropriately if you're not happy.

honestly, it's nothing to worry about. Insist on sedation & you'll be fine.

Make sure you're home for the preparation part. I was planning to take the meds at work and then drive home, thankfully my husband drew my attention to some online posts describing how dramatic the clear out was, he wasn't wrong!

I’ve had an endoscopy without sedation and it was fine. Not pleasant but tolerable. Focus on ur breathing if you lose control of ur breathing u will start to gag but u will get it back under control with breathing, you will not be held down. A nurse will gently hold ur arm and keep you focussed on breathing and it really is only for a few minutes. Also u can tell them to stop at anytime. You can’t be forced to continue or have any treatment. I imagine colonoscopy is much the same,

I don’t know what people are waffling about with the not being able to have a general anaesthetic for endoscopy because you have to swallow…absolute nonsense.

I’ve had both done one after the other and I had an NHS GA for them. I’m pretty hardy with pain etc but I’ve got fairly hefty medical PTSD and it was either a GA or I wasn’t doing it. I explained it very calmly to the gastroenterologist and he had no issues with it. I also wore my own clothes and not a hospital gown.

Well they must have arranged an anesthetist, and I presume you were in main theatres not the Endoscopy unit. It's not as easy as just stating a preference.

It was discussed well in advance and it wasn’t “stating a preference”. I didn’t just wait until the appointment and wing it though.

I've had both done. The procedure itself is fine and soon over. The hardest part is the bowel prep you do at home beforehand.

I’m going for a gastroscope next week under GA. Although I’m private so that may change things. It’s early in the morning and I have been told not to eat for 7 hours before so that suits as I’ll be sleeping.

I've had endoscopies with and without sedation. Without wasn't fun but it was painless and very quick (a few minutes). I used slow breathing and kept my eyes closed. I found endoscopy and colonoscopy with sedation absolutely fine. It's a pain not being able to drive after sedation and the colonoscopy prep is dramatic. But the sedation and procedures should hopefully be OK.

I've had a gastroscopy for coeliac (endoscopy)and a sigmoidoscopy and insisted on sedation for both. With the gastroscopy I just remember swallowing the scope was a bit grim then don't remember a thing until recovery time. I watched the sigmoidoscopy on a screen, no issues, just felt pleasantly floaty. I think midazolam was used, a fentanyl & benzo mix afaik. The enema for the bowel procedure was definitely the worst part, a Fleet enema from memory. You'll be 🤏👍

With sedation you must ensure you have an escort/driver. They're strict about this.
Edited to say:
Just rtft, I see your husband is looking after you so scrub the above!

Thank you all for your replies and advice, much appreciated. I’ve got authorisation from private medical for general anaesthetic and confirmed with consultant this is what I would like. Cancelled my plans for the day before and will hang around the bathroom that day! It’s a morning appt so hopefully will be ok in the car on the morning and husband won’t need to stop for me to use a loo!

I've had sedation for a couple of procedures and it's great, just took away and anxiety or thoughts really, in a good way but so I was vaguely aware of what was going on.

Ive had both.
sedation doesn’t do anything for me but I appreciate I’m in the minority! Definitely go for it.
the other thing you can have is gas and air. Hard to do with endoscopy (you can have a few puffs before they start) but it worked brilliantly during my colonoscopy.
Also you can request something to calm you down. I have lorazepam before certain medical procedures.

You are not alone OP, there are people out there who can do it without sedation, others (like me) could not in a million years. That's the reality and hospital consultants/staff are well used to this.

Mine was done under midazolam/fentanyl sedation. I have an awful fear of choking or anything going into my mouth like a dental impression etc. (sedated for that too!). So I explained to GI doc that putting the mouthguard in (for endoscopy) would freak me out. He reassured me and on the day, his assistant tried (just before they sedated me) and I freaked. No problem, he said he wouldn't use the numbing spray either at that time as it would be uncomfortable for me. They were brilliant and so reassuring. So the next thing was I woke up in recovery.

OP I had both colonoscopy and endoscopy same day. I remember nothing.