How to choose between ordinary colonoscopy and painless colonoscopy?

With the popularization of scientific knowledge, the public has come to understand that colonoscopy is very beneficial. It is not only a gold standard for diagnosing colorectal cancer, but also an effective means of screening for colorectal cancer and precancerous lesions. The purpose is to detect colorectal cancer in a timely manner, or to find the seeds of colorectal cancer, colorectal polyps, and remove them, thus nip colorectal cancer in the bud.

Some friends have some physical discomfort, such as bloody stools, abdominal pain, etc., and they are worried that it is colorectal cancer and want to make an appointment for a colonoscopy. However, when they ask around, they find out that colonoscopy is very painful. After listening to various opinions on the Internet, they are scared and directly give up. A friend told them that painless colonoscopy is more advanced and they must do the painless one. Is that true?

In fact, everyone should make a personalized choice based on their own characteristics. It is not necessary to have a painless colonoscopy. Should I make an appointment for a painless colonoscopy? Is a regular colonoscopy better or a painless colonoscopy? In fact, there is no definitive answer. It just depends on which one is more suitable for you.

If you are very sensitive to pain and you have to have a colonoscopy, you can choose a painless colonoscopy. If you are not very sensitive to pain and have a good tolerance, and you are in a hurry to have a colonoscopy, a regular colonoscopy may be more appropriate. Most people can actually cooperate and complete it.

The poor experience of ordinary colonoscopy comes from several aspects:

The first is pain, which is mainly because our intestines are not straight, but have some bends, and sometimes even form a sharp angle. At this time, when the colonoscopy probe turns, it may cause spasm of our intestines, causing varying degrees of pain.

The second is abdominal distension. In order to better expose the field of vision and facilitate the insertion of the endoscope during colonoscopy, air will be pumped into the intestine to make the intestine swell. Sometimes, if too much air is pumped in, it will cause abdominal distension or even abdominal pain.

The third is the foreign body sensation, which is probably difficult to avoid. Some people are afraid of the thought of a mirror as thick as their little finger going into their buttocks. The pain-sensitive area is near the anus, and it needs to go through the intestines. It may be very painful if you just imagine it.

However, ordinary colonoscopy also has its advantages, because in a sober state, the patient can promptly feedback the pain perception to the doctor, so that the doctor can take more cautious and gentle operation techniques to reduce the patient's discomfort. In addition, the patient can communicate with the doctor in a timely manner during the process, such as whether polyps need to be removed, etc., making the examination process more efficient and personalized.

Painless colonoscopy is actually a colonoscopy performed under general anesthesia. It is painless and many people say that it can be done in one sleep. However, painless colonoscopy also has certain limitations:

First of all, not everyone can undergo general anesthesia, especially some elderly people with poor cardiopulmonary function who cannot tolerate general anesthesia.

In addition, some people may be allergic to anesthetics, etc., and may not be suitable for painless colonoscopy.

Moreover, there are certain risks in doing painless colonoscopy under anesthesia. As mentioned earlier, in ordinary colonoscopy, you feel pain after the scope is inserted, and the doctor knows that this place may not be able to be pierced hard. In fact, pain is a kind of protection for the human body. In the painless state, you have no reaction, and there may be some lesions in the intestines at this place, such as stenosis and twisting. Some doctors are not very skilled when inserting the scope, and if they force the scope in, there is also the possibility of increasing the risk of perforation. Although the probability of intestinal perforation during colonoscopy is very low, if the angle is sharp when turning, and if air needs to be pumped, there may be some local stenosis, and the intestinal wall is relatively weak, there is a risk of perforation and rupture.

Therefore, painless colonoscopy actually has relatively higher requirements for our endoscopists, and is generally performed by doctors with more experience.

Secondly, ordinary colonoscopy can actually be performed by a gastroenterologist and his assistant or nurse, but non-invasive colonoscopy involves more aspects and may require an anesthesiologist, a gastroenterologist, and some nurses or assistants, so the price will be higher.

The appointment time for painless colonoscopy is relatively long. Generally speaking, the appointment time for ordinary colonoscopy is one to two weeks, and sometimes even faster. However, if a painless colonoscopy is scheduled in some large hospitals, especially some public hospitals, due to the large number of patients and shortage of anesthesiologists, it may take several months, or even half a year or a year.

If you have already developed some obvious symptoms, or you are highly suspected of colorectal cancer, then waiting for another half a year or a year will delay the disease. Therefore, if you need to do a regular colonoscopy at this time, do a regular colonoscopy. If you have to wait for a painless colonoscopy, it may not be worth it.

Regardless of which colonoscopy you choose, bowel preparation is key. You should carefully perform bowel cleaning according to the doctor's instructions. You may need to start adjusting your diet a few days in advance, such as eating liquid food or using enteral nutrition preparations. Psychological preparation is equally important. Patients should face the examination positively, reduce the psychological burden, cooperate with the guidance of doctors and nurses, and successfully complete the colonoscopy.

Therefore, colonoscopy does not necessarily have to be painless. The choice should be based on personal pain threshold, health status and actual needs. Ordinary colonoscopy and painless colonoscopy each have their own advantages, and there is no absolute good or bad. As long as the patient cooperates properly and the doctor is skilled in the operation, colonoscopy can usually be completed within half an hour, and most patients can tolerate it. If you are extremely sensitive to pain and conditions permit, painless colonoscopy is also a good choice, especially if you need to undergo a gastroscopy at the same time.

Author: Dr. Chrysanthemum Lin Guole Team

Reviewer: Wang Qiang, deputy chief physician of the Department of Gastroenterology, Peking Union Medical College Hospital

Produced by: China Association for Science and Technology Department of Science Popularization

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.