Colonoscopy, pain and fears: Is it an indissoluble trinomial?

Abstract

Colonoscopy is the reference method in the secondary prevention, diagnosis and, in some cases, treatment of colorectal cancer. It can often cause pain associated with embarrassment, anxiety, and physical and emotional discomfort. Pain intensity is influenced by a lot of factors, and there is a strict relationship among pain, pain perception, and mind. Several methods can be used to break the trinomial colonoscopy, pain and fear. Sedoanalgesia is recommended by several guidelines. If no sedation is offered, the patient must accept a higher chance of unacceptable discomfort and the endoscopist a lower chance of completing the procedure because of patient discomfort. Other non-pharmacologic methods such as acupuncture, music, and hydrocolonoscopy can be used as alternatives to pharmacologic sedoanalgesia. Furthermore, new endoscopic technologies such as variable-stiffness colonoscopes and ultrathin colonoscopes, or the use of carbon dioxide instead of air for colon insufflation, can reduce the pain caused by colonoscopy. In the future, technical improvements such as wireless capsules or robotic probes, will probably enable to overcome the present concept of colonoscopy, avoiding the use of traditional endoscopes. However, at present the poor attention paid by endoscopists to the pain and discomfort caused by colonoscopy can not be justified. There are several methods to reduce pain and anxiety and to break the trinomial colonoscopy, pain and fear. We must use them.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Colonoscopy; Pain; Fear; Anxiety; Discomfort; Conscious sedation Core tip: Colonoscopy can often cause pain associated with embarrassment, anxiety, and physical and emotional discomfort. Control of discomfort and pain during colonoscopy is considered to be a high priority by patients. This review of the literature encompasses the main methods for reducing pain and anxiety, to break the trinomial colonoscopy, pain and fear.

Serbian Translation and Cross-Cultural Validation of the Questionnaire for Assessing Patient Satisfaction with Endoscopic Examination of the Digestive Tract

“…The use of conscious sedation varies from country to country, continent to continent, and even in different endoscopy centres within the same country. The use of conscious sedation is associated with higher costs, an extension of the duration of the procedure, the need for the monitoring of vital functions and an increasing incidence of complications (10,12,14,16,18).…”

“…The values of the factor weights in Table 4 suggest that the first factor includes five questions (questions 1, 2, 3, 4, 5), the second factor includes six questions (questions 13,14,16,17,18,20), the third factor includes four questions (questions 6,7,8,19) and the fourth factor includes four questions (questions 9, 10, 11, 12). Among the questions that belong to each factor, there is a connection.…”

“…Effects of acute pain are comprised of a variety of emotional, physical and psychological events. Fear is a normal emotional response to a real threat and is recognized as truth by individuals, while anxiety represents a state of mind that is non-rational and characterized by a sense of insecurity and the presence of various neurovegetative symptoms (14). Patients have expressed fear of the examination and possible complications more often than fear related with a possible diagnosis (15).…”

“…The modified GHAA-9 questionnaire was recommended by the American Society for Gastrointestinal Endoscopy for the assessment of satisfaction and did not include all the necessary factors for evaluation of patient satisfaction (3,7,19). Some other instruments are mainly used to examine factors affecting the toleration of the examination (2)(3)(4)12,14,16,17,20). In the Serbian language, there is no validated questionnaire for the assessment of patient satisfaction with the endoscopic examination of the digestive tract.…”

The Effects of Inhalation of Aromatherapy with Lavender on Anxiety Amongst Patients Undergoing Colonoscopy

“…Colonoscopy is a diagnostic-therapeutic and screening technique, which is currently used as a reference technique for secondary prevention, diagnosis and treatment of some sorts of colorectal cancers (1). It is one of the endoscopic procedures for the lower gastrointestinal tract.…”