Colonoscopy

Having an enema and then having your colon probed with a long scope or inflated with air and a thick barium solution isn't most people's idea of a good time. Indeed, fear of those invasive tests--sigmoidoscopy, colonoscopy procedure, or double-contrast barium enema. While many people aren't bothered by the tests, others may feel significant discomfort. If you're one of them--or fear you would be--here's what you can do:

Seek a soft touch. If you need a specialist for any of these procedures, ask your doctor, friends, or relatives if they know someone who works gently.

Get the facts (or don't). Studies show that learning about these procedures ahead of time--particularly how they feel--can ease the anxiety and discomfort. But that approach works only if knowing the facts generally calms you down. If you're the type who'd rather not know, ask your doctor to spare you the details.

Consider sedation. The two less invasive procedures, sigmoidoscopy and barium enema, are usually done without any sedation. But people have different anatomies, anxiety levels, and pain tolerances. If you're anxious, don't let false ideas about toughness keep you from asking for an oral tranquilizer before the test.

Virtually everyone receives intravenous sedation and pain medication before and during colonoscopy. But since the discomfort often occurs during unexpectedly long or difficult procedures, ask the gastroenterologist beforehand to supply extra sedation if the test runs long.

Stay in control. Ask your doctor to pause or pull back the scope during sigmoidoscopy or to ease up on the air during the barium enema whenever you signal. If you're still uncomfortable during the procedure, request a slower, gentler approach, stronger sedation, or both. If all else fails, you could ask your doctor to stop the test and reschedule it at a later date; you might even want to try having it done by a different doctor.

You'll probably be too groggy to say anything during colonoscopy. But ask the gastroenterologist ahead of time to supply extra sedation, if necessary, and to consider terminating the test if difficulties arise.

Distract yourself. A recent study found that patients who watched and listened to pleasant scenes and sounds--of the ocean, for example--experienced less discomfort during sigmoidoscopy than patients who were left free to focus on the test. Ask your doctor if you can arrange to have such soothing distractions during sigmoidoscopy or a barium enema. Or just bring a tape player with headphones.

Relax. Staying relaxed is obviously important here. Calming techniques include meditation, deep breathing, visualizing a safe, peaceful place, and practicing progressive muscle relaxation, where you individually tense and then relax all the major muscles in your body. Ask your doctor for instructions, if necessary. Simply exercising before the procedure can help, too. Last updated Nov 26/06