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Comment by dham | Hacker News Reader

They need to lower the screening to 40. I just had mine at 40, turned out fine luckily. Did it without sedation which my doctor said was rare in US, but common outside of US. I found surprising, wasn't that big of a deal. Pain was probably at a 7/10 during the turns (like 3 times) but ok the rest of the time. A little uncomfortable. Some new sensations, some familiar (feeling like you are crapping your pants).

I walked in and walked out no issue and went on about my day. Prep was fine but would be hard if I didn't work at home.

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With old school sedation I think it might be worth avoiding it. But with propofol you are out like a light, and then wake back up just as fast when they turn it off -- and it feels like you just had a nice nap. Aside from feeling a bit groggy for a few minutes, you just get up and walk out the door and go about your day. Personally, I do not think I'd volunteer for 7/10 pain just to avoid that.

My first colonoscopy was without anesthesia, and it was as described above. A little uncomfortable on the one bend, but I don't even think I would put it at 7/10 (perhaps a 4 or 5—but not a sharp pain, mind you).

Definitely enjoyed the following times with anesthesia because, of course 0/10 as far as I know. Also, anesthesia just trips my mind—how seemingly time travel (going forward in time) seems to be involved.

Sounds a bit like the transnasal esophagoscopy I opted for recently in lieu of an upper endoscopy. Thin tube through nose, then down into the esophagus. Uncomfortable while threading it through (chest pain, like swallowing a sharp tortilla chip), but ultimately not a big deal, and done in-office in about 15 minutes.

I may be getting one of those in the next few months. Just had a regular upper endoscopy for dysphagia, and they were unable to solve it or even conclusively identify a cause. They warned me that this transnasal procedure would be next. Sounds like fun...

Which state did you have it done in if I may ask? I'm in Oregon and haven't been able to find a doc that does it without sedation. I can't be put under sedation for medical reasons, but I definitely need this procedure done sooner than later due to new GI problems.

North Carolina. And I wasn't actually aware that some doctors wouldn't do until after I had it done (reading about it online). I just called before my appointment to say I didn't need sedation. They said ok and wrote it down. They weren't really pushy during the appointment other than asking me why I didn't want sedation.

I thought it was going to be awkward but wasn't at all. We just chatted. It was him and an assistant. I was able to watch the TV of my colon while he was doing it.

For people who might be interested in following your advice, the conventional wisdom is that you should definitely look around when choosing the doctor. I.e. do not use a regular gastroenterologist who primarily does sedated colonoscopies, you want one who has experience with non-sedated ones. They have a better idea of what hurts and how to mitigate that.

Yea good point. My doctor said he would see a non sedated like once every 2 weeks or so. Would be better to go to one that does it more frequently.

"They weren't really pushy during the appointment" (:

haha, didn't catch that

I had a colonoscopy and esophagogastroduodenoscopy (thankfully not in that order) without sedation. Had it done in D.C.

My doc looked at me like I was crazy when I asked if it could be done without sedation, and reminded me that it would be uncomfortable, but otherwise didn't have any problem with it. I've endured 50k runs, brutal workouts, and traumatizing childhood neglect - I really can't see what the fuss is with mild discomfort that, by comparison, barely registers, and for such a short amount of time at that.

Yea most of the time it was discomfort but the turns were pretty high up there in pain. But that was only 3 times.

I don't really mind the pain itself, but I could see myself thinking the worst in that situation and imagining the strong pain meant the probe had punctured my colon.

I assume that's not actually a realistic risk, right?

I too had esophagogastroduodenoscopy and the "sedation" I received as a barely noticeable dose of fentanyl. It was unpleasant to feel like I was drowning in saliva but it was quite bearable.

If I ever receive that procedure again, I will ask to skip the fentanyl microdose. The anesthesia and the buzz were not only underwhelming but for some reasons I started to feel the typical opioid warmth when the procedure was almost completed. Had they waited a few minutes after the IM injection I might have had another opinion on the usefulness on fentanyl during endoscopie because the last 30s were almost pleasant!

FYI, there is an alternative, depending on what you need it for: https://jamiekoufman.com/tne-transnasal-esophagoscopy-is-the...

However, doctors who do it are a bit hard to come by.

With a esophagogastroduodenoscopy, I think the main issue is the gag reflex, not necessarily the pain.

> I've endured 50k runs

Did you see this? https://www.nytimes.com/2025/08/19/health/running-colon-canc...

But I agree with you, I would only want this done if I could get it without sedation.

Do you have specific risk factors that caused your doctor to recommend getting it at 40, or did you have to convince them? My understanding is that if the doctor doesn't order it, many insurance companies won't cover it.

I had bleeding, light red, most likely from hemorrhoids (it was), but had a few other factors that the doctor took it seriously. The insurance didn't cover much as far as I know (or any?). Owed like $1800.

The prep is by far the worst of it. I wish they could do it differently.

I had a colonoscopy + upper endocoscopy a few months ago, age 29.

The prep was horrible, particularly the electrolyte drink they make you take the night before. I almost puked several times trying to get that stuff down.

Actual procedure was a breeze. I was sedated, and then I woke up and it was over.

There's an option which doesn't involve drinking any yucky fluids, just water. SuTab. You have two rounds of twelve pills that you drink with three cups of water at various intervals.

I've done it enough times that I'm totally fine with it: the electrolyte drink tastes like slightly bad-tasting Gatorade, which is hardly worth caring about.

And you get diarrhea-like bathroom runs half a dozen times maybe.

Yes it was annoying to get the runs and gross to drink the stuff the first few times, but people eat things like cow tongue or live octopus or whatever... I can handle some bad-tasting Gatorade and some diarrhea just fine, especially given the 5 years of peace-of-mind it buys me afterward.

People react differently. I took the same prep but the waves of nausea and cramping were so intensely painful I sweat through all my clothes and passed out on the toilet. It was some of the worst hours of my life. I’m just over 40 and have some symptoms to check which turned out to be benign, but it was such a harrowing experience I will be doing this as infrequently as possible.

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