If you’re feeling anxious about an upcoming colonoscopy, you’re far from alone. Studies indicate that up to 1 in 5 people undergoing colonoscopy report severe anxiety, often because they anticipate pain and discomfort. Not only is this unpleasant, but it can also lead to increased use of medication and make it more difficult to complete the procedure. Fortunately, there are proven ways to reduce this anxiety and feel more relaxed during the procedure. Here are six tips that can help you get through your next colonoscopy:
Research shows that patients who are knowledgeable about colonoscopy and understand what to expect experience less anxiety, on average, in connection with the procedure. For example, a randomized controlled trial of 150 patients found that those who watched an informational video prior to colonoscopy reported significantly less anxiety than those in the control group. An Australian study of 80 patients further suggested that those who desire more detailed sensory information about what to expect experience less anxiety when that information is also provided. It can help to fully understand what to expect during a colonoscopy as well as why it’s done. This allows you to me a more active participant in your health care decisions, which can help you feel more in control of what’s happening to your body.
Mindfulness meditation is seeing a surge of interest and acceptance for a variety of purposes. Among these are reduction of pain and anxiety. Mindfulness is, in essence, the practice of focusing one’s attention in the present moment. Because anxiety arises when we anticipate potentially painful or otherwise negative events, keeping the mind anchored in the present can help you release troubling thoughts about what might happen in the near future. The truth is that we don’t know exactly what will happen or how we will feel. Fretting about the possibilities is an unhelpful use of mental energy, which can be redirected through the practice of mindfulness.
Studies also indicate that mindfulness meditation can reduce patients’ experience of pain, including chronic pain. Additionally, patients who practice mindfulness meditation report pain as less unpleasant relative to its intensity. This may be because when we experience expected pain, that experience includes the anticipation as well as the emotional aftermath of the physical sensation. When the mind is focused in the present, we’re better able to release those elements of the experience.
Multiple randomized controlled trials have demonstrated the positive effect of music on patients’ experience during colonoscopy. For example, a study of 198 patients at a US veterans' GI facility showed that patients who listened to music for 25 minutes prior to the exam experienced less anxiety that those who instead had 25 minutes of quiet time. Another study of
109 patients found that those who wore headphones that played music during colonoscopy experienced less pain than those who wore muted headphones.
Diaphragmatic breathing, also known as belly breathing, is another practice that’s gaining attention for its ability to calm the nervous system. A 2017 study investigated the effects of this practice on anxiety, depression, and stress by assessing attention, emotional states, and levels of the stress hormone cortisol. All three were found to be positively affected by training subjects in diaphragmatic breathing.
To practice diaphragmatic breathing, sit or lie comfortably, and place a hand on your belly. Breathe in deeply through your nose so that your belly expands. This naturally happens as the diaphragm contracts and draws downward, slightly displacing the organs of the belly. Exhale completely (without forcing it), keeping the breath smooth and even. As the diaphragm relaxes back into its domelike shape below the lungs, the belly will flatten.
Image source: OpenStax College, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons
Standard colonoscopies in the US are typically performed with some type of sedation. The medication used can vary from light sedation to alleviate pain and anxiety to anesthesia that causes patients to sleep through the entire procedure. If you plan to undergo a traditional colonoscopy, be sure to talk to your doctor about the appropriate level of sedation for you.
Other methods of colorectal cancer screening provide alternatives to traditional colonoscopy. CT colonography (commonly known as virtual colonoscopy) normally does not require sedation. That’s because instead of sending a camera through the bowel, a small, flexible tube is inserted just two inches into the rectum to fill the bowel with carbon dioxide. This creates space within the structure so clear CT images can be obtained. The exam takes only about 15 minutes, and because it doesn’t require sedation, patients can resume normal activities immediately after the appointment. If the images reveal no irregularities, there is no need to undergo traditional colonoscopy.
Since its formation in 2001, Iowa Radiology has put excellent patient care first. We offer virtual colonoscopy and are always happy to answer all of our patients’ questions about the exams we perform. We also provide music headsets for your comfort. For more information about CT colonography and other CT exams, click the link below to download our free ebook.
Resources
Girgis A, Butow P, et al. Anxiety and colonoscopy: approaches to minimise anxiety and its adverse effects. wiki.cancer.org.au. Modified March 25, 2019. Accessed January 12, 2022. https://wiki.cancer.org.au/australiawiki/index.php?oldid=200689.
Hall K. What to Do About Pre-Colonoscopy Anxiety. Health.USNews.com. Published October 10, 2017. Accessed January 12, 2022. https://health.usnews.com/health-care/patient-advice/articles/2017-10-10/what-to-do-about-pre-colonoscopy-anxiety.
Xiao Ma, Zi-Qi Yue, Zhu-Qing Gong, et al. Front. Psychol., June 6, 2017. Accessed January 12, 2022. https://doi.org/10.3389/fpsyg.2017.00874.
Zeidan F, Vago DR. Mindfulness meditation-based pain relief: a mechanistic account. Ann N Y Acad Sci. 2016;1373(1):114–127. https://dx.doi.org/10.1111%2Fnyas.13153.