Colonoscopy is a test of the inner lining of your large intestine to find any ulcers, colon polyps, any tumors or areas of inflammation or bleeding. According to the National Cancer Institute, 10.1 per 100,000 men and women will test positive for colon and rectum cancer.

It is predicted that 4.43 percent of men and women will be diagnosed with colon and rectal cancer in their lifetime.  Based on the 2014 data, it is estimated that there were 1, 317,247, in the United States, that were living with colon and rectum cancer. The death rate from cancer, adjusted for age, is 14.8 per 100,000 men and women per year.  Anesthesia for colonoscopy is preferred by many patients.

When a colonoscopy is performed, tissue samples are taken, to remove and any suspected growths. A colonoscopy is a screening test for colon and rectum cancer. A home noninvasive test, Cologuard, tests the stool but is not intended to replace a colonoscopy. Up to 13% of people test a false positive for colon and rectum cancer.  Positives must be followed by a diagnostic colonoscopy. A negative Cologuard test does not guarantee the absence of cancer.

An anesthesiologist’s education includes a four-year college program, four more years of medical school followed by a four-year anesthesiology residency training program. Anesthesiology is a profession that is dedicated to the relief of pain of patients at all times before, during and after surgery. The anesthesiologist manages anesthesia during a colonoscopy, providing airway management, cardiac, pulmonary resuscitation, and advanced life support and pain control.

There is a hierarchy of sedation methods. The levels include minimal sedation which causes significant relaxation, moderate sedation may cause slurred speech, deep sedation, you are at the edge of consciousness but easily awakened and full or general anesthesia where you are in an unconscious state.

There is a debate concerning the levels of anesthesia given when performing a colonoscopy. One research study reported that the use of full anesthesiology varies across regions in the United States. For instance, for some parts of the United States, it is unnecessary to provide patients with full anesthesia.  

The expensive drug, Propofol, a powerful sedative, is the drug of choice, that must be monitored and administered by an anesthesiologist. According to the AMA full anesthesia for colonoscopy adds $1.1 billion dollars annually to medical costs.

Some patients decide to forgo anesthesia during a colonoscopy. But the majority of patients will use anesthesia at the level of a “conscious sedation.” In other words, the patient is kept in a relaxed state to block pain but can participate during the procedure to answer a question concerning the level of discomfort.  

It has been found that a colonoscopy can dangerously penetrate the colon when full anesthesia is administered because the patient cannot report any discomfort.