Editing Colonoscopy (section)

===Patient comfort and pain management===
The pain associated with the procedure is not caused by the insertion of the scope but rather by the inflation of the colon in order to do the inspection. The scope itself is essentially a long, flexible tube about a centimeter in diameter — that is, as big around as the little finger, which is less than the diameter of an average stool.<ref>{{cite journal | vauthors = Ekkelenkamp VE, Dowler K, Valori RM, Dunckley P | title = Patient comfort and quality in colonoscopy | journal = World Journal of Gastroenterology | volume = 19 | issue = 15 | pages = 2355–2361 | date = April 2013 | pmid = 23613629 | pmc = 3631987 | doi = 10.3748/wjg.v19.i15.2355 | doi-access = free }}</ref>

The colon has sensors that can tell when there is unexpected gas pushing the colon walls out—which may cause mild discomfort. Usually, total anesthesia or a partial [[twilight anesthesia|twilight sedative]] are used to reduce the patient's awareness of pain or discomfort, or just the unusual sensations of the procedure. Once the colon has been inflated, the doctor inspects it with the scope as it is slowly pulled backward. If any polyps are found they are then cut out for later biopsy.<ref>{{cite journal |last1=Brown |first1=Shaun |last2=Whitlow |first2=Charles B. |date=1 March 2017 |title=Patient comfort during colonoscopy |url=https://www.sciencedirect.com/science/article/pii/S1043148916300549 |journal=Seminars in Colon and Rectal Surgery |series=SI: Advanced Endoscopy Outline |volume=28 |issue=1 |pages=1–3 |doi=10.1053/j.scrs.2016.11.004 |issn=1043-1489 |url-access=subscription |access-date=10 November 2023 |archive-date=27 February 2024 |archive-url=https://web.archive.org/web/20240227031615/https://www.sciencedirect.com/science/article/abs/pii/S1043148916300549 |url-status=live }}</ref>

Colonoscopy can be carried out without any sedation and a number of studies have been performed evaluating colonoscopy outcomes without sedation.<ref>{{cite journal | vauthors = Zhang K, Yuan Q, Zhu S, Xu D, An Z | title = Is Unsedated Colonoscopy Gaining Ground Over Sedated Colonoscopy? | journal = Journal of the National Medical Association | volume = 110 | issue = 2 | pages = 143–148 | date = April 2018 | pmid = 29580447 | doi = 10.1016/j.jnma.2016.12.003 }}</ref> Though in the US and EU the procedure is usually carried out with some form of sedation.<ref>{{cite journal | url=https://www.giejournal.org/article/S0016-5107(99)70381-0/fulltext | doi=10.1016/S0016-5107(99)70381-0 | title=Patients willing to try colonoscopy without sedation: Associated clinical factors and results of a randomized controlled trial | date=1999 | journal=Gastrointestinal Endoscopy | volume=49 | issue=5 | pages=554–559 | pmid=10228251 | vauthors = Rex DK, Imperiale TF, Portish V }}</ref>