how to handle belly pain after colonoscopy

Belly pain after colonoscopy is uncommon. When it happens, it can be due to many reasons. Air used to distend the colon during colonoscopy may be the cause. Therefore, let the air out. Fart! It may be something very serious like a tear in the colon otherwise known as perforation. You may need surgery for this.

What causes belly pain during colonoscopy

  • Less experienced physician.
  • Type of sedation used. Patients feel less pain when propofol is used compared to IV sedation with fentanyl and versed.  Patients without sedation feel more pain compared to IV sedation. An experienced physician may do colonoscopy with little or no sedation.
  • Type of air used to inflate the colon. During colonoscopy, air is introduced into the colon to distend it and make it easier to see polyps. Using carbon dioxide (C02) for inflate causes less pain than room air. C02 is absorbed across the intestine faster than room air.
  • Low body weight. Patients with low body weight are more likely to have belly pain during colonoscopy than normal or overweight patients.
  • Patient’s anticipation of pain level. Patients that have a high expectation of pain during colonoscopy actually experience more pain.
  • Poor bowel preparation. Patients with poor bowel prep are more likely to have prolonged colonoscopy. Prolonged procedure may cause belly pain.

What causes belly pain after colonoscopy

Post-polypectomy syndrome

This is caused by injury to the wall and muscle of the colon from the electrocautery used in removing a polyp. The injury causes inflammation of the peritoneum without perforation. It occurs in 0.003% to 1% of colonoscopies. Symptoms and signs of post-polypectomy syndrome are abdominal pain, fever, chills, sweats, abdominal tenderness, leukocytosis and fast heart rate.

Symptoms start within 12 hours of colonoscopy but may be delayed up to 5-7 days after colonoscopy. A CT scan can distinguish between post-polypectomy syndrome and perforation.

Most patients with post-polypectomy syndrome can be treated conservatively with pain medications, intravenous fluids and bland diet. Some patients require antibiotics.

Symptoms usually go away within 2-5 days. Most patients do not require surgery.

How to prevent belly pain during colonoscopy

  • Get colonoscopy from an experienced physician.
  • Do not anticipate belly pain during colonoscopy.
  • Ask for C02 instead of room air during colonoscopy.
  • Make sure you have a good bowel prep for colonoscopy.

How to treat belly pain after colonoscopy

  • Release gas. Please, fart away! If the air is trapped, exercises like walking or rolling on your back can help get rid of the air. Warm drinks can help the air pass through the body. A cup of coffee or tea especially a peppermint tea can be helpful. Peppermint is also used to treat irritable bowel syndrome (IBS). An over the counter medication called simethicone can help. Simethicone is found in Gas-X, Alka-Seltzer Anti-Gas, Gas Aide, Mylanta Gas Maximum Strength, Mytab Gas and many other products. Simethicone makes gas come out easier because it allows gas bubbles to come together.
  • If you have persistent abdominal pain or cramps or if your pain is getting worse, you should contact your doctor immediately.

Suggested Reading

How to spot a complication after colonoscopy.

Why People Hate Colonoscopy and What to do about It.

How to understand your colonoscopy result. 

Diarrhea after colonoscopy or no stool after colonoscopy.