The Emotional Experience of a Colonoscopy

I still vividly remember my feelings when my doctor asked me to undertake a colonoscopy examination. As I learned more about the examination and preparation procedures, I started feeling embarrassed and disgusted. My feelings grew so strong that every new piece of information from the doctor seemed less important to me. I understood the reasons for this examination and the potential benefits but still did not schedule the appointment until several days later.

My feelings are not uncommon. Many patients going through colonoscopy examinations report feelings of fear, embarrassment, disgust, and anxiety. However, as an important part of patients’ experiences in colonoscopies, emotions should not be disregarded as mere fleeting feelings. Whether we agree to undergo a colonoscopy examination or feel confident about preparing ourselves for the procedure may hinge on our emotional state. Alarmingly, research indicates that negative emotions rank among the primary reasons for avoiding the examination, particularly among underserved populations. When individuals anticipate feelings of embarrassment, fear or disgust, they are more likely to avoid undergoing a colonoscopy. This is because negative emotions are closely associated with our evolutionary instinct to escape and the need for protecting ourselves. This fundamental action-tendency of negative emotions may explain why I declined the phone call from the doctor's office.

Source: Pavel Danilyuk / Pexel

Although negative emotions have received more attention among researchers and medical professionals, efforts to regulate negative emotions and control their impacts on colonoscopy uptake are scarce. One cause of this gap is that we have not fully identified the causes of each discrete emotion. As a result, we often lose the opportunity to understand what emotions tell us about our needs and concerns that could eventually influence our health behaviors. Researchers and practitioners of colonoscopies often focus on a prototypical cause of negative emotions while failing to recognize other potentially significant reasons. For example, many people, myself included, feel disgusted by handling body waste, but some others could experience disgust by the sight of blood as a potent reminder of death. A systematic review reveals that while some individuals who feel disgusted by fecal matter during colonoscopies might avoid the examination, those experiencing disgust due to anal insertion may actually be more inclined to participate in it. Thus, researchers need to understand what causes individual patients’ emotions in clinical interventions and how different eliciting reasons could influence their decisions regarding participation in the examination.

The arousal of negative emotions can indicate what issues in health care are perceived as a challenge by patients. Thus, recognizing the emotions and their causes on each individual is a starting point to provide essential support that can eventually increase engagement in health behaviors. In the context of colonoscopy, some researchers suggested that exposing patients to disgust-eliciting elements could reduce disgust feelings and increase their preparation for colonoscopy. My own research shows that making jokes about embarrassing issues in the colonoscopy examinations might also play a positive role in increasing the screening intention. Next time, rather than allowing your emotions to dictate your actions, consider easing your embarrassment or disgust with a joke to prepare yourself for the examination ahead better.