Stomach Pain & Gurgling After Colonoscopy: Causes & Treatments (Dr. Farahat)

Quick Insights:

Up to 20% of people can experience stomach pain and bloat after Colonoscopy. The most common cause is trapped gas. 

But other causes can contribute to such condition such as: 

• Longer duration of the procedure.
• Some procedures during colonoscopy such as Cutting off a polyp or taking a biopsy. 
• Colon preparation process.
• Being a female. 
• Suffering from irritable Bowel Syndrome can Contribute to stomach pain after colonoscopy. 
• Rarely, stomach pain can occur due to serious complications such as perforation or post polypectomy coagulation syndrome. 

Red flags of post-colonoscopy pain:

• Severe pain or tenderness over your belly. 
• Fever. 
• Vomiting. 
• Passage of a large amount of reddish or blackish stool. 

To prevent & cure post.colonoscopy stomach pain: 

• Try to move or to do a light exercise.
• Eat bland foods and avoid high fat and fried foods. 
• Use over-the-counter anti-gas medications as simethicone.
• Probiotics seem to help in the short and the long term. 

Stomach pain and gurgling for one or two days after colonoscopy:

It is normal to have stomach pain and gurgling for The following one or two days after your colonoscopy. Studies show that up to 20% of patients like you complain from some sort of pain or discomfort (1). 

Many factors may contribute to the pain you may feel directly after your colonoscopy: –

• Trapped Gas: Your doctor uses air to inflate your colon and this may cause distension, pain, and gurgling after Colonoscopy.
• Sedation medications: can cause some nausea and abdominal discomfort.
• Some procedures during colonoscopy such as removal of a polyp or taking Biopsy.
• If your doctor took a long time performing the colonoscopy, you are more likely to develop pain, bloating, and gurgling.
• Colon preparation process prior to the colonoscopy may affect the balance of microbes and digestion for many days.
• Rarely, complications such As perforation or post-colonoscopy appendicitis but these conditions are extremely rare.
• Another cause of stomach pain And gurgling is eating a heavy meal such as fried or fast food directly after colonoscopy. 

Tripped gas is the single most important cause of stomach pain, Bloating, and gurgling at the first 1-2 days after colonoscopy. 

This 2007 study shows you the frequency of different minor complications in the first week after colonoscopy (1).

– Bloating: is the most frequent condition, (25 %)

– stomach pain: 10.9 %.

– Diarrhea: 6.3 %.

– Nausea: 4%.

– Minor Blood in stool: 3.8%.

– Constipation: 1.9 %

Also, some other factors can contribute to stomach pain.

These factors are not related to the colonoscopy itself, But related to the patient himself!

For Example: –

– If you’re a female: females are more likely to experience pain after colonoscopy (3).

– If you are an irritable bowel syndrome sufferer.

Stomach pain & gurgling For longer periods (A week or more).

Sometimes, you may continue to feel pain or bloating for a relatively long period.

According to this study (3) , the two most common factors related A prolonged pain are

1- longer duration of The procedure: if your doctor took more time performing the colonoscopy.

2- female sex, they feel stomach pain for longer periods than males.

Also, Another study (4) proposed that prolonged stomach pain, bloating, or gurgling may occur by a different mechanism. They Theorized that colon preparation washes out the beneficial bacteria inside your intestine and colon.

 Administration of probiotics (to regain the normal microbes) effectively decreased the number of days of pain (From 2.78 to 1.99 days).

Rare, but serious causes of pain after colonoscopy:

As we mentioned before, colonoscopy is generally a safe procedure. And the incidence of major complications is extremely low (1).

for example:

1. perforation: if your doctor pushes too hard against the wall of your colon, this may lead to a small tear in its wall. 

2. post polypectomy Electrocoagulation syndrome: if your doctor cuts off a colon polyp, he’ll use a tool with electrical current to seal the area. Sometimes, too much electrical current can cause some burning and inflammation to the wall of your colon (5)

3. Infection; a colonoscope can be hard to be cleaned, Raney, you may acquire infection Through the colonoscope. Common microbes are E. coli, Klebsiella, or Enterobacter.

Besides abdominal pain, you may experience diarrhea or fever.

4. post-colonoscopy appendicitis; another extremely rare condition, only 53 cases are reported in this review study (6). Patients present with severe Rt lower abdominal pain after colonoscopy.

When to call your doctor for stomach pain. 

It is ok to feel some stomach pain, gurgling, or bloating for a day or two after colonoscopy.

The pain is usually tolerable, doesn’t interfere with your daily activities, and it is often associated with a sense of distension, bloating, or gurgling. 

But if you experience any of the below “red flags”,  ask for medical help by your doctor: 

• Severe pain or cramping in your belly
• Tenderness or hardness in your stomach (to the degree that you’re unable to touch it).
• Vomiting, especially if more than once.
• Fever.
• Frequent or severe diarrhea that is not going a way.
• No bowel movements for more than 5 to 7 days.
• Bloody bowel movements (one or two minor bleeds after colonoscopy are considered OK).
• Dizziness or severe shortness of Breath.
• Passage of blackish stools (large amount).

Tips to avoid or decrease stomach pain & gurgling after colonoscopy.

1- Move.

Trapped gas after colonoscopy is the most common cause of pain.  The single best way to overcome stomach gas is to move. Walking or moving around helps your colon to pass extra gas.

2- Eat.

Eating is allowed after colonoscopy unless your doctor advises against it. But some foods may contribute to The stomach pain you feel after Colonoscopy. 

DO NOT eat : 

• fried foods. 
• fast food like pizza. 
• high-fat food.
• spicy foods. 
• gas-producing foods such as Beans. 
• Soda and carbonated beverages. 

DO eat: soft, easy to digest foods as: 

• Mashed potatoes 
• soup 
• Tender, cooked vegetables. 
• Yogurt. 
• scrambled eggs. 
• Jell-O. 
• Popsicles. 
• Pudding. 

3- Drink. 

Colon prep. can cause dehydration. And this is particularly common if you are older in age or had vomiting. 

Drinking water,  fruit juice, or vegetable juice can help your stomach pain & gurgling. 

Rehydration helps your digestive system to regain its normal function. 

Another option is to drink peppermint tea. Peppermint is known for its antispasmodic effects.

Also, chamomile tea can help reduce trapped gas, bloating, and stomach pain. 

4- Avoid: 

• Eating too fast or too much. 
• chewing gum. 
• smoking 
• Alcohols. 

5- Simethicone. 

Simethicone is an over-the-counter medication that can help you expel excess gas after colonoscopy. 

it’s available under many names (For example, Gas-x). follow instructions and dosing and make sure to discuss the issue with your doctor. 

6- Try a probiotic. 

As we explained to you before, Some studies suggest that stomach pain and bloating after colonoscopy are due to colon prep. 

As colon prep. washes out the good bacteria inside your colon, A probiotic will help you to regain your normal colon microbe balance. 

A probiotic containing Lactobacillus acidophilus NCFM & Bifidobacterium lactis Bi-07 successfully decrease post-colonoscopy pain (4).

MORE: general ill feeling after colonoscopy.