An exam people put off
Colonoscopy is one of the most useful exams there is, and one of the most postponed. Part of the problem is the bowel prep. Part is the exam itself: discomfort, the feeling of not being in control, the expectation of pain. Many units use sedation, but not always, and not every patient can or wants to have it.
This is where virtual reality has been studied. Not as a replacement for sedation or pain relief, but as an add-on: the patient puts on a headset, sees another place, and their attention is no longer all on what is happening to their body.
What a randomised trial measured
One of the most cited studies was published in the Turkish Journal of Gastroenterology in 2021 (Karaveli Çakır and colleagues). Sixty patients had a colonoscopy without sedation or anaesthesia, randomly split into two groups of 30. One group watched a beach walk in virtual reality, starting one minute before the exam. The other had the exam as usual.
What they found:
- Pain during the exam was lower in the VR group (2.76 vs 3.76 on a 0 to 10 scale), a statistically significant difference.
- Pain after the exam was also lower, but not significantly.
- State anxiety did not change significantly, before or after.
- Exam time was almost identical in both groups, about seven and a half minutes.
So VR did not slow the exam down, and patients felt less pain while it was happening. On anxiety, this study found no difference.
Why it matters, and where the limits are
A 60-person study in a single hospital is not enough for general conclusions. The authors used cardboard goggles with a phone, which is quite different from a current standalone headset. And VR does not change the physiology of the exam. What it changes is where attention goes.
Several registered trials are looking at the same question in upper endoscopy and colonoscopy, and better data will probably come in the next few years. Until then, the honest reading is: there are signs it helps with pain during the exam, the evidence on anxiety is weaker, and nothing suggests it gets in the team's way.
The wider literature on immersive VR in procedures describes effects on pain perception and anxiety, and we keep that evidence on our studies page. We have also written about anxiety before surgery and fear of needles and procedures, where the logic is similar.
How it would work in an endoscopy unit
In practice, a unit's question is not whether VR "works" in the abstract. It is whether it fits the patient pathway without holding anyone up. A few things help:
- Start early. In the study the video began one minute before. Many teams prefer to put the headset on in the waiting area or during prep, when anxiety is often highest.
- Calm content, no tasks. A real, quiet place, no games or controllers. The patient does not have to do anything.
- The team leads. The nurse picks the content, stays with the patient, and can stop at any moment.
- Hygiene between patients. The part that touches the face has a washable cover, cleaned between uses like any shared equipment.
RVer is used by clinical teams in contexts of procedure-related pain and anxiety, always supervised by a professional. It does not replace sedation, pain relief or talking to the patient. It adds to what the team already does.
Frequently asked questions
Does virtual reality replace sedation for a colonoscopy?
No. In the studies it was used as an add-on, and the decision about sedation remains a clinical one.
Does VR make the exam longer?
In the 2021 trial, exam time was practically the same with and without VR.
Does it reduce anxiety?
In that trial, state anxiety did not change significantly. The difference was in pain during the exam.