To identify the key determinants of pre-endoscopic anxiety and to examine how this anxiety influences procedural tolerance, symptom burden, and overall patient satisfaction.

We conducted a cross-sectional observational study including 51 patients scheduled for digestive endoscopy. Anxiety levels were assessed using the Spielberger Anxiety Inventory. Sociodemographic features, medical and psychiatric history, personality traits, previous experiences with endoscopy, knowledge about the procedure, and willingness to undergo unsedated endoscopy were recorded.Per-procedural variables included pain intensity, bloating, nausea/vomiting, incontinence, and procedure duration. Statistical analysis used comparison tests and multivariate linear regression (p < 0.05).

Patients had a mean age of 59.7 years (29–82), with a male-to-female ratio of 1.32. The mean anxiety score was 44.3 (25–70).

Higher anxiety levels were more frequent among patients with an anxious personality (36% vs. 7.7%, p < 0.01), those who had previously had a negative endoscopic experience (45.5% vs. 7.1%, p < 0.05), those with limited knowledge of the procedure (40% vs. 15.4%, p < 0.05), and those who felt uncomfortable with the idea of undergoing the exam without sedation (24% vs. 3.8%, p < 0.05).Age, sex, and medical history showed no significant relationship with anxiety.

Patients with higher anxiety reported more abdominal pain during the procedure (p = 0.005), along with more bloating and more nausea/vomiting. Anxiety did not correlate with the duration of colonoscopy (p = 0.22).

Pain had a clear impact on patient satisfaction: 83% of patients with no pain rated their experience as “very satisfactory”, compared with 44% among those who experienced pain. The same pattern was observed for willingness to repeat the procedure (83% vs. 44%). Nearly half of patients who felt pain wished for sedation during future exams.

Pre-endoscopic anxiety mainly stems from psychological factors and lack of information. It increases discomfort during the procedure and reduces satisfaction. Recognizing and addressing anxiety beforehand could improve patient comfort and enhance their overall experience with endoscopy.