Colonoscopy may be associated with discomfort when performed without sedation.
Researchers from Japan conducted a study to determine whether instillation of water into the colon at the beginning of the procedure reduces intubation time, as well as patient discomfort and pain.
Colonoscopy was performed in 259 patients by 3 endoscopists-in-training with limited experience.
The research team randomly allocated patients to 2 groups.
In the first group, 500 to 1000 ml of water was instilled into the colon by enema at the beginning of the procedure (instillation group, n = 130).
|Patients complaining of abdominal pain:|
- instillation group = 17%
- control group = 33%
In the second, patients underwent a conventional colonoscopy (control group, n = 129).
The team measured and compared intubation time between the groups.
In addition, they measured the level of subjective discomfort experienced by the patients, upon completion of the examination.
The team found that success rates for insertion to the cecum were similar, 95% and 96% for the instillation and control group, respectively.
Furthermore, detection rates for any colorectal diseases were not different between the groups (30% versus 33%).
However, the mean time to cecal intubation was 10.5 minutes in the instillation group and 16.2 minutes in the control group (p < 0.0001).
In addition, the proportion of patients who complained of abdominal pain during the procedure was 17% in the instillation group and 33% in the control group (p < 0.001).
Dr Naoharu Hamamoto's team concluded, "When used by endoscopists-in-training, the water-instillation colonoscopy technique was associated with less discomfort and faster cecal intubation with no decrease in the rate of detection of colorectal diseases".