A team from the USA compared the experiences of patients during imaging tests of the colon.
The prospective study looked at patients who underwent air contrast barium enema (ACBE), flexible sigmoidoscopy, and colonoscopy investigations.
Immediately after each procedure, patients completed a questionnaire. This assessed pre-test anxiety, difficulty with preparation, pain, cramping, bloating, and overall discomfort. Loss of dignity, willingness to repeat the test, and overall satisfaction were also appraised.
A follow-up questionnaire was administered within 48 hours.
In addition, nurses and physicians completed questionnaires, to assess the provider impression of patient experience.
410 patients (80 ACBE, 202 sigmoidoscopy, and 128 colonoscopy) were enrolled in the study.
Sigmoidoscopy was found to cause more pain than ACBE (Odds ratio [OR] 2.64) or colonoscopy (OR 1.83). ACBE and colonoscopy did not differ in the degree of pain.
|Patients were less willing to repeat barium enema than sigmoidoscopy or colonoscopy.
The researchers found that although overall satisfaction appeared to be similar for all tests, patients were less willing to repeat ACBE than sigmoidoscopy (OR 1.85) or colonoscopy (OR 1.82).
Initial and follow-up pain ratings by patients were highly correlated (Spearman correlation, 0.81). However, correlation of pain assessments between staff and patients was found to be poor (Spearman correlation, 0.48).
Lawrence S. Kim, of the University of California, San Francisco, said on behalf of the group, "Sigmoidoscopy was more painful than other colonic imaging modalities. Although ACBE and colonoscopy caused similar pain, patients were less willing to repeat ACBE.
"In aggregate, the data suggest that patients perceive colonoscopy as the most acceptable colonic imaging procedure."
"Better methods are required to allow staff to adequately assess discomfort experienced by patients during these procedures," he concluded.