Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 26 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Water exchange method improves adenoma detection rate

Water exchange method significantly improves adenoma detection rate, reports the latest issue of the American Journal of Gastroenterology.

News image

Adenoma detection rate is a key colonoscopy quality indicator in Western clinical literature. 

Dr Hui Jia and colleagues from China's low adenoma detection rate prompted an assessment of novel methods to improve performance. 

Western retrospective reports suggested that water exchange could increase adenoma detection rate.
 
However, most of these studies used pain score or intubation rate as the primary outcome. 

The researchers tested the hypothesis that water exchange significantly increases adenoma detection rate among Chinese colonoscopists, and design a prospective randomized controlled trial using adenoma detection rate as their primary outcome.

The researchers performed this prospective, randomized controlled trial at 6 centers in China. 

Overall adenoma detection rate was 18% in water exchange, and 13% in air insufflation
American Journal of Gastroenterology
Screening, surveillance, and diagnostic cases were randomized to be examined by water exchange or traditional air insufflation method. 

The team's primary outcome was adenoma detection rate.

From 2014 to 2015, 3,303 patients were randomized to water exchange, and air insufflation. 

The baseline characteristics were comparable. 

Overall adenoma detection rate was 18% in water exchange, and 13% in air insufflation. 

The researchers found that adenoma detection rate in screening patients using air insufflation was 26% in males, and 16% in females. 

Adenoma detection rate in screening patients aged >50 years old was 29% in water exchange, and 23% in air insufflation. 

The increase by water exchange was reproducibly observed in all indication categories, and significant in screening and diagnostic cases. 

The limitation imposed by the unblinded investigators was mitigated by comparable inspection times in cases without polyps, similar adenoma per positive colonoscopy, and reproducible enhancement of adenoma detection rate and adenoma per colonoscopy by water exchange across all 8 investigators.

Dr Jia's team comments, "This prospective study confirms Western retrospective data that water exchange significantly improves adenoma detection rate among Chinese colonoscopists."

"Water exchange may be superior to air insufflation for screening colonoscopy in China."

"Colonoscopists elsewhere with low adenoma detection rate might consider evaluating water exchange for performance improvement."

Am J Gastroenterol 2017; 112:568–576
14 April 2017

Go to top of page Email this page Email this page to a colleague

 26 February 2018 
Metabolic effects of new therapies of NASH
 26 February 2018 
Hepatocellular carcinoma risk in Hep B
 26 February 2018 
Novel targets for hepatocellular carcinoma
 23 February 2018 
Patients on antithrombotic agents undergoing emergency and elective endoscopy
 23 February 2018 
Heavy metals on a gluten-free diet
 23 February 2018 
MRI and NAFLD
 22 February 2018 
Outcomes with Crohn’s after infliximab withdrawal
 22 February 2018 
Elderly onset of IBD

 22 February 2018 
Autophagy enhancers
 21 February 2018 
Management of hemorrhoids in the USA
 21 February 2018 
Adalimumab and infliximab in biologic-naïve Crohn's
 21 February 2018 
Cystic fibrosis and colorectal cancer
 20 February 2018 
Complications and surveillance colonoscopies
 20 February 2018 
Treatment algorithm for polyp cancers
 20 February 2018 
Predictors of postoperative infection in Crohn's
 19 February 2018 
Screening colonoscopy in the right and left colon
 19 February 2018 
NAFLD prevalence in the USA
 19 February 2018 
Fructans in children with IBS

 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us