The water method is effective in difficult colonoscopy - it enhances cecal intubation in unsedated patients with a history of abdominal surgery.

Journal of Interventional Gastroenterology
Felix W LeungJackson Guy

Abstract

BACKGROUND: Colonoscopy in unsedated patients in the US is considered to be difficult. Success rate of cecal intubation is limited by discomfort. Colonoscopy in patients with a history of abdominal surgery is also considered to be difficult due to adhesion-related bowel angulations. The water method has been shown to significantly reduce pain during colonoscopy. OBJECTIVE: To test the hypothesis that the water method enhances the completion of colonoscopy in unsedated patients with a history of abdominal surgery. DESIGN: The data bases of two parallel RCT were combined and analyzed. SETTING: Two Veterans Affairs endoscopy units. PATIENT AND METHODS: The water and air methods were compared in these two parallel RCT examining unsedated patients. Those with a history of abdominal surgery were selected for evaluation. MAIN OUTCOME MEASUREMENTS: Completion of unsedated colonoscopy. RESULTS: Among patients with a history of abdominal surgery, the proportion completing unsedated colonoscopy in the water group (19 of 22) was significantly higher than that (11 of 22) in the air group (p=0.0217, Fisher's exact test). LIMITATIONS: Small number of predominantly male veterans, unblinded colonoscopists, not all types of abdominal surg...Continue Reading

Citations

Feb 22, 2016·Gastrointestinal Endoscopy·Sergio Cadoni, Felix W Leung
Jun 5, 2015·Journal of Crohn's & Colitis·Přemysl FaltMartin Hill
Aug 18, 2012·Gastrointestinal Endoscopy·Felix W LeungVittorio Terruzzi
Sep 17, 2015·Current Gastroenterology Reports·Nicolas A VillaJonathan A Leighton
Aug 3, 2020·Gastrointestinal Endoscopy·Mike Tzuhen WeiShai Friedland

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