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Methods of Reducing Discomfort During Colonoscopy

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Abstract

In the United States sedation for colonoscopy is usual practice. Unsedated colonoscopy is limited to a small proportion of unescorted patients and those with a personal preference for no sedation. Over 80% of patients who accept the option of as-needed sedation can complete colonoscopy without sedation. Colonoscopy in these unsedated patients is performed with techniques similar to those used in the sedated patients. Uncontrolled observations indicate willingness to repeat colonoscopy amongst these patients was correlated significantly with low discomfort score during the examination. Methods reported to minimize patient discomfort or enhance cecal intubation during sedated or unsedated colonoscopy included use of pediatric colonoscope, variable stiffness colonoscope, gastroscope, and inhalation of nitrous oxide or insufflation of carbon dioxide, hypnosis, music, audio distraction, or simply allowing the patients to participate in administration of the medication. Research focusing on confirming the efficacy of a simple inexpensive nonmedication dependent method for minimizing discomfort will likely improve the outcome of care and more importantly will ensure compliance with future surveillance in patients accepting the unsedated option.

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Acknowledgments

Grant support provided in part by Veterans Affairs Medical Research Funds.

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  1. Research and Medical Services, Sepulveda Ambulatory Care Center, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Felix W. Leung

  2. Division of Gastroenterology (111G), Sepulveda Ambulatory Care Center, 16111 Plummer Street, North Hills, CA, 91343, USA

    Felix W. Leung

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Correspondence to Felix W. Leung.

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Leung, F.W. Methods of Reducing Discomfort During Colonoscopy. Dig Dis Sci 53, 1462–1467 (2008). https://doi.org/10.1007/s10620-007-0025-9

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