Factors associated with abdominal discomfort during colonoscopy: a prospective analysis

Elphick et al.
European Journal of Gastroenterology and Hepatology
ISSN: 0954-691X • Frequency: 12/year • Impact Factor: 2.08  • Subscribe Now

Colonoscopy is a standard diagnostic tool for the investigation and surveillance of diseases affecting the colon. Colonoscopy can be an uncomfortable procedure and to relieve discomfort, sedation, opiate analgesia and anaesthetic agents are often used. To increase safety, there is a trend towards lower levels of sedation and analgesia use during colonoscopy. In many endoscopy units, including our own, unsedated colonoscopy with or without use of inhaled nitrous oxide (entonox) is common practice and opiates are rarely used. Previous reports have indicated that unsedated colonoscopy is usually well tolerated, with only 5% reporting it to be very uncomfortable, 45% moderately uncomfortable and 50% not uncomfortable when questioned 14 days after the procedure.

Various factors, including female sex, less-experienced colonoscopists, poor quality of bowel preparation, lower body mass index of the patient and increased age of the patient have been associated with reduced completion rate or increased caecal intubation time. Recently, Park et al. have reported on factors affecting abdominal pain during colonoscopy in patients undergoing colonoscopy with high-level sedation. They found that female sex, younger age (<40 years), lower body mass index, technically difficult insertion and history of gynaeco-pelvic surgery in women were independent factors significantly related to patient discomfort during colonoscopy.

Here, we aim to determine factors associated with higher levels of patient discomfort during colonoscopy performed without, or with low-dose, midazolam sedation. This will allow identification of patients who are more likely to find colonoscopy uncomfortable, to allow targeted use of sedatives and analgesia.

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