Colonoscopy is commonly used in screening for colorectal cancer. A refined technique of colonoscopy involving the use of water as the sole modality to aid colonoscope insertion, water exchange, has been described in recent research papers to decrease patient discomfort and pain, and to reduce the need for sedation during colonoscopy when compared with standard air insufflation. Carbon dioxide insufflation has been described to decrease patient discomfort after colonoscopy. No randomized trial has so far compared the use of water exchange to carbon dioxide insufflation. Our hypothesis is that water exchange inflicts less discomfort to patients undergoing colonoscopy than carbon dioxide insufflation. Patients undergoing screening colonoscopy in two centers in Norway, one center in Poland and one center in The Netherlands will be enrolled and randomized to examination of either of the two methods.
Single blinded randomized controlled trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
SINGLE
Enrollment
473
Water is infused and suctioned in a systematic fashion to obtain luminal view and for cleansing of the colon to facilitate colonoscope insertion. The carbon dioxide pump is turned off, only to be turned on during withdrawal from the cecum.
Carbon dioxide insufflation to obtain luminal view to facilitate colonoscope insertion, considered to be standard procedure.
Sorlandet Hospital
Arendal, Norway
Sorlandet Hospital
Kristiansand, Norway
The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
Warsaw, Poland
Pain during colonoscopy
Patients will be asked by a blinded assistant immediately after colonoscopy to score pain during the procedure.
Time frame: 1 hour
Pain during colonoscopy
Patients will be asked to report pain during colonoscopy to an unblinded study assistant.
Time frame: 30 minutes
Cecal intubation rate
Cecal intubation rate is defined as successful completion of colonoscopy insertion. This will be analyzed on an intention-to-treat basis according to group allocation.
Time frame: 1 hour
Cecal intubation time
The time taken to complete insertion of the colonoscope.
Time frame: 1 hour
Adenoma detection rate
Detection of adenomas during each colonoscopy procedure
Time frame: 1 hour
Polyp detection rate
Detection of any colonic polyp, irrespective of histologic type, during each procedure.
Time frame: 1 hour
Dose of medication
Dose of sedative and analgesic medication needed to complete the colonoscopy.
Time frame: 1 hour
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