title: A randomized controlled trial of total colonic decompression after colonoscopy to improve patient comfort.
abstract: OBJECTIVE
  Bloating occurring after colonoscopy may cause significant discomfort in some patients. We sought to determine whether total colonic decompression decreased bloating and improved comfort after colonoscopy.
  
  
  METHODS
  Consecutive outpatients undergoing elective colonoscopy were randomized to total colonic decompression or to the control group after completion of the routine colonoscopy. The colonoscope was advanced again to the cecum and the air aspirated during withdrawal in patients randomized to decompression and the procedure was terminated without decompression in control patients. Pain and bloating was assessed in the recovery room and in 24-48 h using a five-point scale.
  
  
  RESULTS
  Sixty-five patients were randomized to decompression and 61 were randomized to the control group. The baseline demographic and procedural characteristics were similar between the two groups, but decompression took significantly longer (median, 17 min vs 14 min, p = 0.0002). Seventy-five percent of the decompression group and 80% of the control group denied any pain during colonoscopy. Significantly fewer patients from the decompression group complained of bloating after the procedure (25% vs 59%, p < 0.001) when questioned in the recovery room. However, comparable patients complained of postprocedure bloating when questioned in 24-48 h after the procedure (45% of decompression group vs 47% of control group, p = 0.86). The nurse and the endoscopist were poor at predicting the patient's bloating and significantly overestimated the level of pain.
  
  
  CONCLUSIONS
  Total colonic decompression does not significantly reduce bloating after colonoscopy when assessed 24-48 h after the procedure.
authors.affiliation: Division of Gastroenterology, University of California at Davis Medical Center, Sacramento, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Lee
authors.forename: H
authors.initials: H
authors.lastname: Vigil
authors.forename: J W
authors.initials: JW
authors.lastname: Leung
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003108:Colonic Diseases / Q000175:diagnosis; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods*; D003664:Decompression / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome