title: Is carbon dioxide as an insufflation agent for double contrast barium enema still worthwhile after a same-day flexible sigmoidoscopy?
abstract: OBJECTIVE
  The aim of the study was to evaluate the efficacy of a double-contrast barium enema (DCBE) with CO(2) as a distending gas after a screening flexible sigmoidoscopy for reducing abdominal distension after an examination.
  
  
  METHODS
  A total of 165 DCBEs for patients with positive faecal occult blood tests were randomly allocated to a CO(2) group (n = 83) and a control group (n = 82) using air. Abdominal radiograph were taken before the DCBE, immediately following it, and 30 minutes later to determine residual bowel gas. The degree of abdominal discomfort was recorded using a scoring system.
  
  
  RESULTS
  The patients in the CO(2) group had significantly smaller amounts of residual gas 30 minutes after the DCBE than did the control group, both in the colon (P < 0.02) and in the small intestine (P < 0.001). There was significantly less abdominal distension after the DCBE in the CO(2) group compared to the control group (P < 0.001). The abdominal discomfort score at 30 minutes after CO(2) correlated with the residual gas in the small intestine (r = 0.390,P = 0.003) but not in the colon (r = 0.155, P = 0.15). The quality of the images and the number of polyps detected did not differ between two groups.
  
  
  CONCLUSIONS
  We concluded that using CO(2) when administering a DCBE after a screening sigmoidoscopy was useful for relieving abdominal discomfort following the examination; furthermore, it did not impair the diagnostic ability of the DCBE.
authors.affiliation: Department of Surgery I, Gunma University Faculty of Medicine, Maebashi, Japan. asaot@med.gunma-u.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asao
authors.forename: Kin-ichi
authors.initials: K
authors.lastname: Fujita
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Nakamura
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Morinaga
authors.forename: Hisanori
authors.initials: H
authors.lastname: Shoji
authors.forename: Munenori
authors.initials: M
authors.lastname: Ide
authors.forename: Isao
authors.initials: I
authors.lastname: Hirayama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000388:Air; D001466:Barium Sulfate; D002245:Carbon Dioxide / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011029:Pneumoradiography / Q000009:adverse effects / Q000379:methods*; D012812:Sigmoidoscopy
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide; D001466:Barium Sulfate