title: Procedure-related abdominal discomfort in patients undergoing colorectal cancer screening: a comparison of colonoscopy and flexible sigmoidoscopy.
abstract: OBJECTIVE
  The aims of this study were to determine if there was a difference in procedure-related abdominal discomfort or willingness to return for subsequent screening examinations between patients undergoing colonoscopy and those undergoing flexible sigmoidoscopy.
  
  
  METHODS
  Two groups were compared: patients referred for screening flexible sigmoidoscopy and patients referred for screening colonoscopy. All patients were asymptomatic for colorectal cancer. Four university-based gastroenterologists performed all procedures. Patients received conscious sedation for colonoscopy but not for flexible sigmoidoscopy. A research nurse blinded to the procedure performed and the study purpose administered a standardized telephone questionnaire assessing and quantifying peri-procedural discomfort.
  
  
  RESULTS
  A cohort of 466 patients underwent screening examinations, and 87% were contacted subsequent to their examination. Procedure-related discomfort, postprocedural discomfort, or discomfort at either of these two times ("peri-procedural discomfort") occurred in 28% (68/243), 14% (34/243), and 36% (88/243) of patients undergoing colonoscopy, respectively. Procedure-related discomfort, postprocedural discomfort, or discomfort at either of these two times occurred in 58% (94/162), 16% (26/162), and 62% (100/162) of patients undergoing flexible sigmoidoscopy, respectively. Peri-procedural discomfort was significantly more common in patients undergoing flexible sigmoidoscopy than with colonoscopy (p < 0.0005). Patients undergoing screening colonoscopy were more willing to undergo the procedure again than those undergoing screening flexible sigmoidoscopy (p < 0.0005).
  
  
  CONCLUSIONS
  Patients undergoing screening colonoscopy with conscious sedation are less likely to experience peri-procedural discomfort than those undergoing screening flexible sigmoidoscopy. Although most patients are willing to undergo subsequent screening examinations, patients undergoing screening colonoscopy are significantly more willing to undergo a subsequent examination than those undergoing screening flexible sigmoidoscopy.
authors.affiliation: Department of Gastroenterology, University of Vermont, Fletcher Allen Health Care, Burlington, Vermont 05401, USA.
authors.forename: R
authors.initials: R
authors.lastname: Zubarik
authors.forename: E
authors.initials: E
authors.lastname: Ganguly
authors.forename: D
authors.initials: D
authors.lastname: Benway
authors.forename: N
authors.initials: N
authors.lastname: Ferrentino
authors.forename: P
authors.initials: P
authors.lastname: Moses
authors.forename: J
authors.initials: J
authors.lastname: Vecchio
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D002983:Clinical Competence; D015331:Cohort Studies; D003113:Colonoscopy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012812:Sigmoidoscopy / Q000009:adverse effects*