Procedure-related abdominal discomfort in patients undergoing colorectal cancer screening: a comparison of colonoscopy and flexible sigmoidoscopy.
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.
Zubarik
R
R
Department of Gastroenterology, University of Vermont, Fletcher Allen Health Care, Burlington, Vermont 05401, USA.
Ganguly
E
E
Benway
D
D
Ferrentino
N
N
Moses
P
P
Vecchio
J
J
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*