title: Does insertion of a rectal tube after colonoscopy reduce patient discomfort and improve satisfaction?
abstract: BACKGROUND
  Distention of the colon is a major contributor to patient discomfort after colonoscopy. Some physicians and nurses believe insertion of a rectal tube relieves this discomfort and improves patient satisfaction with the procedure. This prospective, randomized, controlled trial assessed rectal tube insertion for reduction or prevention of abdominal bloating and discomfort after colonoscopy.
  
  
  METHODS
  One hundred fifty-seven patients were prospectively randomized to groups with (n = 68) and without (n = 89) rectal tube insertion after colonoscopy. Patients were evaluated for bloating, discomfort, and pain before the procedure, at its conclusion, at discharge, and 24 hours later (by telephone). Satisfaction was also assessed at discharge and 24 hours later.
  
  
  RESULTS
  There were no differences between groups with respect to age, gender, hospitalization status, comorbidity, or socioeconomic status. In both groups the cecum was reached in 90% of patients and procedure time was similar. There were no differences between the groups in abdominal bloating (patient and nurse assessment), abdominal discomfort, or satisfaction at any time point. There were no serious complications. The subgroup of patients who experienced more severe pain and discomfort, regardless of whether a rectal tube was inserted, was characterized by more complaints of bloating, more incomplete procedures, and a higher rate of previous abdominal operations.
  
  
  CONCLUSIONS
  Insertion of a rectal tube after colonoscopy does not affect abdominal bloating, pain, or discomfort during recovery from the procedure or over the subsequent 24 hours, nor does it affect overall patient satisfaction.
authors.affiliation: Department of Gastroenterology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Hilzenrat
authors.forename: Alex
authors.initials: A
authors.lastname: Fich
authors.forename: H Selwyn
authors.initials: HS
authors.lastname: Odes
authors.forename: Pavel
authors.initials: P
authors.lastname: Krugliak
authors.forename: Leslie
authors.initials: L
authors.lastname: Eidelman
authors.forename: Nava
authors.initials: N
authors.lastname: Gaspar
authors.forename: Genadi
authors.initials: G
authors.lastname: Weisberg
authors.forename: Alex
authors.initials: A
authors.lastname: Rosenthal
authors.forename: Jorge Louis
authors.initials: JL
authors.lastname: Delgado
authors.forename: Ricki
authors.initials: R
authors.lastname: Ginat
authors.forename: Ami D
authors.initials: AD
authors.lastname: Sperber
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000517:prevention & control*; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007327:Insufflation / Q000009:adverse effects; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome