title: Impact of a novel water method on scheduled unsedated colonoscopy in U.S. veterans.
abstract: BACKGROUND
  Intermittent warm-water infusion in lieu of air insufflation permitted 52% of patients who accepted sedation on demand to complete colonoscopy without sedation.
  
  
  OBJECTIVE
  To test the hypothesis that the water method enhances cecal intubation and increases the proportion of patients who report willingness to repeat a scheduled unsedated colonoscopy.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Two consecutive groups of veterans.
  
  
  METHODS
  From June 2005 to May 2006, the usual air insufflation method was used to aid colonoscope insertion. From June 2006 to October 2007, the water method was used.
  
  
  METHODS
  Cecal intubation; report of willingness to repeat unsedated colonoscopy.
  
  
  RESULTS
  Sixty-two and 63 veterans were examined by the air method and the water method, respectively. Intention-to-treat analysis revealed that the cecal intubation rate with the water method (97% [61/63]) was significantly higher than that with the air method (76% [47/62]). The proportion of patients who reported willingness to repeat unsedated colonoscopy was significantly higher with the water method (90% [57/63]) compared with the air method (69% [43/62]).
  
  
  CONCLUSIONS
  Single site, nonrandomized, unblinded, small number of elderly male veterans.
  
  
  CONCLUSIONS
  The effects of the water method in the group for scheduled unsedated colonoscopy were sufficiently provocative to warrant calling for their confirmation by a randomized controlled trial.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Research and Medical Services, Sepulveda Ambulatory Care Center, VAGLAHS, North Hills, California, USA. felix.leung@med.va.gov
authors.forename: Felix W
authors.initials: FW
authors.lastname: Leung
authors.forename: H Steven
authors.initials: HS
authors.lastname: Aharonian
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Leung
authors.forename: Paul H
authors.initials: PH
authors.lastname: Guth
authors.forename: Guy
authors.initials: G
authors.lastname: Jackson
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States; D014728:Veterans; D014867:Water / Q000008:administration & dosage*
chemical_list: D014867:Water