title: Flicking method: a novel colonoscope insertion method for surveillance colonoscopy in ulcerative colitis patients.
abstract: OBJECTIVE
  Periodic surveillance colonoscopy is required for patients with ulcerative colitis to detect colitis-associated dysplasia at an early stage. However, sometimes colonoscopy may damage the fragile mucosa of patients with ulcerative colitis. The aim of this study was to devise a new method of surveillance colonoscopy for patients with mild to moderate ulcerative colitis.
  
  
  METHODS
  The 'flicking method' of colonoscope insertion was recently developed by our team. It is a completely novel method that involves using the elastic force of the colonoscope to introduce it into the deeper regions while using colon mucosa patterns as a guide. The subjects were 66 hospital outpatients with ulcerative colitis who underwent colonoscopies during a 2-year period, from April 2006 to March 2008, with both the conventional insertion method and the flicking method.
  
  
  RESULTS
  Cecal intubation rate, insertion time, patient pain level, change in number of defecations pre- and post-colonoscopy, and change in severity pre- and post-colonoscopy were compared between the conventional and flicking methods. The flicking method was superior in all respects.
  
  
  CONCLUSIONS
  The flicking method is a novel colonoscope insertion method that is regarded as particularly useful in cases when the intestinal mucosa is fragile, as is the case with ulcerative colitis patients.
authors.affiliation: Division of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Japan. toru310318@gmail.com
authors.forename: Toru
authors.initials: T
authors.lastname: Sato
authors.forename: Tetsumaru
authors.initials: T
authors.lastname: Miyawaki
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Katsuno
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Masahito
authors.initials: M
authors.lastname: Inoue
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Etsuo
authors.initials: E
authors.lastname: Hishikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Arai
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000453:epidemiology; D003106:Colon / Q000503:physiopathology*; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D003672:Defecation / Q000502:physiology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D007413:Intestinal Mucosa / Q000473:pathology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult