title: Diagnostic and therapeutic applications of water-immersion colonoscopy.
abstract: Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasingly popular. They were originally designed to reduce colonic spasms, facilitate cecal intubation, and lower patient discomfort and the need for sedation. These maneuvers straighten the rectosigmoid colon and enable the colonoscope to be inserted deeply without causing looping of the colon. Water-immersion colonoscopy minimizes colonic distension and improves visibility by introducing a small amount of water. In addition, since pain during colonoscopy indicates risk of bowel perforation and sedation masks this important warning, this method has the potential to be the favored insertion technique because it promotes patient safety without sedation. Recently, this water-immersion method has not only been used for colonoscope insertion, but has also been applied to therapy for sigmoid volvulus, removal of lesions, lower gastrointestinal bleeding, and therapeutic diagnosis of abnormal bowel morphology and irritable bowel syndrome. Although a larger sample size and prospective head-to-head-designed studies will be needed, this review focuses on the usefulness of water-immersion colonoscopy for diagnostic and therapeutic applications.
authors.affiliation: Shinya Sugimoto, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Sugimoto
authors.affiliation: Shinya Sugimoto, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mizukami
mesh_terms: D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003106:Colon / Q000473:pathology* / Q000601:surgery*; D003108:Colonic Diseases / Q000473:pathology* / Q000601:surgery*; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000601:surgery; D006801:Humans; D007101:Immersion; D045822:Intestinal Volvulus / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome; D014867:Water
chemical_list: D014867:Water
keywords: Colonoscopy; Detorsion; Gastrointestinal bleeding; Irritable bowel syndrome; Polypectomy; Sigmoid volvulus; Underwater; Unsedated; Water exchange; Water immersion