Effectiveness of Intraluminal Air Decompression on Postcolonoscopic Pain According to Reinsertion Site.
BACKGROUND
Colonoscopy is a very effective and essential examination to diagnose colorectal cancer; however, many patients experience discomfort due to post-examination abdominal pain, which reduces colonoscopy compliance. This study was conducted to determine methods for reducing post-colonoscopic abdominal pain.


METHODS
We conducted a randomized controlled study of 405 male and female adults who visited Hana General Hospital in Cheongju. We surveyed general characteristics, history of colonoscopy, and other related factors, then categorized examinees into 5 groups (0-5) according to the site of scope reinsertion. Pain was measured using a numeric rating scale (NRS).


RESULTS
The mean age of examinees in this study was 47.8 years, and 210 participants had prior experience of colonoscopy. No significant difference was observed between variables, with the exception of reinsertion duration (P=0.005). Pain scores were different between performing physicians (P=0.006), and were higher when the subjective level of procedure difficulty was low (P=0.026) in univariate analysis. Pain scores decreased as the reinsertion site became closer to the proximal colon (P<0.001), but there was no significant difference between groups 3 and 4. The results of multiple logistic regression analysis, including univariate analysis, showed that group 1 had 0.48 times, group 2 had 0.38 times, group 3 had 0.09 times, and group 4 had 0.03 times odds ratio (moderate-to-severe pain, NRS ≥4) than control group 0.


CONCLUSIONS
Air decompression by scope reinsertion is an effective way to reduce abdominal pain after colonoscopy. Removing air when the reinserted scope approaches the hepatic flexure seems to be the most effective method to reduce post-colonoscopic pain.
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Young-Jin
YJ
Sur
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Jung-Hyun
JH
Kim
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Seung-Jin
SJ
Jung
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Dong-Won
DW
Lee
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Sang-Hyun
SH
Cho
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Ryang-Pyo
RP
Kim
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Tae-Wan
TW
Kim
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Hyeon-Guk
HG
Shin
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
A-Ram
AR
Hong
Department of Family Medicine, Hana General Hospital, Cheongju, Korea.
Hyun-Woo
HW
Kwon
Colonoscopic; Colonoscopy; Decompression; Pain