Gastroenterologists and colonoscopists may find this clinically interesting. And for gastroenterology marketing, there may be a new message about reducing the unpleasantness of colonoscopy. Please reach for your copy of this month’s GIE: Gastrointestinal Endoscopy.
It’s a considerable marketing challenge to put a positive spin on unsedated colonoscopy procedures—or even the recommendations to patients—but a new study shows improved patient tolerance using a novel water method.
You’ll want to read the study information for yourself, but briefly: “two randomized controlled trials of unsedated colonoscopy comparing water infusion versus air insufflation to distend the colon. Both studies showed that patient tolerance with the water method during unsedated colonoscopy was greater than with air insufflation and enhanced patient willingness to undergo a repeat unsedated exam…”
Unsedated colonoscopy is common worldwide, but in the United States, conscious sedation is dominant and deep sedation is gaining support. Without sedation, the exam can cause discomfort due to the air pumped into the colon. Scheduled unsedated colonoscopy has been requested by seven percent of US patients.
Researchers at Veterans Affairs Healthcare System facilities in California developed a novel water method for scheduled unsedated colonoscopy using water infusion in lieu of air insufflation. They caution that the results should not be generalized without further studies and conclude that "Evaluation of water method-assisted unsedated colonoscopy in diverse settings deserves to be supported."
They do not believe that unsedated colonoscopy may replace sedated procedures; however, the technique might play a role in improving acceptance and tolerability of colonoscopy for patients willing or needing to undergo unsedated procedures.
“The water technique is another option for patients who are at higher risk of, or fear of, anesthesia-related complications, have no escort, want to interact with their physician during the examination, or need to get back to the trading floor that afternoon," they observe.
Ref: American Society for Gastrointestinal Endoscopy News Release; and Gastrointest Endosc. 2010;72:693-700, 701-709, 710-711.