Methods of Reducing Discomfort During Colonoscopy |
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Authors: | Felix W Leung |
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Institution: | (1) Research and Medical Services, Sepulveda Ambulatory Care Center, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;(2) Division of Gastroenterology (111G), Sepulveda Ambulatory Care Center, 16111 Plummer Street, North Hills, CA 91343, USA |
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Abstract: | In the United States sedation for colonoscopy is usual practice. Unsedated colonoscopy is limited to a small proportion of
unescorted patients and those with a personal preference for no sedation. Over 80% of patients who accept the option of as-needed
sedation can complete colonoscopy without sedation. Colonoscopy in these unsedated patients is performed with techniques similar
to those used in the sedated patients. Uncontrolled observations indicate willingness to repeat colonoscopy amongst these
patients was correlated significantly with low discomfort score during the examination. Methods reported to minimize patient
discomfort or enhance cecal intubation during sedated or unsedated colonoscopy included use of pediatric colonoscope, variable
stiffness colonoscope, gastroscope, and inhalation of nitrous oxide or insufflation of carbon dioxide, hypnosis, music, audio
distraction, or simply allowing the patients to participate in administration of the medication. Research focusing on confirming
the efficacy of a simple inexpensive nonmedication dependent method for minimizing discomfort will likely improve the outcome
of care and more importantly will ensure compliance with future surveillance in patients accepting the unsedated option. |
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Keywords: | Colonoscopy Sedated Unsedated As-needed On-demand |
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