Water-assisted colonoscopy in inflammatory bowel diseases: From technical implications to diagnostic and therapeutic potentials

Figure 1 The main differences between water-immersion and water-exchange colonoscopy techniques are as follows: Both techniques, derivatives of water-assisted colonoscopy, utilize water to facilitate the completion of the examination, with distinct differences between them. Compared to standard techniques, water-immersion (WIC) and water-exchange (WEC) offer numerous advantages regarding inflammatory bowel disease (IBD). They facilitate reaching the caecal base with a higher likelihood of achieving terminal ileum intubation. They assist in colorectal cancer screening colonoscopy, which these patients are more susceptible to, by increasing adenoma detection rates both during instrument withdrawal (WIC) and throughout the procedure, including insertion (WEC). Moreover, procedural comfort for patients with IBD, who already suffer from gastrointestinal disorders, is improved to varying degrees with both techniques. In the figure, what pertains (for each parameter indicated in the grey-background boxes) to the WIC is in the blue boxes, while what pertains to the WEC is in the red boxes. WEC: water-exchange colonoscopy; ADR: adenoma detection rate.