Original Articles
Copyright ©The Author(s) 2000. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 15, 2000; 6(5): 659-663
Published online Oct 15, 2000. doi: 10.3748/wjg.v6.i5.659
Does flexible small-diameter colonoscope reduce insertion pain during colonoscopy?
Ying Han, Yoshiharu Uno, Akihiro Munakata
Ying Han, Department of Gastroenterology, Beijing Army General Hospital of Chinese PLA, Beijing 100700, China
Yoshiharu Uno, Akihiro Munakata, First Department of Medicine, School of Medicine, Hirosaki University, 036-8216, Japan
Ying Han, graduated from Postgraduate Medical Institute of Chinese PLA in 1985, professor of internal medicine, major in gastroenterology, having 90 papers published.
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Ying Han, Department of Gastroenterology, Beijing Army General Hospital, Beijing 100700, China. ying.han@mailcity.com
Telephone: 0086-10-66721168 Fax: 0086-10-84043459
Received: May 6, 2000
Revised: May 25, 2000
Accepted: June 2, 2000
Published online: October 15, 2000
Abstract

AIM: It is well known that colonoscopy can be difficult due to abdominal pain induced during colonoscope insertion, if sedative agents are not given. Recently, an extra-flexible, small-diameter colonoscope (CF-SV, Olympus Inc., Japan) was developed in order to improve safety and comfort. The aim of this study was to access the usefulness of the CF-SV.

METHODS: One hundred patients undergoing sigmoidoscopy were recruited and colonoscopy was performed by one experienced colonoscopist. First, a routine-type colonoscope (CF-230I) was inserted into the colon without sedation. When the patient complained of abdominal pain (even if mild), the scope was not advanced further and was withdrawn after the anatomic location of its tip was determined fluoroscopically. Then, the CF-SV was inserted until it reached the cecun or the site where abdominal pain occurred. Previous abdominal surgery and a bdominal disease were considered as unfavorable factors (UF) and the relationship between abdominal pain and UF, age and gender were investigated. Furthermore, the colonic insertion pressures in 36 patients with abdominal pain were measured with a force gauge.

RESULTS: Thirty-four cases (34%) felt no pain with the CF-230I and successful pancolon-oscopies to the cecum were performed. Sixty-six cases (66%) complained of abdominal pain. The procedure was painless for 47% of men and 24% of women, respectively. The CF-230I scope failed to reach the sigmoid-descending colon junctions in 59 (89.4%) of the 66 patients complaining of abdominal pain. However, CF-SV reached proximal area in 94.9% of those who failed with CF-230I. The median pressure for pain-inducing was 700 g/cm2.

CONCLUSION: Unsedated patients with UF were prone to complain of pain when the standard-type CF-230I scope was used. The newly developed extra-flexible CF-SV is useful for the aged and for those with UF or being prone to suffer from abdominal pain. Sedative agents may be unnecessary if this new type of colonoscope is used.

Keywords: colonoscopy; abdominal pain; flexible colonoscope; insertion pressure; unfavorable factors; sigmoidoscopy