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World J Gastroenterol. Mar 7, 2014; 20(9): 2193-2199
Published online Mar 7, 2014. doi: 10.3748/wjg.v20.i9.2193
Published online Mar 7, 2014. doi: 10.3748/wjg.v20.i9.2193
Is the type of insufflation a key issue in gastro-intestinal endoscopy?
Amy C Lord, Department of General Surgery, Basingstoke and North Hampshire Hospital, Basingstoke, Hampshire RG24 9NA, United Kingdom
Stefan Riss, Department of General Surgery, Medical University of Vienna, A-1090 Vienna, Austria
Author contributions: Lord AC and Riss S contributed to conception, design, acquisition and interpretation of data; All authors revised the article and approved the final version.
Correspondence to: Stefan Riss, MD, PD, FRCS, Department of General Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. stefan.riss@meduniwien.ac.at
Telephone: +43-1-404005621 Fax: +43-1-404006932
Received: October 16, 2013
Revised: December 18, 2013
Accepted: January 19, 2014
Published online: March 7, 2014
Processing time: 140 Days and 17.3 Hours
Revised: December 18, 2013
Accepted: January 19, 2014
Published online: March 7, 2014
Processing time: 140 Days and 17.3 Hours
Core Tip
Core tip: With the increasing use of gastrointestinal endoscopy, especially for screening in an asymptomatic population, increasing the tolerability of the procedure is of paramount importance. Our review summarizes evidence that carbon dioxide (CO2) insufflation can reduce both pain and bloating in colonoscopy and endoscopic retrograde cholangiopancreatography although the evidence in gastroscopy is still lacking. Despite established safety concerns about hypercapnia, significant harm has never been demonstrated in the literature. Patients thought to be at higher risk of hypercapnia need to be included in more studies to demonstrate that CO2 insufflation is safe in an unselected screening population but early evidence is encouraging.