Pellegrino R, Palladino G, Izzo M, De Costanzo I, Landa F, Federico A, Gravina AG. Water-assisted colonoscopy in inflammatory bowel diseases: From technical implications to diagnostic and therapeutic potentials. World J Gastrointest Endosc 2024; 16(12): 647-660 [DOI: 10.4253/wjge.v16.i12.647]
Corresponding Author of This Article
Raffaele Pellegrino, MD, Hepatogastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L de Crecchio, Naples 80138, Italy. raffaele.pellegrino@unicampania.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Raffaele Pellegrino, Giovanna Palladino, Michele Izzo, Ilaria De Costanzo, Fabio Landa, Alessandro Federico, Antonietta Gerarda Gravina, Hepatogastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples 80138, Italy
Author contributions: Pellegrino R, Palladino G, Izzo M, De Costanzo I, Landa F and Gravina AG collected the literature, and wrote the initial manuscript; Pellegrino R, Federico A and Gravina AG conceptualized the structure of the text, critically revised the manuscript for important intellectual content; Pellegrino R and Gravina AG conceptualized and drew the figures and table; All authors have read and approved the final manuscript.
Conflict-of-interest statement: Gravina AG has conducted training activities (e.g., ECM, preceptorship) for Pfizer, Galapagos Biopharma, and AbbVie. The remaining authors have no conflicts of interest to declare. The other authors have no direct or indirect conflicts of interest concerning this work to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raffaele Pellegrino, MD, Hepatogastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L de Crecchio, Naples 80138, Italy. raffaele.pellegrino@unicampania.it
Received: July 31, 2024 Revised: November 17, 2024 Accepted: November 26, 2024 Published online: December 16, 2024 Processing time: 133 Days and 13.3 Hours
Abstract
Water-assisted colonoscopy (WAC) application in inflammatory bowel diseases (IBD) endoscopy offers significant technical opportunities. Traditional gas-aided insufflation colonoscopy increases patient discomfort, presenting challenges in the frequent and detailed mucosal assessments required for IBD endoscopy. WAC techniques, including water immersion and exchange, provide superior patient comfort and enhanced endoscopic visualisation. WAC effectively reduces procedural pain, enhances bowel cleanliness, and increases adenoma detection rates, which is crucial for colorectal cancer screening and disease-related evaluations in IBD patients. Additionally, underwater techniques facilitate basic and advanced endoscopic resections, such as polypectomy and endoscopic mucosal and submucosal resections, often required for resecting IBD-associated neoplasia.
Core Tip: Water-assisted colonoscopy (WAC) offers significant advantages over traditional gas-aided colonoscopy, particularly for patients with inflammatory bowel diseases (IBD). WAC enhances patient comfort, reduces procedural pain, and improves bowel cleanliness and mucosal visualisation. These improvements increased adenoma detection rates, enhanced diagnostic accuracy, and facilitated resective endoscopy. Given the elevated risk of colorectal cancer in IBD patients and, consequently, the increased frequency of endoscopic examinations in this population, WAC may prove beneficial for routine IBD endoscopies, ultimately improving the quality of care and patient outcomes.
