Comparison of Water Immersion Versus Air Insufflation Colonoscopy Under Various Bowel Preparation Conditions

Sijia Niu; Youlin Yang; Guoyin Shang; Yingying Chen; Zhibin Ma; Feng Wu; Huichao Zhang

doi:10.5152/tjg.2021.20162

Comparison of Water Immersion Versus Air Insufflation Colonoscopy Under Various Bowel Preparation Conditions

Turk J Gastroenterol. 2021 Feb;32(2):209-217. doi: 10.5152/tjg.2021.20162.

Authors

Sijia Niu¹, Youlin Yang¹, Guoyin Shang¹, Yingying Chen¹, Zhibin Ma¹, Feng Wu¹, Huichao Zhang¹

Affiliation

¹ Department of Gastroenterology, The First Affiliated Hospital of Harbin Medical University, Nangang District, Harbin, China.

Abstract

Background: To investigate the differences between water immersion (WI) and air insufflation (AI) for colonoscopy under various bowel preparation conditions.

Methods: In this study, 526 outpatients were randomly assigned to two groups, namely a WI group (n = 263) and an AI group (n = 263). During the procedure, the quality of bowel preparation, abdominal pain score, cecal intubation rate (CIR), adenoma detection rate (ADR), the intubation times, and other indicators were recorded. After reaching the cecum, each group of patients was subdivided into one of four grades (excellent, good, fair, and poor) according to the quality of bowel preparation.

Results: Under various bowel preparation conditions, the pain scores of the AI group were higher than those of the WI group (P < .05), but there was no significant difference between the two groups in CIR (P > .05). For the WI group compared with the AI group, the cecal intubation time (CIT) was prolonged under good bowel preparation (P = .045) and fair bowel preparation (P < .001). No significant differences were observed between the two groups on ADR in all patients (P = .476).

Conclusion: Compared with AI colonoscopy, WI colonoscopy can decrease colonoscopy-related pain in patients for unsedated colonoscopy under various bowel preparation conditions, but there is no significant difference in CIR. WI colonoscopy requires longer CIT in patients with good and fair bowel preparation conditions. WI colonoscopy does not significantly increase ADR.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Abdominal Pain / etiology
Adenoma* / diagnosis
Cecum
Colonoscopy
Humans
Immersion
Insufflation*
Water

Substances

Water

Grants and funding

Financial supports from by the Natural Science Foundation of Heilongjiang Province (No. H216039), the Higher Education Research Project of Higher Education Committee for the 13th Five-Year Plan of Heilongjiang Province (No. 16Q057), and the Applied Technology Research and Development Project of Harbin (No. 2016RAQXJ158) are greatly appreciated.