Comparison of rectal suction versus rectal tube insertion for reducing abdominal symptoms immediately after unsedated colonoscopy

Abstract

Background and study aims: Abdominal discomfort and bloating are common symptoms after colonoscopy. We aimed to compare the effects of direct rectal suction with insertion of a rectal tube on reducing abdominal symptoms after unsedated colonoscopy. Patients and methods: Consecutive patients undergoing colonoscopy were randomized to have direct rectal suction or placement of a rectal tube immediately after colonoscopy. Post-procedure abdominal pain and bloating were measured with a 0 – 100 visual analogue scale. All participants ranked their satisfaction with either direct rectal suction or insertion of a rectal tube. Results: Abdominal pain and bloating were significantly reduced by direct rectal suction and placement of a rectal tube at 1 minute (both P < 0.05) and 3 minutes (both P < 0.05) after the colonoscopy. Direct rectal suction significantly reduced abdominal pain at 1 minute (P = 0.001) and 3 minutes (P = 0.005) after colonoscopy compared with rectal tube insertion. Bloating was significantly lower in patients with direct rectal suction compared to those with rectal tube insertion at 1 minute (P = 0.03) after colonoscopy. Greater satisfaction was found in patients with direct rectal suction compared to those with rectal tube insertion (P = 0.009). Conclusion: Direct rectal suction is more effective than rectal tube placement in reducing abdominal symptoms immediately after colonoscopy. Our study suggests that direct rectal suction is useful in providing relief of symptoms when patients are having difficulty expelling air or are experiencing abdominal symptoms following colonoscopy.

Randomized Controlled Trial of Polyethylene Glycol versus Oral Sodium Phosphate for Bowel Preparation in Unsedated Colonoscopy

“…Adequate bowel preparation is the premise of successful colonoscopy, and inadequate bowel preparation has a detrimental effect on the procedure [ 1 – 3 ]. Although colonoscopy with sedation has been widely applied, some patients still choose unsedated colonoscopy [ 4 , 5 ]. Because of the characteristics of unsedated colonoscopy, clinicians and medical staff need to be mindful of laxative tolerability and pain during colonoscopy [ 6 ] as well as the outcomes of the procedure.…”

The effect of post colonoscopy abdominal massage on abdominal pain, distension, discomfort and patient satisfaction: a randomized controlled study protocol

“…10,11 In another study, rectal aspiration applied right after colonoscopy was found to be more effective in decreasing abdominal symptoms compared to the application of rectal tubes after colonoscopy. 5 In another study where total colonic decompression through repeating cecal intubation after colonoscopy was applied, the method was found to decrease the distension complaints of patients in the early post colonoscopy period from 59% to 25%. However, in this study, no significant difference between the groups that did and did not receive decompression with regard to abdominal pain and distension could be found 24 to 48 hours after the procedure.…”

“…Abdominal pain, bloating, and discomfort are the most frequently problems experienced by patients undergoing colonoscopy. [1][2][3][4][5][6] These problems are thought to be caused by several factors such as the duration of the process, the technical difficulty level of the process, distension caused by air insufflation, and the expertise level of the endoscopist. 4,7 These problems are experienced by approximately a third of patients undergoing colonoscopy, and may last from a few hours to a few days.…”

“…8 Additionally, the satisfaction of the patients with the colonoscopy process may affect their willingness to undergo repeated colonoscopies in the future which may be required for the surveillance of colon malignity. 5 For these reasons, decreasing post colonoscopy abdominal pain, distension, and discomfort and increasing patient satisfaction may increase the acceptance of future colonoscopy screening for colorectal cancers. 9 Studies focused on decreasing abdominal symptoms after colonoscopy and increasing patient comfort and satisfaction have yielded varying results.…”

Influence of Rectal Decompression on Abdominal Symptoms and Anorectal Physiology following Colonoscopy in Healthy Adults

“…It has been demonstrated that anorectal sensory function is regulated by brain-gut interactions with a link to sensorimotor response of rectoanus during rectal distension [ 5 ]. It is yet unclear whether feeling of abdominal discomfort during rectal distension is physiologically influenced by direct rectal decompression, although we had shown that direct rectal suction helps relieve abdominal symptoms immediately after colonoscopy [ 6 ]. This study was designed to evaluate the effect of rectal decompression on abdominal symptoms following rectal air distension.…”