Methods We examined the factors that might potentially influence patient satisfaction with their colonoscopic procedure using a pre test questionnaire [self reported apprehension, the reason for any concerns, expectations of pain (represented as a visual analogue scale of 0e10, 0¼no pain and 10¼maximum pain) and previous experience of colonoscopy]. Data collected during the test itself (patient self reported pain scores collected immediately post procedure and sedation doses used) were compared with a post test questionnaire of overall satisfaction and willingness to undergo the test again in the future if required. Results 448 patients participated (287 females and 201 males). Age range 18e88 years and mean age was 58 years. The mean anticipation of pain on the visual analogue scale was 2.61. The most common causes of anxiety were "fear of cancer?" (n¼70) followed by "pain" (n¼35), "tear/perforation" (n¼14) and "previous adverse endoscopic experiences" (n¼9). The mean actual patient reported pain scores were 3.14. 63 patients (43 females and 19 males) was very worried before test and their average anticipated pain score (AtPS) was 4.19 (total average 2.61) and the actual pain score (AcPS) 3.48 (average 3.14). 225 patients were worried before test and their AtPS 2.95 and AcPS 3.37. The patients who were not worried, their AtPS were 1.74 and AcPS 2.8. Patients (n¼32) whose expected pre test pain scores were between 7 and 10 on visual analogue scale expressed higher levels of satisfaction with their procedures than those with lower anticipated pain scores (0e6) [93.7% vs 73.8%]. Patients who had a pre test apprehension score >7 were more agreeable to undergo the test again than those with score <6. Conclusion Patient satisfaction is strongly correlated with patient comfort. Patients' appreciating that colonoscopy is a potentially painful procedure report a higher level of satisfaction and acceptance of the sedation offered. The importance appropriate preparation of the patient should not be underestimated.
Introduction CC is classically associated with normal or unremarkable colonoscopy. In the last few years, reports have been published revealing findings that are thought to be characteristic or even pathognomonic of CC, such as alteration of the vascular mucosal pattern, mucosal nodularity and a sequence of mucosal changes from defects/lacerations to cicatricial lesions. The aim of this study was to evaluate the frequency and type of endoscopic findings in patients diagnosed with CC in our centre. Methods Setting: Tertiary hospital, outpatients. Design: Retrospective study. The database of Pathology Department was searched for patients who have been diagnosed with CC between May 2008 and August 2011. Endoscopy reports and endoscopic images were retrieved and reviewed. Results 155 patients were diagnosed with CC in the study period. The indications for colonoscopy were altered bowel habit (acute or chronic diarrhoea) in 126/133; 33 patients reported associated weight loss. The reports from 123 patients (96F/27M; median age 68.7 yrs, range 37e91 yrs) were eventually retrieved and further reviewed. The colonoscopies had been carried out by consultant (medical/surgeons): 47%, nurse endoscopist: 20%, associate specialist: 13% and fellow or registrar: 10%. Of the above cohort, 67 (54.4%) patients had no endoscopic findings and 44 (35.7%) had irrelevant to CC findings such as diverticulosis, polyps or telangiectasias. Twelve (n¼12; 9.75%) had findings previously described as consistent with CC. In particular: 7 (5.7%) had mucosal erythema or oedema (patchy, mild granularity or congestion), 4 (3.25%) had lacerations (cat-scratch mucosa or bigger mucosal breaks) and 1 of them had a few mucosal scars. The sigmoid and the descending colon were the main colonic parts affected (in 7/12 cases) and the rest were found in the caecum-ascending colon area (4/12) while there was only one patient in which the entire large bowel was affected. Conclusion A significant minority of patients with CC (almost 10%) presented endoscopic findings indicative of CC. Furthermore, 4% had findings that are considered pathognomonic for CC. Although still the subject of isolated cases reports, the endoscopic appearances of CC are becoming more familiar among the endoscopic community.
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