Pain After Small Bowel Meal and Pneumocolon:A Randomized Controlled Trial of Carbon Dioxide Versus Air Insufflation

Gellett, Laura R.; Farrow, Richard; Bloor, Colin M.; Farmer, Kim D.; Maskell, Giles

doi:10.1053/crad.1999.0198

Cited by 9 publications

(10 citation statements)

References 9 publications

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“…Several studies have compared CO2 with air insufflation in colonoscopy in unsedated patients [14][15][16]. Bretthauer et al found that CO2 leads to significantly less pain at 1 h, 3 h, 6 h and 24 h after examination measured on a VAS [7].…”

Section: Discussionmentioning

confidence: 99%

CO2 insufflation during colonoscopy decreases post-interventional pain in deeply sedated patients: a randomized controlled trial

Riss

Akan

Mikola³

et al. 2009

Wien Klin Wochenschr

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Section: Discussionmentioning

confidence: 99%

CO2 insufflation during colonoscopy decreases post-interventional pain in deeply sedated patients: a randomized controlled trial

Riss

Akan

Mikola³

et al. 2009

Wien Klin Wochenschr

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“…The faster colonic reabsorption (30-100 times faster than room air [26] and thus better acceptance than room air [27,28,29,30]) has been sufficiently proven in studies with double-contrast barium enema, but for this application a sufficient colonic distention is contested [27,31] and therefore may outweigh the advantages in patient acceptability. However, since we did not remove the rectal tube during the examination, additional CO 2 could easily be insufflated by compression on the CO 2 bag if the scout image revealed poor colonic distention.…”

Section: Limitationsmentioning

confidence: 99%

Patient acceptance for CT colonography: what is the real issue?

et al. 2002

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The aim of this study was to evaluate the discomfort associated with CT colonography compared with colonoscopy and bowel purgation cleansing, and to evaluate patient preference between CT colonography and colonoscopy. In a total of 124 patients, scheduled for multidetector virtual CT colonography and diagnostic colonoscopy, patient acceptance and future preference were assessed during the different steps of the procedure (colon preparation, CT examination, and conventional colonoscopy). Patients who described contradictory findings between the degree of discomfort and their preference regarding follow-up examinations were retrospectively reinterviewed regarding the reason for this discrepancy. Colonoscopy was graded slightly more uncomfortable than virtual CT colonography, but the preparation was clearly the most uncomfortable part of the procedure. Concerning their preference regarding follow-up examinations, 71% of the patients preferred virtual CT colonography, 24% preferred colonoscopy, and 5% had no preference. Twenty-eight percent of the patients preferred virtual CT colonography despite that they thought it was equally or even more uncomfortable than colonoscopy. This was mainly due to the faster procedure (17 patients), the lower physical challenge (14 patients), and the lack of sedation (12 patients) of virtual CT colonography. Factors other than the discomfort related to the examinations play an important role in the patient's preference for virtual CT colonography, namely the faster procedure, the lower physical challenge, and the lack of sedation. Since the preparation plays a major decisive factor in the patient acceptance of virtual CT colonography, more attention should be given to fecal tagging.

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“…Glucagon (1 mg IV) can be given to promote relaxation of the ileocecal valve and facilitate reflux of air into the ileum [4,5]. The use of carbon dioxide (CO 2 ) has been shown to reduce the severity and duration of abdominal pain and distension compared with room air [12], and could now be administered via continuous automated low pressure delivery as is routinely performed at CTC (Fig. 2) [13,14].…”

Section: Fluoroscopic Techniquementioning

confidence: 99%

The peroral pneumocolon revisited: a valuable fluoroscopic and CT technique for ileocecal evaluation

Pickhardt

2011

Abdom Imaging

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The peroral pneumocolon represents a time-honored but somewhat forgotten and underutilized technique for improved ileocecal evaluation at small bowel fluoroscopy. The peroral pneumocolon entails fluoroscopically guided gaseous insufflation per rectum following the arrival of barium at the cecum at conventional small bowel follow-through examination. In most cases, high-quality double contrast evaluation of the terminal ileum can be achieved, often superior to enteroclysis examination for this critical location. The peroral pneumocolon improves diagnostic confidence, including assessment of disease activity, and may result in a reversal of the diagnostic impression. This simple procedure will be discussed and a spectrum of fluoroscopic findings with CT and endoscopic correlation will be provided to demonstrate the added yield of this technique in the evaluation of known or suspected Crohn's disease. Application of the pneumocolon technique to CT for combined small and large bowel evaluation ("CT coloenterography") will also be discussed, which represents an attractive new option for investigating inflammatory bowel disease and other bowel-related conditions. Through the use of automated low-pressure carbon dioxide delivery per rectum, supplemented by IV glucagon for relaxation of the ileocecal valve, a CT-based pneumocolon examination may prove to be a useful hybrid technique for bowel evaluation in the future.

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Pain After Small Bowel Meal and Pneumocolon:A Randomized Controlled Trial of Carbon Dioxide Versus Air Insufflation

Cited by 9 publications

References 9 publications

CO2 insufflation during colonoscopy decreases post-interventional pain in deeply sedated patients: a randomized controlled trial

CO2 insufflation during colonoscopy decreases post-interventional pain in deeply sedated patients: a randomized controlled trial

Patient acceptance for CT colonography: what is the real issue?

The peroral pneumocolon revisited: a valuable fluoroscopic and CT technique for ileocecal evaluation

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