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

Tso-Tsai Liu, Chih-Hsun Yi, Wei-Yi Lei, Hao-Chun Yu, Jui-Sheng Hung, Chien-Lin Chen, Tso-Tsai Liu, Chih-Hsun Yi, Wei-Yi Lei, Hao-Chun Yu, Jui-Sheng Hung, Chien-Lin Chen

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.

Conflict of interest statement

Competing interests: None

Figures

Fig. 1
Fig. 1
CONSORT diagram shows flow chart for patient enrollment. The number of patients at each stage of the procedure is provided.
Fig. 2
Fig. 2
Abdominal pain decreased significantly at 1 minute (*P < 0.05, 1 min vs 0 min) and 3 minutes (**P < 0.05, 3 min vs 0 min) in patients with a rectal tube placement and b rectal suction.
Fig. 3
Fig. 3
Bloating decreased significantly at 1 minute (*P < 0.05, 1 min vs 0 min) and 3 minutes (**P < 0.05, 3 min vs 0 min) in patients with a rectal tube placement and b rectal suction.

References

    1. Brandt L J, Boley S J, Sammartano R. Carbon dioxide and room air insufflation of the colon. Effects on colonic blood flow and intraluminal pressure in the dog. . Gastrointest Endosc. 1986;32:324–329.
    1. Zubarik R S, Eisen G, Fleischer D E. Response. Gastrointest Endosc. 2000;52:704.
    1. Newcomer M K, Shaw M J, Williams D M. et al.Unplanned work absence following outpatient colonoscopy. J Clin Gastroenterol. 1999;29:76–78.
    1. Hilzenrat N, Fich A, Odes H S. et al.Does insertion of a rectal tube after colonoscopy reduce patient discomfort and improve satisfaction? Gastrointest Endosc. 2003;57:54–57.
    1. Lee J G, Vigil H, Leung J W. A randomized controlled trial of total colonic decompression after colonoscopy to improve patient comfort. Am J Gastroenterol. 2001;96:95–100.
    1. Harewood G C, Wright C A, Baron T H. Assessment of patients’ perceptions of bowel preparation quality at colonoscopy. Am J Gastroenterol. 2004;99:839–843.
    1. Stevenson G W, Wilson J A, Wilkinson J. et al.Pain following colonoscopy: elimination with carbon dioxide. Gastrointest Endosc. 1992;38:564–567.
    1. Steinberg E N, Howden C W. Randomized controlled trial of rectal tube placement for the management of abdominal distension following colonoscopy. Gastrointest Endosc. 1997;46:444–446.
    1. Hsieh Y H, Tseng K C, Lin H J. Limited low-air insufflation is optimal for colonoscopy. Dig Dis Sci. 2010;55:2035–2042.
    1. Rabenstein T, Radaelli F, Zolk O. Warm water infusion colonoscopy: a review and meta-analysis. Endoscopy. 2012;44:940–951.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe