Colonoscopy easier, less painful with warm water or oil lubrication

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NEW YORK (Reuters Health), Apr 23 - The use of warm water or corn seed oil for lubrication during colonoscopy facilitates successful intubation in less time and with less pain than standard lubricating methods, the results of a study conducted in Italy suggest.

"Surprisingly, methods of lubrication have rarely been considered a matter of study in colonoscopy, although effective friction-lowering techniques and substances could be of help, reducing forces applied to the scope and consequently, pain and difficulties during the examination," the study team notes in the American Journal of Gastroenterology for March.

Dr. Emilio Brocchi and colleagues from the University of Bologna randomly and evenly assigned 510 patients undergoing colonoscopy to one of three groups: a control group receiving the standard lubricating method (water-soluble jelly applied in the anal region and on the shaft of the scope); a group receiving the standard method plus corn seed oil injection into the colon; or a group receiving the standard method plus injection of warm water into the colon (300 cc at 42°: C).

According to the investigators, successful intubation to the cecum was significantly more frequent in the oil and warm water groups (p < 0.01 and p < 0.001, respectively) than in the control group, and less time was needed to complete the procedure (p < 0.001). There were no significant differences between the oil and warm water groups.

Level of pain and degree of difficulty during colonoscopy were also significantly lower in the oil and warm water groups than in the control group, and again no significant difference was found between the oil and warm water groups.

Moreover, the rate at which intravenous drugs were used to complete colonoscopy was lower in the warm water and oil groups (4.3% and 6.6%, respectively) than in the control group (15.8%).

Warm water or oil-assisted colonoscopy examinations "may be easier for the endoscopist and less painful for the patient" and improve the rate of complete colonoscopy, the authors conclude. "We currently utilize one of these methods during routine colonoscopy," they add.

Am J Gastroenterol 2008;103:581-587.

Last Updated: 2008-04-22 17:55:18 -0400 (Reuters Health)

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