Water-Assisted Colonoscopy Method in the Application of Forced Colonoscopy

Aim: A water-assisted colonoscopy, a safe and cheap method, offers the endoscopist a unique method for addressing challenges in navigating the colonoscope through difficult colons. One benefit of the water technique is the reduction of the requirement for medications used for sedation. Although there is still much contention among endoscopists regarding the true benefit of the water-assisted methods, a few clinical study was reported on that issue. In this study, we aimed to compare the colonoscopy with conventional air insufflation and the colonoscopes with water inserted instead of air insufflation in terms of the cecum intubation success and speed, the pain score and the post-procedural analgesic requirements in the arduous cases. Material and Method: A total of 40 patients with suspected colonoscopy and/or previous history of abdominal-pelvic surgery were included in the study. No sedation was applied before or during the procedure. The patients were randomly divided into two groups as water and air groups. Cecum intubation duration and success, rejection rate when the patient was required to undergo colonoscopy again, abdominal pain score, and postoperative analgesic requirement were all assessed. Results: There was no statistical difference between the two groups in terms of age and body mass index. The abdominal pain score was statistically lower in the water group (p<0.05). One patient (5%) in the water group and 7 (35%) in the air group needed a narcotic agent. The difference between the two groups was statistically significant (p: 0.004). The rate of rejection of colonoscopy without sedation was found in 2 patients (10%) of the water group and in 10 patients (50%) of the air group, and this difference had significance (p: 0.001). There was no difference between the two groups in terms of duration of tracheal intubation and success. Conclusion: The choice of colonoscopy with water instead of colonoscopy with conventional air insufflation seems to be advantageous in terms of abdominal pain reduction without reducing the rate and frequency of intubation