What is it about?
Infusion of water in lieu of air insufflation to insert the colonoscope to the cecum. This reduces elongation of the colon, and makes the procedure easier and more comfortable. With the described method (water exchange, WE) dirty or hazy water is suctioned with the instrument and replaced with clean water.
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Why is it important?
WE significantly decreases colonoscopy pain, increases the number of patients that can undergo a completely painless examination or that will feel just "discomfort", decreases the need for sedation, increases the number of polyps or adenomas found, particularly small ones (<10 mm) in the right part of the colon.
Read the Original
This page is a summary of: A two-center randomized controlled trial of water-aided colonoscopy versus air insufflation colonoscopy, Endoscopy, November 2013, Thieme Publishing Group,
DOI: 10.1055/s-0033-1353604.
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A randomized, controlled trial comparing real-time insertion pain during colonoscopy confirmed water exchange to be superior to water immersion in enhancing patient comfort.
Air insufflation (AI), water immersion (WI), and water exchange (WE) were compared head-to-head to test the hypothesis that WE produces the least insertion pain. In a patient-blinded, prospective, randomized, controlled trial about first-time diagnostic or screening colonoscopy in unsedated patients with the option of on-demand sedation, WE was superior to WI in attenuating real-time insertion pain and enhancing completion of unsedated colonoscopy. WE achieved better colon cleanliness.
Water exchange minimizes magnitude and variations in maximum insertion pain among colonoscopists
Air insufflation (AI), water immersion (WI) and exchange (WE) were compared to assess variations in endoscopist performance, gender differences, estimated institutional savings and patient burden reduction. Two 2-center randomized controlled trials stratified performance (AI, WI, WE) of diagnostic or screening colonoscopy by six colonoscopists. WE showed high repeatability and reproducibility by endoscopists, with substantial institutional and patients' costs savings.
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