COLONOSCOPY WITHOUT PREMEDICATION VERSUS BARIUM ENEMA - A COMPARISON OF PATIENT DISCOMFORT

Background: Colonoscopy is considered a painful procedure requiring ro utine intravenous sedation. We investigated whether unsedated colonosc opy causes more discomfort than barium enema, Methods: Procedure-relat ed discomfort was determined in 100 consecutive patients undergoing co lonoscopy without premedication and in an equal number of patients ref erred for sigmoidoscopy and barium enema. All patients underwent such examinations for the first time and had no history of previous bowel s urgery. During colonoscopy, sedation was offered if significant pain o r discomfort occurred. Results: In patients without stenosis and with satisfactory preparation, the completion rate of colonoscopy was 95%. Five percent of all patients undergoing endoscopy required sedation. O n an analog scale ranging from 1 to 9, patients undergoing colonoscopy and barium enema reported similar ratings for procedure related disco mfort (3.2 +/- 1.7 and 3.1 +/- 1.0) and for discomfort caused by bowel preparation (3.2 +/- 2.1 and 3.1 +/- 1.8). Eighty-seven percent of al l patients undergoing colonoscopy stated that they would prefer no pre medication in the event of repeated examinations. Conclusions: Colonos copy with sedation on demand does not cause more discomfort than bariu m enema and will be accepted by the vast majority of patients undergoi ng this procedure.