Comparison of patients' experiences during imaging tests of the colon

Background: Physical discomfort, anxiety, embarrassment, and other aspects of patient experience impact on future compliance for colonic imaging tests . Therefore, a prospective study was performed comparing patient experience s during air contrast barium enema (ACBE), flexible sigmoidoscopy, and colo noscopy, Methods: Immediately after each procedure, patients completed a questionnai re assessing pretest anxiety, difficulty with preparation, pain, cramping, bloating, overall discomfort, loss of dignity, willingness to repeat the te st, and overall satisfaction. A follow-up questionnaire was administered wi thin 48 hours. Nurses and physicians also completed questionnaires to asses s the provider impression of patient experience. Results: Four hundred ten patients (80 ACBE, 202 sigmoidoscopy, 128 colonos copy) were prospectively enrolled. Sigmoidoscopy caused more pain than ACBE (Odds ratio [ORI 2.64: 95% CI [1.63, 4.27]) or colonoscopy (OR 1.83: 95% C I [1.21, 2.77]). ACBE and colonoscopy did not differ in the degree of pain. Although overall satisfaction appeared to be similar for all tests, patien ts were less willing to repeat ACBE than sigmoidoscopy (OR 1.85: 95% CI [1. 13, 3.02]) or colonoscopy (OR 1.82: 95% CI [1.07, 3.09]), Initial and follo w-up pain ratings by patients were highly correlated (Spearman correlation 0.81); however, correlation of pain assessments between staff and patients was poor (Spearman correlation 0.48). Conclusions: Sigmoidoscopy was more painful than other colonic imaging moda lities. Although ACBE and colonoscopy caused similar pain, patients were le ss willing to repeat ACBE, In aggregate, the data suggest that patients per ceive colonoscopy as the most acceptable colonic imaging procedure. Better methods are required to allow staff to adequately assess discomfort experie nced by patients during these procedures.