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- W1574673175 abstract "Sirs, We read with interest the letter of Brocchi et al.1 Regardless of the presumed mechanism of action, any method that permits a reduction in patient discomfort or enhancement of caecal intubation is worthwhile. In an earlier publication,2 the authors reported the instillation of 30 mL of oil into the sigmoid colon, at the splenic and hepatic flexure or 300 mL of water in the sigmoid colon. They did not specify if air insufflation was precluded during insertion of the colonoscope.1, 2 In our report,3 we described the infusion of a mean of 800 mL of warm water during insertion of the colonoscope. The unique feature of our technique is that water infusion in lieu of air insufflation is used to facilitate scope insertion until the caecum is reached. Air is only used on scope withdrawal to distend the lumen for examination. Water is removed with suction before therapeutic procedures. Water infusion produces local distension to allow identification of the colonic lumen to facilitate scope passage4 without causing lengthening of the colon. With patients in the usual left lateral starting position, water in the more dependent left colon straightens and stabilizes the sigmoid colon5 to facilitate scope passage. Warm water reduces colonic spasm.6 While a poor bowel preparation makes the examination more difficult, the cleansing effect of water facilitates subsequent examination of the colonic mucosa.3 With patients in the left lateral position, insufflated air rises to the less dependent proximal colon producing elongation and increases the difficulty in reaching the caecum.3 As air is used only on scope withdrawal, there is less overall distension of the colon and probably less air escaping into the small bowel to cause symptoms.3 Declaration of personal interests: None declared. Declaration of funding interests: Supported in part by VA Medical Research Funds." @default.
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- W1574673175 date "2007-11-06" @default.
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- W1574673175 title "Sedation during colonoscopy and the benefits of lubrication: authors' reply" @default.
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- W1574673175 doi "https://doi.org/10.1111/j.1365-2036.2007.03571.x" @default.
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