Total decompression after colonoscopy decreases abdominal pain: A randomized controlled trial

Background Abdominal pain occurring after colonoscopy may cause significant discomfort in some patients and residual bowel gas is a key contributor to abdominal pain. Aim To determine whether total decompression decreased abdominal pain and improve patient tolerance compared with the conventional procedure Methods Asymptomatic 163 patients who underwent total colonoscopy were randomized to total colonic decompression or to the control group. The procedure was performed uniformly in both groups. After completion of the routine colonoscopy, the colonoscope was advanced again to the cecum and the air aspirated during withdrawal in the decompression group. We withdrew the colonoscope immediately in the control group. Abdominal pain was assessed in the recovery room and in 24-48 hours using a 10-point scale. Results The two groups were similar with regard to clinical and demographic factors and to procedure factors. Among 156 patients, the incidence of abdominal pain after colonoscopy was 65/156 (41.7%); 44 (56.4%) of 78 patients in the control group and 21 (26.9%) of 78 patients in the decompression group (P <0.01). But there was no significant reduction in the decompression group compared with the control group regarding the abdominal pain when questioned in 24-48 hours after the procedure. The reduction rate of abdominal pain was 81.3% through multivariate analysis (HR 0.187 [0.081-0.429], P <0.001). Furthermore, young age (<50) and female sex were identified as independent factors for abdominal pain. Conclusion Total colonic decompression after colonoscopy had beneficial effect on reducing of abdominal pain without additional complication.