• Aki Imai, Mototsugu Kato, Shouko Ono, Yuichi Shimizu, Hiroshi Takeda, and Masahiro Asaka.
• Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
• J. Gastroenterol. Hepatol. 2012 Oct 1;27(10):1623-8.

Background And AimColonoscopy has the disadvantage of pain and discomfort for patients. It has been shown in randomized controlled trials that carbon dioxide (CO(2) ) insufflations significantly reduce pain and discomfort in patients undergoing colonoscopy. However, there have been no studies in which CO(2) insufflation in colonoscopy of patients with irritable bowel syndrome (IBS) was investigated.MethodsRandomized double-blind controlled study was conducted to assess the suffering from colonoscopy in patients with IBS and the efficacy of CO(2) insufflation in colonoscopy for patients with IBS. Patients with IBS and controls who received colonoscopy were randomized into an air or CO(2) insufflation group. Patients' symptoms such as distension and pain were compared using a 10-cm visual analog scale (VAS).ResultsThere were 18 patients in the IBS/air group, 19 patients in the IBS/CO(2) group, 25 patients in the control/air group and 26 patients in the control/CO(2) group. The mean value of severity of distension after colonoscopy and the mean value of severity of pain from during examination to one hour after the examination were higher in the IBS group than in the control group. The severity of these symptoms was reduced earlier in the CO(2) group. CO(2) insufflation in colonoscopy was more effective in the IBS group than in the control group from 15 min to one hour after the examination.ConclusionRegarding colonoscopy-related suffering, IBS patients showed significant differences from non-IBS patients. CO(2) insufflation in colonoscopy is effective for IBS patients, particularly for patients who commence activities after colonscopy.© 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

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