Carbon dioxide insufflation can significantly reduce toilet use after colonoscopy: a double-blind randomized controlled trial

Background and study aims: Carbon dioxide (CO₂) insufflation during colonoscopy can significantly decrease abdominal pain and bloating after the procedure, but its impact on the frequency and duration of toilet use remains unknown. The aim of this study was to assess the impact of CO₂ insufflation on toilet use after screening colonoscopy.

Methods: From 138 average-risk individuals who underwent screening colonoscopy during March to August 2013, 120 were enrolled and randomized to receive either CO₂ or air insufflation at colonoscopy. Both the colonoscopist and participant were blinded to the type of gas used. Abdominal pain and distension were assessed using a visual analog scoring system. The frequency and duration of toilet visits during a 2-hour postcolonoscopy period were recorded using a radiofrequency identification system.

Results: Baseline characteristics were similar in both groups in terms of age, sex, and procedure time. In the 2 hours after colonoscopy, 50 participants (83 %) in the air group and 18 participants (30 %) in the CO₂ group (P < 0.001) used the toilet at least once. The mean (± SD) duration of each toilet visit was 5.93 ± 4.65 minutes in the air group and 1.53 ± 2.84 minutes in the CO₂ group (P < 0.001). The abdominal discomfort score was lower in the CO₂ group than in the air group both at the end of the colonoscopy (P < 0.001) and 2 hours later (P < 0.001).

Conclusion: Insufflation with CO₂ can significantly reduce abdominal discomfort and toilet use after colonoscopy. Use of this technique may help reduce patient burden and allow more efficient use of space in the endoscopy unit.

• References

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