Background and study aim: Abdominal pain and bloating sensations can occur after colonoscopy. Theoretically, a faster rate of absorption is expected to reduce abdominal pain and bloating when using carbon dioxide (CO2). However, some clinical studies have found that CO2 is not superior to room air (RA). The aim of this study was to compare abdominal pain and bloating sensations after colonoscopy using RA versus CO2 insufflation.
Patients and Methods: A single blinded randomized controlled trial performed on 128 patients who needed diagnostic colonoscopy between July 2021 and March 2023. Eligible patients were randomized into two groups. Group 1 underwent colonoscopy using RA insufflation and Group 2 underwent colonoscopy using CO2 insufflation. Abdominal pain and bloating after the procedure were assessed by a 10-point visual analogue scale (VAS). The participants were asked about abdominal pain and bloating at 15, 60, 180 minutes and 24 hours post-procedural.
Results: There was statistically significant increase in the abdominal pain with RA compared to CO2 insufflation [34.4% vs 9.4% (p=0.024), 43.8% vs 21.9% (p=0.011), and 37.5% vs 9.4%, (p=0.017)] at 15-, 60-, and 180-minutes post-procedural. Also, there was statistically significant increase in the abdominal bloating at 60 minutes post-procedural with RA compared to CO2 insufflation (68.7% vs 18.8%, p=0.018). No statistically significant difference between RA and CO2 regarding cecal intubation time (8.2±1.4 vs 8.7±2.1, p=0.318) and total examination time (18.9±3.5 vs 19.4 ± 2.9, p=0.23). Conclusion: CO2 insufflation is associated with significantly less abdominal pain and bloating after diagnostic colonoscopy compared to RA insufflation.