How Does Tolerability of Double Balloon Enteroscopy Compare to Other Forms of Endoscopy?

Overview

Journal Frontline Gastroenterol

Specialty Gastroenterology

Date 2017 Aug 26

PMID 28839833

Citations 8

Authors

Andrew J Irvine

David S Sanders

Andrew Hopper

Matthew Kurien

Reena Sidhu

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Gastrointestinal endoscopy can be difficult for patients to tolerate. Studies on endoscopic tolerability mainly focus on gastroscopy or colonoscopy with a paucity of data on double balloon enteroscopy (DBE). We aimed to prospectively evaluate tolerability in patients undergoing several forms of endoscopy including DBE.

Methods: Consecutive patients undergoing colonoscopy, flexible sigmoidoscopy, gastroscopy, endoscopic retrograde pancreatography (ERCP), capsule endoscopy (CE) and DBE were prospectively recruited. A questionnaire recorded demographics, procedural data, patient tolerability (pain, discomfort and distress recorded on numerical rating scales) and the Hospital Anxiety and Depression Scale (HADS).

Results: 956 patients were recruited (512 women; median age 57 years). The median pain score for DBE was poor with a score of 5 compared with 1 and 0 for oesophagogastroduodenoscopy and ERCP, respectively (p<0.001). Colonoscopy and retrograde DBE scores were not dissimilar. CE was well tolerated with a median pain score of 0. Patients with DBE required significantly higher doses of sedation and analgesia than other patients. The HADS Anxiety Score was also associated with poorer tolerability.

Conclusions: DBE is poorly tolerated when compared with other forms of endoscopy despite higher doses of sedation. Increasing demand to improve tolerability of DBE in the UK may be addressed with the use of propofol.

Citing Articles

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High-flow nasal oxygenation versus standard oxygenation for gastrointestinal endoscopy with sedation. The prospective multicentre randomised controlled ODEPHI study protocol.

Eugene A, Fromont L, Auvet A, Baert O, Mfam W, Remerand F BMJ Open. 2020; 10(2):e034701.

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Deep sedation and anaesthesia in complex gastrointestinal endoscopy: a joint position statement endorsed by the British Society of Gastroenterology (BSG), Joint Advisory Group (JAG) and Royal College of Anaesthetists (RCoA).

Sidhu R, Turnbull D, Newton M, Thomas-Gibson S, Sanders D, Hebbar S Frontline Gastroenterol. 2019; 10(2):141-147.

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Ching H, Branchi F, Sanders D, Turnbull D, Sidhu R Frontline Gastroenterol. 2018; 9(3):192-199.

PMID: 30046423 PMC: 6056081. DOI: 10.1136/flgastro-2017-100847.

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Ching H, Healy A, Thurston V, Hale M, Sidhu R, McAlindon M World J Gastroenterol. 2018; 24(26):2893-2901.

PMID: 30018484 PMC: 6048428. DOI: 10.3748/wjg.v24.i26.2893.

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