Pain Intensity and Difficulty of Colonoscopy in Patients with Irritable Bowel Syndrome Compared to Patients with Other Diagnoses

Abstract

Background: Irritable bowel syndrome (IBS) is one of the most common functional disorders of gastrointestinal system. The diagnosis of IBS is made by ROME criteria while excluding other organic causes of symptoms. The presence of alarming sings warrants further evaluation by radiologic or endoscopic studies. It is a common belief among gastroenterologists that colonoscopy in the IBS patients (compared to other patients) is more difficult for the colonoscopists and more painful for the patients. The present study aimed at evaluating the difficulty of colonoscopy, intensity of pain sensation, quality of bowel preparation, and other related findings in the IBS patients compared to non-IBS patients. Methods: This study was conducted during January and May 2016 in a single referral academic colonoscopy center in Shiraz University of Medical Sciences on referring adult patients who were classified into 2 groups, IBS and non-IBS. Duration of procedure, quality of colon preparation, severity of pain, and difficulty of the procedure assessed by Visual Analogue Scale (VAS) were the main assessed parameters. Statistical analysis was performed by SPSS software Version No.16, and independent t test was used to compare the means. Results: In this study, 172 patients (59 males and 113 females) were enrolled and allocated into 2 groups, IBS: 72, non-IBS:100. The mean age in IBS and non-IBS groups was 43.4 and 46.6 years, respectively. Although IBS patients had a more statistically significant pain sensation than non-IBS patients during the procedure (5 vs. 4.4 in VAS, P = 0.03), the quality of colon preparation and difficulty of the procedure revealed no significant differences (7.5 vs. 7.2, P = 0.23; and 4.7 vs. 4.8 in VAS, P = 0.6, respectively). The duration of procedure was significantly lower in the IBS group (13.1 vs. 14.1 minutes, P = 0.006), while the success rate for cecal intubation was similar in both groups (97% vs. 95%, P = 0.7). Conclusions: Our results showed that IBS patients had more pain sensation during the colonoscopy, but the procedure itself was not more difficult in this group of patients. Finally, with a similar success rate the duration of colonoscopy was shorter in IBS patients.