Randomized controlled trial of rectal tube placement for the management of abdominal distension following colonoscopy

Abstract

Background: Traditionally, endoscopists have sought to provide maximum comfort for patients undergoing colonoscopy but may have been less concerned with the level of patient discomfort following the procedure. The aim of this study was to examine the effectiveness of rectal tube placement for abdominal decompression following colonoscopy in an effort to limit patient discomfort. Methods: We conducted a prospective, single-blind, randomized controlled trial in 67 consecutive men undergoing elective colonoscopy. At the end of the procedure, patients were randomized to rectal tube placement or standard management without tube placement. Patients were evaluated by standardized criteria 30 minutes after completion of colonoscopy, and again 24 hours later. Results: Thirty patients were randomized to rectal tube placement and 37 served as controls. The two groups were well matched with respect to age, duration of colonoscopy, quality of bowel preparation, prevalence of diverticulosis, frequency of polypectomy, and degree of difficulty in colonoscopy. At 30 minutes after colonoscopy, patients' overall satisfaction rating (mean ± SD) from a 10-point scale was 9.1 ± 3.2 in treated patients and 5.7 ± 3.9 in controls ( p < 0.05; 2-tailed unpaired t test). Conclusion: Placement of a rectal tube at the conclusion of colonoscopy reduces patient discomfort, and improves satisfaction. (Gastrointest Endosc 1997;46:444-6.)