Response to Shaikh et al.

Abstract

To the Editor: We are thankful to Shaikh et al. (1) for their interest in our work and for sharing their data with us. Unfortunately, although withdrawal time is an important quality parameter, we do not have data on withdrawal time in our database. As our database started at the end of 2007 we also cannot tell you how many of these patients underwent repeated unsedated colonoscopy. However, we also think that it is an important issue that has to be addressed in future trials. Many patients in rural areas approach endoscopy units by car and prefer unsedated screening colonoscopy. In these cases, patients’ motivation to change from unsedated to sedated colonoscopy will be low, despite possible unpleasant memories of their previous colonoscopy. In our study, patients who received sedation during the procedure were included in the sedation group, and, unfortunately, cannot be analyzed separately (2). We do agree that changing from unsedated colonoscopy to sedated colonoscopy may increase the relative CIR in the sedation group, although we think that there is no need to discriminate if sedation is started at the beginning of the procedure or later to pass the fixed angulation of the colon. The median age in sedated and unsedated patients was the same (sedated 60.6 years (interquartile range: 54.3–67.5), unsedated 60.7 years (interquartile range: 54.4–67.9)).