Context: Assistant-administered abdominal pressure is usually required to reduce loop formation during a colonoscopy. The effect of patient self-administered abdominal pressure has not been evaluated.
Objective: To compare the effectiveness of patient self-administered abdominal pressure with assistant-administered abdominal pressure to reduce loop formation during colonoscopy performed with minimal sedation.
Patients: Consecutive patients who underwent colonoscopy were randomized to receive either patient self-administered abdominal pressure (patient group, n = 51) or assistant-administered abdominal pressure (assistant group, n = 52) when looping occurred during colonoscopy minimally sedated with meperidine. When patient-administered abdominal pressure failed to reduce the loop formation, an assistant took over and delivered the abdominal pressure.
Results: No difference was found regarding cecal intubation rate, intubation time, mean pain scores, and overall satisfaction of patients between groups. However, fewer patients required assistant-administered pressure in the patient group than in the assistant group (18/51 vs. 41/52, P < 0.001).
Conclusions: Patient self-administered pressure is effective in reducing looping during minimally sedated colonoscopy.