Saudi Journal of Gastroenterology
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Year : 2011  |  Volume : 17  |  Issue : 4  |  Page : 289-292

Unsedated colonoscopy: Is it feasible?

1 The Research and Medical Services, Sepulveda Ambulatory Care Center, VA Greater Los Angeles Healthcare System; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
2 King Khalid University Hospital, KSU, Internal Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia

Correspondence Address:
Felix W Leung
111G, Sepulveda Ambulatory Care Center, VAGLAHS, 16111 Plummer Street, North Hills, CA 91343
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.82588

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Unsedated colonoscopy has been an evolving subject ever since its initial description four decades ago. Failure in unsedated diagnostic cases due to patient pain led to the introduction of sedation. Extension to screening cases, albeit logical, created a sedation-related barrier to colonoscopy screening. In recent years a water method has been developed to combat the pain during unsedated colonoscopy in the US. In randomized controlled trials the water method decreases pain, increases cecal intubation success, and enhances the proportion of patients who complete unsedated colonoscopy. The salvage cleansing of suboptimal bowel preparation by the water method serendipitously may have increased the detection of adenoma in both unsedated and sedated patients. The state-of-the-art lecture concludes that unsedated colonoscopy is feasible. The hypothesis is that recent advances, such as the development of the water method, may contribute to reviving unsedated colonoscopy as a potentially attractive option for colon cancer screening and deserves to be tested.

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