Factors associated with abdominal pain in patients submitted to colonoscopy☆

This was a cross-sectional observational study that evaluated patients who underwent colonoscopy between February 2014 and February 2015. Physical characteristics, surgical history and previous colonoscopies, indication and current examination conditions, fentanyl and midazolam dose, and pain level were analyzed. Significance level adopted: p < 0.05. Chi-squared test was used for association of categorical variables, Student's t-test was applied for comparison of means, and Spearman's coefficient was used for correlation.

Results:

A total of 566 women and 391 men with mean age of 54.81 years and mean BMI of 27,064 were evaluated. Of the total, 29 (3.0%) had mild pain, 42 (4.4%) had moderate pain, and 18 (1.9%) had severe pain. Women were less tolerant (p = 0.011) and had longer cecal intubation times (p = 0.001). Mean duration of colonoscopy and mean dose of midazolam were higher in patients with pain (p = 0.001), (p < 0.001*). Among the 39 patients with an incomplete examination, 8 reported pain (p = 0.049).

Conclusion:

Female gender and prolonged intubation time were significantly associated with abdominal pain during colonoscopy. Patients with discomfort had a higher failure rate on the exam. Additional doses of midazolam given to patients with pain were not effective.

Keywords:
Colonoscopy; Conscious sedation; Abdominal pain; Sedation

Characteristics	Number (%)
Gender
Female	566 (59.1)
Male	391 (40.9)

Age (mean)
<54.81 years	409 (42.7)
≥54.81 years	548 (57.3)

BMI
<18.5	12 (1.3)
≥18.5 < 25.0	319 (33.3)
≥25.0 < 30.0	395 (41.3)
≥30.0	231 (24.1)

Previous colonoscopy
Yes	216 (22.6)
No	741 (77.4)

Preparation of colon
Suitable	941 (98.3)
Inapporpriate	16 (1.7)

Complete examination
Yes	918 (95.9)
No	39 (4.1)

Indication	Frequency (%)
Abdominal pain	268 (28)
Intestinal bleeding	191 (20)
Change in bowel habits	141 (14.7)
Monitoring	132 (13.8)
Family history of colorectal cancer/polyposis	46 (4.8)
Indication not mentioned	33 (3.4)
Anemia	31 (3.2)
Inflammatory bowel disease	30 (3.1)
Oncological follow-up	28 (2.9)
Post-polypectomy follow-up	24 (2.5)
Weight loss	13 (1.4)
Proctalgia/tenesmus	11 (1.1)
Endometriosis	03 (0.3)
Pre/Post-operative	02 (0.2)
Alteration of CEA level^a a Antígeno Carcinoembrionário/Carcinoembryonic antigen.	02 (0.2)
Portal hypertension	01 (0.1)
Alteration of digital rectal exam	01 (0.1)
Total	957 (100)

	Mild pain	Moderate pain	Intense pain	p-Value
Gender
Female	21 (3.7%)	31 (5.5%)	15 (2.6%)	0.011
Male	08 (2%)	11 (2.8%)	03 (0.8%)

	No pain	Mild pain	Moderate pain	Intense pain	p-Value
Abdominal surgery					0.485
Yes	244 (89.4%)	8 (2.9%)	13 (4.8%)	8 (2.9%)
No	624 (91.2%)	21 (3.1%)	29 (4.2%)	10 (1.5%)

Pelvic surgery					0.270
Yes	349 (88.6%)	15 (3.8%)	20 (5.1%)	10 (2.5%)
No	519 (92.2%)	14 (2.5%)	22 (3.9%)	8 (1.4%)

Previous colonoscopy					0.340
Yes	197 (91.2%)	3 (1.4%)	12 (5.6%)	4 (1.8%)
No	671 (90.6%)	26 (3.5%)	30 (4%)	14 (1.9%)

Indication					0.785
Diagnostic	849 (90.8%)	21 (3%)	48 (4.4%)	17 (1.8%)
Therapeutic	19 (86.4%)	1 (4.5%)	1 (4.5%)	1 (4.5%)

Preparation of colon					0.354
Suitable	854 (90.8%)	29 (3.1%)	40 (4.2%)	18 (1.9%)
Inappropriate	14 (87.5%)	0 (0%)	2 (12.5%)	0 (0%)

Complete examination					0.049
Yes	837 (91.2%)	27 (2.9%)	37 (4.0%)	17 (1.9%)
No	31(79.5%)	2 (5.1%)	5 (12.8%)	1 (2.6%)

Sociedade Brasileira de Coloproctologia Av. Marechal Câmara, 160/916, 20020-080 Rio de Janeiro/RJ Brasil, Tel.: (55 21) 2240-8927, Fax: (55 21) 2220-5803 - Rio de Janeiro - RJ - Brazil
E-mail: sbcp@sbcp.org.br

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[1] *Corresponding author. E-mail: amandabellei@hotmail.com (A.C. Bellei).

Brasil

Brasil

Factors associated with abdominal pain in patients submitted to colonoscopy☆ ☆ Study conducted at the Clínica Pró-Vida, Serviço de Endoscopia e Colonoscopia, Tubarão, SC, Brazil.

Fatores associados à dor abdominal em pacientes submetidos à colonoscopia

ABSTRACT

Objective:

Methods:

Results:

Conclusion:

Factors associated with abdominal pain in patients submitted to colonoscopy^☆ ☆ Study conducted at the Clínica Pró-Vida, Serviço de Endoscopia e Colonoscopia, Tubarão, SC, Brazil.