CO2 and Colonoscopy

iStock_000020932248_MediumHave you had a colonoscopy?  Jokes abound about this screening exam for colorectal cancer, but it's no joke that death rates from this form of cancer have declined quite a lot since such testing has become routine.  Then why not, as published in Annals of Internal Medicine this week, make the procedure more comfortable for patients by using carbon dioxide to inflate the colon rather than other gases? Rick and I agree on PodMed this week that this is one area where patients can, and likely should, advocate strongly for themselves.

The paper reviews the evidence that CO2 is easily administered, is much more readily absorbed from the gut and exhaled through the lungs rapidly after being used to inflate the colon, and adds less than $2.00 to the cost of the exam after purchase of needed equipment. CO2 overcomes the sometimes significant pain patients experience post-procedure when room air is used to expand their colon, as well as the occasional leakage of feces. It's rather daunting to read the authors' assertion that slow adoption of CO2 insufflation is due to a lack of importance assigned to improvement of patient experience.  So the word on the street if you're scheduled for a colonoscopy, ask about CO2.

Other topics this week include infant swaddling and SIDS in Pediatrics, and the impact of providing care to the chronically ill for caregivers and the significance of symptoms in smokers, both in NEJM.  Until next week, y'all live well.



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