Incontinence after colonoscopy--an unrecognized and preventable problem. A cross-sectional study from the Gastronet...

Area of Science:

• Gastroenterology
• Endoscopy
• Patient Safety

Background:

• Colonoscopy visualization relies on gas insufflation, typically air.
• Post-colonoscopy incontinence is a known complication.
• Carbon dioxide (CO₂) is readily absorbed by the bowel mucosa.

Purpose of the Study:

• To evaluate the risk of post-colonoscopy incontinence.
• To determine if CO₂ insufflation reduces incontinence compared to air.

Main Methods:

• Prospective, multicenter study involving 7812 patients undergoing colonoscopy.
• Comparison of outcomes between patients insufflated with air (5015) and CO₂ (2797).
• Data collected via a national quality assurance program in Norway.

Main Results:

• Overall incontinence rate was 4.3% (336/7812 patients).
• CO₂ group had significantly lower incontinence (2.1%) vs. air group (5.5%).
• Female patients exhibited a higher risk of incontinence than males.

Conclusions:

• Approximately 5.5% of patients experience incontinence after air insufflation colonoscopy.
• Switching to CO₂ insufflation can reduce post-colonoscopy incontinence by 60%.
• CO₂ insufflation is a viable strategy to mitigate post-colonoscopy incontinence.