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Related Concept Videos

Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy01:26

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This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Lower GI Series: Barium Enema01:23

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Updated: Mar 7, 2026

Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
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Water-Assisted Colonoscopy.

Sergio Cadoni1, Felix W Leung2,3

  • 1Digestive Endoscopy Unit, CTO Hospital, Via R. Cattaneo snc, 09016, Iglesias, Carbonia-Iglesias, Italy. cadonisergio@gmail.com.

Current Treatment Options in Gastroenterology
|February 17, 2017
PubMed
Summary
This summary is machine-generated.

Water-assisted colonoscopy techniques, including water immersion (WI) and water exchange (WE), reduce insertion pain and improve adenoma detection rates (ADR). Water exchange (WE) shows superior results compared to water immersion (WI) for difficult colonoscopies and increasing ADR.

Keywords:
Adenoma detectionColon cleanlinessSedationWater exchangeWater immersionWater-aided colonoscopy

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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Medical Technology

Background:

  • Traditional air insufflation (AI) in colonoscopy is associated with interval cancers, potentially due to low adenoma detection rates (ADR).
  • Sedation methods for colonoscopy introduce costs and patient burdens.
  • Water-assisted methods (WI and WE) have emerged to improve colonoscopy insertion and patient comfort.

Purpose of the Study:

  • To review randomized controlled trials (RCTs) comparing water immersion (WI) and water exchange (WE) with gas insufflation colonoscopy.
  • To evaluate the impact of WI and WE on insertion pain and adenoma detection.

Main Methods:

  • Systematic review of published randomized controlled trials (RCTs).
  • Comparison of water immersion (WI), water exchange (WE), and air insufflation (AI) techniques.
  • Analysis of insertion pain (primary outcome) and adenoma detection (secondary outcome).

Main Results:

  • Both WI and WE decrease insertion pain and facilitate difficult colonoscopies.
  • WE demonstrates a superior impact on reducing pain and improving colonoscopy completion compared to WI.
  • Water exchange (WE) is consistently associated with an increased adenoma detection rate (ADR).

Conclusions:

  • Water-assisted colonoscopy techniques, particularly WE, offer significant advantages over traditional AI.
  • WE is recommended for average colonoscopists to optimize success rates and increase ADR, especially when difficult procedures are anticipated.