Same Day Bidirectional Endoscopies - Does the Sequence of Procedures or Choice of Insufflator Matter?

Summary

Upper endoscopies (Esophagogastroduodenoscopies-EGDs) as well as a lower endoscopies (Colonoscopies) are routinely performed by gastroenterologists to assess the lining of patients' upper and lower gastrointestinal tracts using a video endoscope (a long tube with a video camera on the end). An EGD is performed to examine the upper digestive tract to look for areas of inflammation, ulcerations, or other abnormalities in the swallowing tube, stomach, or duodenal lining. Similarly, a colonoscopy is performed to directly visualize the large bowel for polyps, inflammation, or other abnormalities in the lower bowel lining.

During these procedures, room air is routinely used to insufflate (expand/inflate the stomach and the colon) to allow for better viewing of the lining of the upper and lower gastrointestinal tracts; however, recently the use of carbon dioxide (CO2) (instead of air) has been shown to possibly have less post-procedure patient discomfort. Additionally, when both procedures are performed in the same day, it is currently unknown as to which sequence of procedures is better overall -whether to perform the EGD before colonoscopy or vice versa.

The overall aim of our research is to compare patients' comfort, total amount of sedation used, and overall satisfaction with the procedures between four randomly allocated groups, to see which method of insufflation and which procedural sequence is better when both procedures need to be performed in the same day. We hypothesize that in patients requiring same day endoscopies, performing an EGD prior to Colonoscopy with carbon dioxide (CO2) used as an insufflator is the best tolerated sequence associated with decreased sedation use and increased patient satisfaction/comfort.

Conditions

• Anemia
• Colon Polyps

Interventions

DEVICE

Carbon dioxide insufflation

using an automated carbon dioxide insufflator the gas will be infused on demand during the endoscopies

DEVICE

room air insufflation

using standard care room air will be infused on demand

PROCEDURE

EGD (Esophagogastroduodenoscopy) before Colonoscopy

the order of endoscopies will be randomized as well

PROCEDURE

Colonoscopy before EGD (Esophagogastroduodenoscopy)

Sponsors & Collaborators

• Queen's University

  lead OTHER

Principal Investigators

• Lawrence Hookey, MD · Queen's University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2016-01-31

Primary Completion

2017-11-30

Completion

2017-12-31

Countries

• Canada

Study Locations