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Alternatives to Incomplete Colonoscopy

  • Large Intestine (B Cash, Section Editor)
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Abstract

A thorough and complete colonoscopy is critically important in preventing colorectal cancer. Factors associated with difficult and incomplete colonoscopy include a poor bowel preparation, severe diverticulosis, redundant colon, looping, adhesions, young and female patients, patient discomfort, and the expertise of the endoscopist. For difficult colonoscopy, focusing on bowel preparation techniques, appropriate sedation and adjunct techniques such as water immersion, abdominal pressure techniques, and patient positioning can overcome many of these challenges. Occasionally, these fail and other alternatives to incomplete colonoscopy have to be considered. If patients have low risk of polyps, then noninvasive imaging options such as computed tomography (CT) or magnetic resonance (MR) colonography can be considered. Novel applications such as Colon Capsule™ and Check-Cap are also emerging. In patients in whom a clinically significant lesion is noted on a noninvasive imaging test or if they are at a higher risk of having polyps, balloon-assisted colonoscopy can be performed with either a single- or double-balloon enteroscope or colonoscope. The application of these techniques enables complete colonoscopic examination in the vast majority of patients.

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Conflict of Interest

Nicolas A. Villa declare that he has no conflict of interest.

Rahul Pannala has received research support from FujiFilm, USA unrelated to this article.

Jonathan A. Leighton has served as a consultant to Covidien, Olympus, unrelated to this article.

Shabana Pasha has received honoraria from Covidien and expense reimbursement from Capsovision, unrelated to this article. Dr. Pasha’s institution has received grants from Covidien and Capsovision, unrelated to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, 13400 E Shea Blvd., Scottsdale, AZ, 85259, USA

    Nicolas A. Villa, Rahul Pannala, Shabana F. Pasha & Jonathan A. Leighton

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  1. Nicolas A. Villa
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  2. Rahul Pannala
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Correspondence to Jonathan A. Leighton.

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Villa, N.A., Pannala, R., Pasha, S.F. et al. Alternatives to Incomplete Colonoscopy. Curr Gastroenterol Rep 17, 43 (2015). https://doi.org/10.1007/s11894-015-0468-7

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