Effectiveness of RL- vs LL-starting Position in Unsedated Water Immersion Colonoscopy
Effectiveness of RL- vs LL-starting Position in Unsedated Water Immersion Colonoscopy
Abdominal discomfort is of the most important patient interest when in an unsedated
 colonoscopy examination. Water method for colonoscopy examination has been studied widely and
 evidence showed effectiveness in reducing discomfort and increase cecal intubation time and
 increasing cecal intubation rates in unsedated patients.
Abdominal discomfort is of the most important patient interest when in an unsedated
 colonoscopy examination. Water method for colonoscopy examination has been studied widely and
 evidence showed effectiveness in reducing discomfort and increase cecal intubation time and
 increasing cecal intubation rates in unsedated patients. Our previous studies showed that
 water immersion method reduced the VAS score, accelerated the intubation time significantly
 without different changing cecal intubation rate. Previous right-sided vs. left-sided
 starting position colonoscopy study in sedated patients with air insufflation colonoscopy
 method showed that right-sided starting position improved the abdominal discomfort score and
 faster cecal intubation time. We want postulate that the right-sided starting position can
 also maximize the water method advantages in lowering the discomfort score, faster cecal
 intubation time and higher cecal intubation rates, and it will improve patient acceptance of
 water unsedated colonoscopy and willingness to repeat.
Inclusion Criteria:

 -  Adult ≥18 years old with the indication for colonoscopy, such as chronic diarrhea,
 chronic constipation, hematochezia, chronic lower abdominal pain, positive fecal
 occult blood test, and other change of bowel habit symptoms indicative of the need for
 diagnostic colonoscopy examination.

 Exclusion Criteria:

 -  Patients who refuse to participate, patients with obstructive lesions in the colon
 distal of the cecum. , patients with experienced colon resection, patients who are
 hemodynamically unstable, and patients with severe cardiac disorders (such as acute
 myocardial infarction, unstable angina, malignant arrhythmia, and moderate to severe
 congestive heart failure ).