Colonic Distension

After colonic preparation, the examination is ready to be performed. Colonic distension should be performed entirely by a trained technologist or a nurse. A radiologist does not need to be present for high quality data acquisition to proceed. An experienced technologist or nurse is required, thus minimizing radiologist time needed for data acquisition.

Immediately prior to data acquisition, the patient should evacuate any residual fluid from the rectum. Therefore, easy access to a nearby bathroom is essential. For colonic insufflation, either room air or carbon dioxide (CO2) can be used. Room air is easy, clean, and inexpensive to use. Proponents of CO2 argue that because it is readily absorbed from the colon it causes less cramping folowing the procedure than room air insufflation. While initial discomfort is usually present with either CO2 or room air, delayed cramping appears to be a lesser problem with CO2.

The use of a bowel relaxant is controversial. Previous data have shown minimal benefit to the routine use of IV or intramuscular (IM) glucagon. We do not routinely use a bowel relaxant. This minimizes cost and patient anxiety since it does not necessitate the use of needles. Excellent results have been achieved distending the colon without the use of a bowel relaxant. A report from England showed that hyoscine butylbromide improved colonic insufflation and suggested that it should be routinely administered when available [11]. However, this product has not been approved by the FDA and is not available for use in the United States.

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