[Irritable bowel syndrome: colonoscopy painful and difficult?].

Background And Purpose: Hyperalgesia induced by pelvic colon distension has been demonstrated in patients with irritable bowel syndrome (IBS). In this study the authors analyzed whether colonoscopy of patients with IBS is more painful and technically more demanding as compared to non-IBS patients.

Patients And Methods: In a prospective study 639 patients (132 with IBS, 507 without IBS) who underwent colonoscopy were evaluated for sex, age, body mass index, administration of sedatives and analgesics, time for cecal intubation, intensity of pain during examination (intensity graduated 1-5), diagnosis and degree of diverticulosis, spasticity, loop formation, elongation and distortion, respectively. A statistical comparison of both patient groups was performed.

Results: Patients of the IBS group were significantly younger compared with patients in the control group (p < 0.001). In an age-matched comparison of both groups low pain (intensity 1) was noted in 29 (22%) of IBS patients and 82 patients (31%) in the control group. Severe pain (intensity 4 and 5) occurred in 17 (12.9%) and six (4.5%), respectively, of IBS patients and in 21 (8%) and five patients (2%), respectively, of the control group. The differences were statistically not significant (p = 0.1). Administration of analgesics occurred significantly more frequently in the IBS group (p = 0.01), however, only nine IBS patients (6.8%) and four patients without IBS (1.5%) received analgesics. All other parameters analyzed did not show significant differences between the groups.

Conclusion: Regarding perception of procedure-related pain and technical problems in colonoscopy, patients with IBS do not show significant differences compared to patients without IBS.