CC BY 4.0 · Endosc Int Open 2024; 12(11): E1267-E1276
DOI: 10.1055/a-2401-6804
Original article

Analysis of painful situations during unsedated esophagogastroduodenoscopy

1   Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)
2   Internal medicine, Tsuyama Chuo hospital, Tsuyama, Japan
,
Sakiko Kuraoka
1   Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)
,
Takuya Satomi
1   Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)
,
Shotaro Okanoue
1   Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)
,
3   Practical Gastrointestinal Endoscopy, Okayama University, Okayama, Japan (Ringgold ID: RIN12997)
,
4   Gastroenterology and Hepatology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan (Ringgold ID: RIN199491)
,
1   Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)
,
Seiji Kawano
1   Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)
,
Yoshiro Kawahara
3   Practical Gastrointestinal Endoscopy, Okayama University, Okayama, Japan (Ringgold ID: RIN12997)
,
Hiroyuki Okada
1   Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)
5   Internal medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan (Ringgold ID: RIN36996)
,
Motoyuki Otsuka
4   Gastroenterology and Hepatology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan (Ringgold ID: RIN199491)
› Author Affiliations
Supported by: Fujifilm Corporation

Clinical Trial: Registration number (trial ID): 000043688, Trial registry: UMIN Japan (http://www.umin.ac.jp/english/), Type of Study: Prospective observational study

Abstract

Background and study aims Although esophagogastroduodenoscopy (EGD) is a widely used technique, the procedure is often associated with discomfort. This study aimed to analyze painful situations, their frequency, and factors associated with patient discomfort during EGD.

Patients and methods This prospective observational study included patients scheduled to undergo EGD. Seven endoscopists recruited patients scheduled for EGD screening or surveillance. Each endoscopist enrolled 20 patients, performing 10 EGD procedures using ultraslim endoscopes and 10 with standard-sized endoscopes. Data regarding painful situations and frequency were collected using specialized buttons pressed by the patients during EGD. A survey about overall discomfort was conducted after the procedure.

Results We analyzed data from 140 patients. Esophageal insertion and duodenal observation were associated with the highest incidence of pressing the pain button, accounting for 59.3% and 40.7% of the cases, respectively. The factor associated with pressing the pain button during esophageal insertion was endoscopist experience (< 10 years). In contrast, younger age and female sex were the factors associated with pressing the pain button during duodenal observation. In the post-procedure survey, 63.6% of patients reported discomfort. Factors associated with patient discomfort included pressing the pain button during esophageal insertion (odds ratio [OR]: 2.84, P = 0.01) and previous painful EGD experience (OR: 2.41, P = 0.03).

Concusions This study provides objective data on painful situations, their frequency, and related factors during EGD. Further research and interventions focusing on pain reduction during endoscopic procedures are warranted. The results of this study will help endoscopists manage painful situations and potentially improve skills.



Publication History

Received: 13 February 2024

Accepted after revision: 23 August 2024

Accepted Manuscript online:
30 September 2024

Article published online:
07 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 
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