PLOS ONE · 17 authors, 3 centres
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In a single-blinded RCT of 96 patients with ulcerative colitis in clinical remission undergoing colonoscopy, CO₂ insufflation significantly reduced post-procedural abdominal fullness and pain compared to air insufflation, and was associated with a lower clinical relapse rate at 8 weeks in patients not in complete remission.
This single-blinded RCT enrolled 96 patients with ulcerative colitis in clinical remission (partial Mayo score ≤ 2) undergoing total colonoscopy between March 2015 and December 2019 at Osaka University Hospital, randomly assigning them to CO₂ or air insufflation. Mean abdominal fullness and pain scores were significantly lower in the CO₂ group immediately and 30 minutes after colonoscopy. The overall clinical relapse rate within 8 weeks did not differ between groups. However, among patients not in complete remission (Mayo endoscopic subscore ≥ 1 or partial Mayo score ≥ 1), clinical relapse at 8 weeks was significantly lower in the CO₂ group. Study limitations include the single-center design, lack of double-blinding, small sample size, inability to measure the exact volume of insufflated gas, and restriction to patients in clinical remission.
