Gluteal Squeeze for Left Colon Distension

Study Overview
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Brief Summary
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Good distension of the colon during colonoscopy is essential to detect polyps. Gas sometimes escapes the colon through the anus resulting in compromised distension. Pressure on gluteal muscles when the colonoscope tip is in the left colon might help preventing this and thus increase visibility. No previous study looked at this.

Official Title
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Gluteal Squeeze for Left Colon Distension During Withdrawal in Colonoscopy

Conditions
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Colorectal Neoplasms

Intervention / Treatment
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* Other: Gluteal squeeze
* Other: No squeeze


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age greater than or equal to 40 years Scheduled colonoscopy Exclusion Criteria: Inflammatory bowel disease History of colorectal cancer or colon resection Any colorectal cancer syndromes (FAP, HNPCC, SPS) Patient with poor bowel preparation identified during insertion

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Gluteal squeeze<br>Patients behind pressed together during part of the colonoscopy (The technicians arms will be covered with a towel to mask the provider of any pressure being applied) | Other: Gluteal squeeze<br>* During procedure, the doctor performing colonoscopy will ask for gluteal pressure. The technician will perform the maneuver, but the doctor will be blinded as the arms of the technician along with the patients behind are covered by a towel.<br>|
| Sham Comparator: Non-squeeze<br>When the doctor asks for gluteal pressure, a technician will not administer the pressure but their arms will be covered with a towel and the doctor will not know if the pressure is being administered or not. | Other: No squeeze<br>* During procedure, the doctor performing colonoscopy will ask for gluteal pressure. The technician will not perform the maneuver, but the doctor will be blinded as the arms of the technician along with the patients behind are covered by a towel.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Left colon distension score | Provider reported distension score in the left colon | during the procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Left colon withdrawal time | Time taken to withdraw the scope in the left colon | during the procedure | 
| Left colon examination time | Time taken to inspect during left colon withdrawal | during the procedure | 
| Left colon adenoma detection rate | proportion of patients with at least one left colon adenoma | during the procedure | 
| Left colon sessile serrated lesion detection rate | proportion of patients with at least one left colon sessile serrated lesion | during the procedure |