OBJECTIVE The number of colonoscopies required to reach competency is not well established. The primary aim of this study was to determine the number of colonoscopies trainees need to perform to attain competency, defined by a caecal intubation rate (CIR) ≥90%. As competency depends on completion, we also investigated trainee factors that were associated with colonoscopy completion. DESIGN Th...

BACKGROUND The prevalence of colorectal polyps and adenomas in the general population of Mexico is unknown. AIM To determine the prevalence and risk factors for colorectal polyps detected during flexible sigmoidoscopy (FSIG) in asymptomatic patients. MATERIAL AND METHODS From 1995 to 2008, FSIG was performed as part of a complete check-up in patients who had lived in northeast Mexico for ov...

Background—Flexible sigmoidoscopy is a technical skill that has been successfully performed by suitably trained colorectal nurse practitioners in the USA. However, no recognised training course exists for nurse practitioners in the UK. Aims—To design and evaluate a training programme for nurse endoscopists. Methods—A multidisciplinary committee of nurses and clinicians developed a structured pr...

Two preparations for outpatient flexible sigmoidoscopy, Picolax and Klyx enemas, have been compared in a randomized controlled trial. There was no difference in efficacy between the two preparations, but patients preferred Picolax.

BACKGROUND Several screening tests are available to detect colorectal cancer (CRC) and reduce the incidence and mortality of CRC. The purpose of this review was to determine how current CRC screening strategies for CRC compare with no screening and whether agreement exists with regard to the cost effectiveness of different strategies. METHODS Databases were searched for cost-effectiveness ana...

Case history The male patient (then aged 38 years) first presented in 1948 after an episode oflower abdominal pain and vomiting lasting several hours. Three similar attacks had occurred in the previous 14 years, 2 of which had required hospital admission. Physical examination was unremarkable but a barium enema showed a mobile caecum attached to a mesentery and a long redundant sigmoid loop, su...

BACKGROUND Nitrous oxide gas (N(2)O) has been proposed as an alternative to intravenous (i.v.) analgesia in patients undergoing lower gastrointestinal endoscopy. AIM To perform a systematic review of randomized studies where N(2)O was compared against control in patients undergoing either flexible sigmoidoscopy or colonoscopy. METHODS Electronic databases were searched; reference lists were...

BACKGROUND It is unknown to what extent at what expense flexible sigmoidoscopy and colonoscopy add to the diagnosis of irritable bowel syndrome (IBS). The aim of the study was to assess the incremental cost-effectiveness of endoscopic procedures in the workup for IBS. METHODS Using the Bayes formula, we calculated the increase in diagnostic certainty for a consecutive number of tests. We also...

OBJECTIVES Guidelines for colorectal cancer screening and surveillance in people at average risk and at increased risk have recently been published by the American Gastroenterological Association. The guidelines for the population at average risk were evaluated using cost-effectiveness analyses. METHODS Since colorectal cancers primarily arise from precancerous adenomas, a state transition mo...

mid-1980s to the late 1990s, colorectal cancer (CRC) continues to be the leading cause of cancer death in nonsmokers in Ontario (National Cancer Institute of Canada 2003). Fortunately, CRC’s long, identifiable pre-malignant phase makes it preventable and an ideal candidate for a screening program. It has been recommended that all asymptomatic, averagerisk adults be screened beginning at age 50 ...