Which hurts the most? A comparison of pain rating during double-contrast barium enema examination and colonoscopy.

PURPOSE

To study the degree of pain caused by double-contrast barium enema examination and colonoscopy and to compare pain ratings by patients and medical personnel.

MATERIALS AND METHODS

In a random sample, 190 patients (aged 45-79 years) (mean, 63.1 years) recorded their experiences of pain during each procedure and the medical staff recorded their impressions of the patients' pain, on a 10-point progressive scale. The data were analyzed with the Wilcoxon rank test, Spearman rank correlation, and generalized kappa value.

RESULTS

Patients' pain ratings were significantly higher during colonoscopy than during double-contrast barium enema examination (P < .0001). Pain was rated significantly higher by patients than by personnel for both procedures (P < .0001).

CONCLUSION

In the choice of procedure, patients' high level of pain during colonoscopy should be remembered. The medical staff frequently underestimated patients' pain during both procedures, and this study documents a need for more extensive pain relief measures during potentially painful examinations of the large bowel.