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ColonoscopyNCT07830823

Water Exchange Colonoscopy in Elderly Patients

A study testing Water exchange colonoscopy, Gas insufflation colonoscopy and Propofol and opioid anesthesia in people with Colonoscopy and Colorectal Cancer Screening, run by First People's Hospital Of Lin'an District, Hangzhou at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Colonoscopy is an important test for detecting colorectal polyps and cancer, but it can cause pain and discomfort, especially in older adults. Traditional colonoscopy uses air to expand the colon. Water exchange colonoscopy uses warm water instead of air, which may reduce pain and make the examination easier. Read more about this study

Who is it for?
Ages 55 to 80 years
Conditions the study is for
Colonoscopy, Colorectal Cancer Screening
What is being tested?
Water exchange colonoscopy, Gas insufflation colonoscopy and Propofol and opioid anesthesia
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
1 siteChina
Study dates
1 Nov 2024to 1 Jan 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 55 years
  • Indications for colonoscopy
  • Signed informed consent form

Who cannot join

  • History of intestinal surgery
  • Severe intestinal stenosis or obstruction
  • Cognitive impairment that precludes cooperation with assessment

Trial locations and contacts

1 site in 1 country.

China1 site
  • Department of Colorectal Surgery, The First People's Hospital of Lin'an District, Hangzhou

    Hangzhou, Zhejiang, 311300

Other trials in China

About this study

Official title: Water Exchange Colonoscopy in Elderly Patients: A Prospective Randomized Controlled Trial

Colonoscopy is an important test for detecting colorectal polyps and cancer, but it can cause pain and discomfort, especially in older adults. Traditional colonoscopy uses air to expand the colon. Water exchange colonoscopy uses warm water instead of air, which may reduce pain and make the examination easier. This study compared four colonoscopy methods in patients aged 55 years and older: non-anesthesia water injection, non-anesthesia gas insufflation, anesthesia water injection, and anesthesia gas insufflation. Two hundred participants were randomly assigned to one of the four groups. The study measured pain using a visual analog scale, the time needed to reach the cecum, and blood levels of inflammatory markers (IL-1β, IL-6, and PGE2). The results may help doctors choose a safer and more comfortable colonoscopy method for older patients, especially when anesthesia may not be suitable.

Read the detailed description

Background: Colorectal cancer incidence and mortality increase with age, and colonoscopy is essential for screening and managing colorectal polyps. Conventional gas insufflation can cause abdominal distension, pain, and loop formation, particularly in elderly patients who often have relaxed abdominal muscles, elongated colons, and comorbidities that increase anesthesia risk. Water exchange colonoscopy has been reported to reduce pain by using warm water to navigate the colon without full gas distension.

Objective: To evaluate the clinical value of non-anesthesia water exchange colonoscopy in elderly patients and compare it with anesthesia water exchange, non-anesthesia gas insufflation, and anesthesia gas insufflation.

Methods: This was a single-center, prospective, randomized controlled trial that enrolled 200 patients aged 55 years or older undergoing colonoscopy between November 2024 and December 2025. Participants were randomly assigned (1:1:1:1) using a random number table to four groups (n=50 each): non-anesthesia water injection (NW), non-anesthesia gas insufflation (NA), anesthesia water injection (AW), and anesthesia gas insufflation (AA). All procedures were performed by an experienced endoscopist using a high-definition colonoscope (Olympus CF-HQ290I). Bowel preparation used standard polyethylene glycol electrolyte powder. In water injection groups, warm water at 37°C was injected through the biopsy channel during insertion, with suction of gas and fluid as needed. In gas insufflation groups, conventional air insufflation was used. Anesthesia groups received intravenous propofol combined with a small amount of opioid, administered by an anesthesiologist with continuous vital sign monitoring. The non-anesthesia groups received no anesthesia or analgesia.

Outcomes: The primary outcomes included maximum pain score during examination measured by a 10-point visual analog scale (VAS), cecal intubation time (minutes from insertion to identification of the ileocecal landmark), and serum levels of inflammatory and pain mediators (IL-1β, IL-6, and PGE2) measured by ELISA before and during colonoscopy. Non-inferiority of AW versus NW was assessed for inflammatory mediator inhibition using pre-specified margins. Statistical analysis used SPSS 25.0, with one-way ANOVA, Tukey HSD test, chi-square test, and non-inferiority testing; P<0.05 was considered statistically significant.

Being tested
Water exchange colonoscopy, Gas insufflation colonoscopy, Propofol and opioid anesthesia
Keywords
Water exchange colonoscopy, elderly patients, non-anesthesia, pain score, inflammatory mediators

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Water exchange colonoscopyProcedure or surgery

    Also called Water-aided colonoscopy

    During endoscope insertion, warm water at 37°C is injected through the biopsy channel to facilitate the procedure. Gas and liquid within the cavity are aspirated as thoroughly as possible. A minimal amount of gas is introduced for observation when necessary.

  • Gas insufflation colonoscopyProcedure or surgery

    Also called Air insufflation colonoscopy

    Conventional air insufflation is employed to expand the intestinal lumen, thereby aiding in endoscope insertion.

  • Propofol and opioid anesthesiaDrug

    Also called Intravenous anesthesia

    Intravenous general anesthesia consisting of propofol combined with a small quantity of opioid drugs, administered by an anesthesiologist prior to the examination, with continuous monitoring of vital signs.

Study groups in NCT07830823
Study groupRoleWhat they receive
Non-anesthesia water injection (NW)ExperimentalParticipants receive water exchange colonoscopy without anesthesia. Warm water at 37°C is injected through the biopsy channel during insertion; gas and fluid are aspirated as needed. No anesthesia or analgesia is administered.
Receives: Procedure: Water exchange colonoscopy
Non-anesthesia gas insufflation (NA)ExperimentalParticipants receive conventional gas insufflation colonoscopy without anesthesia. Air is used to expand the intestinal lumen. No anesthesia or analgesia is administered.
Receives: Procedure: Gas insufflation colonoscopy
Anesthesia water injection (AW)ExperimentalParticipants receive water exchange colonoscopy under intravenous general anesthesia with propofol and a small quantity of opioid drugs, administered by an anesthesiologist with continuous vital sign monitoring.
Receives: Procedure: Water exchange colonoscopy; Drug: Propofol and opioid anesthesia
Anesthesia gas insufflation (AA)ExperimentalParticipants receive conventional gas insufflation colonoscopy under intravenous general anesthesia with propofol and a small quantity of opioid drugs, administered by an anesthesiologist with continuous vital sign monitoring.
Receives: Procedure: Gas insufflation colonoscopy; Drug: Propofol and opioid anesthesia

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Serum inflammatory factors and pain mediators

    Change from baseline in serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and prostaglandin E2 (PGE2) measured by ELISA before and during colonoscopy. Used for non-inferiority comparison between non-anesthesia water injection (NW) and anesthesia water injection (AW).

    Measured: Baseline and periprocedural

  2. Pain score (VAS)

    Maximum pain level during colonoscopy assessed by the patient using a visual analog scale (VAS, 0-10 points, where 0 indicates no pain and 10 signifies severe pain).

    Measured: Periprocedural

Secondary outcomes (2)
  1. Cecal intubation time

    Duration from colonoscope insertion to reaching the ileocecal area and identifying the cecal landmark (e.g., appendiceal orifice or ileocecal valve), recorded in minutes.

    Measured: Periprocedural

  2. Adverse events

    Incidence of procedure-related adverse events, including abdominal distension, pain, intestinal perforation, respiratory depression, cardiovascular events, and allergic reactions.

    Measured: Periprocedural

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Sep 2026
  2. Study start1 Nov 2024
  3. Primary completion1 Dec 2025
  4. Study completion1 Jan 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants were randomly assigned to one of four parallel groups (1:1:1:1 ratio): non-anesthesia water injection (NW), non-anesthesia gas insufflation (NA), anesthesia water injection (AW), and anesthesia gas insufflation (AA).
Masking
None (open label)
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07830823
Sponsor's protocol ID
LY2024013K
Status last verified
Sep 2026
First submitted
10 Sep 2026
Last updated
21 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Xu X, Ni D, Lu Y, Huang X. Diagnostic application of water exchange colonoscopy: A meta-analysis of randomized controlled trials. J Int Med Res. 2019 Feb;47(2):515-527. doi: 10.1177/0300060518819626. Epub 2019 Jan 11.

    PubMed 30632431
  • Cadoni S, Ishaq S, Hassan C, Falt P, Fuccio L, Siau K, Leung JW, Anderson J, Binmoeller KF, Radaelli F, Rutter MD, Sugimoto S, Muhammad H, Bhandari P, Draganov PV, de Groen P, Wang AY, Yen AW, Hamerski C, Thorlacius H, Neumann H, Ramirez F, Mulder CJJ, Albeniz E, Amato A, Arai M, Bak A, Barret M, Bayupurnama P, Cheung R, Ching HL, Cohen H, Dolwani S, Friedland S, Harada H, Hsieh YH, Hayee B, Kuwai T, Lorenzo-Zuniga V, Liggi M, Mizukami T, Mura D, Nylander D, Olafsson S, Paggi S, Pan Y, Parra-Blanco A, Ransford R, Rodriguez-Sanchez J, Senturk H, Suzuki N, Tseng CW, Uchima H, Uedo N, Leung FW. Water-assisted colonoscopy: an international modified Delphi review on definitions and practice recommendations. Gastrointest Endosc. 2021 Jun;93(6):1411-1420.e18. doi: 10.1016/j.gie.2020.10.011. Epub 2020 Oct 16.

    PubMed 33069706
  • Ding Y, Lin X. Outcomes and safety of colonoscopy in elderly patients aged 80 years and older: a retrospective cohort study. PeerJ. 2025 Nov 19;13:e20404. doi: 10.7717/peerj.20404. eCollection 2025.

    PubMed 41282981
  • Singal AG, Gupta S, Skinner CS, Ahn C, Santini NO, Agrawal D, Mayorga CA, Murphy C, Tiro JA, McCallister K, Sanders JM, Bishop WP, Loewen AC, Halm EA. Effect of Colonoscopy Outreach vs Fecal Immunochemical Test Outreach on Colorectal Cancer Screening Completion: A Randomized Clinical Trial. JAMA. 2017 Sep 5;318(9):806-815. doi: 10.1001/jama.2017.11389.

    PubMed 28873161
  • He KQ, Huang TT, Tan MY, Gao C, Wang S. Efficacy and Safety of Ciprofol Versus Propofol as Anesthetic for Patients Undergoing Painless Colonoscopy. Pain Ther. 2024 Dec;13(6):1633-1644. doi: 10.1007/s40122-024-00662-x. Epub 2024 Oct 14.

    PubMed 39400664

Questions about this trial

What is this clinical trial studying?

A study testing Water exchange colonoscopy, Gas insufflation colonoscopy and Propofol and opioid anesthesia in people with Colonoscopy and Colorectal Cancer Screening, run by First People's Hospital Of Lin'an District, Hangzhou at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Serum inflammatory factors and pain mediators (time frame: Baseline and periprocedural). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07830823, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2026.

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