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

Abstract

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. 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. 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). 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.