Diagnostic and therapeutic applications of water-immersion colonoscopy

Shinya Sugimoto, Takeshi Mizukami

Research output: Contribution to journalReview articlepeer-review

21 Citations (Scopus)


Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasingly popular. They were originally designed to reduce colonic spasms, facilitate cecal intubation, and lower patient discomfort and the need for sedation. These maneuvers straighten the rectosigmoid colon and enable the colonoscope to be inserted deeply without causing looping of the colon. Water-immersion colonoscopy minimizes colonic distension and improves visibility by introducing a small amount of water. In addition, since pain during colonoscopy indicates risk of bowel perforation and sedation masks this important warning, this method has the potential to be the favored insertion technique because it promotes patient safety without sedation. Recently, this water-immersion method has not only been used for colonoscope insertion, but has also been applied to therapy for sigmoid volvulus, removal of lesions, lower gastrointestinal bleeding, and therapeutic diagnosis of abnormal bowel morphology and irritable bowel syndrome. Although a larger sample size and prospective head-to-head-designed studies will be needed, this review focuses on the usefulness of water-immersion colonoscopy for diagnostic and therapeutic applications.

Original languageEnglish
Pages (from-to)6451-6459
Number of pages9
JournalWorld Journal of Gastroenterology
Issue number21
Publication statusPublished - 2015 Jun 7


  • Colonoscopy
  • Detorsion
  • Gastrointestinal bleeding
  • Irritable bowel syndrome
  • Polypectomy
  • Sigmoid volvulus
  • Underwater
  • Unsedated
  • Water exchange
  • Water immersion

ASJC Scopus subject areas

  • Gastroenterology


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