Alternatives to Incomplete Colonoscopy

Nicolas A. Villa, Rahul Pannala, Shabana F. Pasha, Jonathan A. Leighton

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


A thorough and complete colonoscopy is critically important in preventing colorectal cancer. Factors associated with difficult and incomplete colonoscopy include a poor bowel preparation, severe diverticulosis, redundant colon, looping, adhesions, young and female patients, patient discomfort, and the expertise of the endoscopist. For difficult colonoscopy, focusing on bowel preparation techniques, appropriate sedation and adjunct techniques such as water immersion, abdominal pressure techniques, and patient positioning can overcome many of these challenges. Occasionally, these fail and other alternatives to incomplete colonoscopy have to be considered. If patients have low risk of polyps, then noninvasive imaging options such as computed tomography (CT) or magnetic resonance (MR) colonography can be considered. Novel applications such as Colon Capsule™ and Check-Cap are also emerging. In patients in whom a clinically significant lesion is noted on a noninvasive imaging test or if they are at a higher risk of having polyps, balloon-assisted colonoscopy can be performed with either a single- or double-balloon enteroscope or colonoscope. The application of these techniques enables complete colonoscopic examination in the vast majority of patients.

Original languageEnglish (US)
Article number43
JournalCurrent gastroenterology reports
Issue number11
StatePublished - Nov 23 2015


  • Balloon enteroscope-assisted colonoscopy
  • CT or MR colonography
  • Check-Cap
  • Colon Capsule
  • Double-contrast barium enema
  • Magnetic endoscopic imaging

ASJC Scopus subject areas

  • Gastroenterology


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