Factors Influencing the Degree of Discomfort in Examinees Undergoing Upper Gastrointestinal Endoscopy

Abstract

Objective: We aimed to clarify the factors influencing the degree of discomfort in examinees undergoing upper gastrointestinal endoscopy (GIE).

Methods: We included 5,249 individuals who underwent a health check-up including the upper GIE between November 2018 and April 2019 at our clinic. After the health check-up, a self-administered questionnaire survey was conducted to assess the examinees’ discomfort during GIE and their satisfaction with the health check-up. We obtained data on subjects’ background factors and GIE examination findings regarding the following aspects: transnasal or transoral, sedated or unsedated, use of thin (diameter 5.9mm) or conventional (diameter 9.3mm) endoscope, the degree of vomiting reflexes, and body movement during GIE.

Results: After multivariate adjustment, younger age, female sex, higher pre-GIE anxiety, less number of previous GIEs, long time for GIE, and high number of vomiting reflexes and body movement during GIE were observed to be associated with discomfort during GIE. Transnasal GIE significantly reduced the number of vomiting reflexes, while using sedatives reduced discomfort. In transoral GIE, using a thin endoscope reduced discomfort better than a conventional endoscope, especially without sedatives. The examinees who felt stronger discomfort during GIE tended to be more dissatisfied with the health check-up.

Conclusion: Depending on age, sex, pre-GIE anxiety, the number of past GIEs, and discomfort level during past GIEs, using sedatives and/or a thin scope may be useful for reducing the discomfort level during GIE, possibly leading to improved examinee satisfaction with the health check-up.