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Background: Colonoscopy is a very effective and essential examination to diagnose colorectal cancer; however,many patients experience discomfort due to post-examination abdominal pain, which reduces colonoscopy compliance. This study was conducted to determine methods for reducing post-colonoscopic abdominal pain. Methods: We conducted a randomized controlled study of 405 male and female adults who visited Hana GeneralHospital in Cheongju. We surveyed general characteristics, history of colonoscopy, and other related factors, thencategorized examinees into 5 groups (0–5) according to the site of scope reinsertion. Pain was measured using anumeric rating scale (NRS). Results: The mean age of examinees in this study was 47.8 years, and 210 participants had prior experience of colonoscopy. No significant difference was observed between variables, with the exception of reinsertion duration(P=0.005). Pain scores were different between performing physicians (P=0.006), and were higher when the subjectivelevel of procedure difficulty was low (P=0.026) in univariate analysis. Pain scores decreased as the reinsertionsite became closer to the proximal colon (P<0.001), but there was no significant difference between groups 3 and 4. The results of multiple logistic regression analysis, including univariate analysis, showed that group 1 had 0.48times, group 2 had 0.38 times, group 3 had 0.09 times, and group 4 had 0.03 times odds ratio (moderate-to-severepain, NRS ≥4) than control group 0. Conclusion: Air decompression by scope reinsertion is an effective way to reduce abdominal pain after colonoscopy. Removing air when the reinserted scope approaches the hepatic flexure seems to be the most effective methodto reduce post-colonoscopic pain.

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