BLOG: Would you like Beethoven with Your Colonoscopy?

Healio Gastroenterology is pleased to introduce our DDW Blog, offering researchers’ insight into their data presented during the meeting. This introductory blog, by Arjuna P. De Silva, MBBS, MD, MSc, MRCP, FRCP, looks at the use of music during colonoscopy.

“Music,” it is often said, “has charms to soothe the savage beast.” Indeed, we have experimentally demonstrated the truth of the calming powers of music — as applied to colonoscopy. Our new study shows the harmonious result of using “audio distraction” to ease patients’ anxiety about the procedure.

My colleagues and I set out to test the ability of both audio and visual distraction to reduce pain, anxiety and discomfort, thereby increasing the likelihood that patients would be persuaded that their colonoscopy was not as bad as they anticipated and would return the next time. We discussed our encouraging findings at Digestive Disease Week 2015 , the world’s largest gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

In our study, 77 patients undergoing screening colonoscopies were randomized into three groups: one was told they could listen to the music of their choice; another was allowed to choose a film to watch; and a third group was a control, with no distractions. Patient-controlled sedation was available to all participants, and we tracked the number of times each patient requested an additional “top-up” of sedative and the total amount each patient needed. We also tracked the patients’ assessments of their pain levels.

Our supposition was that video distraction was likely to be the most effective. We theorized that the combination of visual images plus sound would be most engaging and distracting. Previous studies had experimented with the use of a succession of still images, such as lakes, mountains and rivers, and we speculated that film would be even more diverting.

But, our results showed otherwise — the group using headphones to listen to their favorite music reported significantly less pain, needed fewer top-ups and required less sedative overall than the other groups. And, 72 percent expressed willingness to undergo a repeat procedure when needed.

The visual group, however, watching films on a 3D video-glass device, did not achieve nearly the overall pain reduction and lessening of sedation as the audio group. Nonetheless, the visual group was equally willing to undergo repeat procedures.

Our results showed clear evidence of the effectiveness of audio distraction. We believe that the visual distraction was not as strong, because patients remained more alert and awake trying to follow the movie and, therefore, were more aware of their discomfort.

We hope that more practitioners will take advantage of our findings, offer this option to their patients and encourage them to try it. Patients really have nothing to lose, except perhaps their anxieties. – Arjuna P. DeSilva

Arjuna P. DeSilva is professor in medicine and head of the department of medicine, faculty of medicine, University of Kelaniya, Sri Lanka. He obtained his MD from the University of Colombo, MSc from the University of Oxford and FRCP (London). He obtained his postgraduate training in gastroenterology at the Radcliffe infirmary in Oxford. Current research interests are IBD, endoscopy and colonoscopy.

For more information:

De Silva AP, et al. Sa1420. Presented at: Digestive Disease Week, May 16-19, 2015; Washington, D.C.

Disclosure: De Silva reports no relevant financial disclosures Please see the DDW faculty disclosure index for all other researchers’ relevant financial disclosures.