Green Endoscopy: Can Filtered Water Use in Endoscopy Be a Safe, Economical Alternative Which Promotes Sustainable Healthcare?

INTRODUCTION

Sustainable healthcare is an evolving paradigm of growing importance that focuses on reducing environmental impact whilst maintaining quality patient care. Currently, evidence is lacking to support the use of sterile water in diagnostic colonoscopy resulting in a growing shift towards use of tap water and appropriate recycling of bottles. This single centre interventional study assessed patient outcomes, quantitative water use, cost and environmental benefits during colonoscopy when using filtered tap water for irrigation.

METHODS

Patients who underwent a colonoscopy at this single centre in Melbourne, Australia over 3 months were included consecutively. Trained endoscopy nursing staff prepared filtered, room temperature water for all diagnostic colonoscopy procedures during this time. Quantitative measurements of volume of water per procedure were recorded electronically. Peri-procedural and post-procedural complications were retrospectively audited 1 month after the procedure.

RESULTS

Complete patient data were collected on 133 patients between 1st February 2025 and 30th April 2025. No infective presentations/complications were recorded. Five patient complications were noted: abdominal pain, intra-operative atrial fibrillation, per-rectal bleeding and constipation. Mean water use per colonoscopy was 205 mL. The extrapolated/calculated economic savings for the health service was $5000 per annum. Carbon Footprint saving 1.37 kg CO2 Eq per bottle saved.

CONCLUSION

Tap water use in endoscopy can be a safe, simple, economic alternative which promotes sustainable healthcare for the future.