BACKGROUND Colonoscopy as a screening and diagnostic tool is generally safe and well-tolerated, and significant complications are rare. The rate of more mild adverse effects is difficult to estimate, particularly when such effects do not result in hospital admission. We aimed to identify the rate and timing of adverse effects as reported by users querying symptoms on an internet search engine. METHODS We identified queries made to Bing originating from users in the United States containing the word "colonoscopy" during a 12-month period and identified those queries in which the timing of colonoscopy could be estimated. We then identified queries from those same users for medical symptoms during the time span from 5 days before through 30 days after the colonoscopy date. RESULTS Of 641,223 users mentioning colonoscopy, 7013 (1.1%) had a query that enabled identification of their colonoscopy date. The majority of queries about colonoscopy preceded the procedure, and concerned diet. 28% of colonoscopy-related queries were made afterwards, and included queries about diarrhea and cramps, with 2.6% of users querying respiratory symptoms after the procedure, including cough (1.2%) and pneumonia (0.6%). Respiratory symptoms rose significantly at days 7-10 after the colonoscopy. CONCLUSIONS Internet search queries for respiratory symptoms rose approximately one week after queries relating to colonoscopy, raising the possibility that such symptoms are an under-reported late adverse effect of the procedure. Given the widespread use of colonoscopy as a screening modality and the rise of anesthesia-assisted colonoscopy in the United States in recent years, this signal is of potential public health concern.

中文翻译：

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与结肠镜检查有关的不良事件；检查在线问题。

背景技术作为检查和诊断工具的结肠镜检查通常是安全且耐受性良好的，并且很少发生重大并发症。较轻的不良反应的发生率难以估计，尤其是当这些不良反应并未导致入院时。我们旨在确定用户在互联网搜索引擎上查询症状所报告的不良反应的发生率和时机。方法我们确定了在12个月内对来自Bing的查询，这些查询来自美国的用户，其中包含“结肠镜检查”一词，并确定了那些可以估计结肠镜检查时间的查询。然后，我们从结肠镜检查日期之前的5天到检查后的30天的时间范围内，从这些相同的用户那里查询了医疗症状。结果641,223名用户提到了结肠镜检查，即7013（1。1％）进行了查询，从而能够确定其结肠镜检查日期。有关结肠镜检查的大多数询问是在手术之前进行的，并且与饮食有关。此后，进行了28％的结肠镜检查相关查询，包括有关腹泻和抽筋的查询，有2.6％的用户在手术后查询呼吸道症状，包括咳嗽（1.2％）和肺炎（0.6％）。结肠镜检查后第7-10天，呼吸道症状显着上升。结论在与结肠镜检查有关的查询后大约一周，互联网上有关呼吸道症状的搜索查询增加了，这增加了此类症状是该手术未报告的晚期不良反应的可能性。鉴于近年来结肠镜作为筛查手段的广泛应用以及麻醉辅助结肠镜在美国的兴起，