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Previous studies have favored esophagogastroduodenoscopy (EGD) followed by colonoscopy as the optimal sequence in bidirectional endoscopy (BDE) with air insufflation. However, the optimal sequence in same-day BDE with WE colonoscopy is unclear. A total of 200 patients undergoing BDE with propofol sedation from May 2018 to January 2021 were randomized to either the EGD-first group (n = 10 or the colonoscopy-first group (n = 10. The EGD-first group required a longer cecal-intubation time (median 16.0 min vs. 13.7 min, 0.001) and a