Advances in Bowel Preparation for Colonoscopy

Cohen, Lawrence B.

doi:10.1016/j.giec.2014.11.003

Cited by 24 publications

(18 citation statements)

References 65 publications

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“…A poor bowel preparation for colonoscopy has detrimental consequences, such as decreased identification of pathology, increased procedure time, and decreased rates of cecal and terminal ileum intubation. Inadequate bowel preparation also leads to shortened interval colonoscopy duration and increased health care costs, not to mention additional risks to the patient and increased time off of work than would be required otherwise [13,14]. Furthermore, risk of adverse events such as colon perforation may be increased with inadequate colon cleansing [14].These factors emphasize the importance of prospective studies reviewing the efficacy and quality of bowel cleansing, especially in hospitalized patient cohorts.…”

Section: Discussionmentioning

confidence: 99%

Effect of Bowel Preparation Volume in Inpatient Colonoscopy. Results of a Prospective, Randomized, Comparative Pilot Study

Hernandez

Horsley‐Silva

Snyder

et al. 2020

Preprint

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Background: Inpatient status has been shown to be a predictor of poor bowel preparation for colonoscopy; however, the optimal bowel preparation regimen for hospitalized patients is unknown. Our aim was to compare the efficacy of bowel preparation volume size in hospitalized patients undergoing inpatient colonoscopy. Methods: This prospective, single blinded (endoscopist), randomized controlled trial was conducted as a pilot study at a tertiary referral medical center. Hospitalized patients undergoing inpatient colonoscopy were assigned randomly to receive a high, medium, or low-volume preparation. Data collection included colon preparation quality, based on the Boston Bowel Preparation Scale, and a questionnaire given to all subjects evaluating the ability to completely finish bowel preparation and adverse effects (unpleasant taste, nausea, and vomiting). Results: Twenty-five colonoscopies were performed in 25 subjects. Patients who received low-volume preparation averaged a higher mean total BBPS (7.4, SD 1.62), in comparison to patients who received high-volume (7.0, SD 1.41) and medium-volume prep (6.9, SD 1.55), P = 0.77. When evaluating taste a higher score meant worse taste. The low-volume group scored unpleasant taste as 0.6 (0.74), while the high-volume group gave unpleasant taste a score of 2.2 (0.97) and the medium-volume group gave a score of 2.1 (1.36), P < 0.01. Conclusion: In this pilot study, the low-volume colon preparation Prepopik® may be preferred in the inpatient setting due its better rate of tolerability and comparable bowel cleanliness when compared to larger volume preparation, although we cannot overreach any definitive conclusion. Further more robust studies are required to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Effect of Bowel Preparation Volume in Inpatient Colonoscopy. Results of a Prospective, Randomized, Comparative Pilot Study

Hernandez

Horsley‐Silva

Snyder

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Adequate bowel preparation is essential before a colonoscopy because hindrance of the visualization of the colon by fecal material increases the probability of missing a lesion and lengthens the procedure time, which causes patient discomfort [18] . An effective method of bowel cleansing that will ensure patient compliance should improve the effectiveness of the examination and minimize the risk of procedural complications [19] . The ideal method of colon cleansing should be fast and safe, and provide proper cleaning with minimal discomfort for the patient [16] .…”

Section: Discussionmentioning

confidence: 99%

Colonoscopy Preparation: Efficacy and Efficiency of Hospitalmade Polyethylene Glycol (PEG) Compared with Commercial PEG

Makmun¹,

Abdullah

Syam

et al. 2015

Journal of Gastroenterology and Hepatology Research

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AIM:Colorectal cancer is the third most deadly cancer worldwide, and colonoscopy is an effective method for screening for this cancer. Reducing the cost of colonoscopy could help increase adherence of patients with indications for this disease. The aim of this study was to compare the efficacy and cost-effectiveness for bowel clearance between hospital-made polyethylene glycol and the commercial product.

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“…Studies have reported that bowel preparation is inadequate in 15 % to 35 % of colonoscopies, with rates varying across medical settings and patient populations [44][45][46][47][48][49][50]. Inadequate bowel preparation negatively impacts the ADR and other indicators of colonoscopy quality (e. g., cecal intubation rates), lengthens procedure times (e. g., increased time washing and suctioning debris, prolonged withdrawal time), and results in shorter surveillance intervals and increased costs [44,46,49,[51][52][53][54][55][56][57][58][59][60]. A pooled analysis of eight prospective studies (n = 9167) found that metachronous CRC was diagnosed in 0.6 % of patients ▶ Table 1 Bowel preparation grading scales assessing quality across the length of the colon [36][37][38][39][40][41][42]…”

Section: Clinical Importance Of Adequate Bowel Preparationmentioning

confidence: 99%

The importance of colonoscopy bowel preparation for the detection of colorectal lesions and colorectal cancer prevention

2020

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Background and study aims Colonoscopy for colorectal cancer (CRC) screening has reduced CRC incidence and mortality and improved prognosis. Optimal bowel preparation and high-quality endoscopic technique facilitate early CRC detection.This review provides a narrative on the clinical importance of bowel preparation for colonoscopy and highlights available bowel preparations. Methods A PubMed search was conducted through June 2019 to identify studies evaluating clinical outcomes, efficacy, safety, and tolerability associated with bowel preparation for CRC screening-related colonoscopy. Results Selecting the optimal bowel preparation regimen is based on considerations of efficacy, safety, and tolerability, in conjunction with individual patient characteristics and preferences. Available bowel preparations include high-volume (4 L) and low-volume (2 L and 1 L), polyethylene glycol (PEG) solutions, sodium sulfate, sodium picosulfate/magnesium oxide plus anhydrous citric acid, sodium phosphate tablets, and the over-the-counter preparations magnesium citrate and PEG-3350. These preparations may be administered as a single dose on the same day or evening before, or as two doses administered the same day or evening before/morning of colonoscopy. Ingesting at least half the bowel preparation on the day of colonoscopy (split-dosing) is associated with higher adequate bowel preparation quality versus evening-before dosing (odds ratio [OR], 2.5; 95 % confidence interval [CI], 1.9−3.4). Conclusions High-quality bowel preparation is integral for optimal CRC screening/surveillance by colonoscopy. Over the last 30 years, patients and providers have gained more options for bowel preparation, including low-volume agents with enhanced tolerability and cleansing quality that are equivalent to 4 L preparations. Split-dosing is preferred for achieving a high-quality preparation.

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Advances in Bowel Preparation for Colonoscopy

Cited by 24 publications

References 65 publications

Effect of Bowel Preparation Volume in Inpatient Colonoscopy. Results of a Prospective, Randomized, Comparative Pilot Study

Effect of Bowel Preparation Volume in Inpatient Colonoscopy. Results of a Prospective, Randomized, Comparative Pilot Study

Colonoscopy Preparation: Efficacy and Efficiency of Hospitalmade Polyethylene Glycol (PEG) Compared with Commercial PEG

The importance of colonoscopy bowel preparation for the detection of colorectal lesions and colorectal cancer prevention

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