Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease

Megna, Bryant; Weiss, Jennifer M.; Ley, Dana; Saha, Sumona; Pfau, Patrick R.; Grimes, Ian; Li, Zhanhai; Caldera, Freddy

doi:10.1016/j.gie.2018.09.039

Cited by 23 publications

(14 citation statements)

References 34 publications

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“…The most common reason for not carrying out DCE was inadequate bowel preparation and the presence of disease activity, which is consistent with other studies . There was overall no difference in the proportion of colonoscopies limited by poor bowel preparation pre‐ and post‐August 2016.…”

Section: Discussionsupporting

confidence: 88%

Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance

Smith

Cannatelli

Bazarova

et al. 2019

Digestive Endoscopy

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Background and Aim: Dye-based chromoendoscopy (DCE) with targeted biopsies is recommended for inflammatory bowel disease (IBD) surveillance. However, DCE has not yet been widely adopted into clinical practice. We evaluated quality indicators in IBD surveillance following introduction of structured changes in service delivery.Methods: In August 2016, we introduced a number of changes to IBD surveillance practice in our endoscopy unit. These included training using interactive videos/images in a structured module, DCE as standard by using a foot-pedal operated pump jet, allocation of 45-minute procedure timeslots, targeted biopsies (except in high-risk patients), scoring of endoscopic disease activity, and lesion detection/morphology characterization. All IBD surveillance colonoscopies were allocated to a small team of four DCE-trained endoscopists. We compared quality measures for surveillance procedures carried out pre-and post-August 2016. The two groups were compared using chi-squared statistics Results: A total of 598 IBD surveillance procedures (277 pre-August 2016 and 321 post-August 2016) were done and included in the study. Use of DCE increased (54.2% vs 76.0% P < 0.0005) whereas random biopsy surveillance decreased (12.3% vs 3.1% P < 0.0005). Use of Paris classification (26.1% vs 57.0% P < 0.0005) and Kudo pit pattern increased (21.7% vs 59.0% P < 0.0005). There was also an increase in lesion detection rate (24.9% vs 33.1% P < 0.05).Conclusions: Implementation of extensive changes in practice of surveillance colonoscopy resulted in significant improvement in quality indicators within a short period of time. Training, education and audit may continue to facilitate the adoption of DCE and further improve quality of performance in IBD surveillance.

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Section: Discussionsupporting

confidence: 88%

Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance

Smith

Cannatelli

Bazarova

et al. 2019

Digestive Endoscopy

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“…Current consensus guidelines recommend chromoendoscopy with targeted biopsies for IBD surveillance [161]. No study has yet focused on which preparation regimes are optimal for chromoendoscopy; however a recent case series noted that having a clear liquid diet for 24 hours pre-procedure led to a higher probability that preparation would be good enough to allow chromoendoscopy (OR 0.11, 95 %CI 0.01 -0.85; P < .034) [174].…”

Section: Patients With Inflammatory Bowel Disease (Ibd)mentioning

confidence: 99%

Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

et al. 2019

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Main RecommendationsESGE recommends a low fiber diet on the day preceding colonoscopy.Strong recommendation, moderate quality evidence.ESGE recommends the use of enhanced instructions for bowel preparation.Strong recommendation, moderate quality evidence.ESGE suggests adding oral simethicone to bowel preparation.Weak recommendation, moderate quality evidence.ESGE recommends split-dose bowel preparation for elective colonoscopy.Strong recommendation, high quality evidence.ESGE recommends, for patients undergoing afternoon colonoscopy, a same-day bowel preparation as an acceptable alternative to split dosing.Strong recommendation, high quality evidence.ESGE recommends to start the last dose of bowel preparation within 5 hours of colonoscopy, and to complete it at least 2 hours before the beginning of the procedure.Strong recommendation, moderate quality evidence.ESGE recommends the use of high volume or low volume PEG-based regimens as well as that of non-PEG-based agents that have been clinically validated for routine bowel preparation. In patients at risk for hydroelectrolyte disturbances, the choice of laxative should be individualized.Strong recommendation, moderate quality evidence.

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“…In a Polish study, Mytyk et al (25) found that 6-18-year-old children showed no differences between the CLD group and LRD group with regard to a total BBPS score. Moreover, Megna et al (26) recently reported that CLD was an independent predictive factor of good bowel preparation for chromoendoscopy in patients with inflammatory bowel disease. We believe that the short-term and simplified CLD will be suitable for the Turkish patient population.…”

Section: Discussionmentioning

confidence: 99%

Can a 1-day clear liquid diet with a split -dose polyethylene glycol overcome conventional practice patterns during the preparation for screening colonoscopy?

Etık

Suna

Gündüz

et al. 2019

Turk J Gastroenterol

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Background/Aims: A successful screening colonoscopy is closely linked to the quality of a bowel preparation. In this study, we aimed to determine the impact of a 1-day clear liquid diet (CLD) compared to a 3-day combined diet (CMD) accompanied by a split-dose regimen of polyethylene glycol and electrolyte lavage solution (PEG-ELS) for screening colonoscopy. Materials and Methods: This was a prospective, randomized, endoscopist-blinded study. Patients referred for screening colonoscopy were randomized to four groups as a 1-day CLD+PEG-ELS vs. a 1-day CLD+sulfate free (SF)-PEG-ELS and a 3-day CMD+PEG-ELS vs. a 3-day CMD+SF-PEG-ELS. An assessment of the quality of colon cleaning, tolerability to the preparation, and symptoms related to the preparation were recorded. Results: A total of 506 patients were enrolled in this study. The quality of bowel preparation was significantly inferior in the CM-D+PEG-ELS group than CLD+PEG-ELS (p=0.004) and CMD+SF-PEG-ELS groups (p=0.007). There were no statistical differences among the groups in terms of the polyp detection rate. With respect to an easy rating of diet following and the consumption of laxative, there were no significant differences among the four groups. Gastric fullness and nausea/vomiting were pointed out much more, especially in the SF-PEG-ELS users (p=0.008 and p=0.004, respectively). Conclusion: A 1-day CLD was not inferior to a 3-day CMD for colonoscopy preparation in terms of bowel cleaning, the polyp detection rate, and patient tolerance.

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Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease

Cited by 23 publications

References 34 publications

Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance

Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance

Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

Can a 1-day clear liquid diet with a split -dose polyethylene glycol overcome conventional practice patterns during the preparation for screening colonoscopy?

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