Complete colonoscopy: impact of patients' demographics and anthropometry on caecal intubation time

Abstract

Background and aimFactors that affect caecal intubation during colonoscopy include age and sex of the patient, quality of bowel preparation, prior abdominal or pelvic surgery and pelvic inflammatory disease, among others. The aim of this prospective study was to evaluate the effects of patients' demography such as age and sex, as well as anthropometry (height, weight and body mass index (BMI)) on caecal intubation time (CIT).Patients and methodsAll consecutive patients referred for colonoscopy over a period of 6 months were recruited into the study. Prior to the procedure, patients' demographic data as well as history of prior abdominal or pelvic surgery were recorded. The height and weight of each patient were taken, and the BMI calculated. CIT was measured from the time of insertion of the colonoscope into the anal canal to the time when the base of the caecum was intubated.ResultsA total of 167 patients comprising 99 (59.3%) males and 68 (40.7%) females were studied. The mean CIT of the procedures was 912.5±477.1 s with a range of 180–3180 s. It was more prolonged in patients older than 65 years of age, in males and in those with prior abdominal/pelvic surgery, although no significant difference was observed among the groups. Multivariate logistic regression analysis showed that increased BMI and non-usage of additional manoeuvres independently reduced CIT.ConclusionsOlder age, male gender, prior abdominal/pelvic surgery, use of additional manoeuvres and lower BMI were found to prolong CIT.

Effects of body mass index on cecal intubation time in women

“…It was revealed that CIT was shorter in cases with higher BMI. The results obtained are consistent with the literature (4,(8)(9)(10). It is known that there is somewhat more fat accumulation in the retroperitoneal area of the women with higher BMI than those with normal BMI.…”

“…Over the years, the relationship between the body weight and the technical difficulties encountered during colonoscopy has been a matter of serious debate, especially in the stage of reaching the caecum. There are different data in the literature indicating that weak or obese patients cause difficulty for the endoscopist during colonoscopy (3,4). In fact, obesity is considered to be an independent factor that causes difficult and long colonoscopy and is associated with poor intestinal cleansing (5).…”

“…We believe that stored fat pads in this area may cause the colonoscope to move smoothly at sharp curves during the colonoscopy procedure and shorten CIT. At the same time, the fact that overweight patients have relatively shorter colon than the normal population can also provide an additional contribution to the shortening of CIT (4,11).…”

“…Cecal intubation, an important factor in the evaluation of colonoscopy performance, is necessary to ensure that the colon examination is whole and complete (2). Cecal intubation time (CIT) describes the length of time in which colonoscopy reaches from the anal region to the caecum, and is a determining factor for difficult colonoscopies (4). It is reported in the literature that CIT is affected by advanced age, female gender, abdominal surgical history, diverticulosis, poor intestinal cleansing and by the colonoscopy experience of endoscopist (3,4).…”

Sex difference in bowel preparation quality and colonoscopy time

“…There have been some reports regarding sex difference in colonoscopy quality [13,[31][32][33]. Ness et al [13] have suggested that male sex (odds ratio, 0.85) is associated with inadequate bowel preparation.…”