Duration of the interval between the completion of bowel preparation and the start of colonoscopy predicts bowel-preparation quality

Siddiqui, Ali A.; Yang, Guozi; Spechler, Stuart J.; Cryer, Byron; Davila, Raquel E.; Cipher, Daisha J.; Harford, William V.

doi:10.1016/j.gie.2008.09.047

Cited by 178 publications

(143 citation statements)

References 19 publications

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“…However, that study did suggest a better quality of the bowel preparation was found in patients with a shorter time between finishing the bowel prep and the start of colonoscopy. Similar results were found in another prospective study of 378 patients [32] , but these investigators did not use a validated scale to assess the quality of bowel preparation. Nevertheless, it appears that a shorter "runway" time between finishing the prep and undergoing colonoscopy is associated with a better quality preparation [33] .…”

Section: Discussionsupporting

confidence: 66%

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Baba

Lewis

2016

Journal of Gastroenterology and Hepatology Research

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AIM: Several bowel preps are currently used for colonoscopy but only limited data are available comparing the different products. METHODS:We retrospectively reviewed all colonoscopies performed at Georgetown U. Hospital from May 2013 to May 2014. A 9-point modified Boston Bowel Preparation Scale (BBPS) was utilized (best score = 9) by experienced endoscopists. Colonoscopies without a BBPS score were excluded. seen for women vs men overall for both split-dose and day-prior dosepreps (with the exception of Moviprep ® in PD preps). Higher scores were seen for a.m. procedures but were not significant. All preps had lower scores in the right colon, regardless of being splitdose or day-prior dose. CONCLUSIONS: This real world experience in nearly 3600 patients confirms that split dosing is superior to day-prior dosing. We found women had higher BBPS scores than men but no differences were seen between morning and afternoon procedures. All preps were relatively comparable, however differences in price may be an important decision-maker. RESULTS:

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Section: Discussionsupporting

confidence: 66%

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Baba

Lewis

2016

Journal of Gastroenterology and Hepatology Research

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“…The clinical rationale of same-day bowel preparation is the same as that of split-dosing, i.e., to shorten the interval between the completion of bowel preparation and colonoscopy [19] . It has been demonstrated that the quality of bowel preparation improves when the interval between the last dose of bowel preparation and colonoscopy does not exceed 8 h [20][21][22] . After that period a viscous bile-stained mucous enters the colon and distributes over the colonic mucosa of the right colon with the potential to cover small or flat lesions containing high dysplasia.…”

mentioning

confidence: 99%

Same-day 2-L PEG-citrate-simethicone plus bisacodylvssplit 4-L PEG: Bowel cleansing for late-morning colonoscopy

Leone

Tamayo²,

Fiori³

et al. 2013

WJGE

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AIM:To evaluate the efficacy, tolerability, acceptability and feasibility of bisacodyl plus low volume polyethyleneglycol-citrate-simeticone (2-L PEG-CS) taken the same day as compared with conventional split-dose 4-L PEG for late morning colonoscopy. METHODS:Randomised, observer-blind, parallel group, comparative trial carried out in 2 centres. Out patients of both sexes, aged between 18 and 85 years, undergoing colonoscopy for diagnostic investigation, colorectal cancer screening or follow-up were eligible. The PEG-CS group received 3 bisacodyl tablets (4 tablets for patients with constipation) at bedtime and 2-L PEG-CS in the morning starting 5 h before colonoscopy. The control group received a conventional 4-L PEG formulation given as split regimen; the morning dose was taken with the same schedule of the low volume preparation. The Ottawa Bowel Preparation Scale (OBPS) score was used as the main outcome measure. RESULTS:A total of 164 subjects were enrolled and 154 completed the study; 78 in the PEG-CS group and 76 in the split 4-L PEG group. The two groups were comparable at baseline. The OBPS score in the PEG-CS group (3.09 ± 2.40) and in the PEG group (2.39 ± 2.55) were equivalent (difference +0.70; 95%CI: -0.09-1.48). This was confirmed by the rate of successful bowel cleansing in the PEG-CS group (89.7%) and in the PEG group (92.1%) (difference -2.4%; 95%CI: -11.40-6.70). PEG-CS was superior in terms of mucosa visibility compared to PEG (85.7% vs 72.4%, P = 0.042). There were no significant differences in caecum intubation rate, time to reach the caecum and withdrawal time between the two groups. The adenoma detection rate was similar (PEG-CS 43.6% vs PEG 44.7%). No serious adverse events occurred. No difference was found in tolerability of the bowel preparations. Compliance was equal in both groups: more than 90% of subjects drunk the whole solution. Willingness to repeat the same bowel preparations was about 90% for both regimes. CONCLUSION:Same-day PEG-CS is feasible, effective as split-dose 4-L PEG for late morning colonoscopy and does not interfere with work and daily activities the day before colonoscopy. Key words: Bowel preparation; Polyethyleneglycol; Simethicone; Ottawa Bowel Preparation Scale; Colonoscopy Core tip: The timing of bowel preparation is fundamental for high quality colonoscopy and also for patient satisfaction. Split-dose preparation improves the rate of adequate cleansing and patient compliance. This study shows that the same-day low volume polyethyleneglycol-citrate-simeticone (PEG-CS) plus bisacodyl tablets is feasible, and as effective as split 4-L PEG. The low volume bowel preparation taken the same day of the exam may be an attractive option for late morning September 16, 2013|Volume 5|Issue 9|

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“…When the patients have been prepared the day before, the time interval is different. One study used an intensive preparation strategy (4-L PEG plus a regular dose of NaP), with a median time interval from the last dose of the preparation agent to the start of colonoscopy of 13.5 h [54] . In this study, only 14% of examinations had excellent quality cleansing and 38% good quality.…”

Section: A Key Factor For Optimal Preparation: Timing Of Administrationmentioning

confidence: 99%

“…There are several factors that could facilitate a better preparation quality in that situation. First, the study by Siddiqui et al [54] showed that when the interval beteween the preparation and the start of colonoscopy exceeds 13 h, the quality of cleansing becomes worse. Therefore, the interval should be reduced as much as possible, and should never be longer than 13 h. Secondly, as will be explained later in this article, a low-fiber preparation on the day before the colonoscopy is more patient friendly.…”

Section: A Key Factor For Optimal Preparation: Timing Of Administrationmentioning

confidence: 99%

Achieving the best bowel preparation for colonoscopy

Parra‐Blanco¹,

Ruiz²,

Álvarez-Lobos³

et al. 2014

WJG

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Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. Core tip: Bowel preparation for colonoscopy is a central issue related to the quality of the procedure. There are different agents for bowel preparation that can be administered with different schedules. We review the most commonly used agents, as well as new agents and combinations. Moreover, certain considerations should be taken into account for special populations in order to improve safety, efficacy and tolerance. Regimens for bowel preparation in special situations are discussed, such as for pedi...

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Duration of the interval between the completion of bowel preparation and the start of colonoscopy predicts bowel-preparation quality

Cited by 178 publications

References 19 publications

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Same-day 2-L PEG-citrate-simethicone plus bisacodylvssplit 4-L PEG: Bowel cleansing for late-morning colonoscopy

Achieving the best bowel preparation for colonoscopy

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