Impact of bowel preparation on caecal intubation time during colonoscopy

Alvi, Haris; Rasheed, Tazeen; Shaikh, Majid Ahmed; Ali, Faiza Sadaqat; Zuberi, Bader Faiyaz; Samejo, Asad Ali

doi:10.12669/pjms.35.6.1031

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…In our study females were more; this is concordant with a study conducted by Joukar et al 16 and Alvi 17 while other studies documented more males having lower GI pathologies undergoing colonoscopy 9,18,19 . Cecal intubation rate was 58.6% in our study.…”

Section: Discussionsupporting

confidence: 93%

Indications of Colonoscopy and Their Diagnostic Yield

Anwar¹,

Achakzai²,

Ullah³

et al. 2021

PJMHS

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Aims: To look for common indications and gastrointestinal pathologies observed on colonoscopy and to assess its diagnostic yield with respect to different clinical indications. Study design: Observational cross-sectional study Place and duration of study: Department of Medicine, Rehman Medical Institute from 1st January 2018 to 31st March 2019 Methodology: Five hundred and seventy three patients referred for colonoscopy were included. The demographic profile, indication of colonoscopy and colonoscopy findings were noted. Results: There were 231 (40.3%) males and 342 (59.7%) females with mean age 42.32±17.51 years. Bleed per rectum was most common indication noted in 284 (49.6%) followed by altered bowel habits 125 (21.8%) cases. Two hundred and fifty two (44%) colonoscopies were normal. One hundred and seventy three (30.2%) revealed significant lesions and 148 (25.8%) lesions were insignificant. Internal hemorrhoids were observed in 130 (22.7%) followed by colitis in 54 (9.4%). Abnormal computerized tomography abdomen revealed significant lesions in 62.2% of patients. Chronic diarrhea followed by constipation, altered bowel habits and iron deficiency anemia (IDA) showed 34.5%, 25.7%, 17.6% and <10% significant lesions respectively. Conclusion: Rectal bleed was the most common indication followed by altered bowel habits. Most common colonoscopy findings were hemorrhoids followed by colitis and abnormal growth. Abnormal computerized tomography abdomen gave the best diagnostic yield for colonoscopy. Keywords: Colonoscopy, Indications, Diagnostic yield

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Section: Discussionsupporting

confidence: 93%

Indications of Colonoscopy and Their Diagnostic Yield

Anwar¹,

Achakzai²,

Ullah³

et al. 2021

PJMHS

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“…The relationship between bowel preparation, one of the quality indicators in colonoscopy, and the CIT is not clear [4,19,20]. In our study, we found that better bowel preparation reduces CIT.…”

Section: Discussionmentioning

confidence: 51%

Factors Affecting Cecal Intubation Time in Colonoscopy: Impact of Obesity

Göksoy¹,

Kiyak²,

Karadağ³

et al. 2021

Cureus

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This study aims to determine the factors that prolong cecal intubation time (CIT) and determine the effect of obesity on CIT measured using multiple indexes. MethodsPatients who underwent elective colonoscopy between July 10, 2020, and January 20, 2021, were evaluated in this prospective observational study. Age, gender, constipation, bowel preparation, presence of diverticulosis, previous surgery history, auxiliary maneuver and additional analgesic requirement, cecum intubation length (CL) and obesity indices [body mass index (BMI), waist circumference (WC), waist-toheight ratio (WHtR)] were analyzed. Factors affecting CIT were assessed by both univariate and multivariate logistic regression (LR) analyses. ResultsA total of 512 patients were analyzed. Mean CIT was 5.6 ± 1.6 min, and median CIT was 5.17 min. The CIT median was ≤5.17 min in 264 (51.5%) of the patients, and the CIT median was >5.17 min in 248 (48.5%). In the univariate LR results, young age, constipation, poor bowel preparation, increased CL, additional analgesic requirement, low WHtR, and low BMI (<25 kg/m2) were the factors that prolonged CIT (p <0.05). In the multivariate LR analysis results, WHtR >0.5 and BMI >30 kg/m2 were found to be independent factors that decrease CIT [OR: 0.01 (0.01 0.03) p <0.001; OR: 0.28 (0.13 0.57) p <0.001]. ConclusionYounger age, low WHtR, low BMI, increased CL, constipation, inadequate bowel preparation, and the use of extra analgesics were found to be associated with longer CIT. When all factors were evaluated together, obesity measured by only WHtR (>0.5) and BMI (>30 kg/m2) were the best predictors of decreased CIT.

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“…However, inadequate bowel preparation is a common problem in gastroenterological practice worldwide. Inadequate bowel cleansing adversely affects various aspects of the colonoscopy procedure, such as prolonging CIT and reducing ADRs (Alvi et al, 2019; Zhang et al, 2021). Poor preparation quality may also increase the risk of procedural-related complications (e.g., perforation, bleeding), as well as increase healthcare costs and patient discomfort due to the need for reexamination (Hotta, 2022; Murphy et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Exercise Therapy for Bowel Preparation

Zhang

Chui

Hilmi

2023

Gastroenterology Nursing

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This systematic review aims to evaluate (1) the effectiveness of exercise therapy in bowel preparation for colonoscopy, and (2) the characteristics of exercise programs for bowel preparation. Systematic searches were done in PubMed, EMBASE, the Cochrane Library, Web of Science, and CINAHL from inception to November 2022. Randomized controlled trials and quasi-experimental studies assessing the efficacy of exercise during bowel preparation were included in this review. Two reviewers independently assessed the methodological quality using a modified Downs and Black checklist. A narrative synthesis was conducted. A total of five studies (1,109 participants) were included in this review. In all eligible studies, the characteristics of the exercise programs varied and included mainly two types of exercise (walking and yoga), various amount of exercise (3,000–10,000 steps or 0.5–1.9 hours), and two exercise timing (during and 1 hour after taking the laxative). Available evidence indicated that exercise therapy is effective in improving the quality of bowel preparation. However, there was insufficient high-quality evidence to conclude the effects on procedure-related indicators, adverse events, and willingness to repeat preparation. Exercise should be recommended as an important part of routine bowel preparation for patients undergoing colonoscopy to improve the quality of bowel preparation. More rigorous studies focusing on the effects on procedure-related indicators, adverse events, and willingness to repeat preparation are needed. To ensure the effectiveness and safety of the intervention, it is critical to establish a standard, well-structured exercise program for bowel preparation.

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Impact of bowel preparation on caecal intubation time during colonoscopy

Cited by 7 publications

References 15 publications

Indications of Colonoscopy and Their Diagnostic Yield

Indications of Colonoscopy and Their Diagnostic Yield

Factors Affecting Cecal Intubation Time in Colonoscopy: Impact of Obesity

A Systematic Review of Exercise Therapy for Bowel Preparation

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