Patient Acceptance, Convenience, and Efficacy of Single-dose Versus Split-dose Colonoscopy Bowel Preparation

Khan, Maqsood Ahmed; Piotrowski, Z; Brown, Michael D.

doi:10.1097/mcg.0b013e3181c2c92a

Cited by 24 publications

(18 citation statements)

References 7 publications

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“…In this respect, 2 recent studies reported that most patients are willing to wake early if convinced that the timing of ingesting the laxative will enhance the outcome of their colonoscopy. 33,34 Another key finding from this study is that endoscopists were shown to be significant factors for ADR. A recent study has shown that the ADR of individual endoscopists at screening colonoscopy is associated with colonoscopic withdrawal time and is also an independent predictor of interval CRC.…”

Section: Discussionmentioning

confidence: 88%

Different Bowel Preparation Schedule Leads to Different Diagnostic Yield of Proximal and Nonpolypoid Colorectal Neoplasm at Screening Colonoscopy in Average-Risk Population

Chiu

Lin

Lee

et al. 2011

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 88%

Different Bowel Preparation Schedule Leads to Different Diagnostic Yield of Proximal and Nonpolypoid Colorectal Neoplasm at Screening Colonoscopy in Average-Risk Population

Chiu

Lin

Lee

et al. 2011

Diseases of the Colon &Amp; Rectum

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“…Acceptance of and compliance with split-dose bowel preparation is high and should not pose a deterrent to prescribing split-dose preparations for colonoscopy ( 39,40 ). Th e risk of fecal incontinence during transit to the endoscopy center is increased only minimally with split dosing ( 40 ).…”

Section: Obstacles To Split and Same-day Regimensmentioning

confidence: 99%

Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the US Multi-Society Task Force on Colorectal Cancer

Johnson

Barkun

Cohen

et al. 2014

American Journal of Gastroenterology

136

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The American Journal of GASTROENTEROLOGY PRACTICE GUIDELINESColorectal cancer (CRC) is the second leading cause of cancerrelated deaths in the United States ( 1 ). Colonoscopy can prevent CRC by the detection and removal of precancerous lesions. In addition to CRC screening and surveillance, colonoscopy is used widely for the diagnostic evaluation of symptoms and other positive CRC screening tests. Regardless of indication, the success of colonoscopy is linked closely to the adequacy of preprocedure bowel cleansing.Unfortunately, up to 20-25% of all colonoscopies are reported to have an inadequate bowel preparation ( 2,3 ). Th e reasons for this range from patient-related variables such as compliance with preparation instructions and a variety of medical conditions that make bowel cleansing more diffi cult to unit-specifi c factors (eg, extended wait times aft er scheduling of colonoscopy) ( 4 ). Adverse consequences of ineff ective bowel preparation include lower adenoma detection rates, longer procedural time, lower cecal intubation rates, increased electrocautery risk, and shorter intervals between examinations ( 3,5-7 ).Bowel preparation formulations intended for precolonoscopy cleansing are assessed based on their effi cacy, safety, and tolerability. Lack of specifi c organ toxicity is considered to be a prerequisite for bowel preparations. Between cleansing effi cacy and tolerability, however, the consequences of inadequate cleansing suggest that effi cacy should be a higher priority than tolerability. Consequently, the choice of a bowel cleansing regimen should be based on cleansing effi cacy fi rst and patient tolerability second. However, effi cacy and tolerability are closely interrelated. For example, a cleansing agent that is poorly tolerated and thus not fully ingested may not achieve an adequate cleansing.Th e goals of this consensus document are to provide expert, evidence-based recommendations for clinicians to optimize colonoscopy preparation quality and patient safety. Recommendations are provided using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) scoring system, which weighs the strength of the recommendation and the quality of the evidence ( 8 ). METHODS Search StrategyComputerized medical literature searches were conducted from January 1980 (fi rst year of approval of polyethylene glycol-electrolyte lavage solution [PEG-ELS]-based preparation by the Food and Drug Administration [FDA]) up to August 2013 using MEDLINE, PubMed EMBASE, Scopus, CENTRAL, and ISI Web of knowledge. We used a highly sensitive search strategy to identify reports of randomized controlled trials ( 9 ) with a combination of medical subject headings adapted to each database and text words related to colonoscopy and gastrointestinal agents, bowel preparation, generic name, and brand name. Th e complete search terms are available in Appendix A. Recursive searches and cross-referencing also were performed using a "similar articles" function; hand searches of articles were identifi ed aft er an i...

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“…However, surveys have shown that the great majority of patients assigned to early morning appointment slots will get up during the night to take the preparation, and potential patients demonstrate willingness to get up once they understand the purpose and value of split dosing [33]. Further, initial studies suggest that the risk of incontinence on the way to the endoscopy unit is equal to or only slightly greater than that which occurs with evening before dosing [34]. In our unit, we give all preparations in split fashion, though we will allow same-day dosing for patients with afternoon appointments [35][36][37].…”

Section: Bowel Preparationmentioning

confidence: 95%

Guidelines for an Optimum Screening Colonoscopy

Vemulapalli

Rex

2011

Curr Colorectal Cancer Rep

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Effective colonoscopy requires a high rate of excellent and good bowel preparations, which can be achieved by split dose or same day dosing. Cecal intubation rates in screening patients should exceed 95%, and experts frequently achieve 99% or more. Cecal intubation should be documented by photographs of the appendiceal orifice and ileocecal valve and notation of landmark visualization. Withdrawal technique must include meticulous inspection of the proximal sides of the folds, clean-up of residual fluid and feces, adequate luminal distension, and adequate withdrawal time. The endoscopist must be familiar with the full spectrum of endoscopic lesions, including flat and depressed lesions and serrated lesions. Optimal screening colonoscopy includes documentation of high quality by adequate adenoma detection rates, cecal intubation rates, and use of appropriate surveillance intervals.

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Patient Acceptance, Convenience, and Efficacy of Single-dose Versus Split-dose Colonoscopy Bowel Preparation

Cited by 24 publications

References 7 publications

Different Bowel Preparation Schedule Leads to Different Diagnostic Yield of Proximal and Nonpolypoid Colorectal Neoplasm at Screening Colonoscopy in Average-Risk Population

Different Bowel Preparation Schedule Leads to Different Diagnostic Yield of Proximal and Nonpolypoid Colorectal Neoplasm at Screening Colonoscopy in Average-Risk Population

Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the US Multi-Society Task Force on Colorectal Cancer

Guidelines for an Optimum Screening Colonoscopy

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