Impact of bowel preparation on caecal intubation time during colonoscopy.

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

doi:10.12669/pjms.35.6.1031

Haris Alvi, Majid Ahmed Shaikh + Show 4 more

Open Access

https://doi.org/10.12669/pjms.35.6.1031

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Abstract

Objective:To determine the caecal intubation time depending on bowel preparation as per Boston Bowel Preparation Scale.Methods:This cross-sectional study was conducted at Dr. Ruth K. M. Pfau, Civil Hospital Karachi between August 2018 to February 2019. A total of 201 patients were included in the study. Time was recorded from insertion of colonoscope to the time required to reach the cecum. Bowel preparation was graded during withdrawal of colonoscope by using Boston Bowel Preparation Scale. Pearson Correlation test was used to study correlation of BBPS scores with CIT, gender, BMI, adenoma and polyp detection.Results:In this study 201 patients undergoing colonoscopy were included. Mean ±SD of age of patients was 36.9 ±15.8 years. Out of the 201 patients 112 (56%) were males and 89 (44%) were females. The results of our study showed that increased Boston Bowel Preparation Scale Scores were associated with decreased caecal intubation time. The mean CIT was 10.7 ±5.4 minutes and Pearson correlation was significant at 0.002. Significant correlations of BBPS were also found with BMI and adenoma detection.Conclusion:The diagnostic effectiveness of colonoscopy depends upon the quality of the preparation. Good bowel preparation improves the speed of colonoscopy and its completeness.

Highlights

Caecal intubation time is defined as the time required to reach caecum after insertion of colonoscope
Other factors are measurable and obtained from history, but bowel preparation is measured by different scales including American Society for Gastrointestinal Endoscopy (ASGE) and American Gastroenterological Association (AGA) Task Force who used the terms as “excellent, good, fair and
Bowel preparation was graded during withdrawal of colonoscope by using Boston Bowel Preparation Scale (BBPS) from 0 to 3, where higher score means good bowel preparation, details of Boston Bowel Scale is given as under: 0 = poor preparation with solid stool on mucosa that cannot be cleaned and hinder the mucosal visualization. 1 = some mucosa seen while rest of mucosa cannot be seen due to solid or loose stool. 2 = some mucosa cannot be seen due to solid or loose stool while rest of mucosa is visualized. 3 = good preparation and visualization of entire mucosa.[7]

Summary

Introduction

Caecal intubation time is defined as the time required to reach caecum after insertion of colonoscope It indicates the difficulty of advancing the scope till caecum.[1] It is affected by many factors including age, sex, increased or decreased body mass index, waist circumference, history of abdominal or pelvic surgery, experience of endoscopist, and the bowel preparation.[1,2,3] It is affected by length of colonoscope and advance features present in colonoscope such as variable stiffness.[4] other factors are measurable and obtained from history, but bowel preparation is measured by different scales including American Society for Gastrointestinal Endoscopy (ASGE) and American Gastroenterological Association (AGA) Task Force who used the terms as “excellent, good, fair and. This lacks standard definition and results in variability in comments on bowel preparation.[5,6]

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