Abstract
Low-volume polyethylene glycol (PEG) plus ascorbic acid solutions are widely used for bowel cleansing before colonoscopy. This study aimed to investigate the pre-endoscopic predictive factors for inadequate preparation in subjects receiving low-volume PEG plus ascorbic acid. A prospective study was performed at Gangnam Severance Hospital, Korea, from June 2016 to December 2016. All participants received low-volume PEG plus ascorbic acid solutions for outpatient colonoscopy. The split-dose bowel preparation was administered in subject with morning colonoscopy while same day bowel preparation was used for afternoon colonoscopy. 715 patients were enrolled (mean age 56.1 years, 54.4% male), of which 138 (19.3%) had an inadequate bowel preparation. In multivariable analysis, cirrhosis (OR 4.943, 95% CI 1.191–20.515), low (less than 70%) compliance for three-day low-residual diet (OR 2.165, 95% CI 1.333–3.515), brown liquid rectal effluent (compared with clear or semi-clear effluent) (OR 7.604, 95% CI, 1.760–32.857), and longer time interval (≥2 hours) between last defecation and colonoscopic examination (OR 1.841, 95% CI, 1.190–2.849) were found as an independent predictors for inadequate preparation. These predictive factors may be useful in guiding additional intervention to improve quality of bowel preparation.
Highlights
Adequate preparation of the bowels is a crucial prerequisite for a complete and successful colonoscopy
Our study shows that cirrhosis, lack of adherence to a three-day low-residual diet, brown liquid rectal effluent, and ≥2 hours from last defecation to colonoscopic examination were independent predictors of inadequate preparation in patients using low-volume polyethylene glycol (PEG) (2 L) plus ascorbic acid treatment for bowel preparation in outpatient colonoscopy
Our study showed that cirrhosis is an independent predictor of poor bowel preparation under low-volume PEG (2 L) plus ascorbic acid preparation
Summary
Adequate preparation of the bowels is a crucial prerequisite for a complete and successful colonoscopy. High volume (4 L) polyethylene glycol (PEG)-based solutions have been used for bowel cleansing for a long time[3,4], the large volume and unpleasant salty taste frequently lead to poor patient compliance[5,6] Because of these PEG solution drawbacks, a combination of PEG with other osmotic or stimulant agents has been attempted to reduce the required PEG solution volume[7]. Several studies have reported the predictors associated with inadequate bowel preparation, including older age, female sex, diabetes, constipation, history of abdominal or gynecologic surgery, and www.nature.com/scientificreports compliance with preparation instructions[11,12,13] Most of these parameters are identified based on the classic, large volume regimen, and the risk factors for inadequate preparation in low-volume PEG plus ascorbic acid are not well understood. The aim of this study was to investigate the pre-endoscopic predictive factors for inadequate preparation in patients receiving low-volume PEG plus ascorbic acid treatment
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