S1048 A Prospective Cohort Study of the Effects of Bowel Preparation and Prolonged Fasting on the Results of Transient Elastography

Abstract

INTRODUCTION: With the worldwide epidemic of metabolic syndrome, the incidence of NAFLD is on the rise. NASH related liver cirrhosis and HCC will soon become the most common indication of liver transplantation. Screening patients for NAFLD can be a crucial step in the prevention of advanced steatosis and cirrhosis. Fibroscan akaTransient elastography has become a screening test of choice for non-invasive evaluation of liver fibrosis and cirrhosis. Studies have shown that meal ingestion can markedly increase liver stiffness and can influence the result of Fibroscan. We investigated the changes in the result of fibroscan from bowel preparation and prolonged fasting and compared the result of fibroscan in patients who had their two fibroscan within one year- one with conventional 3 hours of fasting and another one with prolonged( >12 hours) fasting with bowel preparation. with prolonged (>12 hours) fasting with bowel preparation. METHODS: This study was an IRB approved prospective cohort study that enrolled 18 patients who had their last Fibroscan within last 12 months and who attended their routine elective colonoscopy and/or UGI endoscopy with fully prepped bowel and prolonged fasting. TE was performed when patients attended their elective procedures. A comparison of the result of both Fibroscan was performed. RESULTS: The average time from the first procedure to the second procedure was 57 days(IQR 31–88). The correlation between dB/m measures was rho 0.84 (P 0.0001) and between kPa measures was rho 0.737 (P 0.0017). 11/15 (73.33%) had complete agreement in their scoring of fibrosis. For the rest, 3 of the four were of higher fibrosis score on the scan after a three hour fast. (Kappa 0.6250, P 0.0000). CONCLUSION: No difference was found between the results of conventional Fibroscan and the study Fibroscan results. We found that bowel preparation and prolonged fasting do not affect the result of the Fibroscan study compared to the conventional 3 hours fasting. We recommend that routine TE can be offered to all patients who attend the GI outpatient clinics for their elective procedures. Conclusion: No difference was found between the results of conventional Fibroscan and the study Fibroscan results. We found that bowel preparation and prolonged fasting do not affect the result of the Fibroscan study compared to the conventional 3 hours of fasting. We recommend that routine TE can be offered to all patients who attend the GI outpatient clinics for their elective procedures.