S3230 Factors Associated With Inadequate Bowel Preparation for Colonoscopies in Inflammatory Bowel Disease

Abstract

INTRODUCTION: Colonoscopy plays a key role in the diagnosis, management, and surveillance of patients with inflammatory bowel disease (IBD). Adequate bowel preparation is a core issue in colonoscopy in general, but may have an outsized impact in a patient population at high risk of dysplasia and malignancy. There is currently very limited data on bowel preparation adequacy in the IBD patient population. METHODS: We conducted a single-center retrospective study of IBD patients who have undergone colonoscopy procedures. Detailed information was extracted from the hospital system’s EMR, including demographics, bowel preparation type and quality, and procedural characteristics. The Boston Bowel Preparation Scale (BPPS) was utilized to assess bowel preparation quality and was dichotomized into “inadequate” (BPPS 0–5) and “adequate” (BPPS 6–9). Patient variables were tested for association with inadequate preparation quality in bivariate analyses. For categorical variables, chi-squared or Fisher’s exact tests were utilized. Continuous variables were analyzed with the Student’s t-test. RESULTS: Data was extracted from the EMR for 386 IBD patients. 64% had Crohn’s disease and 36% had ulcerative colitis. The quality of preparation was deemed “inadequate” for 8% of the colonoscopies. Bivariate analyses revealed two patient variables that were associated with the quality of bowel preparation: history of any (P = 0.036) and rectal disease involvement (P = 0.005). Furthermore, disease extent, disease severity, and having a history of gastrointestinal resection did not influence the quality of bowel preparation. Additionally, the quality of bowel preparation was associated with colonoscopy completion (P < 0.001) and limited colonoscopies (either visually limited or the procedure was aborted such that disease severity could not be assessed) (P = 0.015). CONCLUSION: In our single center study, a history of any malignancy and rectal disease were significantly associated with the quality of bowel preparation. Inadequate preparations were more often associated with incomplete colonoscopy.