Colonic Research Articles

Bowel preparation after mid-gut tubing enhanced the efficacy and compliance of magnetic resonance enterography in Crohn's disease: a randomized controlled trial.

Magnetic resonance enterography (MRE) has become a routine intestinal imaging examination for Crohn's disease (CD). Sufficient bowel preparation is fundamental for MRE. To compare the efficacy and compliance of bowel preparation between through a mid-gut tube and oral administration for MRE in CD. This was an open-label, prospective, multicenter, randomized controlled trial. Eligible patients were randomized at a 1:1 ratio into an oral group (bowel preparation by oral administration) and a tubing group (bowel preparation through a mid-gut tube). Bowel preparation for MRE included bowel cleaning and bowel distention. The primary outcomes were the degree of discomfort and grade of bowel distention. The secondary outcomes were diagnostic accuracy rate through MRE, mental stress, and bowel preparation method preference. A total of 95 CD patients were included in the final analysis. Subjects in the tubing group complained of less vomiting during bowel preparation than those in the oral group (p < 0.05). The degree of nausea and bloating during bowel cleaning for MRE was lower in the tubing group than in the oral group (all p < 0.05). The distention grade was higher in the tubing group compared to the oral group in the splenic flexure of the colon and rectosigmoid colon. The tubing group demonstrated a higher overall diagnostic sensitivity in ulcers compared to the oral group (p = 0.048). Additionally, bowel preparation via the mid-gut tube ameliorated mental stress (p = 0.020) and increased bowel preparation preference (p < 0.001). Bowel preparation through the mid-gut tube enhanced the efficacy and compliance for MRE in CD. This study highlighted the concept of physician-patient satisfaction using mid-gut tube for proper bowel preparation for MRE, enteral nutrition and microbial therapy. ClinicalTrials.gov, NCT03541733, registered 5 May 2018.

Outcomes of Laparoscopic Suture vs Mesh Rectopexy for Complete Rectal Prolapse.

Objective To compare outcomes of laparoscopic suture and laparoscopic mesh rectopexy for the treatment of complete rectal prolapse in adults. Materials and methods This study was conducted between December 2020 to December 2022, involving 75 patients (Group A: 34; Group B: 41). Inclusion criteria encompassed confirmed complete rectal prolapse. Preoperative measures included comprehensive assessments, mechanical bowel cleansing, prophylactic antibiotics, and rectal irrigation. Surgical techniques involved laparoscopic suture rectopexy for Group A and laparoscopic mesh rectopexy for Group B. Postoperative care and follow-up evaluations were conducted. Results Group A demonstrated advantages in terms of shorter operative times, quicker bowel activity resumption, and reduced hospital stays. Intraoperative bleeding was absent in Group A, while wound-related complications were higher in Group B. Recurrence rates were lower in Group A (2.9%) compared to Group B (9.8%). Both groups exhibited improvements in incontinence grades postoperatively. Constipation increased in both groups. Conclusion Both techniques are effective in treating complete rectal prolapse, each with its advantages and considerations. Group A showed potential benefits in terms of operative efficiency and fewer complications, albeit with a potential for increased recurrence. The study emphasizes the need for individualized patient care, considering factors such as operative characteristics, postoperative outcomes, and patient preferences.

Development and validation of a three-dimensional deep learning-based system for assessing bowel preparation on colonoscopy video.

The performance of existing image-based training models in evaluating bowel preparation on colonoscopy videos was relatively low, and only a few models used external data to prove their generalization. Therefore, this study attempted to develop a more precise and stable AI system for assessing bowel preparation of colonoscopy video. We proposed a system named ViENDO to assess the bowel preparation quality, including two CNNs. First, Information-Net was used to identify and filter out colonoscopy video frames unsuitable for Boston bowel preparation scale (BBPS) scoring. Second, BBPS-Net was trained and tested with 5,566 suitable short video clips through three-dimensional (3D) convolutional neural network (CNN) technology to detect BBPS-based insufficient bowel preparation. Then, ViENDO was applied to complete withdrawal colonoscopy videos from multiple centers to predict BBPS segment scores in clinical settings. We also conducted a human-machine contest to compare its performance with endoscopists. In video clips, BBPS-Net for determining inadequate bowel preparation generated an area under the curve of up to 0.98 and accuracy of 95.2%. When applied to full-length withdrawal colonoscopy videos, ViENDO assessed bowel cleanliness with an accuracy of 93.8% in the internal test set and 91.7% in the external dataset. The human-machine contest demonstrated that the accuracy of ViENDO was slightly superior compared to most endoscopists, though no statistical significance was found. The 3D-CNN-based AI model showed good performance in evaluating full-length bowel preparation on colonoscopy video. It has the potential as a substitute for endoscopists to provide BBPS-based assessments during daily clinical practice.

Limited summer palate with no colonic irrigation required: life of a migratory shark through the metabarcoding lens.

Limited summer palate with no colonic irrigation required: life of a migratory shark through the metabarcoding lens.

Sacral Neuromodulation Versus Conservative Treatment for Refractory Idiopathic Slow-transit Constipation: The Randomized Clinical No.2-Trial.

Assess the effectiveness of sacral neuromodulation (SNM) versus personalized conservative treatment (PCT) in patients with refractory idiopathic slow-transit constipation (STC). Evidence on SNM for idiopathic STC is conflicting and of suboptimal methodological quality. The No.2-Trial was a multicenter, open-label, pragmatic, randomized trial performed in 2 Dutch hospitals. Sixty-seven patients with idiopathic STC, a defecation frequency <3 per week and refractory (ie, unresponsive) to maximal conservative (nonoperative) treatment were included. Exclusion criteria included outlet obstruction, rectal prolapse, and previous colon surgery. Patients were randomized (3:2) to SNM (n=41) or PCT (n=26) with randomization minimization between February 21, 2017 and March 12, 2020. In SNM patients, an implantable pulse generator was implanted after a successful 4-week test stimulation. PCT patients received conservative treatment such as laxatives or retrograde colonic irrigation. The primary outcome was treatment success (defined as average defecation frequency ≥3 per week) after 6 months. Secondary outcomes included constipation severity, fatigue, quality of life, and adverse events. Analysis was according to intention-to-treat. After 6 months, 22 (53.7%) patients were successfully treated with SNM versus 1 (3.8%) patient with PCT (odds ratio 36.4, 95% CI 3.4-387.5, P =0.003). At 6 months, SNM patients reported lower constipation severity and fatigue scores ( P <0.001) and improved quality of life compared with PCT ( P <0.001). Eight serious adverse events (6 SNM, 2 PCT) and 78 adverse events (68 SNM, 10 PCT) were reported. SNM is a promising surgical treatment option in a homogeneous group of adults and adolescents with refractory idiopathic STC. No.2-Trial registered at ClinicalTrials.gov NCT02961582.

CCRA: A colon cleanliness rating algorithm based on colonoscopy video analysis

ObjectiveA Colon Cleanliness Rating Algorithm (CCRA) based on colonoscopy image analysis is proposed in this paper, in order to solve the problem that the results of Colon Cleanliness (or Bowel Preparation Quality) rating caused by manual inspection are inconsistent. MethodsFirstly, CCRA intercepts images from the colonoscopy video. Secondly, each colonoscopy image's stool area is segmented by U-Net to obtain the 2-classification segmentation results. Finally, the colon cleanliness is obtained by comparing the average area of the stool area with the standard proportion. ResultsAfter testing, the pixel accuracy of the U-Net model is 97.02 %, IoU is 83.67 %, accuracy is 92.17 %, recall is 90.21 %, F1-Score is 90.95 %. The accuracy of CCRA is 92.45 %–99.275 % ConclusionThe experimental results show that the CCRA proposed in this paper can quickly and accurately output the colon cleanliness rating of patients without manpower.

Comparing Low Volume Versus Conventional Volume of Polyethylene Glycol for Bowel Preparation during Colonoscopy: A Randomised Controlled Trial.

Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance patient tolerability and compliance in bowel preparation. Accordingly, this study compared the effectiveness of two difference PEG volumes for bowel preparation before colonoscopy in terms of bowel cleanliness, completeness of colonoscopy, patient tolerability and colonoscopy duration. Using a prospective randomised controlled single-blinded study design, 164 patients scheduled for colonoscopy were allocated to two groups (n = 82 patients in each) to receive either the conventional PEG volume (3 L, control group) or the low volume (2 L, intervention group). The Boston Bowel Preparation Scale (BBPS), a validated scale for assessing bowel cleanliness during colonoscopy, was used to score bowel cleanliness in three colon segments. Secondarily, colonoscopy completeness, tolerability to drinking PEG and the duration of colonoscopy were compared between the groups. There were no statistically significant differences between the two intervention groups in terms of bowel cleanliness (P = 0.119), colonoscopy completion (P = 0.535), tolerability (P = 0.190) or the amount of sedation/analgesia required (midazolam, P = 0.162; pethidine, P = 0.708). Only the duration of colonoscopy differed between the two groups (longer duration in the control group, P = 0.039). Low-volume (2 L) PEG is as effective as the standard 3 L solution in bowel cleaning before colonoscopy; however, the superiority of either solution could not be established.

Colonoscopy indications and findings in older adults

Aims: The share of older population is increasing globally. Colonoscopy is a frequently used diagnostic/therapeutic procedure, no study to our knowledge comprehensively examines the indications and findings of colonoscopy in geriatric population. We aimed to reveal these in older adults.&#x0D; Methods: Colonoscopy procedures performed in older adults (≥65 years), which covered a 5-year period (2017-2022), were analyzed retrospectively. Indications and findings of colonoscopies were assessed. The relationship between the indications and the associated findings was also evaluated on an indication basis.&#x0D; Results: In the study, 2370 colonoscopy procedures were examined. 27.8% were performed in very old (≥75 years) patients. Colonoscopy was completed in 84.3%. Colon cleansing was not optimal in approximately one-fourth. The frequency of completion of colonoscopies and optimal cleaning were similar in the very old. Iron deficiency anemia (IDA) or fecal occult blood test (FOBT) positivity and screening colonoscopy were the common indications. Regarding indications, IDA-FOBT positivity and bleeding were more frequent, screening colonoscopy, IBD and polyp control were less frequent in the very old group. Colonoscopy was reported as normal in 42.4% of the patients, while polyps (28.3%) and diverticula (17.5%) were the common findings. Among findings tumor, diverticula and solitary rectal ulcer were higher in the very old. IDA -FOBT positivity, bleeding, and colonoscopy performed due to findings of other imaging modalities were related to diagnosis of a tumor.&#x0D; Conclusion: In this study, we presented the indications and results of colonoscopy in a large number of older patients. The main indications for colonoscopy can be listed as IDA-FOBT positivity, screening colonoscopy and control of previous polyp-tumor. Near one of two colonoscopies were found to be normal, polyps and diverticula were the major pathologies in the rest. It should be emphasized that IDA -FOBT positivity, bleeding, and findings of other imaging modalities were related to tumor in colonoscopy.

Flying endoscopists in the Arctic: initiatives for quality assurance of endoscopies in Greenland

BackgroundSurgical coastal expeditions (SCEs) have been organized in Greenland for many years. They aim to provide small coastal hospitals with specialist services, such as endoscopies (SCEEs), by deploying specialist personnel, surgeons, and the necessary equipment to the hospital temporarily. The purpose of this program is to increase accessibility for patients, while simultaneously reducing the costs associated with patient transport to the central hospital.MethodsThis retrospective pilot review of medical records identified quality indicators, such as bowel cleansing (BP), cecal intubation rate (CIR), and adenoma and advanced adenoma detection rates (ADR, AADR), to investigate the status and establish a system for quality monitoring of SCEsE in Greenland.ResultsDuring two SCEs (8 working days), 89 SCEE were performed at Qaqortoq and Sisimiut Hospitals. The 60 patients who underwent colonoscopy included 32 men and 28 women with a mean age of 61 years (range 24–80 years). The unadjusted CIR was 91.7%. In eight (13.3%) examinations, bowel preparation was rated as unsatisfactory, resulting in two incomplete procedures. The ADR and AADR were 35% and 11.7%, respectively, and one cancer was detected (1.7%).ConclusionThe results showed satisfactory ADR, AADR, and CIR levels. However, the review also highlighted the need for increased attention to BP by developing a new procedure that considers differences due to specific eating habits in Greenland and provides much better information for patients. The review provided a snapshot of the quality of colonoscopies in Greenland, highlighting the necessity to continue this process to ensure that the quality is up to standard. Furthermore, SCE helps reduce the environmental footprint of gastrointestinal endoscopy by avoiding the need for patient air transport; instead of 77 round trips (61,830 km), only 8 (6440 km) were required.

Colon Bowel Preparation in the Era of Artificial Intelligence: Is There Potential for Enhancing Colon Bowel Cleansing?

Proper bowel preparation is of paramount importance for enhancing adenoma detection rates and reducing postcolonoscopic colorectal cancer risk. Despite recommendations from gastroenterology societies regarding the optimal rates of successful bowel preparation, these guidelines are frequently unmet. Various approaches have been employed to enhance the rates of successful bowel preparation, yet the quality of cleansing remains suboptimal. Intensive bowel preparation techniques, supplementary administration of bowel solutions, and educational interventions aimed at improving patient adherence to instructions have been commonly utilized, particularly among patients at a high risk of inadequate bowel preparation. Expedited strategies conducted on the same day as the procedure have also been endorsed by scientific organizations. More recently, the utilization of artificial intelligence (AI) has emerged for the preprocedural detection of inadequate bowel preparation, holding the potential to guide the preparation process immediately preceding colonoscopy. This manuscript comprehensively reviews the current strategies employed to optimize bowel cleansing, with a specific focus on patients with elevated risks for inadequate bowel preparation. Additionally, the prospective role of AI in this context is thoroughly examined. While a majority of outpatients may achieve cleanliness with standard cleansing protocols, dealing with hard-to-prepare patients remains a challenge. Rescue strategies based on AI are promising, but such evidence remains limited. To ensure proper bowel cleansing, a combination of strategies should be performed.

Bowel preparation for endoscopy: an overview

A clear bowel is essential to a successful lower gastrointestinal endoscopy. Therefore, nurses are required to select and inform patients about bowel preparations in order to achieve this. This may involve patients drinking a solution, such as CitraFleet® and Picolax®, Citramag® or KLEAN-PREP®, MOVIPREP® and PLENVU®. This article aims to outline and discuss these, including their efficacy and safety, to support nurses in achieving adequate bowel cleansing and safe and effective lower gastrointestinal endoscopic procedures.

Lubiprostone plus polyethylene glycol electrolyte lavage solution (PEG-ELS) versus PEG-ELS for bowel preparation in chronic constipation: a randomized controlled trial

Colonoscopy is considered the standard procedure for early detection and prevention of colorectal cancer. Adequate bowel cleansing is an important determinant of the efficacy of colonoscopy screening. Currently, there is no standard method of bowel preparation for patients with chronic constipation. The aim was to access the rate of adequate bowel cleansing achieved using split-dose polyethylene glycol electrolyte lavage solution (PEG-ELS) plus lubiprostone in comparison with split-dose PEG-ELS alone. A single-centre, endoscopist-blinded, randomized controlled trial was conducted. Seventy-eight constipated patients aged 18–75 years who were indicated for colonoscopy in the gastroenterology unit of Srinagarind Hospital, Khon Kaen University, between February 2020 and February 2021 were randomly allocated to receive either split-dose PEG-ELS in combination with lubiprostone (N = 39) or split-dose PEG-ELS alone (N = 39) before colonoscopy. Adequate bowel cleansing was defined as an Ottawa bowel preparation score ≤ 7. The rate of adequate bowel cleansing was comparable between the PEG-ELS plus lubiprostone group and the PEG-ELS alone group (50% vs. 52.9%, p value = 0.81) with a relative risk of 1.13 (95% CI = 0.43–2.91). There were no significant differences in adenoma detection rate (41.2% vs. 35.3%, p value = 0.62), adverse events, acceptance, compliance, or patient satisfaction between the 2 groups. No additional benefit to successful bowel preparation was achieved by the combination of lubiprostone and PEG-ELS in chronic constipation patients undergoing colonoscopy.

Correlation between prescribing doctor attributes and intestinal cleanliness in colonoscopy: a study of 22522 patients

Objective This study aimed to analyze the correlation between different attributes of doctors who prescribe colonoscopies and the cleanliness of the intestine to guide the development of colonoscopy application protocols. Methods Data on colonoscopy cases conducted in the gastroenterology department of Hangzhou First People’s Hospital between April 2018 and March 2021 were collected. The gender, age, professional attributes of the prescribing doctors, and Boston Bowel Preparation Scale (BBPS) score were recorded. In addition, the correlation between the prescribing doctors’ characteristics and the intestine’s cleanliness was analyzed. Results The study included 22,522 patients with a mean BBPS score of 6.83 ± 1.94. There were 16,459 male and 6,063 female doctors with similar BBPS scores (p = 0.212). The study found no significant difference in BBPS scores between 19,338 internist and 3,184 non-internist (p = 0.154). However, BBPS scores differed significantly between 18,168 gastroenterologists and 4,354 non-gastroenterologists (p = 0.016) and between 19,990 intestinal-related specialties(gastroenterology and gastrointestinal surgery) and 2,532 non-intestinal-related specialties (p = 0.000). In addition, BBPS scores were significantly different between 18,126 prescribing endoscopiests and 4,396 non-endoscopiests (p = 0.014). However, there was no significant difference in BBPS scores among doctors of different ages (p = 0.190). The study found significant differences in BBPS scores between male and female patients and those under or over 40 years (p = 0.000). Conclusion To improve colonoscopy preparation quality, priority should be given to doctors in gastroenterology, intestinal-related specialties, and endoscopiests. Their expertise may result in better education and improved bowel cleanliness.

The efficacy and tolerability of polyethylglycol solution with and without bisacodyl in preparation of colon before colonoscopy.

Objective: To compare the efficacy of four liter Polyethylin glycol alone with two liter polyethylin glycol plus bisacodyl in preparation of large bowel before colonoscopy. Study Design: Randomized Control Trial. Setting: Department of Gastroenterology, Hepatology and GI Endoscopy, SZABMU, Pakistan Institute of Medical Sciences, Islamabad. Period: 1st January 2021 to 31st December 2021. Material &amp; Methods: One hundred seventy patients, both males and females, who had indications for colonoscopy were included. After informed consent two equal groups of 85 were made. In group A, bisacodyl was added with two liters polyethylin glycol while in group B four liter Polyethylin glycol alone was used to prepare the gut before colonoscopy. Results: Out of 170 patients, the calculated Ottawa score was almost same in both groups. Extraordinary cleaning was found more regularly within the combination group (p &lt; 0.05). No intense adverse effects were found among the 2 regimens besides nausea, abdominal pain, and anal irritation which were seen a bit more in group B. The tolerability was better with bisacodyl and 2-L PEG preparation (P&lt;0.05). Conclusion: 2 L PEG+ bisacodyl preparation is a good alternative to 4-L PEG preparation for bowel cleansing, with distinct advantages in terms of tolerability, acceptability and compliance.

Bowel preparation: modifiable factors to improve bowel cleansing: Erratum.

Bowel preparation: modifiable factors to improve bowel cleansing: Erratum.

Capsule Enteroscopy Using the Mirocam® versus OMOM® Systems: A Matched Case-Control Study.

Although several devices are available for small bowel capsule endoscopy, few studies have compared their visualization quality and diagnostic yield, despite users reporting subjective differences between them. This study aims to compare two widely used systems (Mirocam® MC1600 and OMOM® HD). Patients who underwent OMOM® HD capsule enteroscopy between August 2022 and February 2023 were prospectively included consecutively (cases). Controls were retrospectively selected from a database of patients who underwent Mirocam® MC1600 enteroscopy between March 2018 and July 2022 in a 1:1 ratio. Controls were matched for potential confounders (age, sex, indication, hospitalization, comorbidities, and opioid prescription). The small bowel cleanliness (global and divided by tertiles), the diagnostic yield (positive findings) and the transit times (TT) were compared. Overall, 214 patients were included (107:107). Global bowel preparation was similar between the OMOM® and Mirocam® groups. However, the average scores for each tertile were significantly higher when the OMOM® HD capsule was used (p < 0.05). Small bowel TT was shorter for OMOM® HD (265 ± 118 versus 307 ± 87 min, p = 0.020), while the diagnostic yield (55.0%) and relative distribution of lesions were similar. This study suggests that capsule characteristics, namely resolution, and illumination, systematically interfere with the perception of preparation quality. However, this did not affect the diagnostic yield.

Novel Colon Preparation Method Combining Bowel Cleanser Reduction and Unique Walking.

Poor bowel preparation increases the difficulty of colonoscopy and affects lesion detection. In this study, we investigated the usefulness of a new bowel preparation method using polyethylene glycol electrolyte formulation containing ascorbic acid (PEG plus ascorbic acid: PEG-Asc, MOVIPREP) to improve bowel cleansing and shorten preparation time. This was a single-center, retrospective study. In the new method, patients were instructed to take a laxative the day before the examination and PEG1L on the day of the examination. In addition, we instructed the patients to walk, which we designed. The primary endpoints were the degree of bowel cleansing (assessed by the Boston bowel preparation scale, BBPS) and time to the cecum. The conventional group reached the cecum in 606.5±225.8 seconds (mean±SD), whereas the introduced group reached the cecum in 500±217.1 seconds, a significantly shorter time (P<0.05). In the BBPS, the score in the introduced group was significantly higher (P<0.01): 6.8±2.14 points in the conventional group and 8.6±0.74 points in the introduction group. Pretreatment combining the 1L weight loss method and walking improves bowel cleansing and shortens the time to reach the cecum.

Bowel cleansing effectiveness and safety of 1L PEG + Asc in the real-world setting: Observational, retrospective, multicenter study of over 13000 patients.

Background and study aims Effective bowel cleansing is critical for detecting lesions during colonoscopy, highlighting the importance of bowel preparations. 1L polyethylene glycol (PEG) + ascorbate (Asc) is the only recommended 1L PEG product in Europe and the United States. Its efficacy was demonstrated in large-scale controlled trials and confirmed in smaller-scale real-world studies. However, no large-scale real-world data exist. Patients and methods This observational, retrospective, multicenter study, used outpatient follow-up data from medical records from 10 centers in Spain and two in Portugal. Outpatients aged ≥18 years using 1L PEG + Asc as bowel preparation were included. The main outcome measures were overall adequate colon cleansing (Boston Bowel Preparation Scale [BBPS] score ≥6 with BBPS score ≥2 in each segment) and high-quality cleansing of the right colon (BBPS score=3). Results Data from 13169 eligible patients were included. Overall cleansing success was achieved in 89.3% (95%CI 88.7%-89.8%) and high-quality cleansing in the right colon in 49.3% (95%CI 48.4%-50.2%) of patients. For the overnight split-dose and same-day regimens, overall adequate quality cleansing success rate was 94.7% and 86.7% ( P <0.0001) and high-quality cleansing of the right colon rate was 65.4% and 41.4% ( P <0.0001), respectively. Colonoscopy was completed in 97.3% of patients, with non-completion due to poor preparation in only 0.8%; 2.3% of patients experienced at least one adverse event (AE). Conclusions This large-scale, real-world study demonstrates the effectiveness of 1L PEG + Asc in the total and right colon, with a low percentage of patients with AEs in routine clinical practice.

The safety and effects of high- and low-volume polyethylene glycol bowel preparation methods before colonoscopy on bowel cleanliness: a systematic review and meta-analysis.

Although both high- and low-volume polyethylene glycol (PEG) are widely used in intestinal preparation before colonoscopy, there is still controversy over the superiority of their cleaning effects. This meta-analysis sought to explore the safety and effects of high-volume PEG solution and low-volume PEG mixed solution on intestinal cleanliness before colonoscopy. The PubMed, EMBASE, and Cochrane Library databases were searched to retrieve relevant articles on the effects of high- and low-volume PEG mixture solutions on intestinal cleanliness from the inception of the databases to October 15, 2022. Two independent researchers screened the literature according to the predetermined inclusion and exclusion criteria, and extracted the required data separately. A bias risk assessment was conducted for each study using the relevant tools in the Cochrane Handbook. The included data were subjected to a meta-analysis using R 4.2.1 software. This article includes a total of 15 studies involving a total of 5,847 patients. There was no difference in the cleanliness score, qualified rate of intestinal cleanliness and patient compliance between the high- and low-volume group. The patients in the low-volume PEG mixed solution group had a higher repeat willingness bowel cleansing rate than those in the high-volume PEG group [risk ratio (RR) =0.71, 95% confidence interval (CI): 0.62-0.82, P<0.01]. Compared with the low-volume group, the incidence of adverse reactions such as nausea, vomiting, and abdominal pain increased in the high-volume group (RR =1.38, 95% CI: 1.22-1.56, P<0.01; RR =1.79, 95% CI: 1.41-2.27, P<0.01; RR =1.05, 95% CI: 1.01-1.08, P<0.01). In the pre-colonoscopy preparation method for patients, although the high-volume PEG and low-volume PEG mixed regimen have similar effects on intestinal cleanliness, the low-volume mixed regimen has a higher willingness to repeat and a lower incidence of adverse reactions. In clinical practice, considering patient compliance and safety, a low-volume mixed regimen may be a more optimal option.

A descriptive investigation of the adequacy of bowel preparation prior to colonoscopy: protocol of a retrospective study

Background: colonoscopy is the most widely used technique for examining the colorectal mucosa. The diagnostic accuracy and therapeutic reliability of the examination depend on many factors including the quality of colon cleansing and bowel preparation. The aim of the study is to determine the standard of bowel preparation in patients undergoing colonoscopy. Methods: an observational, retrospective, single-center study. Inpatients and outpatients undergoing colonoscopy at the Alessandria Hospital's SS Digestive Endoscopy between 1 January 2021 and 31 December 2021 will be eligible. The study will use, the Boston Bowel Preparation Scale to assess bowel preparation. Study data will be collected by reviewing medical records and entered into the online computerized platform “Electronic Data Capture”. Conclusions: assessing the quality of bowel preparations is crucial to monitoring and detecting any problems that will be later reflected in the outcome of the procedure and enables the practitioners involved to seek possible solutions.