Bowel Preparation In Patients Research Articles

S418 Use of Flavored Polyethylene Glycol and Sulfate Solution Bowel Preparation in Patients with Obesity, Diabetes, or Taking Glucagon-Like Peptide-1 Receptor Agonists

S418 Use of Flavored Polyethylene Glycol and Sulfate Solution Bowel Preparation in Patients with Obesity, Diabetes, or Taking Glucagon-Like Peptide-1 Receptor Agonists

Glycemic Control Impacts the Quality of Bowel Preparation in Patients Undergoing Elective Colonoscopy: A Multicenter Retrospective Cohort Study

Introduction: Diabetes Mellitus has been linked to poor quality of bowel preparation (BP) but the impact of various glycemic control levels remains unclear. The primary objective of this study was to investigate the relationship between the quality of BP and the glycemic control in patients with diabetes. Methods: Data was collected retrospectively to identify adults who underwent elective colonoscopy from March 2020-December 2022. The patient population was subdivided into two groups based on the quality of BP. Univariate and multivariate analyses were used to assess associations between glycemic control, medications, sociodemographic factors, and BP quality. Results: A total of 1458 patients who met the inclusion criteria were included in the final analysis. Of these, 6.3% of patients had suboptimal BP. Non-diabetics, prediabetics, and well-controlled diabetics had lower odds (0.28, 0.20, and 0.32;p<0.001) of having suboptimal BP as compared to poorly controlled diabetics. Insulin users had higher odds (5.39;p<0.01), non-smokers and former smokers had lower odds (0.54, 0.40;p<0.04), and medicare and commercial insurance holders had lower odds (0.49, 0.28;p<0.001) of suboptimal BP. Gender, body mass index, and the use of glucagon-like peptide-1 (GLP-1) agonists were not shown to impact the quality of BP. Conclusions: This study shows that poorly controlled and insulin-dependent diabetics have higher rates of suboptimal QBP, leading to missed lesions and increased colon cancer risk. Limited access to healthcare due to low socioeconomic status indirectly contributes to poorly controlled DM and higher rates of suboptimal QBP. Identifying poor preparation risks allows targeted interventions to enhance QBP in high-risk patients. By prioritizing bowel preparation optimization, we can enhance the overall quality of colonoscopy screening, leading to earlier detection of colorectal malignancies, improved patient outcomes, and a reduction in the burden of colorectal cancer.

Assessment of the adequacy of bowel preparation in patients undergoing colonoscopy: a retrospective study

Assessment of the adequacy of bowel preparation in patients undergoing colonoscopy: a retrospective study

Establishment of a risk prediction model for bowel preparation failure prior to colonoscopy

BackgroundThis study aimed to determine the factors that contribute to the failure of bowel preparation in patients undergoing colonoscopy and to develop a risk prediction model.MethodsA total of 1115 outpatients were included. Patients were randomly divided into two groups: the modeling group (669 patients) and the validation group (446 patients). In the modeling group, patients were further divided into two groups based on their success and failure in bowel preparation using the Boston Bowel Preparation Scale. A logistic regression analysis model was used to determine the risk factors of bowel preparation failure, which was subsequently visualized using an alignment diagram.ResultsAfter controlling for relevant confounders, multifactorial logistic regression results showed that age ≥ 60 years (OR = 2.246), male (OR = 2.449), body mass index ≥ 24 (OR = 2.311), smoking (OR = 2.467), chronic constipation (OR = 5.199), diabetes mellitus (OR = 5.396) and history of colorectal surgery (OR = 5.170) were influencing factors of bowel preparation failure. The area under the ROC curve was 0.732 in the modeling group and 0.713 in the validation group. According to the calibration plot, the predictive effect of the model and the actual results were in good agreement.ConclusionsAge ≥ 60 years, male, body mass index ≥ 24, smoking, chronic constipation, diabetes mellitus, and history of colorectal surgery are independent risk factors for bowel preparation failure. The established prediction model has a good predictive efficacy and can be used as a simple and effective tool for screening patients at high risk for bowel preparation failure.

Evaluation of the Effect of Individualized Health Education on Bowel Preparation in Patients Undergoing Colonoscopy

Evaluation of the Effect of Individualized Health Education on Bowel Preparation in Patients Undergoing Colonoscopy

Telephone instructions improve the quality of bowel preparation for colonoscopy: A meta-analysis of randomized controlled trials.

To evaluate the effect of telephone instructions on the quality of bowel preparation in patients undergoing colonoscopy. Online English databases (PubMed, Web of Science, Cochrane Library, and Embase) were screened for randomized controlled trials on telephone instructions regarding bowel preparation for colonoscopy from inception to April 15, 2022. After data extraction, the Review Manager software was used for meta-analysis. Nine randomized controlled trials with 3,836 patients were included in the meta-analysis. The rate of adequate bowel preparation was significantly higher in the telephone group than in the control group. The pooled relative risk (RR) was 1.17 (95% confidence interval [CI]: 1.05-1.30, P < 0.01). The pooled mean difference (MD) for the Boston Bowel Preparation Scale score was 1.32 (95% CI: 0.15-2.49, P < 0.05), and that for the Ottawa Bowel Preparation Scale score was -1.93 (95% CI: -2.35 to -1.51, P < 0.01). The polyp detection rate was significantly higher in the telephone group than in the control group (RR = 1.58, 95% CI: 1.23-2.04, P < 0.01), whereas no significant difference was noted in the adenoma detection rate between the groups (RR = 1.37, 95% CI: 0.97-1.94, P = 0.08). Telephone instructions for patients undergoing colonoscopy significantly improved the quality of bowel preparation and increased polyp detection rate.

Linaclotide combined with polyethylene glycol regimen for bowel preparation in patients with chronic constipation: A prospective randomized controlled study

Linaclotide combined with polyethylene glycol regimen for bowel preparation in patients with chronic constipation: A prospective randomized controlled study

S702 The Impact of Glycemic Control on the Quality of Bowel Preparation in Patients Undergoing Elective Colonoscopy: A Retrospective Multi-Center Study

S702 The Impact of Glycemic Control on the Quality of Bowel Preparation in Patients Undergoing Elective Colonoscopy: A Retrospective Multi-Center Study

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.

Pemberian Edukasi Berbasis Multimedia dalam Meningkatkan Kualitas Persiapan Usus pada Pasien Kolonoskopi

This study aims to determine the effectiveness of providing multimedia-based education in improving the quality of bowel preparation in patients undergoing colonoscopy. The method used is a systematic review of the literature using PRISMA diagrams based on the PICO format. In October 2022, article searches were conducted using four web databases. The results of the study showed that there were five articles that matched the aims of the researchers and were analyzed further. These five articles examined the effectiveness of multimedia-based education in colonoscopy patients and obtained a positive effect on improving the quality of bowel preparation in colonoscopy patients. In conclusion, the application of multimedia-based education is recommended as an educational method about bowel preparation for patients who will undergo colonoscopy to get an increase in the quality of bowel preparation.&#x0D; Keywords: Bowel preparation; Colonoscopy; Multimedia Education.

The Colonoscopy Cookbook: Analysis of effect of a recipe resource on quality and experience of bowel preparation in colonoscopy.

Background High-quality bowel preparation for a colonoscopy improves identification of early lesions in the large bowel, decreases procedure time and increases intervals between colonoscopies. Current recommendations advise a low-residue diet in the days leading up to colonoscopy to improve quality of preparation. This study prepared and provided a recipe resource to patients undergoing colonoscopy and assessed the quality of bowel preparation and patient experience. Patients and methods A "Colonoscopy Cookbook" resource of recipes that comply with the preoperative diet recommendations was created and added to routine preoperative information given to patients undergoing elective colonoscopies at a regional Australian hospital over a 12-month period. Endoscopic reports were reviewed for each case and quality of bowel preparation was classified as "adequate'' or "inadequate". Data collected were compared to a representative local cohort from 2019. Results Procedure reports from 96 patients who were provided with the resource were compared with 96 patients who were not. Adequate bowel preparation was nine times as likely when the resource was available (odds ratio 8.54, 95 % confidence interval: 2.85 to 25.60, P < 0.001) compared to when it was not. The patient experience was assessed using a post-procedure survey, which demonstrated a positive experience in recipe preparation. Most patients would use the resource prior to future colonoscopies. Conclusions Further randomized controlled trials are required to validate this scoping review. Pre-procedure recipe resources may improve quality of bowel preparation in patients undergoing colonoscopy.

Impact of glucagon-like peptide 1 receptor agonist liraglutide and dipeptidyl peptidase-4 inhibitor sitagliptin on bowel cleaning and gastrointestinal symptoms in type 2 diabetes.

Objective: Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4i) profoundly affect the gastrointestinal motor system, which may increase the incidence of inadequate bowel cleaning and gastrointestinal symptoms. Hence, this observational study mainly aimed to assess the influence of GLP-1 RAs liraglutide and DPP-4i sitagliptin on bowel preparation in type 2 diabetes (T2DM). Method: This observational study consecutively enrolled T2DM scheduled for a colonoscopy. Participants were prospectively separated into the liraglutide group (n = 120), sitagliptin group (n = 120), and control group (n = 120) based on the current hypoglycemic regimen. 3L split-dose polyethylene glycol regimens were used for bowel preparation. Experienced gastrointestinal endoscopists conducted colonoscopies. Lawrance Bowel-Preparation Tolerability Questionnaire and Boston Bowel Preparation Scale (BBPS) were conducted to assess bowel cleaning quality, tolerability, and safety. Results: The incidence of inadequate bowel cleaning was 17.5% in the liraglutide group, 20.5% in the sitagliptin group, and 21.7% in the control group. The difference among the three groups was not statistically significant (p = 0.927). Meanwhile, there were no significant differences in the mean BBPS, cecal intubation time, and polyp-detecting rates among the three groups (all p > 0.0.05). Nausea, vomiting, and bloating scores were increased in the liraglutide group compared with the other two groups (p < 0.05), whereas most were mild or very mild. Subgroup analyses showed that the incidence of inadequate bowel cleaning in T2DM with diabetic peripheral neuropathy (DPN) was increased in the liraglutide group compared with the sitagliptin group (61.3% vs. 32.1%, p = 0.022) and control group (61.3% vs. 32.8%, p = 0.025). Conclusion: GLP-1RA liraglutide or DPP-4i sitagliptin did not significantly increase the incidence of inadequate bowel cleaning and gastrointestinal symptoms during bowel preparation. Liraglutide may increase the incidence of inadequate bowel preparation in patients with DPN. This study reveal that more attention and aggressive bowel preparation regimens should be given to the T2DM with DPN. Clinical Trial Registration: (https://www.chictr.org.cn/index.aspx), identifier (ChiCTR2200056148).

Quality of bowel preparation in patients with inflammatory bowel disease undergoing colonoscopy: What factors to consider?

An adequate bowel preparation in patients with inflammatory bowel disease (IBD) is a prerequisite for successful colonoscopy for screening, diagnosis, and surveillance. Several bowel preparation formulations are available, both high- and low-volume based on polyethylene glycol. Generally, low-volume formulations are also based on several compounds such as magnesium citrate preparations with sodium picosulphate, oral sulphate solution, and oral sodium phosphate-based solutions. Targeted studies on the quality of bowel preparation prior to colonoscopy in the IBD population are still required, with current evidence from existing studies being inconclusive. New frontiers are also moving towards the use of alternatives to anterograde ones, using preparations based on retrograde colonic lavage.

Randomized clinical trial evaluating three low-volume preparations for colonoscopy in outpatients with Inflammatory Bowel Disease: the EII-PREP trial

Background Data regarding bowel preparation in patients with Inflammatory Bowel Disease (IBD) are scarce. Aim To compare efficacy, safety, and tolerability of low-volume preparations in patients with IBD. Methods Single-center, randomized, prescriber, and colonoscopist-blinded clinical trial. IBD outpatients undergoing colonoscopy were randomized 1:1:1 to receive 1 Liter-polyethylene glycol-ascorbate (1L-PEG), 2 Liters-PEG, or sodium picosulfate (SP). The primary endpoint was percentage of quality cleansing assessed via the Boston Bowel Preparation Scale (BBPS ≥6, segments ≥2). Secondary endpoints were total high quality cleansing (BBPS 8 or 9), high-quality segmental BBPS (≥2), and patients’ tolerability, symptoms, and satisfaction, assessed by questionnaires. Safety was monitored by adverse event reporting, laboratory evaluation at colonoscopy, and telephonic follow-up. Results Ninety-two patients were included (33 1L-PEG, 28 2L-PEG, and 31 SP). No significant differences between preparations were observed in quality or high-quality total BBPS or high-quality segmental BBPS. Complete intake of the solution was higher for SP (p = 0.006) and lower for 1L-PEG (p = 0.02) compared to 2L-PEG intake (p = 0.55). Clinically irrelevant hyponatremia was higher in the SP group (p < 0.0001). SP instructions were easier to understand from patient’s point of view (p = 0.01). Willingness to retake was higher with SP (p < 0.0001) and less for 1L-PEG (p < 0.0001). No serious adverse events were reported. Conclusions We observed no differences in efficacy between low-volume preparations in patients with IBD. Complete intake was higher for SP and lower for 1L-PEG. SP and 2L-PEG instructions were better understood and graded, and SP was more likely to be retaken. Willingness to retake was lower for 1L-PEG. No serious adverse events were reported. Summary No differences in terms of efficacy were regarded in this clinical trial comparing low-volume preparations for colonoscopy in patients with IBD: however, Sodium Pisoculfate is better tolerated and accepted from patient’s point of view. No serious adverse events were reported.

Risk factors for inadequate bowel preparation in patients using high- and low-volume cleansing products.

Bowel preparation is crucial for colonoscopy completeness and lesions detection. Today, several cleansing products are equally recommended by guidelines, irrespective of patients' characteristics. Identification of preparation-specific risk factors for inadequate bowel preparation may lead to a personalized prescription of cleansing products to refine patients' tolerance and improve endoscopic outcomes. We prospectively enrolled consecutive outpatients referred for colonoscopy using either a high-volume [HV: 4 l polyethylene glycol (PEG)] or a low-volume (LV: 2 l PEG + bisacodyl) preparation. Day-before regimen or split-dose regimen was used for morning or afternoon colonoscopies, respectively. Univariate and multivariate analyses were conducted to identify risk factors related to inadequate bowel preparation, according to the Boston bowel preparation scale for HV and LV preparations. We enrolled 2040 patients, of which 1815 were included in the final analysis (average age 60.6 years, 50.2% men). Half of them (52%) used LV preparation. Adequate preparation was achieved by 87.6% without differences between the HV and LV groups (89.2% vs. 86.6%; P = 0.098). The use of day-before regimen and incomplete assumption of PEG were independent predictors of poor visibility for either HV or LV preparation. However, different specific risk factors for HV [diabetes: odds ratio (OR), 3.81; 95% confidence interval (CI), 1.91-7.58; low level of instruction: OR, 1.95; 95% CI, 1.11-3.44; and previous abdominal surgery: OR, 2.27; 95% CI, 1.20-4.30] and for LV (heart disease: OR, 2.06; 95% CI, 1.09-3.88; age > 65 years: OR, 1.51; 95% CI, 1.01-2.27) preparations were identified. Day-before preparation and incomplete assumption of the purgative agents affect bowel visibility irrespective of the preparation volume. LV should be preferred to HV preparations in patients with diabetes, low level of instruction, and previous abdominal surgery, whereas an HV preparation should be preferred in patients with heart disease and in older patients.

S853 Factors Affecting Pouchoscopy Bowel Preparation in Patients With an Ileal Pouch Anal Anastomosis

Introduction: Inadequate bowel preparation (prep) limits visualization and can results in the need for repeat endoscopy. There is no standard recommended bowel prep prior to pouchoscopy. We hypothesized that many patients with history of ileal pouch anal anastomosis (IPAA) undergoing pouchoscopy have inadequate prep. We hope that further analysis of patients with, and without, adequate prep will lead to insights informing the development of a standardize prep. Methods: This was a retrospective review of adult patients with inflammatory bowel disease (IBD) or polyposis syndromes (PS) who underwent pouchoscopy at a tertiary referral center between June 2020-March 2022. Patient demographics, clinical characteristics, oral intake prior to pouchoscopy, recommended bowel prep, and endoscopic bowel prep were abstracted. Inadequate bowel prep was defined as “poor” or “fair” and adequate bowel prep was defined as “adequate”, “good” or “excellent” as described by the endoscopist. If the quality of the bowel prep was not described, two independent reviewers performed endoscopic photo review (DF, JK). Pouch age was defined as the time from pouch creation to time of pouchoscopy. χ2 test was used for comparative statistical analysis, a p value < 0.05 was defined as statistically significant. Results: Fifty-six patients underwent 89 pouchoscopy evaluations, 27/56 (48%) were female. IPAA was indicated for IBD in 47 patients [43 ulcerative colitis, 4 Crohn’s disease] and 9 patients with PS. Median age at time of procedure was 43y (range 18-71y), median pouch age was 8y (range 0-36y). Twenty patients (22%) were noted to have inadequate bowel prep compared to 69 (78%) with adequate bowel prep. Table compares these two groups. 17/17 (100%) of procedures done in patients with PS indication had adequate bowel prep compared to 52/72 (72%) in patients who underwent IPAA due to IBD (p=0.014). Other variables were not statistically significant. However, inadequate bowel prep was common with enema prep (9/21) and rare with large volume preps (1/15). Most PS patient used large volume prep. Conclusion: About 1 in 5 of patients with IPAA had inadequate bowel prep, all with a history of IBD. Inadequate bowel was uncommon with a large volume prep and consideration should be given to large volume prep being standard of care. Inadequate prep did not occur in PS patients, perhaps as large volume prep was commonly used by this group. Table 1. - Comparison between patients with inadequate bowel prep and appropriate bowel prep according to clinical and endoscopic characteristics Total = 89 Inadequate bowel prep (20) Adequate bowel prep (69) p value Indication for IPAA IBD (72) 20 52 0.014 Polyposis syndromes (17) 0 17 Sex Female (46) 12 34 0.398 Male (43) 8 35 Pouch age at time of procedure < 5 years (21) 5 16 0.981 5-10 years (28) 6 22 >10 years (40) 9 31 Oral intake 24 hour prior procedure Clear liquid diet (32) 5 27 0.246 Full meal (57) 15 42 Bowel prep Large volume oral bowel prep (16) 1 15 0.408 Low volume oral bowel prep (11) 5 13 Low volume oral prep and enema prep (16) 4 12 Enema prep only (30) 9 21 No bowel prep (8) 1 7 Large volume prep given Yes 1 15 0.086 No 19 54 Large/low volume oral bowel prep completeness Complete bowel prep (100% intake) (31) 5 26 0.455 Incomplete bowel prep (3) 1 2 Procedure timing Morning (60) 11 49 0.178 Afternoon (29) 9 20 Presence of distal pouch stricture Yes (20) 3 17 0.363 No (69) 17 52 Large volume bowel prep = Golytely, Miralax. Low volume bowel prep: Moviprep, Clenpiq, Suprep, magnesium citrate. Enema therapy = tap water or fleet enema.

S727 Endoscopic Disease Activity and Biologic Therapy Are Independent Predictors of Suboptimal Bowel Preparation in Patients With Inflammatory Bowel Disease Undergoing Colonoscopy: A Multicenter Analysis

S727 Endoscopic Disease Activity and Biologic Therapy Are Independent Predictors of Suboptimal Bowel Preparation in Patients With Inflammatory Bowel Disease Undergoing Colonoscopy: A Multicenter Analysis

Mechanical bowel preparation and oral antibiotic bowel preparation in patients undergoing combined hysterectomy and bowel resection (002)

Mechanical bowel preparation and oral antibiotic bowel preparation in patients undergoing combined hysterectomy and bowel resection (002)

A Novel Convolutional Neural Network Model as an Alternative Approach to Bowel Preparation Evaluation Before Colonoscopy in the COVID-19 Era: A Multicenter, Single-Blinded, Randomized Study.

Adequate bowel preparation is key to a successful colonoscopy, which is necessary for detecting adenomas and preventing colorectal cancer. We developed an artificial intelligence (AI) platform using a convolutional neural network (CNN) model (AI-CNN model) to evaluate the quality of bowel preparation before colonoscopy. This was a colonoscopist-blinded, randomized study. Enrolled patients were randomized into an experimental group, in which our AI-CNN model was used to evaluate the quality of bowel preparation (AI-CNN group), or a control group, which performed self-evaluation per routine practice (control group). The primary outcome was the consistency (homogeneity) between the results of the 2 methods. The secondary outcomes included the quality of bowel preparation according to the Boston Bowel Preparation Scale (BBPS), polyp detection rate, and adenoma detection rate. A total of 1,434 patients were enrolled (AI-CNN, n = 730; control, n = 704). No significant difference was observed between the evaluation results ("pass" or "not pass") of the groups in the adequacy of bowel preparation as represented by BBPS scores. The mean BBPS scores, polyp detection rate, and adenoma detection rate were similar between the groups. These results indicated that the AI-CNN model and routine practice were generally consistent in the evaluation of bowel preparation quality. However, the mean BBPS score of patients with "pass" results were significantly higher in the AI-CNN group than in the control group, indicating that the AI-CNN model may further improve the quality of bowel preparation in patients exhibiting adequate bowel preparation. The novel AI-CNN model, which demonstrated comparable outcomes to the routine practice, may serve as an alternative approach for evaluating bowel preparation quality before colonoscopy.

Addition of Prucalopride to Standard Bowel Preparation Does Not Improve Colonic Mucosa Visualization—A Retrospective Observational Cohort Study

Abstract Background Colonoscopy is currently gold standard for visualizing colonic mucosa. Presence of constipation is generally associated with poor bowel preparation. We compared effect on colonic cleansing when prucalopride was used as adjunct with polyethylene glycol (PEG) in patients of constipation. Methods A retrospective study was conducted at our center. One 70 patients with constipation were enrolled in two groups of who took only PEG and other of prucalopride plus PEG+ for bowel preparation. They underwent colonoscopy by a single-blinded experienced endoscopist. Bowel preparation quality was reported by Boston bowel preparation scale prior to washing or suctioning. The groups were analyzed for bowel preparation quality and side effects in either groups based on preformed questionnaire. Results Mean Boston Stool preparation Score (BSS) in PEG group (5.33 ± 1.43) was slightly higher than PEG+ (5.16 + 1.37) (p-value =0.44). The total number of patients with side effects was higher in PEG+ group than PEG group. (p &lt; 0.05). Conclusion We conclude addition of prucalopride has no additional benefit when added with standard bowel preparation in patients of constipation. It may rather lead to noncompliance and inferior bowel preparation due to increased side effects.