Bowel Preparation Time Research Articles

An algorithm-based active cleansing protocol can reduce the bowel preparation time for screening colonoscopy: A propensity score matching study.

Methods that minimize the time for on-site bowel preparation before colonoscopy are needed. We prospectively validated that a novel algorithm-based active cleansing (ABAC) protocol could reduce the time for preparation compared with the conventional method. This was an open-label, multicenter, prospective comparative study from April to October 2021. The study compared the bowel preparation time for colonoscopy between patients instructed with the ABAC protocol and control groups. Patients in the ABAC protocol group as well as the control group were administered 2000 mL of polyethylene glycol (PEG) within 2 hours. After the first two hours, patients in the protocol group voluntarily took 300 ml of the solution without the instruction of nursing staff depending on the number of defecations in the first 2 hours. The intervention and control groups were adjusted for background characteristics by propensity score matching (PSM). After adjustment by PSM, 174 patients in each of the two groups were included in the final analysis. In the intention-to-treat analysis, the preparation time was significantly shorter in the intervention group than that in the control group (126.3 ± 32.7 min vs. 144.9 ± 39.9 min, P = 0.018). The proportion of additional PEG intake was significantly higher in the intervention group (16 [9.2%] vs. 6 [3.4%], P = 0.047). The number of defecations was also higher in the intervention group than in the control group (7.8 ± 2.5 vs. 6.3 ± 2.2, P = 0.001). Simple active instruction protocol is effective to reduce on-site bowel preparation time and nursing staff labor for colonoscopy.

Optimizing Bowel Preparation for Capsule Endoscopy and Colonoscopy: A Patient-Centered Protocol Revision and Application

Objective: This study aimed to evaluate the effectiveness of a modified patient experience-based bowel preparation protocol for capsule endoscopy combined with colonoscopy. Methods: A total of 262 patients who underwent capsule endoscopy combined with colonoscopy in a tertiary hospital in Zhuhai city from July to December 2021 were enrolled in this study. They were divided into the control group (n=141) and the experimental group (n=121) using the random number method. The experimental group used the modified bowel preparation protocol while the control group used the conventional preparation protocol. Post-examination indicators, including sleep quality, gastrointestinal discomfort, nausea, vomiting, abdominal pain, and satisfaction, were compared between the two groups. Results: The data showed that the experimental group’s preparation medication had a better taste and was effective in improving patient symptoms, such as gastrointestinal discomfort, nausea and vomiting, abdominal pain, and sleep quality, compared to the control group. Moreover, both patients and nurses reported greater satisfaction with the experimental group’s bowel preparation time compared to the control group, with statistically significant differences observed (P < 0.05). Conclusions: The modified bowel preparation protocol could improve patient sleep quality, reduce adverse reactions, and increase patient comfort and satisfaction.

Effect of Compound Polyethylene Glycol Electrolyte Powder on the Quality of Gastrobowel Preparation before Enteroscopy Intervention.

Objective To study the effect of compound polyethylene glycol electrolyte powder (PGEP) on the quality of gastrobowel preparation before enteroscopy intervention. Methods From March 2021 to January 2022, among the patients who needed enteroscopy in our hospital, 280 patients who volunteered for this study were randomly selected as the research objects. All the subjects were randomly divided into the control group (140 cases) and the observation group (140 cases). Both groups received routine treatment before enteroscopy intervention. On this basis, patients in the control group were given 9 g of senna every day before operation, and 250 ml of 20% mannitol and 2500 ml of water were taken orally from 9:00 am to 11:00 am on the day of examination. Patients in the observation group took PGEP orally from 9:00 am to 11:00 am. The effective rate of bowel cleaning, the frequency of defecation and duration of diarrhea, the levels of blood electrolyte indexes such as Na+, K+, and Cl− before and after the intervention, and the incidence of adverse reactions were compared between the two groups. Results The effective rate of bowel cleaning in the observation group was significantly higher than that in the control group (P < 0.05). The frequency of defecation and duration of diarrhea in the observation group were significantly lower than those in the control group (P < 0.05). Compared with the control group, the levels of blood electrolyte indexes in the observation group after the intervention were not statistically significant (P > 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion Using PGEP for gastrobowel preparation before enteroscopy intervention can achieve high bowel cleaning efficiency, short bowel preparation time, and low incidence of adverse reactions, which does not affect the water-electrolyte balance of patients, and the psychological state of patients before enteroscopy intervention is more stable. This program is worthy of clinical promotion.

Effects on BBPS score with bowel preparation time and dosage.

Background:To evaluate the effects on the Boston Bowel Preparation Scale (BBPS) score with different bowel preparation times and dosages.Methods:Six hundred patients who underwent colonoscopy in the Endoscopy Center of Ningbo No.9 Hospital in 2021 were recruited and randomly assigned to 3 groups: Group A: “4-hour 1 + 2L” bowel preparation regimen; Group B: “6-hour 1 + 2L” bowel preparation regimen; and Group C: “4-hour 0 + 2L” bowel preparation regimen. BBPS score among these groups is compared and analyzed in the Statistical Product and Service Solutions software.Results:There was no difference in baseline characteristics among the three groups of patients (P > .05). There was no significant difference in the BBPS score between Group B and Group C, whereas the BBPS score in Group A was significantly higher than that in Groups B and C (P < .05).Conclusion:The “4-hour 1 + 2L” bowel preparation regimen can obtain higher BBPS score for colonoscopy, which is suggested to be the optimal plan for colonoscopy patients of the time and dosage. Definitely, higher BBPS score can improve the quality of colonoscopy diagnosis and treatment consequence.

Efficacy of elobixibat as bowel preparation agent for colonoscopy: Prospective, randomized, multi‐center study

Background and AimElobixibat is a novel ileal bile acid transporter inhibitor. This study aimed to compare the efficacy, tolerability, and safety of the combination of elobixibat and 1 L of polyethylene glycol formulation containing ascorbic acid (PEG‐Asc) solution versus the combination of sodium picosulfate and 1‐L PEG‐Asc solution as bowel preparation for colonoscopy.MethodsThis multi‐center, randomized, observer‐blinded, non‐inferiority study recruited 210 outpatients who were assigned to either the elobixibat plus 1‐L PEG‐Asc group (group A) or the sodium picosulfate plus 1‐L PEG‐Asc group (group B). The quality of the bowel cleansing level was assessed by the Boston Bowel Preparation Scale (BBPS) and compared the bowel cleansing level between the groups. Data regarding bowel preparation time, patients’ tolerability, and adverse events were also analyzed.ResultsData for 196 patients (99 in group A and 97 in group B) were analyzed finally. BBPS was comparable between group A and B (8.3 ± 0.9 vs. 8.3 ± 0.7; P = 0.88). Consequently, the adequate bowel preparation rate in groups A and B was 95.0% and 99.0%, respectively (−4.0%, 95% CI −9.3 to 1.5). Bowel preparation time in group A was similar to that in group B (348.2 ± 79.8 min vs. 330.8 ± 82.5 min; P = 0.13), whereas, sleep disturbance was significantly less frequent in group A than in group B (10.2% vs. 22.7%; P = 0.02).ConclusionsThe combination of elobixibat and 1‐L PEG‐Asc can be considered an alternative bowel preparation for colonoscopy considering the equivalent bowel cleansing effect and less frequent sleep disturbance. The Japan Registry of Clinical Trials (jRCTs41180026).

Detection of aberrant crypt foci with image-enhanced endoscopy.

Background and study aims Conventional detection of aberrant crypt foci (ACF) with dye-spraying and magnifying observation is labor- and skill-intensive. We performed a prospective non-inferiority study to investigate the utility of image-enhanced endoscopy (IEE) for detection of ACF. Patients and methods Patients with a history of colorectal neoplasm were eligible. The number of ACF in the lower rectum was counted first using IEE magnification with narrow-band imaging (NBI) or blue-laser imaging (BLI), and subsequently using the methylene blue method. The primary endpoint was the ACF detection rate with IEE, i. e., the number of ACF detected with IEE relative to the number of ACF detected with methylene blue. The secondary endpoints were bowel preparation time, ACF detection time, and the detection rate with NBI or BLI. Results A total of 40 patients were enrolled (NBI 20 and BLI 20). The overall detection rate for ACF with IEE was 81.7 % (503/616; 95 %CI 78.8 – 84.6 %), meeting the primary endpoint. The detection rate for ACF with BLI (84.9 %, 258/304) was significantly higher than with NBI (78.5 %, 245/312; P < 0.05). Both bowel preparation time and ACF detection time were significantly shorter with IEE versus the methylene blue method ( P < 0.01, respectively). The detection rates for dysplastic and non-dysplastic ACF with IEE were 84.4 % (27/32) and 80.3 % (469/584), respectively. Conclusion IEE is able to detect ACF during colonoscopy with sensitivity non-inferior to that of the conventional methylene blue method. IEE is simpler than the methylene blue method and is therefore a potentially useful new tool for ACF detection.

Clinical research of different bowel cleansing methods on bowel preparation operation before enteroscopy

Objective To study the clinical effect and preoperative nursing of different bowel methods in intestinal preparation before colonoscopy. Methods A total of 200 patients who underwent colonoscopy in our hospital from April 2013 to April 2014 were randomly selected and divided into experimental group and control group.The two groups were given oral polyethylene glycol electrolyte solution (PEG-ELS) and castor oil.The defecation character and number of patients after taking the medicine, the cleanliness of the intestinal tract, the reaction of the patients after taking the medicine, and the occurrence of bubbles in the intestinal cavity were observed.Blood pressure and heart rate should be measured before and after colonoscopy, and the electrolyte is determined by routine blood test.The sleep quality of the two groups was assessed by Pittsburgh sleep quality assessment. Results The bowel preparation time was about 2 to 5 hours by using polyethylene glycol electrolyte solution cleansing method.However, the bowel preparation time of patients who took electrolyte solution with the addition of castor oil cleansing method orally was about 6 to10 hours, and the difference had statistical significance(P 0.05). The effect of the two groups on sleep quality was statistically significant(P<0.05). After the patients of both groups took medicine, the influence difference on sleep quality had statistical significance(P<0.05). Conclusions Relative to the bowel cleansing effect of taking castor oil orally, the nursing of taking polyethylene glycol electrolyte solution orally to cleanse bowel is simple, which can replace the traditional methods of taking electrolyte solution and castor oil orally. Key words: Polyethylene glycol-electrolyte solution; Bowel preparation; Colonoscopy examination; Clinical effect; Nursing

Rapid colonoscopy preparation using bolus lukewarm saline combined with sequential posture changes: a randomized controlled trial.

ObjectiveIn this randomized clinical trial, we have compared the Shudh™ colon cleanse (SCC) with HalfLytely® colon prep (HCP) to evaluate the efficacy, bowel preparation time (BPT), adverse events, electrolyte abnormalities and patient acceptability.MethodsPatients were randomized to receive either SCC (n = 65) or HCP (n = 68). All colonoscopies were performed by a single, blinded endoscopist. Colon prep was evaluated on a 5 point grading scale. Statistical non-inferiority was pre-defined as a difference of <15 % in the lower limit of the 95.5 % confidence interval for the treatment difference. Data that were collected include bowel prep score, BPT, adverse events, electrolyte abnormalities and patient acceptability.ResultsBowel preparation efficacy was rated as “successful” for 59/65 (90.7 %) in SCC versus 66/68 (97.1 %) in HCP. This gave a success difference of −6.4 % with a 1-sided 95 % lower confidence limit (LCI) for the difference = −13.3 % (non-inferiority p = 0.25). This difference fell within the predefined limit for non-inferiority. The average BPT for SCC was 1.9 h versus 10.9 in HCP (p < 0.001). No serious adverse events were reported in either group. None of the patients in either group had any clinically significant electrolyte imbalance. Patient ratings for palatability and willingness to repeat were significantly better for SCC (p < 0.05).ConclusionSCC was found to not be inferior to PEG with regards to the quality of bowel preparation. It is worth highlighting that a major advantage of SCC is shorter BPT. (Clinical trial registration number: NCT01547130).Electronic supplementary materialThe online version of this article (doi:10.1007/s10620-013-2598-9) contains supplementary material, which is available to authorized users.