Bowel Preparation For Colonoscopy Research Articles

Impact of Personalized Nursing Care on Bowel Preparation for Colonoscopy.

Effective bowel preparation is critical for successful colonoscopy, yet inadequate preparation frequently impairs outcomes. This study evaluated personalized nursing care (PNC) against standard care in improving bowel preparation quality for colonoscopy. A prospective, 2-phase, single-center trial was conducted from July 2023 to July 2024. In phase 1, patients received standard care; in phase 2, personalized preparations were used. Among 1057 patients, PNC significantly improved bowel preparation quality (P <.001). Adequate preparation was achieved by 79% of the PNC group vs 64.3% of the control group. Adherence to bowel preparation was higher in the PNC group (84.0% vs 70.4%, P <.001), as were polyp detection rates (38.2% vs 28.1%, P =.003). Patient satisfaction increased with PNC interventions. PNC enhances colonoscopy preparation, boosting clinical effectiveness and patient satisfaction and advocating for its integration into routine protocols.

Evaluation of Language Disparity in Adequacy of Bowel Preparation for Colonoscopy and Adenoma Detection Rate

Evaluation of Language Disparity in Adequacy of Bowel Preparation for Colonoscopy and Adenoma Detection Rate

Auricular acupressure for minimizing adverse reactions to colonoscopic bowel preparation in hospitalized patients: A randomized controlled trial

Auricular acupressure for minimizing adverse reactions to colonoscopic bowel preparation in hospitalized patients: A randomized controlled trial

Real-world effectiveness and safety of 1L polyethylene glycol and ascorbic acid for bowel preparation in patients aged 80 years or over

Background and study aim: Clinical trials and real-world studies show a 1L polyethene glycol and ascorbic acid solution (1L PEG-ASC) to be an effective and safe bowel preparation for colonoscopy in the general population. Here, the effectiveness and safety of 1L PEG-ASC were evaluated in patients aged 80 years or over in a real-world setting. Patients and methods: A post-hoc analysis of an observational, multicentre, retrospective study assessed the effectiveness and safety of 1L PEG-ASC on out-patients aged ≥80 years old undergoing a colonoscopy at 8 centres in Spain and Portugal. Cleansing quality was assessed using the Boston Bowel Preparation Scale, with overall scores ≥6 and all segmental scores ≥2 considered adequate colon cleansing, and overall scores ≥8 or 3 in the right colon considered high-quality cleansing. The caecal intubation rate, withdrawal time, polyp and adenoma detection rates, and adverse events (AEs) were also monitored. Results: Data were analysed from 423 patients aged ≥80 years; mean age 83.5 (±3.2) years and 49.2% males. The adequate colon cleansing success rate was 88.9%, with high-quality cleansing of the overall and right colon achieved in 54.1% and 46.1% of the patients, respectively. Colonoscopy was complete in 94.1% of cases, and the adenoma detection rate was 51.3%. At least one AE was experienced by 4.5% of participants, the most frequent being mild dehydration (2.8%) and nausea (1.2%). Conclusions: This post-hoc analysis confirms 1L PEG-ASC to be an effective and safe bowel cleansing preparation for patients aged 80 years or over in a real-world setting.

Bowel preparation before colonoscopy: Consequences, mechanisms, and treatment of intestinal dysbiosis.

The term "gut microbiota" primarily refers to the ecological community of various microorganisms in the gut, which constitutes the largest microbial community in the human body. Although adequate bowel preparation can improve the results of colonoscopy, it may interfere with the gut microbiota. Bowel preparation for colonoscopy can lead to transient changes in the gut microbiota, potentially affecting an individual's health, especially in vulnerable populations, such as patients with inflammatory bowel disease. However, measures such as oral probiotics may ameliorate these adverse effects. We focused on the bowel preparation-induced changes in the gut microbiota and host health status, hypothesized the factors influencing these changes, and attempted to identify measures that may reduce dysbiosis, thereby providing more information for individualized bowel preparation for colonoscopy in the future.

A clinical pilot trial of an artificial intelligence-driven smart phone application of bowel preparation for colonoscopy: a randomized clinical trial

Background High-quality bowel preparation is paramount for a successful colonoscopy. This study aimed to explore the effect of artificial intelligence-driven smartphone software on the quality of bowel preparation. Methods Firstly, we utilized 3305 valid liquid dung images collected via mobile phones as training data. the most effective model was employed on mobile phones to evaluate the quality of bowel preparation. Secondly, From May 2023 to September 2023, colonoscopy patients were randomly assigned to two groups – the AI group (n = 116) and the control group (n = 116) – using a randomized, controlled, endoscopist-blinded method. We compared the two groups in terms of Boston Bowel Preparation Scale (BBPS) scores, polyp detection rate, adverse reaction rate, and factors related to bowel preparation quality. The primary endpoint was the percentage of patients who achieved a BBPS ≥6 among those who effectively utilized the smartphone software. Results EfficientNetV2 exhibited the highest performance, with an accuracy of 87%, a sensitivity of 83%, and an AUC of 0.86. In the patient validation experiment, the AI group had higher BBPS scores than the control group (6.78 ± 1.41 vs. 5.35 ± 2.01, p = 0.001) and showed an improvement in the detection rate (71.55% vs. 56.90%, p = 0.020) for polyps. Multifactor logistic analysis indicated that compliance with enema solution usage rules (OR: 5.850, 95% confidence interval: 2.022–16.923), total water intake (OR: 1.001, 95% confidence interval: 1.001–1.002), and AI software reminders (OR: 2.316, 95% confidence interval: 1.096–4.893) were independently associated with BBPS scores ≥6. Conclusion Compared with traditional methods, the use of artificial intelligence combined with software to send reminders can lead to more accurate assessments of bowel preparation quality and an improved detection rate for polyps, thus demonstrating promising clinical value.

Comparison of L L Polyethylene Glycol Plus Ascorbic Acid and Oral Sodium Sulfate Tablets for Colonoscopy Bowel Preparation.

Background and Aims: A low-volume (1 L) polyethylene glycol plus ascorbic acid (PEG-A) solution and an oral sodium sulfate tablet (OST) formulation are recently introduced agents for colonoscopy bowel preparation. This study investigated the efficacy, safety, and tolerability of 1 L PEG-A vs. OST. Methods: This single-center, prospective, randomized, endoscopist-blinded study randomly assigned patients into 2 groups: 1 L PEG-A (group A); and OST (group B). Efficacy of bowel preparation was evaluated using the Boston Bowel Preparation Scale (BBPS). Tolerability and safety were investigated with a standardized questionnaire. Results: A total of 174 patients were included in the final analysis (group A, n = 92; group B, n = 82). Successful bowel preparation was achieved in 91.3% and 95.1% of patients in groups A and B, respectively (p = 0.324). Overall mean satisfaction with bowel preparation was greater among those in group B vs. those in group A (8.2 ± 1.7 vs. 6.8 ± 2.0, respectively; p < 0.001). Although abdominal distension was less common in group A than group B (3/92 [3.3%] vs. 9/82 [11.0%], respectively; p = 0.045), overall adverse events developed similarly in both groups (27/92 [29.3%] vs. 21/82 [25.6%], p = 0.583). In subgroup analysis of older patients (≥65 years of age), efficacy, overall satisfaction, and safety profiles were not different between groups A and B. Conclusions: Both 1 L PEG-A and OST demonstrated efficacy, tolerability, and safety for colonoscopy bowel preparation. OST was slightly better tolerated, whereas 1 L PEG-A resulted in less abdominal distension. Both agents were effective and safe in older patients.

Comparative efficacy of different bowel preparations for colonoscopy: A network meta-analysis.

The quality of a colonoscopy is heavily reliant on the effectiveness of bowel cleansing. Various cleansing solutions are currently available, but their comparative efficacy remains uncertain. This systematic review and network meta-analysis aims to compare the performance of different bowel preparations for colonoscopy. MEDLINE, Embase, Scopus, and the Cochrane Library were systematically searched for randomized controlled trials (RCTs) comparing the efficacy of different bowel preparations. The primary outcome was cleansing success (CS), and the secondary outcome was adenoma detection rate (ADR). On network meta-analysis for CS (22 RCTs, 7179 patients, 14 bowel preparations), 2 L PEG + simethicone (RR = 1.25 [95 %CI = 1.13-1.37]), 2 L PEG + lactulose (RR = 1.22 [95 %CI = 1.10-1.38]) and 1 L PEG + ascorbate (ASC) (RR = 1.03 [95 %CI = 1.01-1.06]) were significantly superior to 2 L PEG + ASC. Overall, 2 L PEG + lactulose resulted as the best product (SUCRA 0.94), followed by 2 L PEG + simethicone (SUCRA 0.93). On network meta-analysis for ADR (17 RCTs, 6639 patients, 11 bowel preparations), only 2 L PEG + simethicone (RR = 1.60 [95 %CI = 1.05-2.43]) resulted significantly superior to 2 L PEG + ASC. 2 L PEG + simethicone, 2 L PEG + lactulose, and 1 L PEG + ASC seemed to provide high rates of CS, albeit only 2 L PEG + simethicone was associated with significantly higher ADR. Consequently, these products should be preferred for bowel preparation of colonoscopy. Further randomized studies with adequate sample sizes are needed for a more accurate comparison of these products on ADR.

Novel regimen for colonoscopy bowel preparation with oral lactulose: a prospective comparative study.

Polyethylene glycol (PEG) is considered the gold standard regimen for bowel preparation; however, due to the necessity of a large volume, patient tolerance is impaired. Therefore, lactulose is a novel alternative for colonoscopy preparation. This study aimed to investigate the efficacy and safety of lactulose-based bowel preparations in comparison with PEG for colonoscopy. This is a prospective, non-blinded, comparative study. Outpatients were randomly divided into two groups: group 1 (111 patients), PEG; and group 2 (111 patients), lactulose. The following clinical outcomes were assessed in each group: degree of bowel clearance using the Boston bowel preparation score, colorectal polyp detection rate, adenoma detection rate, tolerability, and side effects. The rate of inadequate bowel preparation was 8.1% and 1.8% for the PEG and lactulose groups, respectively (p=0.030). The Boston bowel preparation score for the entire colon was 7.34±1.17 and 8.36±1.09 for the PEG and lactulose groups, respectively (p<0.001). The satisfactory overall experience rates were 27.9% and 62.2% for the PEG and lactulose groups, respectively (p<0.001). The novel bowel preparation with oral lactulose was superior to that with PEG in terms of colon cleansing, adenoma detection rate, tolerance, and patient experience.

Factors Affecting Pre-Endoscopic Bowel Preparation

Bowel preparation for colonoscopy was designed as a means to improve the diagnostic and therapeutic accuracy and safety of the procedure. Adequate bowel preparation is important for a successful colonoscopy. The effectiveness of colonoscopy may limited by the particular circumstances of a person’s health such as age, pregnancy and comorbidities or even mental state that impede the ability to comply with the instructions for preparation of the bowel. Therefore, it is necessary for the endoscopic healthcare team to identify the specific conditions of the patient and to choose the suitable laxative agent. The purpose of this review is to explore the most efficient and safest bowel preparation for colonoscopy in individuals with underlying diseases, to reduce the frequency of inadequate preparation, adverse side effects, mis-diagnoses and suffering of the patient from the need to repeat the examination. For patients with diarrhea, renal failure, hepatic failure, heart problems, dehydration, bleeding, inflammatory bowel diseases, taking antihypertensive medications or are pregnant is safe and effective the use of polyethylenoglycol (PEG). For patients with diabetes, PEG with magnesium citrate or sodium phosphate (NaP) is recommended and for patients with constipation NaP or mosapride. Also, for the elderly before the administration of any laxative, biochemical tests should be done. PEG is the gold standard bowel preparation in patients with underlying diseases. Administration of NaP should be done with caution taking into account its absolute contraindications. The bowel preparations have not been adequately studied in special populations, while there is a need to develop new and more efficient preparation drugs with improved tolerability and reduced side-effects. The selection of a laxative agent should be tailored to each individual, taking into account the underlying disease and patient preference.

Quality of bowel preparation for colonoscopy in patients on glucagon-like peptide-1 receptor agonists

We aimed to assess the quality of bowel preparation in a matched cohort of patients actively using and not using GLP-1 RAs in a large health system in the United States. We performed a retrospective review of adult patients undergoing colonoscopy in 22 endoscopy units across 18 sites in the US. Our cohort comprised 6235 patients (3344 cases and 2891 controls). Baseline variables causing suboptimal bowel preparation were setting of procedure (inpatient), sex (male), BMI (higher), T2D, IBD, opioid medications, heart failure, and cirrhosis. Total BBPS was significantly higher in controls even after controlling for the abovementioned variables (p < 0.01). Cases were significantly more likely to meet the definition of inadequate bowel preparation. There was no significant difference between different classes of GLP-1 RAs. Patients using GLP-1 RAs are more likely to have inadequate bowel preparation during colonoscopy, even accounting for other comorbidities.

Glucagon-like peptide-1 receptor agonists significantly affect the quality of bowel preparation for colonoscopy.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) affect gastrointestinal motility, slowing gastric emptying and colonic transit. GLP-1RAs have an impact on gastric residue before endoscopy, but only limited data are available regarding its effect on the adequacy of colonic preparation. We investigated the association between GLP-1RA use and inadequate bowel preparation (IBP) for colonoscopy. We performed a multicenter retrospective study with GLP-1RA cases matched with controls (using propensity scores for age, sex, diabetes mellitus [DM], obesity, and co-morbidities). Data on demographics, medication use, procedural indications, and colonoscopy findings were collected. IBP ("poor preparation" on Aronchik scale or Boston Bowel preparation scale <5) was the primary outcome. 4876 patients treated with GLP-1RAs were included in the analysis and compared with 4876 controls selected from 333 648 patients without GLP-1RA use. Among the GLP-1RA patients, 10% (n = 487) had IBP compared with 197 (4%) of the control group (P<0.001). Subgroup analysis showed a higher rate of IBP among diabetic patients treated with GLP-1RA (284/2364 [12%]) than among diabetic patients without GLP-1RA treatment (118/2364 [5%]; P<0.001). Additionally, 203/2512 nondiabetic patients treated with GLP-1RAs had IBP (8%) compared with 79 of the nondiabetic non-GLP-1RA group (3%; P<0.001). On multivariate analysis, diabetes and GLP-1RA use were both found to be independent risk factors for IBP (odds ratio [OR] 1.4 and OR 2.7, respectively; both P<0.001). Our findings highlight the necessity for special attention and tailored recommendations for both diabetic and nondiabetic patients treated with GLP-1RAs in terms of colonic preparation prior to colonoscopy.

S349 Impact of Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) on Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis

S349 Impact of Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) on Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis

S866 The Impact of GLP-1 Receptor Agonists on Bowel Preparation for Colonoscopy

S866 The Impact of GLP-1 Receptor Agonists on Bowel Preparation for Colonoscopy

S920 Clear Liquid Diet and Colonoscopy Bowel Preparation Are Effective in Eliminating Retained Gastric Contents in Those on GLP1-RA Agents Undergoing Endoscopic Procedures

S920 Clear Liquid Diet and Colonoscopy Bowel Preparation Are Effective in Eliminating Retained Gastric Contents in Those on GLP1-RA Agents Undergoing Endoscopic Procedures

S503 The Impact of Buprenorphine Compared to Methadone on Bowel Preparation for Screening Colonoscopy

S503 The Impact of Buprenorphine Compared to Methadone on Bowel Preparation for Screening Colonoscopy

S381 Does Race and Insurance Status Determine the Quality of Bowel Preparation for Screening Colonoscopy?

S381 Does Race and Insurance Status Determine the Quality of Bowel Preparation for Screening Colonoscopy?

S916 Impact of a Standardized Inpatient Bowel Prep Order Set on Adequacy of Bowel Preparation for Colonoscopy

S916 Impact of a Standardized Inpatient Bowel Prep Order Set on Adequacy of Bowel Preparation for Colonoscopy

S851 Effect of Glucagon-Like Peptide-1 Receptor Agonists on Quality of Bowel Preparation for Colonoscopy: A Matched Case-Control Study

S851 Effect of Glucagon-Like Peptide-1 Receptor Agonists on Quality of Bowel Preparation for Colonoscopy: A Matched Case-Control Study

S370 Efficacy and Safety of the 1 Liter NER1006 Bowel Preparation for Colonoscopy in Adults With Comorbid Conditions That May Impact Prep Quality

S370 Efficacy and Safety of the 1 Liter NER1006 Bowel Preparation for Colonoscopy in Adults With Comorbid Conditions That May Impact Prep Quality