Tu1071 INCIDENCE AND RISK FACTORS FOR ISCHEMIC COLITIS AS A COMPLICATION OF BOWEL PREPARATION PRIOR TO COLONOSCOPY

Background. Colonoscopy is widely used for the diagnosis and management of colorectal disease and requires adequate bowel preparation. Ischemic colitis is a form of intestinal ischemia that presents with abdominal pain, diarrhea, and hematochezia. Risk factors include advanced age, cardiovascular disease, and diabetes. Both colonoscopy and bisacodyl bowel preparation have been described as rare causes of ischemic colitis with less than 35 cases collectively in the literature. Our review found that of these cases, there exists significant heterogeneity within individual patient characteristics. The majority of the cases are managed conservatively without complications or sequela. Due to the risk of ischemic colitis, the FDA has withdrawn bisacodyl bowel preparations from use in the USA. Bisacodyl bowel preparations are still used in Canada. Cases. Here, we present two cases of ischemic colitis in previously healthy women aged 57 and 69 who underwent screening colonoscopy using bisacodyl bowel preparation. Both were treated conservatively without complications. Conclusion. Thus far, there has been one documented case of ischemic colitis following colonoscopy with bisacodyl bowel preparation; here, we present two additional cases with one case occurring without the presence of known risk factors for ischemic colitis. Our literature review finds that there is limited evidence surrounding bisacodyl as a causative agent of ischemic colitis. Cases often contain confounding variables such as the presence of known risk factors for ischemic colitis. Our report aims to highlight the need for a more comprehensive analysis evaluating the safety of bowel preparations as well as increasing the clinical awareness surrounding the rare risk of colonoscopy-induced ischemic colitis.

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Role of acquired and hereditary thrombotic risk factors in patients with ischemic colitis

Gastroenterology ◽

10.1016/s0016-5085(01)81398-6 ◽

2001 ◽

Vol 120 (5) ◽

pp. A282-A282

Author(s):

I KOUTROUBAKIS ◽

A SFIRIDAKI ◽

A THEODOROPOULOU ◽

A LIVADIOTAKI ◽

P DIMOULIOS ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Colitis ◽

Thrombotic Risk

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Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy

Journal of Clinical Medicine ◽

10.3390/jcm10122740 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2740

Author(s):

Efrat L. Amitay ◽

Tobias Niedermaier ◽

Anton Gies ◽

Michael Hoffmeister ◽

Hermann Brenner

Keyword(s):

Risk Factors ◽

Bowel Preparation ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Screening Colonoscopy ◽

Cross Sectional ◽

Factors Associated ◽

Screening Practice ◽

Abdominal Symptoms ◽

Inadequate Bowel Preparation

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.

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Colonoscopy-induced ischemic colitis in patients without risk factors

World Journal of Gastroenterology ◽

10.3748/wjg.v20.i13.3698 ◽

2014 ◽

Vol 20 (13) ◽

pp. 3698 ◽

Cited By ~ 10

Author(s):

Sang Ok Lee

Keyword(s):

Risk Factors ◽

Ischemic Colitis

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Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery

Gastroenterology Research and Practice ◽

10.1155/2017/9015854 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Caroline Gronnier ◽

Fabian Grass ◽

Christiane Petignat ◽

Basile Pache ◽

Dieter Hahnloser ◽

...

Keyword(s):

Risk Factors ◽

Minimally Invasive ◽

Bowel Preparation ◽

Emergency Surgery ◽

Protective Factor ◽

Enhanced Recovery ◽

Multinomial Logistic Regression ◽

Surveillance Program ◽

Colonic Surgery ◽

Invasive Approach

Background. The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods. Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical details, compliance, and outcome were retrieved from a prospectively maintained database. SSI were traced by an independent National surveillance program. Risk factors for SSI were identified by univariate and multinomial logistic regression. Results. Fifty-four out of 397 patients (14%) developed SSI. Independent risk factors for SSI were emergency surgery (OR 1.56; 95% CI 1.09–1.78, p=0.026), previous abdominal surgery (OR 1.7; 95% CI 1.32–1.87, p=0.004), smoking (OR 1.71; 95% CI 1.22–1.89, p=0.014), and oral bowel preparation (OR 1.86; 95% CI 1.34–1.97, p=0.013), while minimally invasive surgery (OR 0.3; 95% CI 0.16–0.56, p<0.001) protected against SSI. Compliance to ERAS items of >70% was not retained as a protective factor for SSI after multivariate analysis (OR 0.94; 95% CI 0.46–1.92, p=0.86). Conclusions. Smoking, open and emergency surgery, and bowel preparation were risk factors for SSI. ERAS pathway had no independent impact while minimally invasive approach did. This study was registered under ResearchRegistry.com (UIN researchregistry2614).

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