The impact of low- versus standard-volume bowel preparation on participation in primary screening colonoscopy: a randomized health services study

Abstract Background The aim of this study was to evaluate the impact of low-volume vs. standard-volume bowel preparation on participation in screening colonoscopy, bowel preparation quality, and lesion detection rates. Methods This was a multicenter, randomized, health services study within the population-based primary colonoscopy screening program in Poland. Individuals aged 55 – 62 years were randomized in a 1:1 ratio to bowel preparation with a low-volume (0.3 L sodium picosulfate with magnesium citrate) or standard-volume (4 L polyethylene glycol) regimen and then invited to participate in screening colonoscopy. The primary outcome measure was the rate of participation in screening colonoscopy. Compliance with the assigned bowel preparation, bowel preparation quality, and lesion detection rates were also evaluated. Results A total of 13 621 individuals were randomized and 13 497 were analyzed (6752 in the low-volume group and 6745 in the standard-volume group). The participation rate (16.6 % vs. 15.5 %; P = 0.08) and compliance rate (93.3 % vs. 94.1 %; P = 0.39) did not differ significantly between the groups. In the low-volume group, fewer participants had adequate bowel preparation compared with the standard-volume group (whole colon 79.0 % vs. 86.4 %, P < 0.001; proximal colon 80.1 % vs. 87.3 %, P < 0.001). Detection rates of advanced adenoma (AADR) and advanced serrated polyps (ASPDR) were lower in the low-volume group than in the standard-volume group (AADR in the proximal colon 2.6 % vs. 4.3 %, P = 0.02; ASPDR in the whole colon 2.0 % vs. 3.3 %, P = 0.04; ASPDR in the proximal colon 1.0 % vs. 1.9 %, P = 0.048). Conclusion When compared with a standard-volume bowel preparation with polyethylene glycol, low-volume bowel preparation with sodium picosulfate/magnesium citrate did not improve participation rate or lesion detection rates, and negatively affected bowel preparation quality.

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Impact of low-volume versus standard-volume bowel preparation on participation in primary screening colonoscopy: a randomized health services study

10.26226/morressier.57c5383bd462b80296c9c202 ◽

2016 ◽

Author(s):

Małgorzata Pisera

Keyword(s):

Health Services ◽

Bowel Preparation ◽

Screening Colonoscopy ◽

Volume Versus ◽

Primary Screening ◽

Low Volume

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A low-volume polyethylene glycol solution was associated with an increased suboptimal bowel preparation rate but had similar recommendations for an early repeat colonoscopy, procedure times, and adenoma detection rates

PLoS ONE ◽

10.1371/journal.pone.0176265 ◽

2017 ◽

Vol 12 (4) ◽

pp. e0176265 ◽

Cited By ~ 2

Author(s):

Sam C. Hankins ◽

Bryan B. Brimhall ◽

Vineel Kankanala ◽

Gregory L. Austin

Keyword(s):

Polyethylene Glycol ◽

Bowel Preparation ◽

Detection Rates ◽

Adenoma Detection ◽

Adenoma Detection Rates ◽

Low Volume ◽

Repeat Colonoscopy ◽

Glycol Solution

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Factors Affecting Proximal Colon Cleansing Based on Bowel Movement Kinetics: A Prospective Observational Study

Gastroenterology Research and Practice ◽

10.1155/2019/7032971 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Dae Bum Kim ◽

Kang-Moon Lee ◽

Sung-Goo Kang ◽

Sung Hoon Jung

Keyword(s):

Waist Circumference ◽

Bowel Preparation ◽

Female Gender ◽

Distal Colon ◽

Proximal Colon ◽

Screening Colonoscopy ◽

Factors Affecting ◽

Colon Cleansing ◽

Fair Poor

Background. Previous studies have suggested that relatively poor bowel preparation in the proximal colon, compared to that in the distal colon, could decrease the usefulness of colonoscopy. The aim of this study was to determine whether the “first defecation time” after polyethylene glycol (PEG) administration affects the cleansing quality in the proximal colon. Methods. A total of 425 individuals who were scheduled to undergo a screening colonoscopy were enrolled prospectively at the healthcare center of St. Vincent’s Hospital, Suwon, Korea, between April 2015 and March 2016. Bowel cleansing was performed using 4 L of PEG. Surveys were conducted to obtain information regarding the “first defecation time.” Endoscopists assessed the quality of bowel preparation in each bowel segment. Results. We investigated 425 consecutive eligible cases. The mean “first defecation time” after PEG administration was 54.35 min. The quality of bowel preparation was poorer in the proximal colon than that in the distal colon. The adequate (excellent, good) and inadequate (fair, poor) proximal colon preparation groups comprised 360 (84.7%) and 65 (15.3%) patients, respectively. A multivariate analysis revealed that female gender (P=0.029), small waist circumference (P=0.027), and the long “first defecation time” (P=0.034) were independently associated with inadequate bowel preparation in the proximal colon. Conclusion. Our data document that the “first defecation time,” female gender, and a small waist circumference affect the quality of preparation in the proximal colon. Inadequate preparation in the proximal colon was more common in females. Patients with these factors undergoing colonoscopy should be monitored carefully.

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The Impact of Patient Education with a Smartphone Application on the Quality of Bowel Preparation for Screening Colonoscopy

Clinical Endoscopy ◽

10.5946/ce.2017.025 ◽

2017 ◽

Vol 50 (5) ◽

pp. 479-485 ◽

Cited By ~ 11

Author(s):

JeongHyeon Cho ◽

SeungHee Lee ◽

Jung A Shin ◽

Jeong Ho Kim ◽

Hong Sub Lee

Keyword(s):

Patient Education ◽

Bowel Preparation ◽

Smartphone Application ◽

Screening Colonoscopy ◽

The Impact

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Su1554 A Comparative Study of Low-Volume Bowel Preparation Methods for Colonoscopy; Sodium Picosulfate Versus PEG-ASC

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.02.298 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB319

Author(s):

Jong Soo Lee ◽

Yoon Tae Jeen ◽

Seung Han Kim ◽

Jae MIN Lee ◽

Hyuk Soon Choi ◽

...

Keyword(s):

Comparative Study ◽

Bowel Preparation ◽

Preparation Methods ◽

Sodium Picosulfate ◽

Low Volume

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Sa1061 In the Era of Split Dose Bowel Preparation, Does Volume Matter? The Impact of Low Volume Split Dose Preparation Versus Large Volume Split Dose Preparation on Boston Bowel Preparation Score (BBPS)

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.284 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB221

Author(s):

Hassan A. Siddiki ◽

Francisco C. Ramirez ◽

Douglas O. Faigel ◽

Jonathan A. Leighton ◽

Mohanad Al-Qaisi ◽

...

Keyword(s):

Bowel Preparation ◽

Large Volume ◽

Split Dose ◽

Low Volume ◽

The Impact

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Better Segmental Bowel Preparation Scores Correlate with Higher Advanced Adenoma Detection Rates During Screening Colonoscopy

The American Journal of Gastroenterology ◽

10.14309/00000434-201110002-01144 ◽

2011 ◽

Vol 106 ◽

pp. S426-S427 ◽

Cited By ~ 1

Author(s):

Manpreet Singh ◽

Shashideep Singhal ◽

Mahesh Krishnaiah ◽

Mojdeh Momeni ◽

Sury Anand

Keyword(s):

Bowel Preparation ◽

Screening Colonoscopy ◽

Advanced Adenoma ◽

Detection Rates ◽

Adenoma Detection ◽

Adenoma Detection Rates

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Adenoma and Polyp Detection Rates in Colonoscopy according to Indication

Gastroenterology Research and Practice ◽

10.1155/2017/7207595 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

Erika S. Boroff ◽

Molly Disbrow ◽

Michael D. Crowell ◽

Francisco C. Ramirez

Keyword(s):

Distal Colon ◽

Proximal Colon ◽

Screening Colonoscopy ◽

Bowel Habit ◽

Polyp Detection ◽

Age And Gender ◽

Detection Rates ◽

Adenoma Detection ◽

And Gender ◽

Colon Data

Background. Adenoma detection rate (ADR) is a validated quality measure for screening colonoscopy, but there are little data for other indications. The distribution of adenomas is not well described for these indications. Aim. To describe ADR and the adenoma distribution in the proximal and distal colon based on colonoscopy indication. Methods. Outpatient colonoscopies are subdivided by indication. PDR and ADR for the entire colon and for proximal and distal colon. Data were compared using generalized estimating equations to adjust for clustering amongst endoscopists while controlling for patient age and gender. Results. 3436 colonoscopies were reviewed (51.2%: men (n=1759)). Indications are screening 49.2%, surveillance 29.3%, change in bowel habit 8.4%, bleeding 5.8%, colitides 3.0%, pain 2.8%, and miscellaneous 1.5%. Overall ADR was 37% proximal ADR 28%, and distal ADR 17%. PDR and ADR were significantly higher in surveillance than in screening (PDR: 69% versus 51%; ADR: 50% versus 33%; p=0.0001). Adenomas were more often detected in the proximal than in the distal colon, for all indications. Conclusions. Prevalence of polyps and adenomas differs based on colonoscopy indication. Adenoma detection is highest in surveillance and more commonly detected in the proximal colon. For quality assurance, distinct ADR and PDR targets may need to be established for different colonoscopy indications.

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