scholarly journals Effect of physician-provided education on the quality of bowel preparation

2021 ◽  
Vol 84 (3) ◽  
Author(s):  
B Dikkanoğlu ◽  
A.E. Duman ◽  
S Hülagü
Keyword(s):  
Bowel Preparation ◽  
Control Group ◽  
Procedure Time ◽  
Cecal Intubation ◽  
Detection Rates ◽  
Written Information ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Inadequate Bowel Preparation

Background and study aims : Inadequate bowel preparation inpatients scheduled for colonoscopy is an important problem. Inour study, we aimed to investigate the effect of physician-providedbowel preparation education on the quality of bowel preparationand process. Patients and methods : A total of 150 outpatients who were referredto Kocaeli University Medical Faculty Hospital GastroenterologyUnit for colonoscopy between May 2019 and October 2019 wereenrolled in our prospective, endoscopist-blinded study. Patientswere divided into two groups. Group 1 (education group) included73 patients who received 10 minutes of verbal information froma physician in addition to a written information form. Group 2(control group) included 75 patients who received informationfrom a medical secretary in addition to a written information form.During colonoscopy, the quality of bowel preparation was assessedusing the Boston bowel preparation scale (BBPS). A BBPS score≥ 5 was considered adequate bowel preparation. The mean BBPSscore, polyp detection rate, cecal intubation rate and time, andprocedure time were also evaluated. Results : The rate of adequate bowel preparation (BBPS score≥ 5) was 90.4% and 74.7% in groups 1 and 2, respectively (p =0.021). The odds ratio for having a BBPS score ≥ 5 in the educationgroup was 3.199 compared with the control group (95% confidenceinterval = 1.254-8.164; p = 0.015). The cecal intubation rates were91.8% and 88% in groups 1 and 2, respectively (p > 0.05). The cecalintubation time, procedure time, and adenoma detection rates weresimilar between the groups. The relationships of age, educationlevel, sex, diabetes mellitus, medicine use, procedure time, andintraabdominal surgery with inadequate bowel preparationwere analysed using a logistic regression model. Univariate andmultivariate analyses revealed no significant factors associatedwith inadequate bowel preparation. Conclusions : Patient education on the bowel preparationprocess via a physician improved the quality of bowel preparation.

scholarly journals Comparing the influence of 1-day versus 3-day low-residue diet on bowel preparation for colonoscopy:a randomized controlled trial

2019 ◽  
Author(s):  
Li Jiao ◽  
Junmin Wang ◽  
Wenjuan Zhao ◽  
Huan Ma ◽  
Xiao Fan ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Controlled Trial ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Patient Tolerance ◽  
Significant Difference ◽  
Low Residue Diet

Abstract Backgroud :A low-residue diet (LRD) can potentially reduce the hunger of patients while improving compliance and tolerance,without compromising the quality of bowel preparation.This study investigated the effects of 1-day low-residue diets compared with 3-day for colonoscopic bowel preparation . Methods: Patients undergoing bowel preparation before colonoscopy were randomly divided into 1-day and 3-day LRD groups.Oral polyethylene glycol (PEG) electrolyte solution and simethicone were applied to all patients submitted to bowel preparation. The primary outcome measure included the quality of the bowel preparation rated by the Boston bowel preparation scale(BBPS), and the secondary measures included (i) cecal intubation time and withdrawal time, (ii) polyp detection rate, (iii) patient tolerance and (iv) the willingness of the patient to repeat the diet protocol thereafter. Results: No significant difference was detected in regards the quality of the bowel preparation when comparing the two groups, since the mean of BBPS score was 6.54 versus 6.55 in the 1- and 3-day LRD groups. The cecal intubation times,withdrawal times, polyp detection rates,and the patient tolerance (i.e.hunger-comfort score[1]) showed no significant difference between the 1- and 3-day LRD groups. However,overall satisfaction was higher with the 1-day LRD group than with the 3-day LRD group. Conclusion: The 1-day and 3-day low-residue diets showed no major effect on bowel preparation previously to colonoscopy, while the tolerance and satisfaction of patients were higher after 1-day low-residue diet. Trial registration: Clinical Trial Registry Identifier:ChiCTR1900025843.Date of registration:September 10,2019 “Retrospectively registered”. Key words: colonoscopy; bowel preparation; low-residue diet; duration; bowel-cleansing quality

scholarly journals Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial

2020 ◽  
Vol 9 (10) ◽  
pp. 3286
Author(s):  
Youn I Choi ◽  
Jong-Joon Lee ◽  
Jun-Won Chung ◽  
Kyoung Oh Kim ◽  
Yoon Jae Kim ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Controlled Trial ◽  
Screening Colonoscopy ◽  
Control Group ◽  
Case Group ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Bowel Cleansing

Although adequate bowel preparation is essential in screening colonoscopy, patient intolerability to bowel cleansing agents is problematic. Recently, a probiotic mixture solution with bisacodyl emerged to improve patient tolerability. We investigated the efficacy, safety, and patient tolerability profiles of probiotics with bisacodyl versus conventional polyethylene glycol (PEG) solution for bowel preparation for screening colonoscopies in healthy patients in this prospective, randomized, case-control study. In total, 385 volunteers were randomly assigned to receive 2 L of water + 200 mL of probiotic solution (case group, n = 195) or 4 L of PEG solution (control group, n = 190). The efficacy of the bowel cleansing was evaluated using the Ottawa scale system, polyp detection rate, and adenoma detection rate, and the patient tolerability profiles were assessed using a questionnaire. The demographics were not significantly different between groups. When the Ottawa score for each bowel segment was stratified into an adequate vs. inadequate level (Ottawa score ≤ 3 vs. >3), there were no statistical differences between groups in each segment of the colon. There were no significant differences in the polyp and adenoma detection rates between groups (38.42% vs. 32.42, p = 0.30; 25.79% vs. 18.97%, p = 0.11). The case group showed significantly fewer events than the control group, especially nausea, vomiting, and abdominal bloating events. Regarding the overall satisfaction grade, the case group reported significantly more “average” scores (95% vs. 44%, p < 0.001) and were more willing to use the same agents again (90.26% vs. 61.85%, p < 0.001). As patient compliance with bowel preparation agents is associated with an adequate level of bowel cleansing, a probiotic solution with bisacodyl might be a new bowel preparation candidate, especially in patients who show a poor compliance with conventional bowel preparation agents.

scholarly journals Effect of Physician-Delivered Patient Education on the Quality of Bowel Preparation for Screening Colonoscopy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Tze-Yu Shieh ◽  
Ming-Jen Chen ◽  
Chen-Wang Chang ◽  
Chien-Yuan Hung ◽  
Kuang-Chun Hu ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Screening Colonoscopy ◽  
Control Group ◽  
Education Group ◽  
Adenoma Detection ◽  
Secondary Outcomes ◽  
Inadequate Bowel Preparation ◽  
Bowel Preparations ◽  
Intensive Education

Background. Inadequate bowel preparation is common in outpatients undergoing screening colonoscopy because of unawareness and poor adherence to instruction.Methods. Herein, 105 consecutive outpatients referred for screening colonoscopy were enrolled in this prospective, colonoscopist-blinded study. The patients were assigned to an intensive-education group, with 10 minutes of physician-delivered education, or to standard care. At the time of colonoscopy, the quality of bowel preparation was assessed using the Boston Bowel Preparation Scale (BBPS). The primary outcome was a BBPS score ≥5. The secondary outcomes were the mean BBPS score, insertion time, adenoma detection rate, and number of adenomas detected.Results. We analyzed 39 patients who received intensive education and 60 controls. The percentage of adequate bowel preparations with a BBPS score ≥5 was higher in the intensive-education group than in the control group (97.4% versus 80.0%;P=0.01). The adjusted odds ratio for having a BBPS score ≥5 in the intensive-education group was 10.2 (95% confidence interval = 1.23–84.3;P=0.03). Other secondary outcomes were similar in the 2 groups.Conclusions. Physician-delivered education consisting of a brief counseling session in addition to written instructions improves the quality of bowel preparation in outpatients undergoing screening colonoscopy.

scholarly journals Efficacy of Macrogol 4000 Plus Electrolytes in Bowel Preparation for Colonoscopy in Patients with Chronic Constipation

2021 ◽  
Author(s):  
Ryoji Ichijima ◽  
Sho Suzuki ◽  
Mitsuru Esaki ◽  
Tomomi Sugita ◽  
Kanako Ogura ◽  
...  
Keyword(s):  
Adverse Events ◽  
Bowel Preparation ◽  
Chronic Constipation ◽  
Detection Rate ◽  
Observation Time ◽  
Insertion Time ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Polyp Detection Rate ◽  
Adenoma Detection

Abstract Background: Chronic constipation is a significant factor in poor bowel preparation for colonoscopy. Macrogol 4000 plus electrolytes (Movicol, EA Pharma, Tokyo, Japan), containing polyethylene glycol (PEG) and electrolytes, have been used recently to treat patients with constipation. However, prospective studies on the use of macrogol 4000 for bowel cleansing for colonoscopy are lacking. This study aimed to investigate the efficacy and safety of macrogol 4000 in addition to PEG administered in patients with chronic constipation.Methods: This single-center, single-arm prospective study enrolled patients with chronic constipation who were scheduled to undergo colonoscopy. The primary endpoint was the proportion of good bowel preparation assessed using the Boston Bowel Preparation Scale (BBPS) (6 or more points). The secondary endpoints were the time from when pPEG (MoviPrep, EA Pharma, Tokyo, Japan) was taken until colonoscopy could be started, amount of PEG taken, number of defecations, whether additional PEG doses were taken, and adverse events. Endoscopy-related endpoints included cecal intubation rate, insertion time, observation time, adenoma detection rate (ADR), and polyp detection rate (PDR). The tolerability of PEG and macrogol 4000 was assessed using a questionnaire.Results: Forty patients were included in the analysis. The median BBPS was 7 (range, (3–9)) and ³6 points in 37 cases (92.5%). The median time until colonoscopy can be started was 210 min (90–360 min), the median volume of PEG taken was 1500 mL (1000–2000 mL), and the median number of defecations was 7 (3-20). No adverse events were observed. Fourteen patients required an additional dose of PEG. Cecal intubation was achieved in all cases, the median insertion time was 6.0 min (range, 2.3–22 min), and the median observation time was 8.8 min (range, 4.0–16.0 min). The ADR and PDR were 60.0% and 75.0%, respectively. A greater proportion of patients rated the tolerability of macrogol 4000 as good compared with that of PEG (95.0% vs. 50.0%, p < 0.01).Conclusions: Intake of macrogol 4000 in addition to PEG is effective and safe for colonoscopy in patients with chronic constipation.

scholarly journals A120 NO EVIDENCE OF A FRIDAY EFFECT ON COLONOSCOPY QUALITY OUTCOMES

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 101-102
Author(s):  
Z Hindi ◽  
L Guizzetti ◽  
S cocco ◽  
M Brahmania ◽  
A Wilson ◽  
...  
Keyword(s):  
Detection Rate ◽  
Hospital Setting ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Detection Rates ◽  
Adjusted Risk ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Colonoscopy Quality

Abstract Background Colonoscopy quality may be influenced by operator fatigue. Prior studies have shown lower adenoma detection rates for procedures performed at the end of the day. However, it is unknown if colonoscopy quality is impaired at the end of the work week. Aims We investigated whether colonoscopy quality-related metrics differ at the end of the work week using the South West Ontario Colonoscopy Cohort. Methods Between April 2017 to February 2018, 45,510 consecutive colonoscopies from 20 academic and community hospitals in our health region were captured to form the cohort. In Canada, outpatient endoscopies are generally performed between Monday to Friday, taking Friday, or the last business day, as the last day of the work week compared to the rest of the work week. When a statutory holiday occurred on a Friday, Thursday was designated the last day of the work week. The primary outcome was adenoma detection rate (ADR), and secondary outcomes were sessile serrated polyp detection rate (ssPDR), polyp detection rate (PDR), and failed cecal intubation. Outcomes were presented as unadjusted and adjusted risk ratios derived from modified Poisson regression and adjusting for physician-level clustering, and characteristics of the patient (age, sex, severity), procedure (hospital setting, trainee presence, indication, sedation, bowel preparation quality) and physician (experience and specialty). Results During the observation period, 9,132 colonoscopies were performed on the last day of the work week compared to 36,378 procedures during the rest of the work week. No significant difference was observed for ADR (26.4% vs. 26.6%, p=0.75), ssPDR (4.5% vs. 5.0%, p=0.12), PDR (44.1% vs. 43.1%, p=0.081), or failed cecal intubation (2.8% vs. 2.9%, p=0.51) for colonoscopies performed on the last day of the work week compared to the rest of the week, respectively. After adjusting for potential confounders, there were no significant differences in the ADR (RR 1.01, 95% CI [0.88, 1.15], p=0.94), ssPDR (RR 0.90, 95% CI [0.70, 1.14], p=0.38), PDR (RR 1.00, 95% CI [0.92, 1.09], p=0.94), or failed cecal intubation (RR 0.92, 95% CI [0.72, 1.18], p=0.51) for colonoscopies performed on the last day of the work week compared to the rest of week, respectively. Conclusions Colonoscopy quality metrics, including ADR, ssPDR, PDR, and failed cecal intubation are not significantly different at the end of the week. Funding Agencies None

scholarly journals Improved Bowel Preparation with Multimedia Education in a Predominantly African-American Population: A Randomized Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shashank Garg ◽  
Mohit Girotra ◽  
Lakshya Chandra ◽  
Vipin Verma ◽  
Sumanjit Kaur ◽  
...  
Keyword(s):  
African American ◽  
Bowel Preparation ◽  
Statistical Significance ◽  
Randomized Study ◽  
Control Group ◽  
American Population ◽  
African American Population ◽  
Multimedia Education ◽  
Adenoma Detection

Background and Aim. Inadequate bowel preparation is a major impediment in colonoscopy quality outcomes. Aim of this study was to evaluate the role of multimedia education (MME) in improving bowel preparation quality and adenoma detection rate. Methods. This was an IRB-approved prospective randomized study that enrolled 111 adult patients undergoing outpatient screening or surveillance colonoscopy. After receiving standard colonoscopy instructions, the patients were randomized into MME group (n=48) and control group (n=46). The MME group received comprehensive multimedia education including an audio-visual program, a visual aid, and a brochure. Demographics, quality of bowel preparation, and colonoscopy findings were recorded. Results. MME group had a significantly better bowel preparation in the entire colon (OR 2.65, 95% CI 1.16–6.09) and on the right side of the colon (OR 2.74, 95% CI 1.12–6.71) as compared to control group (p<0.05). Large polyps (>1 cm) were found more frequently in the MME group (11/31, 35.5% versus 0/13; p<0.05). More polyps and adenomas were detected in MME group (57 versus 39 and 31 versus 13, resp.) but the difference failed to reach statistical significance. Conclusion. MME can lead to significant improvement in the quality of bowel preparation and large adenoma detection in a predominantly African-American population.

scholarly journals Impact of Video Aid on Quality of Bowel Preparation Among Patients Undergoing Outpatient Screening Colonoscopy

2018 ◽  
Vol 11 ◽  
pp. 117955221880330
Author(s):  
Sanna Fatima ◽  
Deepanshu Jain ◽  
Christopher Hibbard
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Screening Colonoscopy ◽  
Advanced Adenoma ◽  
Control Group ◽  
P Value ◽  
Group I ◽  
Adenoma Detection

Aim: To investigate the effect of video aid on quality of bowel preparation. Study: A retrospective study was done on patients undergoing outpatient screening colonoscopy. All subjects received educational video prior to colonoscopy in addition to the standard counseling. Patient charts were reviewed to collect data regarding quality of bowel preparation (adequate or inadequate). The study population was stratified into four groups according to viewing status: Group I 0% (control group), Group II <50%, Group III >50% to <75%, and Group IV watched ⩾75% of the video. Results: A total of 338 patients with an average age of 59.1 years and 60.3% females were included in the final study cohort. Of the patients in Groups I, II, III, and IV, 94.3%, 90.9%, 100%, and 91.7%, respectively, had adequate preparation ( P value = .827). Adenoma detection rate (ADR) for Groups I, II, III, and IV was 28.8%, 50%, 50%, and 22.6%, respectively ( P value = .305). The mean cecal intubation time was 20.7, 16.4, 16.57, and 17 minutes for Groups I, II, III, and IV, respectively ( P value = .041). Conclusions: Video aid use for patients undergoing screening colonoscopy lacked a statistically significant impact on the quality of bowel preparation, ADR, and advanced adenoma detection rate when compared with standard practice.

scholarly journals Colonoscopy quality across Europe: a report of the European Colonoscopy Quality Investigation (ECQI) Group

2021 ◽  
Vol 09 (10) ◽  
pp. E1456-E1462
Author(s):  
Cristiano Spada ◽  
Anastasios Koulaouzidis ◽  
Cesare Hassan ◽  
Pedro Amaro ◽  
Anurag Agrawal ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Gastrointestinal Endoscopy ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Withdrawal Time ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Cecal Intubation Rate ◽  
Colonoscopy Quality

Abstract Background and study aims The European Colonoscopy Quality Investigation (ECQI) Group comprises expert colonoscopists and investigators with the aim of raising colonoscopy standards. We assessed the levels of monitoring and achievement of European Society of Gastrointestinal Endoscopy (ESGE) performance measures (PMs) across Europe using responses to the ECQI questionnaires. Methods The questionnaire comprises three forms: institution and practitioner questionnaires are completed once; a procedure questionnaire is completed on multiple occasions for individual total colonoscopies. ESGE PMs were approximated as closely as possible from the data collected via the procedure questionnaire. Procedure data could provide rate of adequate bowel preparation, cecal intubation rate (CIR), withdrawal time, polyp detection rate (PDR), and tattooing resection sites. Results We evaluated ECQI questionnaire data collected between June 2016 and April 2018, comprising 91 practitioner and 52 institution questionnaires. A total of 6445 completed procedure forms were received.Institution and practitioner responses indicate that routine recording of PMs is not widespread: adenoma detection rate (ADR) is routinely recorded in 29 % of institutions and by 34 % of practitioners; PDR by 42 % and 47 %, CIR by 62 % and 64 %, bowel preparation quality by 56 % and 76 %, respectively.Procedure data showed a rate of adequate bowel preparation of 84.2 %, CIR 73.4 %, PDR 40.5 %, mean withdrawal time 7.8 minutes and 12.2 % of procedures with possible removal of a non-pedunculated lesion ≥ 20 mm reporting tattooing. Conclusions Our findings clearly show areas in need of quality improvement and the importance of promoting quality monitoring throughout the colonoscopy procedure.

scholarly journals Melanosis Coli: A Helpful Contrast Effect or a Harmful Pigmentation?

2018 ◽  
Vol 11 ◽  
pp. 117955221881732 ◽  
Author(s):  
Fadi Abu Baker ◽  
Amir Mari ◽  
Dan Feldman ◽  
Muhammad Suki ◽  
Oren Gal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Detection Rate ◽  
Control Group ◽  
P Value ◽  
Polyp Detection ◽  
Detection Rates ◽  
Benign Condition ◽  
Melanosis Coli ◽  
Polyp Detection Rate ◽  
Adenoma Detection

Background: Melanosis coli, a brown discoloration of colonic mucosa, is considered as a benign condition mainly observed in patients under chronic anthranoid laxatives. Recent data link this condition with an increased adenoma detection rate. Moreover, its tumorigenic potential and possible association with the development of colorectal cancer remains uncertain. We conducted this study to compare the polyp detection rate and colorectal cancer diagnosis in patients with melanosis against matched control group without melanosis. Patients and methods: A retrospective single-center study. Patients diagnosed with melanosis coli on colonoscopy over a 15-year period were included. Each melanosis coli patient was matched with three controls by age, gender, setting (inpatient/outpatient), and procedure’s indication. Polyp detection rate and diagnosis of colorectal cancer were recorded and compared between the groups before and after adjustment for bowel preparation. Results: A cohort of 718 patients with melanosis and 2154 controls were included. The polyp detection rates were 33.4% and 21.8% of melanosis and control groups, respectively ( P < .001). Melanosis coli, however, was associated with less diagnosis of colorectal cancer than controls (0.3% vs 3.9%; P < .001). In multivariate analysis, melanosis diagnosis on endoscopy was significantly associated with higher polyp detection rate (odds ratio [OR] = 1.986, 95% confidence interval [CI]: 1.626-2.425; P value < .01). Conclusions: Melanosis coli is not associated with increased diagnosis of colorectal cancer. It is associated, however, with enhanced polyp detection likely due to chromo-endoscopy-like effect.

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