Low-Fibre Diet as an Option for Bowel Preparation Prior to Colonoscopy: ARandomised Controlled Clinical Trial

Introduction: Bowel preparation for colonoscopy plays an important role in the evaluation of the colon. Many methods for preparing the colon for colonoscopy do not work well. Aim: To use a low-fibre diet as a standard and applicable method for bowel preparation in performing colonoscopy and increasing patients’ adherence to colonoscopy. Materials and Methods: Clinical control trial design was used to compare bowel preparation in people receiving a low-fibre diet with those who did not receive food {Nil Per Os (NPO)} for bowel preparation. The participants included 477 patients who were randomly divided into two groups including 223 patients having a low-fibre diet (for dinner) and 254 patients having nothing for dinner (NPO). Data were recorded including age, sex, weight, height, level of education, bowel preparation score, colonoscopy diagnosis and sedative dose. Both groups were given a solution of 3 L of ethylene glycol and 60 mg of bisacodyl at three occasions: 3 pm and 7 pm the day before colonoscopy and 6 am on the colonoscopy day. Scoring criteria for colonoscopy preparation included excellent (clean and free of any liquids), very good (clean with clear fluid, underlying mucus visible in clear fluid), good (clean with dirty liquid), poor (with particles including stools, but can be assessed at 80% mucus), and very poor (containing stool particles, and mucosal evaluation below 80%, colonoscopy was cancelled in this group). The data were analysed by SPSS version 21.0 using Chi-square and Independent Samples Test. Results: About 82% of patients who consumed a low-fibre diet for bowel preparation the night before colonoscopy had an excellent and very good quality of bowel preparation compared with 74.9% of patients not receiving any diet. The number of patients who cancelled the colonoscopy were more in the group not receiving any diet (4.7% versus 2.6%). The data indicated that the quality of colon preparation decreased by age (p=0.0001), whereas Body Mass Index (BMI) did not differ on colon cleansing. When having dinner, patients with Irritable Bowel Syndrome (IBS) had significantly more secretion of air bubble and foam formation than patients not eating dinner (p=0.002). The results showed that the difference in bowel preparation quality between the two groups was not significant (p=0.169), and increased patient adherence to colonoscopy in the first group. Conclusion: Implementing a proper bowel preparation method is very important in improving the quality of colonoscopy and increasing the patient’s adherence to colonoscopy. Using a low-fibre diet on the day before colonoscopy can help achieve this goal.

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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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Perbandingan Tingkat Sedasi Klonidin Syrup 2 mcg/kgBB dengan Diazepam Syrup 0.4 mg/kgBB sebagai Premedikasi pada Pasien Anak yang Menjalani Pembedahan dengan General Anestesi

Jurnal Ilmu Kedokteran ◽

10.26891/jik.v5i2.2011.111-117 ◽

2017 ◽

Vol 5 (2) ◽

pp. 111

Author(s):

Vera Muharrami ◽

A. Sani P. Nasution ◽

Nazaruddin Umar

Keyword(s):

Pediatric Surgery ◽

Optimal Dose ◽

Controlled Clinical Trial ◽

Subjective Feeling ◽

Double Blind ◽

Adrenoceptor Agonist ◽

Number Of Patients ◽

Significant Difference ◽

Preanesthetic Medication

Introduction: Anxiety in children undergoing surgery is characterized by subjective feeling of tension, apprehension,nervousness and worry that may be expressed in various forms. Clonidine, an alpha 2-adrenoceptor agonist, has beenshown to be as a preanesthetic medication in childrens. The current study was designed to investigate the differencesof level sedation clonidine syrup and diazepam syrup as a premedicant in children.Methods: In a randomized, double-blind, controlled clinical trial, 40 children, aged 2-12 yr, undergoing electivesurgery received 2 micrograms/kg clonidine syrup or 0.4 mg/kg diazepam syrup orally. These agents were administered120 min before the estimated time of induction of general anesthesia and noted the children’s level of sedation. Thelevel of sedation were compared among the two groups. PASS <1 demanded rescue intravenous sedation.Result: Clonidine syrup 2 mcg/kgBB provided better quality of sedation after 60 min of premedicant but it wasn’tsignificant(1.8±0.92) and diazepam syrup (0.80±0.89; p>0.05) and number of patients with rescue intravenous diazepamacceptance were same both clonidine group compared to diazepam, there was no significant difference between twogroups, 10% of clonidine group patients, 10 % of diazepam group patients (p>0.05). No clinically significanthypotension or bradycardia was observed after preanesthetic medications of diazepam and clonidine syrup.Discussion: These data indicate that, even in pediatric surgery, the 2 micrograms/kg syrup clonidine is an effectivepremedication. However, the safety and optimal dose of clonidine in this setting remain to be determined.

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A160 THE EFFECT OF AN INSTRUCTIVE VIDEO ON THE BOWEL PREPARATION EXPERIENCE

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.159 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 24-25

Author(s):

D K Saraswat ◽

P H Fung ◽

A Dong ◽

R Sultanian ◽

O Farooq ◽

...

Keyword(s):

Bowel Preparation ◽

Patient Adherence ◽

Healthcare Providers ◽

Screening Colonoscopy ◽

Control Group ◽

University Of Alberta ◽

Research Award ◽

Bowel Preparations ◽

Experimental Group

Abstract Background Over 26000 new cases of colorectal cancer (CRC) are diagnosed each year in Canada. This number has been decreased significantly by the implementation of CRC screening that includes removal of any polyps found during colonoscopies. Despite this, approximately 1 in 4 colonoscopies are inadequate for the detection of early neoplasms due to insufficient bowel preparation prior to the colonoscopy. Consequently, there is a need to improve patient adherence to the bowel preparation protocol. Previous research has shown that enhanced education, including the methods and rationale for bowel preparation prior to a colonoscopy, improves the quality of the bowel preparation. Aims We hypothesised that patients with access to a replayable video explaining the bowel preparation protocol and its importance would have increased satisfaction and noninferior bowel preparations. Methods 100 patients undergoing programmatic screening colonoscopy were randomly assigned into one of two groups. The control group was given the standard presentation currently given to patients. The experimental group was given the same presentation and also given access to an educational video. This video is based on Alberta provincial bowel preparations which have been tested and evaluated. Participants in both groups were sent a survey one day after their colonoscopy. Subjects completed a modified version of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems survey with added questions designed to assess their satisfaction with the education they received on the bowel preparation. Bowel preparation quality was assessed on a 4-point Likert scale by the endoscopist. Results 17 participants (10 female), aged 40–72 (Mage = 60) have enrolled in the study thus far; however, most have yet to have their colonoscopy. Initial results revealed that all participants had high levels of satisfaction with the presentation they were given. Those in the control group indicated that they would have liked to have had access to a video guide to the bowel preparation before their procedure. The participant in the experimental group indicated high levels of satisfaction with this video, noting that it provided important information not available from other sources. Information on the quality of their bowel preparations is pending. Conclusions The use of multimedia explanations of the bowel preparation has promise in improving patient satisfaction with the bowel preparation. Further studies may guide best methods for implementing a video assisted educational model to enhance colonoscopy preparation. Funding Agencies The first author received an Edna Wakefield Rowe Memorial Summer Research Award from the Faculty of Medicine & Dentistry at the University of Alberta to support this work.

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Kepatuhan Diet dengan Kualitas Hidup Pasien Hemodialisa di RSUP Dr. Soeradji Tirtonegoro: Korelasi Studi

WIRARAJA MEDIKA ◽

10.24929/fik.v10i2.1009 ◽

2020 ◽

Vol 10 (2) ◽

pp. 78-83

Author(s):

Heru Ginanjar Triyono ◽

Dian Novita K ◽

Sugiarto Sugiarto ◽

Tengku Isni Yuli ◽

Winda Rofiyati

Keyword(s):

Quality Of Life ◽

Cross Sectional Study ◽

The Body ◽

Bivariate Analysis ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Number Of Patients ◽

Chi Square Test

Abstract Kidney is one the organs that has an important function in the body. These functions include regulating the concentration of salt in the blood, and regulating the balance of acid base and the excretion of excess salt.Design Of this study was analytic with total Random Sampling. Research that uses descriptive quantitative type using cross sectional. This researcher only observed and measured variables without giving treatment. Cross sectional design or cross-sectional study, researchers only make observations and measure variables at one time. The Sampling in this study. The sampling in this study were 30 respondents who underwent hemodialysis. The amount was obtained based on data on the number of patients. The results of the analysis of the relationship of diet adherence with the quality of life of hemodialysis patients at Hospital using the chi square test. From table 4.4 the chi suare correlation test results obtained sig (2-tailed) values with the results of 0.003 p value <0.05 to 0.003 <0.05 showed a relationship between diet compliance with quality of life. Data generated from the bivariate analysis of respondents who comply with good quality of life were 14 respondents (66.7%), while respondents who were not compliant and with less quality of life were 4 respondents (44.4%). Key word: Diet, Kidney Failure, Quality Of Life, Hemodialysis

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Polyethylene Glycol versus sodium picosulfalte Bowel Preparation in the Setting of a Colorectal Cancer Screening Program

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2015/350587 ◽

2015 ◽

Vol 29 (7) ◽

pp. 384-390 ◽

Cited By ~ 3

Author(s):

Omar Kherad ◽

Sophie Restellini ◽

Myriam Martel ◽

Alan N Barkun

Keyword(s):

Colorectal Cancer ◽

Polyethylene Glycol ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Bowel Preparation ◽

Screening Program ◽

Split Dose ◽

Colon Cleansing ◽

Cancer Screening Program

BACKGROUND: Adequate bowel preparation for colonoscopy is an important predictor of colonoscopy quality.OBJECTIVE: To determine the difference in terms of effectiveness between different existing colon cleansing products in the setting of a colorectal cancer screening program.METHODS: The records of consecutive patients who underwent colonoscopy at the Montreal General Hospital (Montreal, Quebec) between April 2013 and April 2014 were retrospectively extracted from a dedicated electronic digestive endoscopic institutional database.RESULTS: Overall, 2867 charts of patients undergoing colonoscopy were assessed, of which 1130 colonoscopies were performed in a screening setting; patients had adequate bowel preparation in 90%. Quality of preparation was documented in only 61%. Bowel preparation was worse in patients receiving sodium picosulfate (PICO) alone compared with polyethylene glycol, in a screening setting (OR 0.3 [95% CI 0.2 to 0.6]). Regardless of the preparation type, the odds of achieving adequate quality cleansing was 6.6 for patients receiving a split-dose regimen (OR 6.6 [95% CI 2.1 to 21.1]). In multivariable analyses, clinical variables associated with inadequate bowel preparation in combined population were use of PICO, a nonsplit regimen and inpatient status. The polyp detection rate was very high (45.6%) and was correlated with withdrawal time.CONCLUSION: Preparation quality needs to be more consistently included in the colonoscopy report. Split-dose regimens increased the quality of colon cleansing across all types of preparations and should be the preferred method of administration. Polyethylene glycol alone provided better bowel cleansing efficacy than PICO in a screening setting but PICO remains an alternative in association with an adjuvant.

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Optometry Services in Saudi Arabia

Global Journal of Health Science ◽

10.5539/gjhs.v9n8p91 ◽

2017 ◽

Vol 9 (8) ◽

pp. 91 ◽

Cited By ~ 3

Author(s):

Abdullah Z. Alotaibi

Keyword(s):

Saudi Arabia ◽

Care Delivery ◽

Quality Of Services ◽

Clinical Practices ◽

Chi Square ◽

Healthcare Facilities ◽

Number Of Patients ◽

The Government ◽

The Impact

The purpose of this research study is to examine the quality of services provided by the Optometrists in the four provinces of Saudi Arabia. Further, recommendations shall be provided for future improvements based on the findings of the study. Two hundred and forty healthcare facilities were examined by conducting a questionnaire-based survey. Among these healthcare facilities, around 210 facilities were administered by private sector. The study hypothesis to be tested is based on evaluating the impact of hospital category on the quality of optometric services provided. The questionnaires were analyzed by the application of Chi-square test and it was observed that the responses of the participants do not vary on the basis of type of hospital, but the quality of services were dependent on the number of visiting patients. This shows that higher number of patients in the government hospitals, as compared to private and military healthcare centers increase the clinical experience of the practitioners and hence could be associated with the quality of care provided. The government and healthcare agencies should collaborate to develop standardized methods for eye-care delivery which are consistent with the guidelines of World Council of Optometry. Moreover, adequate training and awareness should be provided to the healthcare professionals to ensure quality clinical practices.

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Strategies to Improve Inpatients’ Quality of Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2019/5147208 ◽

2019 ◽

Vol 2019 ◽

pp. 1-15 ◽

Cited By ~ 4

Author(s):

Paraskevas Gkolfakis ◽

Georgios Tziatzios ◽

Ioannis S. Papanikolaou ◽

Konstantinos Triantafyllou

Keyword(s):

Bowel Preparation ◽

Meta Analysis ◽

Educational Interventions ◽

Significant Heterogeneity ◽

Random Effects Model ◽

Colon Cleansing ◽

Inverse Variance ◽

Colon Preparation ◽

The Impact

Background and Aims. Inpatients’ bowel preparation before colonoscopy is frequently inadequate, and various interventions have been investigated to improve it, so far. We aimed to evaluate the efficacy of various interventions to improve inpatients’ colon preparation quality. Methods. We systematically reviewed the literature for publications on interventions aiming to improve the quality of inpatients’ colon preparation until June, 2018. Significant heterogeneity—measured with I2—was detected at the level of P<0.1. Adequacy rates were measured using inverse variance, and the size effect of different interventions was calculated using random effects model and expressed as odds ratio (OR). Results. Seventeen studies enrolling 2733 inpatients were included. Overall, 67% (60-75%) of the participants achieved adequate colon cleansing (I2=97%; P<0.001). In six studies assessing the impact of educational interventions to patient/physician/nurse vs. no intervention, adequate bowel preparation was achieved in 77% (62-91%) vs. 50% (32-68%) of the patients (OR 95%CI=3.49 (1.67-7.28), P=0.0009; I2=74%; P=0.002). Ten studies examined variations (qualitative and/or quantitative) in bowel preparation regimens with adequate preparation detected in 71% (60-81%) of the participants, and a single study examined the administration of preparation through an esophagogastroduodenoscope, resulting in adequate prep in 71% of the patients. Conclusions. Despite several interventions, only two-thirds of inpatients achieve adequate colon preparation before colonoscopy. Educational interventions significantly improve inpatients’ bowel preparation quality.

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Treatment Outcomes Based on Patient’s Oral Health Related Quality of Life (OHRQoL) after Receiving Conventional Clasp or Precision Attachment Removable Partial Dentures in Distal Extension Cases: A Randomized Controlled Clinical Trial

Brazilian Dental Science ◽

10.14295/bds.2019.v22i4.1819 ◽

2019 ◽

Vol 22 (4) ◽

pp. 528-537

Author(s):

Rania Ibrahim Mamdouh ◽

Nancy Nader El-Sherbini ◽

Yusr Omar Mady

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Treatment Options ◽

Controlled Clinical Trial ◽

Health Related Quality ◽

Chi Square ◽

Significant Difference ◽

Related Quality ◽

Health Related

Purpose: To compare the effect of two treatment options in mandibular Kennedy class I cases regarding oral health related quality of life (OHRQoL) and the biting force, removable partial dentures retained by either precision attachment (PA-RPD) or clasps (C-RPD)Materials and methods: The study included 32 partially edentulous patients which 16 patients received PA-RPD (OT Cap Attachment) and 16 patients received C-RPD. All the patients in both groups were asked to fill the OHRQoL questionnaire after 1 week (baseline), 3 months, 6 months and 12 months after prosthesis insertion. Biting force was measured using the i-load Star Sensor one week, 3 months, 6 months and 1 year after partial denture insertion for all patients in both groups. Statistical analysis comprised Mann Whitney U test, Friedman’s test, Dunn’s test and Chi-square test.Results: The results of OHRQoL revealed that at the baseline, 3 months and 6 months the PA-RPD showed statistically significant lower mean total OHIP-14 score than the C-RPD. However, after 12 Monthes , there was no statistically significant difference between total OHIP-14 scores in the two groups. Concerning the biting force there was no statistically significant difference between the two groups.Conclusion: Within the limitations of this study it was concluded that the OHRQoL of both the PA-RPD and the C-RPD was comparable after 12 months. Similarly the biting force was the same for both treatment options.

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Prospective randomized controlled trial comparing efficacy of 1-L Peg-Asc with prucalopride and 2-L Peg-Asc for the bowel preparation.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.597 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 597-597

Author(s):

Seong Ji Choi ◽

Yoon Tae Jeen ◽

Eun Sun Kim ◽

Woojung Kim ◽

Geeho Min ◽

...

Keyword(s):

Bowel Preparation ◽

Controlled Trial ◽

Split Dose ◽

Colon Cleansing ◽

Bowel Cleansing ◽

Prospective Randomized Controlled Trial ◽

Group A ◽

Survey Results ◽

Group B

597 Background: Though numerous researches enabled decrease of the bowel preparation solution volume, it is still a major complaint of patients preparing colonoscopy. There have been studied that additional administration of laxatives could lessen the amount of aqueous formula with prokinetic effect. Prucalopride is a serotonin (5-HT4) receptor agonist which stimulate colonic mass movements and provide main propulsive force for defecation. The aim of this study is to compare 2-L PEG-Asc and 1-L PEG-Asc plus prucalopride for quality of bowel cleansing while preparing for colonoscopy and patient compliance. Methods: Two hundred patients were prospectively enrolled. Patients referred for colonoscopy were divided into group A (the split-dose 2-L PEG-Asc) and group B (1-L PEG-Asc + prucalopride) randomly. During colonoscopy, each patient’s bowel preparation quality was evaluated with The Boston Bowel Preparation Scale (BBPS) and Aronchick Preparation Scale (APS). The tolerability and satisfaction of patients was determined based on a questionnaire-based survey. Results: One hundred patients received either 2-L PEG-Asc or 1-L PEG-Asc with prucalopride. Regarding colon cleansing outcome (BPPS and APS), the 1-L PEG-Asc with prucalopride group showed similar, but non-inferior results compared to the 2-L PEG-Asc group on both BBPS (7.65±1.27 vs 7.52±1.40, p = 0.586) and APS scales (93.3% vs 95%, p = 0.717). Tolerability was similar for both 1-L PEG-Asc with prucalopride and 2-L PEG-Asc. Conclusions: 1-L PEG-Asc plus prucalopride preparation showed comparable result to traditional 2-L PEG-Asc preparation. 1-L PEG-Asc plus prucalopride preparation method could be an alternative method for bowel preparation which can relieve patient’s discomfort. Clinical trial information: KCT0002409.

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Adherence to Recommendations and Quality of Endoscopic Colorectal Cancer Surveillance in Long-Standing Ulcerative Colitis

Inflammatory Intestinal Diseases ◽

10.1159/000511010 ◽

2020 ◽

pp. 1-7

Author(s):

Giulia Santi ◽

Pierre Michetti ◽

Florian Froehlich ◽

Jean-Benoît Rossel ◽

Valérie Pittet ◽

...

Keyword(s):

Colorectal Cancer ◽

Ulcerative Colitis ◽

Bowel Preparation ◽

Disease Duration ◽

Screening Colonoscopy ◽

Withdrawal Time ◽

Crc Screening ◽

Number Of Patients ◽

Increased Risk

Background: Long-standing ulcerative colitis has been associated with an increased risk of colorectal cancer (CRC). Current guidelines recommend endoscopic CRC screening after 8 years of disease duration. The objectives of our study were to assess the adherence to recommendations and the quality of endoscopic procedure in long-standing ulcerative colitis. Methods: This is a retrospective cohort study. We selected patients included in the Swiss IBD cohort with a disease duration of ≥8 years and an extension above the rectosigmoid junction. The complementary medical chart review focused on endoscopy and associated histological reports in 8 Swiss centers. Descriptive analyses focused on patients and their colonoscopies. Results: 309 colonoscopies were conducted among 116 patients with the following characteristics: women 47%, mean age at diagnosis 31 years, and pancolitis disease extent in 65.5% of cases; 38.8% of patients had a first screening colonoscopy <8 years, 13.8% between 8 and 10 years, and 47.4% >10 years. Cecal intubation was performed in 94.5% of cases, and bowel preparation was good to excellent in 61.5% of endoscopies. Chromoendoscopy was used in 7.4% of cases, and the mean withdrawal time was 16.4 min. Dysplasia was found in 6.2% of cases. Conclusion: Despite current international recommendations, a significant number of patients did not receive a proper endoscopic surveillance. An increased use of chromoendoscopy, monitoring of withdrawal time, and appropriate bowel preparation would increase the quality of CRC screening. The adherence to screening guidelines and endoscopic quality should be promoted and standardized.

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