Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

Hassan, Cesare; East, James E.; Radaelli, Franco; Spada, Cristiano; Bénamouzig, Robert; Bisschops, Raf; Bretthauer, Michael; Dekker, Evelien; Dinis-Ribeiro, Mário; Ferlitsch, Monika; Fuccio, Lorenzo; Awadie, Halim; Gralnek, Ian M.; Jover, Rodrigo; Kaminski, Michal F.; Pellisé, María; Triantafyllou, Konstantinos; Vanella, Giuseppe; Mangas-Sanjuán, Carolina; Frazzoni, Leonardo; Hooft, Jeanin E. van; Dumonceau, Jean Marc

doi:10.1055/a-0959-0505

Cited by 408 publications

(527 citation statements)

References 204 publications

(166 reference statements)

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“…Our results also revealed that simethicone with high or low dose had no signi cant difference of ADR and PDR, suggesting that the low-dose simethicone was not inferior to the high-dose one in terms of ADR and PDR, which is similar to the study of Li et al [39]. Although residual simethicone in biopsy channels could promote bio lm formation [40], simethicone adding to PEG solution could decrease the infection risk of endoscope-transmission [31].However, the optimal dose of SIM is yet to be ascertained [41]. Further research is required to determine the optimal dose of simethicone in clinical practice.…”

Section: Discussionsupporting

confidence: 73%

Effect of Antifoaming Agent on Colorectal Benign Tumours in Colonoscopy: A Meta-Analysis

Zhang¹,

Liu²,

Ls³

2020

Preprint

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Background: Although several trials have showed that addition of antifoaming agent to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agent has a beneficial role in detection of benign tumours during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the effect of detection of colorectal benign tumours.Methods: The PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps.Results: Twenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group with simethicone. We also found that simethicone could significantly improve the ADR in proximal colon, but did not affect the colorectal polyp detection rate (PDR). Furthermore, the subgroup analyses revealed that the beneficial effect of simethicone in the ADR among Asian (P=0.005) and ADR < 25% (P =0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of colorectal benign tumours.Conclusions: In summary, the addition of simethicone to PEG might benefit to improve diminutive adenomas in the right colon for colonoscopy in Asia. The low-dose simethicone was recommend to the detection of colorectal benign tumours. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.

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Section: Discussionsupporting

confidence: 73%

Effect of Antifoaming Agent on Colorectal Benign Tumours in Colonoscopy: A Meta-Analysis

Zhang¹,

Liu²,

Ls³

2020

Preprint

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“…Intestinal preparation plays an important role in colonoscopy and is the key to ensuring high-quality completion of colonoscopy. The 2019 European Digestive Endoscopy Society Guidelines for Intestinal Preparation [9] pointed out that poor bowel preparation could lead to poor bowel preparation. The detection rate of intestinal adenoma decreased, the failure rate of ileocecal bronchoscopy increased, the patient's pain increased, and the medical expenses were increased.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

Zhou

Zhang

Yang

2020

Gastroenterology Research and Practice

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Objective. To analyze the correlation of intestinal cleanliness in each segment of the Boston Intestinal Preparation Scale. Methods. From February 2017 to October 2019, the data of patients who underwent colonoscopy in the Department of Gastroenterology, Hangzhou First People’s Hospital, Zhejiang University School of Medicine, were collected. Statistical analysis was performed according to the Boston Intestinal Preparation Scale score, and the correlation of intestinal cleanliness in each region was obtained. Results. A total of 1739 patients were included. The overall score of BBPS was 6.77±1.88. The scores of each region were 2.04±0.84 (right lateral colon), 2.25±0.68 (transverse colon), and 2.48±0.64 (left colon). The difference between the regions was statistically significant (P<0.05). The bowel cleanliness showed a gradual deterioration trend, and there was a positive correlation between colon cleanliness in each region. The accuracy of the transverse colon in predicting the right colon (AUC=0.809) is higher than that of the left colon (AUC=0.735), and the accuracy of predicting the cleanliness of the right colon intestinal tract by the cleanliness of the left colon intestinal tract is relatively low. Conclusion. Intestinal cleanliness gradually deteriorates from the direction of the insert. It is not reliable to predict the right side of poor cleanliness by using the left colon intestinal cleanliness (BBPS 0-1 score). It should continue to further endoscopy. When the cleanliness of the transverse colon is poor, then stopping further endoscopy is considered.

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“…Despite of the various methods for bowel preparation, the rates of inadequate bowel preparation are recorded to be between 20% and 30% [15,16]. The European Society of Gastrointestinal Endoscopy Guideline in 2019 suggested that the minimum standard for adequate bowel preparation should not be less than 90% [7]. Therefore, it's necessary for us to improve the rates of adequate bowel preparation.…”

Section: Discussionmentioning

confidence: 99%

“…than CLD in the quality of bowel preparation and has better tolerability [2][3][4][5]. Both the American Society for Gastrointestinal Endoscopy (ASGE) Guideline in 2015 and the European Society of Gastrointestinal Endoscopy (ESGE) Guideline in 2019 recommend LFD with FDA-approved purgatives for bowel preparation [6,7]. However, a LFD is considered as too restrictive to provide enough calories, leading to starvation, fatigue and hypoglycemia-induced side effects.…”

mentioning

confidence: 99%

Comparison of the effect of regular diet and low-fiber diet on bowel cleansing before colonoscopy

Liu

Zhang

Dong-lian

et al. 2020

Preprint

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Abstract BACKGROUNDHigh quality bowel preparation is essential for colonoscopy. A low-fiber diet (LFD), changing people’s dietary habit, is recommended for the day before colonoscopy. The aim of this study was to compare the quality of bowel preparation of regular diet (RD) with that of LFD.METHODSPatients undergoing colonoscopy in the morning were randomly to LFD group, which took a LFD the day before the procedure, or RD group. All patients recieved a split dose of 3L PEG regimen. The diet satisfaction and adverse events were recorded by a questionnaire before colonoscopy. The quality of the bowel preparation was ranked according to the Boston Bowel Preparation Scale (BBPS) by the endoscopists. Per-protocol (PP) and intention-to-treat (ITT) analyses were conducted for the clinical outcomes. A non-inferiority analysis was performed to prove the quality of bowel preparation of RD was not inferior to that of LFD.RESULTS400 patients (200 in RD group, 200 in LFD group) were included. In PP analysis (n = 357), no significant difference was found in the quality of the bowel preparation between the RD group and the LFD group (P = 0.440). The diet satisfaction (P = 0.978), polyp detection rate (PDR) (P = 0.763) and adenoma detection rate (ADR) (P = 0.800) were not significantly different between the two groups. Similar results were found in the ITT analysis (n = 400, P = 0.440, 0.778, 0.724, 0.893). Hunger in RD group was significantly lower than that in LFD group (P = 0.010), especially in young patients (P = 0.029) and inpatients (P = 0.036).CONCLUSIONThe quality of the bowel preparation of RD is comparable to that of LFD. RD could reduce hunger, especially in young patients and inpatients. Without changing patients’ eating habits, RD may be more acceptable for patients before undergoing colonoscopy.Trial registration: Current Controlled Trials ChiCTR1900021836 on 12 March 2019.

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Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

Cited by 408 publications

References 204 publications

Effect of Antifoaming Agent on Colorectal Benign Tumours in Colonoscopy: A Meta-Analysis

Effect of Antifoaming Agent on Colorectal Benign Tumours in Colonoscopy: A Meta-Analysis

Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

Comparison of the effect of regular diet and low-fiber diet on bowel cleansing before colonoscopy

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