Effect of bowel preparation volume in inpatient colonoscopy. Results of a prospective, randomized, comparative pilot study

Abstract

Background: Inpatient status has been shown to be a predictor of poor bowel preparation for colonoscopy; however, the optimal bowel preparation regimen for hospitalized patients is unknown. Our aim was to compare the efficacy of bowel preparation volume size in hospitalized patients undergoing inpatient colonoscopy. Methods: This prospective, single blinded (endoscopist), randomized controlled trial was conducted as a pilot study at a tertiary referral medical center. Hospitalized patients undergoing inpatient colonoscopy were assigned randomly to receive a high, medium, or low-volume preparation. Data collection included colon preparation quality, based on the Boston Bowel Preparation Scale, and a questionnaire given to all subjects evaluating the ability to completely finish bowel preparation and adverse effects (unpleasant taste, nausea, and vomiting). Results: Twenty-five colonoscopies were performed in 25 subjects. Patients who received low-volume preparation averaged a higher mean total BBPS (7.4, SD 1.62), in comparison to patients who received high-volume (7.0, SD 1.41) and medium-volume prep (6.9, SD 1.55), P = 0.77. When evaluating taste a higher score meant worse taste. The low-volume group scored unpleasant taste as 0.6 (0.74), while the high-volume group gave unpleasant taste a score of 2.2 (0.97) and the medium-volume group gave a score of 2.1 (1.36), P < 0.01. Conclusion: In this pilot study we found that low-volume colon preparation may be preferred in the inpatient setting due its better rate of tolerability and comparable bowel cleanliness when compared to larger volume preparation, although we cannot overreach any definitive conclusion. Further more robust studies are required to confirm these findings. Trial registration: The Affect of Low-Volume Bowel Preparation for Hospitalized Patients Colonoscopies. Trial registration: NCT01978509 (terminated). Retrospectively registered on November 07, 2013.

A multicenter, prospective, inpatient feasibility study to evaluate the use of an intra-colonoscopy cleansing device to optimize colon preparation in hospitalized patients: the REDUCE study

“…This clarity score has the potential to be a predictive tool for identifying patients that may benefit from initiating the procedure with Pure Vu loaded on the scope to optimize the procedural success of the colonoscopy. Similar to a recently published prospective, single-blind, randomized trial, the volume of purgative consumed did not correlate to the level of preparation in the inpatient setting [13].…”

The Efficacy and Safety of Remimazolam Tosilate versus Etomidate-Propofol in Elderly Outpatients Undergoing Colonoscopy: A Prospective, Randomized, Single-Blind, Non-Inferiority Trial

“…All patients underwent bowel preparation in accordance with the standard protocol. 17 Supplemental oxygen at a rate of 4 L/min by nasal cannula was administered to all patients immediately after they entered the examination room until they were fully alert, according to sedation guidelines. 18 Patients with ASA standard monitoring (blood pressure, heart rate [HR], pulse oxygen saturation, and end-tidal carbon dioxide) received 0.5 μg/kg fentanyl for analgesia after the introduction of 500 mL of a 0.9% sodium chloride solution.…”

Could atmospheric temperature impact on adequate colon cleansing for colonoscopy? An observational, single-institution study

“…Regarding procedure related risk factors, several studies have proposed that low-volume hyperosmolar PEG and split-dose regimen were associated with an higher rate of adequate bowel cleansing [25][26][27][28][29][30][31].…”