Endoscopy

Abstract

Background: The quality of colonoscopy cleansing degrades with increasing time between last preparation intake and beginning of the procedure (runway time)(1, 2). Split-dose bowel preparation is better tolerated with more effective colon cleansing, compared to entire-day or eveningbefore colonoscopy preparation(2). However, concerns regarding anaesthetic related aspiration-risk during deep sedation exist with split-dose colonoscopy preparation. This usually requires 1 litre of polyethylene glycol (PEG) containing preparation within 4 hours pre-procedure. Prior studies suggest that pulmonary aspiration-risk increases with RGV > 25 ml and pH < 2.5(3, 4). Objective: Our aim is to examine RGV, pH, runway time and quality of colonoscopy preparation in patients undergoing combined esophagogastroduodenoscopy (EGD) and colonoscopy. Methods: In a single-centre study, 624 consecutive patients undergoing combined EGD and colonoscopy were prospectively recruited between December 2013 to date. At EGD, RGV and pH were recorded. Colonoscopy followed immediately. Patient demographics, comorbidities, and quality of bowel preparation were recorded. Mean ± Standard deviation (SD) was recorded for all data and Spearman-Rho was used to detect correlation between non-parametric data. Results: Shorter runway time resulted in better quality of colonoscopy cleansing (r = −0.164, p < 0.001). Mean runway time was 5.8 ± 2 hours with mean RGV 17.7 ± 19.3 ml. There was no correlation between RGV, pH and runway time (r = −0.006/p = 0.89 and r = −0.063/p = 0.159 respectively). Presence or absence of diabetes, including treatment and RGV, demonstrated no correlation. No difference is seen in RGV or pH with runway time ≤4 hours or >4 hours (Table 1). Mean RGV in 13 patients (2%) with runway time ≤3 hours was 18 ± 15.2 ml, compared to mean RGV of 17.5 ± 0.7 ml in 611 patients (98%) with runway time >3 hours (p = 0.92). Corresponding mean pH were 2.6 ± 0.4 and 2.8 ± 0.1 (p = 0.66). Routine follow up phone call to all patients one month postprocedure revealed no reported symptoms suggestive of the clinical diagnosis of aspiration pneumonia. Conclusion: Shorter runway time resulted in better quality of colonoscopy cleansing. Consumption of colonoscopy preparation within 4 hours before deep sedation resulted in similar RGV and pH, compared to more prolonged fasting time with no increased risk of aspiration. School of Medicine, University of QueenslandIntroduction: Most studies of colorectal polyp prevalence have been from screening colonoscopy in patients aged ≥50 years. The aim of this study was to evaluate the prevalence of adenomas in patients aged ≤50 years undergoing colonoscopy. Methods: We conducted a prospective observational single centre study of polyp detection in consecutive patients ≤50 years who underwent a colonoscopy over a 4 year period. Inclusion criteria were age 14-50 years. Patients were excluded if they had a history of inflammatory bowel disease or polyposis syndrome. Results: A total of 547 colonoscopies were performed on 53...