Evaluation of the combined effect of factors influencing bowel preparation and adenoma detection rates in patients undergoing colonoscopy

Abstract

BackgroundColonoscopy is a commonly used modality for screening and surveillance of colorectal cancer (CRC). Therefore, it is essential to have adequate bowel preparation (prep) for the procedure which depends on type of bowel regimens, diet before colonoscopy and timing of the procedure.AimsThe purpose of this study is to analyse the effect of multiple factors on adenoma detection rate (ADR) and prep quality of colonoscopy. This is the also the first study determining outcomes based on various combinations of diet, timing of the procedure and bowel prep regimens.MethodsThis is a retrospective single-centre observational study. Data about diet before procedure, bowel prepprep regimen and timing of the procedure was collected for patients coming for screening colonoscopy.ResultsPatients with split prep had higher good prep rates (73.8% vs 56.2%) and higher ADRs (34.2 % vs 29.9%) as compared with non-split prep. The good prep quality (65.8% vs 62.1%) and ADRs (31.9% vs 31.5%) were comparable in patients who received clear liquid diet as compared with low residue diet. The good results of bowel prep were obtained with split prep with either clear liquids or low residue diet irrespective of the timing of procedure. The poor prep was noticed in patients who underwent procedure in afternoon, with a low restrictive diet and non-split bowel regimen.ConclusionsThe current study adds to our knowledge about the combined effect of multiple variables affecting the bowel prep quality and ADR. It is imperative to opt for the best combination required for colonoscopy, as this will influence the effectiveness of colonoscopies regarding timely cancer detection and prevention.

Bowel cleansing efficacy for colonoscopy: prospective, randomized comparative study of same-day dosing with 1-L and 2-L PEG + ascorbate

“…Several studies suggest that the success of bowel preparation is influenced by a number of factors, such as the bowel preparation selected, the dosing regimen used, the time between completion of the preparation, and the procedure and patient education (e. g., telephone re-education the day before a colonoscopy) 10 11 12 13 14 15 . Despite advances in this area, inadequate preparation remains a problem during colonoscopies 7 8 .…”

A Systematic Review and Meta-Analysis of Low-Residue Diet Versus Clear Liquid Diet

“…First, only RCTs published in English were included, which resulted in an English language bias and made it easier to yield the expected conclusion. However, none of the 16 included studies or other related literature ( Tariq et al, 2019 ) reported that the quality of bowel preparation with the CLD was superior to that with the LRD, suggesting that we should not strongly consider the effects of this bias. Second, different studies adopted different schemes so that patients could use the LRD.…”

Ward nurses-focused educational intervention improves the quality of bowel preparation in inpatients undergoing colonoscopy

“…Poor bowel preparation leads to missed adenomas, repeat examinations, patient discomfort, and higher healthcare cost. [ 22 ] Patient compliance is an important factor affecting the quality of colonoscopy. [ 23 , 24 ] Educational interventions significantly improve the patients’ bowel preparation quality.…”