Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study

Froehlich, Florian; Wietlisbach, Vincent; Gonvers, Jean‐Jacques; Burnand, Bernard; Vader, John‐Paul

doi:10.1016/s0016-5107(04)02776-2

Cited by 846 publications

(637 citation statements)

References 21 publications

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“…Inadequate bowel preparation is related to lower adenoma detection rates, longer procedural times and an increase in costs and need for repeat exams [1][2][3][4][5] . Various bowel regimens are commercially available for pre-colonoscopy preparations [6] and each has been studied for its efficacy and tolerability.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Baba

Lewis

2016

Journal of Gastroenterology and Hepatology Research

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AIM: Several bowel preps are currently used for colonoscopy but only limited data are available comparing the different products. METHODS:We retrospectively reviewed all colonoscopies performed at Georgetown U. Hospital from May 2013 to May 2014. A 9-point modified Boston Bowel Preparation Scale (BBPS) was utilized (best score = 9) by experienced endoscopists. Colonoscopies without a BBPS score were excluded. seen for women vs men overall for both split-dose and day-prior dosepreps (with the exception of Moviprep ® in PD preps). Higher scores were seen for a.m. procedures but were not significant. All preps had lower scores in the right colon, regardless of being splitdose or day-prior dose. CONCLUSIONS: This real world experience in nearly 3600 patients confirms that split dosing is superior to day-prior dosing. We found women had higher BBPS scores than men but no differences were seen between morning and afternoon procedures. All preps were relatively comparable, however differences in price may be an important decision-maker. RESULTS:

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Section: Introductionmentioning

confidence: 99%

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Baba

Lewis

2016

Journal of Gastroenterology and Hepatology Research

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“…10 Randomized controlled trials have also shown a high level of inadequate bowel preps ranging from 10% to 75%. 11 The authors reported that procedures in poorly prepared patients were longer, more difficult, and more often incomplete. Additionally, the detection of polyps depended on cleansing quality with an OR 1.73 for intermediate-quality compared with low-quality preparation.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a simplified “patient friendly” split dose polyethylene glycol colonoscopy prep in Veterans Health Administration patients

Cohen

Tang²,

Groessl³

et al. 2012

jig

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Background and Objectives:Adequate colon cleansing is an important factor in performing quality colonoscopy. Split dose Polyethylene Glycol (PEG) solutions have been shown to improve colon cleansing, but the effectiveness in a large clinical practice of elderly co-morbid patients has not been demonstrated. The aim of this study was to assess the efficacy of a simplified split PEG bowel prep in Veterans Health Administration (VHA) patients. Methods: Prospective pre-post study design of VHA patients undergoing routine colonoscopy. Bowel prep quality was assessed using a standardized semi-quantitative 5-point scale. "Standard" 4L PEG prep was consumed once the evening before the procedure. "Split" prep was consumed half in the early evening and half in the late evening or early morning depending on procedure time. Results: Right colon preps were Excellent/Good in 81.4% of split preps (n=199) vs. 63% of standard preps (n=447, p<0.001). Left colon preps were Excellent/Good in 85.9% of split preps vs. 71.6% of standard preps (p<0.001). Diabetics (n=133) had significantly more right colon preps rated fair or worse compared to non-diabetics irrespective of prep (39.9% vs. 29.0%, p=0.02). Split prep in diabetics resulted in fewer right colon preps rated fair or worse compared to diabetics using standard prep (28.3% vs. 45.9%, p=0.049). Average adenomas detected per colonoscopy were 1.04 for split prep vs. 0.85 for standard prep (p=NS). Patient satisfaction was higher for split preps. Conclusion: System-wide implementation of a split PEG prep resulted in significantly improved bowel cleansing in VHA patients, particularly in the right colon. Improved bowel cleansing with split preps was associated with higher patient satisfaction.

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“…1 Several different oral bowel cleansing agents are widely used for this purpose, which can be broadly divided into non-absorbed isosmotic agents (i.e. polyethylene glycol [PEG]-based preparations), hyperosmolar agents (sodium phosphate, magnesium compounds) and stimulants (sodium picosulpate, senna).…”

Section: Introductionmentioning

confidence: 99%

Service implications of implementing guidance for oral bowel cleansing agents in colonoscopy

Pk¹,

Ms²,

Sm³

et al. 2011

J R Coll Physicians Edinb

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Introduction:Bowel preparation has led to serious adverse events. Consequently, regulatory and advisory bodies have issued guidance, including a risk stratification of patients, aiming to minimise this risk. Aims: To determine the impact of the new guidance on our current practice of Picolax used in colonoscopy with regard to patient stratification, compliance and service implementation. Methods: Patients listed for day case colonoscopy during October 2009 were audited using data from the hospital and endoscopy databases. A follow-up, structured patient telephone interview evaluated side effects, the assessment process and patient experience. Results: Of the participating 112 patients, 97.4% were clinically reviewed before colonoscopy, 98.3% received written instructions and 70% verbal instructions. None had their preparation dispensed by a regulated professional. Although 62% of patients were retrospectively identified as 'at risk' (elderly, with congestive cardiac failure, cirrhosis or chronic kidney disease or on angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, diuretics or non-steroidal anti-inflammatory drugs), none were identified before their procedure. Significant events (postural hypotension, collapse, dizziness, palpitations, faint) were seen in 4.4%, all of whom could potentially be identified as 'at risk' using a stratification of low estimated glomerular filtration rate with relevant co-morbidity (congestive cardiac failure or cirrhosis). Conclusions: Given the difficulties with compliance and the high prevalence of 'at risk' patients, the implementation will be challenging and require significant service redesign.

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Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study

Cited by 846 publications

References 21 publications

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Effectiveness of a simplified “patient friendly” split dose polyethylene glycol colonoscopy prep in Veterans Health Administration patients

Service implications of implementing guidance for oral bowel cleansing agents in colonoscopy

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