Incidence of minor complications and time lost from normal activities after screening or surveillance colonoscopy

Ko, Cynthia W.; Riffle, Stacy; Shapiro, Jean A.; Saunders, Michael D.; Lee, Scott D.; Tung, Bruce Y.; Kuver, Rahul; Larson, Anne M.; Kowdley, Kris V.; Kimmey, Michael B.

doi:10.1016/j.gie.2006.06.020

Cited by 147 publications

(126 citation statements)

References 15 publications

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“…The other major reason cited for not adopting CO2 was that advantages for the patients were not sufficiently significant. This likely relates to a lack of information among endoscopists about postcolonoscopy patient inconvenience (only one-third of them knew that 20% of patients need ≥ 2 d before being able to return to their normal activities after screening colonoscopy) [16] . Endoscopists currently pay more attention to patients' comfort; for example, polyethylene glycol is being replaced by sodium phosphate for bowel preparation before colonoscopy [17] .…”

Section: Discussionmentioning

confidence: 99%

“…Another example is the use of propofol for sedation in replacement of benzodiazepines [19] . CO2 deals with the postprocedure phase of colonoscopy by reducing bloating and abdominal pain, the most frequent side effects of colonoscopy [16] . However, it remains to be demonstrated if the advantages conferred by CO2 are sufficiently significant to improve patient acceptance of endoscopic procedures and cost-effectiveness (by reducing loss from normal activities after endoscopy).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Janssens¹,

Devière²,

Eisendrath³

et al. 2009

WJG

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AIM:To assess the adoption of Carbon dioxide (CO2) insufflation by endoscopists from various European countries, and its determinants. M E T H O D S :A s u r v e y w a s d i s t r i b u t e d t o 5 8 0 endoscopists attending a live course on digestive endoscopy. RESULTS:The response rate was 24.5%. Fewer than half the respondents (66/142, 46.5%) were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy, and 4.2% of respondents were actually using CO2 as the insufflation agent. Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice (84% and 49% of answers, respectively; two answers were permitted for this item). CONCLUSION:Based on this survey, adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional. A majority of endoscopists were not aware of this possibility, while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Janssens¹,

Devière²,

Eisendrath³

et al. 2009

WJG

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show abstract

“…Minor complications occurred in 162 subjects (34%) in a prospective cohort study by Ko et al most commonly bloating (25%) and abdominal pain (11%) [52]. Minor adverse events were more common in women, and when the procedure lasted 20 minutes or longer.…”

Section: Abdominal Pain and Other Minor Gi Symptomsmentioning

confidence: 96%

“…Colonic preparation was reported by patients as the most difficult part of the procedure in 77%. Most patients (94%) missed 2 or fewer days from normal activities for the preparation, procedure itself, or recovery [52].…”

Section: Abdominal Pain and Other Minor Gi Symptomsmentioning

confidence: 99%

Complications of Colonoscopy

Waye

Aisenberg

Rubin

2013

Practical Colonoscopy

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“…Unfortunately, bowel preparation is oft en inadequate to permit complete examination of the colon (1) , necessitating shorter screening and surveillance intervals. Perhaps most importantly, patients report that the bowel preparation is both the leading deterrent to undergoing screening colonoscopy (4) and the most diffi cult part of the examination (5) .…”

mentioning

confidence: 99%

Editorial: A Light Breakfast, a Jug of Salt Water and Bowel

Balaban¹

2009

Am J Gastroenterol

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Successful colonoscopy is predicated on achieving adequate colon cleansing. An ideal bowel preparation would be low in volume, acceptable to patients, reliable in cleansing effi cacy, and safe. The study by Di Palma et al. in this issue shows that a novel, low-volume (960 ml) preparation of mixed sulfate salts can achieve excellent bowel cleansing with acceptable tolerability and minimal electrolyte shifts. A split-dosing strategy, with a proportion of the preparation administered on the day of colonoscopy, achieved a 97.2 % preparation success rate vs. 82.4 % using a regimen provided entirely the day before colonoscopy. These results were comparable with control groups using a commercially available polyethylene glycol solution. Endoscopists and patients alike should be encouraged by the trend toward lower-dose bowel cleansing regimens that achieve equivalent effi cacy compared with large-volume preparations. Am J Gastroenterol 2009; 104:2285-2287 doi: 10.1038/ajg.2009 It could be argued that there is no medication more commonly prescribed by a busy endoscopist than a bowel preparation. Yet, the volume of scientifi c literature on the pharmacokinetics, efficacy, and side eff ects of bowel cleansing agents used for colonoscopy and other medical procedures is scant when compared with other agents used for digestive health. Th e importance of bowel preparation before colonoscopy cannot be understated. Inadequate colon cleansing is associated with lower endoscopic yield for adenomas (1,2) , decreased fi nd rates for fl at lesions (3), and longer examinations (2) . Unfortunately, bowel preparation is oft en inadequate to permit complete examination of the colon (1) , necessitating shorter screening and surveillance intervals. Perhaps most importantly, patients report that the bowel preparation is both the leading deterrent to undergoing screening colonoscopy (4) and the most diffi cult part of the examination (5) .In this issue of the American Journal of Gastroenterology , Di Palma et al . report the results of a randomized, multicenter, industry-sponsored, endoscopist-blinded trial of a novel oral sulfate solution for pre-colonoscopic bowel preparation (6) . Study subjects were randomized to one of two therapeutic dosing strategies: same-day (PM before examination) vs. split-dose (PM / AM) preparation. Case subjects used two 480-ml doses of a solution comprised of sodium, potassium, and magnesium sulfate salts. Controls used two 1-L doses of a commercially available polyethylene glycol solution with electrolytes and ascorbic acid (PEG-EA, MoviPrep, Salix Pharmaceuticals, Morrisville, NC). Th e primary endpoint was bowel preparation success defi ned as a score of " excellent " or " good " using a previously published scale (7,8) . Tolerability was assessed using a questionnaire administered on the date of the examination.Th e intention-to-treat analysis included 387 subjects randomized to the same-day dosing strategy (194 sulfate, and 364 subjects in the split-dose strategy (181 sulfate, 183 PEG-EA). Bowel preparati...

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Incidence of minor complications and time lost from normal activities after screening or surveillance colonoscopy

Cited by 147 publications

References 15 publications

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Complications of Colonoscopy

Editorial: A Light Breakfast, a Jug of Salt Water and Bowel

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