Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation: development and validation of a prediction score

Dik, Vincent K.; Hüyük, Melek; Monkelbaan, Jan F; Oijen, Martijn G.H. van; Moons, Leon M.G.; Schaar, Peter van der; Cappel, Wouter H. de Vos tot Nederveen; Borg, Pieter C. J. ter; Tang, Thjon J.; Borg, Frank ter; Meijssen, M. A. C.; Ouwendijk, Rob J.; Fèvre, Doris M. Le; Stouten, Merijn; Galiën, Onno van der; Hiemstra, Theo J.; Kuipers, Ernst J.; Siersema, Peter D.

doi:10.1016/j.gie.2014.09.066

Cited by 125 publications

(136 citation statements)

References 23 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…This was true in both study groups. Further, despite recent evidence reporting high rates (10%-30%) of inadequate preparation, particularly when performed at home (7,10,12,15,23) , our study found that almost all patients had adequate preparation, regardless of having had home or hospital preparation. The fact that our study population was composed only by ASA I and II patients could explain such a good preparation quality.…”

Section: Discussioncontrasting

confidence: 99%

“…Colonoscopy is currently the standard method for mucosa imaging of the entire colon and is widely used for the diagnosis and treatment of colonic disorders (10,12,22) . The effectiveness of colonoscopy, including its ability to diagnose precancerous lesions and prevent colorectal cancer, is highly dependent on adequacy of bowel cleansing (7) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SAFETY OF MANNITOL USE IN BOWEL PREPARATION: a prospective assessment of intestinal methane (CH4) levels during colonoscopy after mannitol and sodium phosphate (NaP) bowel cleansing

Paulo

Martins

Macedo

et al. 2016

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Background -Adequate bowel preparation is critical for the quality of colonoscopy. Despite reported occurrence of colonic explosion due to methane and hydrogen production by bacterial fermentation during colonoscopy, gas exchange during the procedure is believed to be effective in lowering existing methane concentration, allowing for safe utilization of mannitol for bowel preparation. Thus, mannitol is widely used for bowel cleansing prior to colonoscopy, considering its low cost and effectiveness for bowel preparation.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

SAFETY OF MANNITOL USE IN BOWEL PREPARATION: a prospective assessment of intestinal methane (CH4) levels during colonoscopy after mannitol and sodium phosphate (NaP) bowel cleansing

Paulo

Martins

Macedo

et al. 2016

Arq. Gastroenterol.

View full text Add to dashboard Cite

show abstract

“…Diabetics are 22% more likely to be up to date with their CRC screening; however, having DM is an independent risk factor for inadequate bowel preparation [53, 66–69]. This is most likely due to diabetics having slower gastric emptying and colonic transit [70].…”

Section: Diabetes Mellitus and Bowel Preparation For Colonoscopymentioning

confidence: 99%

Diabetes Mellitus and the Colon

Piper

Saad

2017

Curr Treat Options Gastro

View full text Add to dashboard Cite

Opinion statement Diabetes mellitus (DM) can affect the structure and function of the colon promoting commonly encountered lower gastrointestinal symptoms such as constipation, diarrhea, abdominal distention, bloating, and abdominal pain. Specific colonic disorders for which adults with DM are at greater risk include chronic constipation, enteropathic diarrhea, colorectal cancer (CRC), inflammatory bowel disease, microscopic colitis, and Clostridium difficile colitis. Smooth muscle structure and function, density of the interstitial cells of Cajal, and the health and function of the autonomic and enteric nerves of the colon are all potential affected by DM. These effects can in turn lead to alterations in colon motility, visceral sensation, immune function, endothelial function, and the colonic microbiome. The evaluation and treatment for slow transit constipation as well as pelvic floor dysfunction should be considered when constipation symptoms are refractory to initial treatment measures. DM-related medications and small bowel conditions such as celiac disease and small intestinal bowel overgrowth should be considered and excluded before a diagnosis of enteropathic diarrhea is made. Given the higher risk of CRC, adults with DM should be appropriately screened and may require a longer bowel preparation to ensure an adequate evaluation.

show abstract

“…Recently, the US Multi‐Society Task Force on CRC defined adequate bowel preparation as one that enables the endoscopist to follow the recommended screening and surveillance guidelines and the ability to detect lesions >5 mm in size (target of ≥85%) 30. Alternately, by including patients with risk factors for poor bowel preparation such as diabetes, opioid use, and laxative use (as a marker of constipation),31 bowel preparation success rates in our study may have been lowered. A limitation of this study was that we compared groups with different dietary regimens (White Diet vs clear fluids), bowel preparation types (low‐volume Picosalax vs combination PEG/SPMC), and bowel preparation dose timing (split‐dose vs day‐before) which makes it difficult to determine which of the study variables resulted in the improved tolerance of the bowel preparation found in the WD/PICO group.…”

Section: Discussionmentioning

confidence: 87%

White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

et al. 2017

View full text Add to dashboard Cite

Background and AimBowel preparations with polyethylene glycol (PEG) and clear fluids are often poorly tolerated. We compared an innovative low‐residue White Diet and low‐volume, split‐dose Picosalax with the standard preparation at our institution of day‐before clear fluids and combination PEG plus sodium picosulfate/magnesium citrate (SPMC).MethodsAdults undergoing morning colonoscopy were randomized to either the White Diet and split‐dose, two sachets of Picosalax (WD/PICO) or day‐before clear fluids and 1‐L PEG plus two sachets of SPMC (CF/PEG + SPMC). The primary endpoint was successful bowel preparation defined by an Ottawa bowel preparation score ≤ 6. An intention‐to‐treat analysis with a predefined non‐inferiority margin of 15% was used to compare efficacy.ResultsA total of 250 patients were randomized (125 WD/PICO and 125 CF/PEG + SPMC). WD/PICO was non‐inferior to CF/PEG + SPMC for successful bowel preparation by intention‐to‐treat analysis (58% WD/PICO vs 62% CF/PEG + SPMC, 95%CI: −14.2 to 6.2%) and per‐protocol analysis (64% WD/PICO vs 65% CF/PEG + SPMC, 95%CI: −11.3 to 9.4%). Patients in the WD/PICO group reported greater satisfaction with the diet (P < 0.001), greater ease of following the diet (P < 0.001), and improved experience compared with prior colonoscopy (P < 0.0001), less bloating (P = 0.02), less weakness (P = 0.046), less hunger (P < 0.0001), and less interference with daily activities (P = 0.001). Procedure/withdrawal times and adenoma detection rates were similar between groups.ConclusionBowel preparation with the White Diet and low‐volume, split‐dose Picosalax was preferred and better tolerated without detriment to bowel preparation success compared with clear fluids and combination PEG plus SPMC for morning colonoscopy.

show abstract

Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation: development and validation of a prediction score

Cited by 125 publications

References 23 publications

SAFETY OF MANNITOL USE IN BOWEL PREPARATION: a prospective assessment of intestinal methane (CH4) levels during colonoscopy after mannitol and sodium phosphate (NaP) bowel cleansing

SAFETY OF MANNITOL USE IN BOWEL PREPARATION: a prospective assessment of intestinal methane (CH4) levels during colonoscopy after mannitol and sodium phosphate (NaP) bowel cleansing

Diabetes Mellitus and the Colon

White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

Contact Info

Product

Resources

About