Preparing for Colonoscopy

Abstract

Endoscopic Procedures in Colon and Rectum 18 followed by repeated procedures. In a study of 200 consecutive outpatient colonoscopies, imperfect bowel preparation resulted in a 12% increase in costs at a university hospital and 22% increase in costs at a public hospital (Rex et al., 2002). Types of bowel preparationsThe ideal colon preparation should rapidly and reliably cleanse the colon of fecal material while having no effect on the gross or microscopic appearance of the colon (Wexner et al., 2006). It should require a short period for ingestion and evacuation, cause no discomfort, and produce no significant fluid or electrolyte shifts while also being palatable, simple, and inexpensive. Agents used for bowel preparation can be divided into three main categories according to their mechanism of action, these being isosmotic, hyperosmotic, and adjunctive preparations. Polyethylene glycol-electrolyte lavage solutions (PEG-ELSs) and sodium phosphate (NaP) formulations are among the most commonly used. 2.2

Complications of Colonoscopy

“…Use of aspirin or any other non-steroidal anti-inflammatory drugs (NSAIDs) alone does not increase risk of postpolypectomy bleeding. Thus, the American Society for Gastrointestinal Endoscopy (ASGE) recommends continuing aspirin and NSAIDs if one of them is used alone and if its use is necessary [24][25][26][27]. However, there is some evidence that combination of aspirin with one or more NSAIDs may increase the risk of bleeding after polypectomy; therefore discontinuation of NSIADs 2-3 days before polypectomy is recommended in patients receiving aspirin [24][25][26][27].…”

“…Thus, the American Society for Gastrointestinal Endoscopy (ASGE) recommends continuing aspirin and NSAIDs if one of them is used alone and if its use is necessary [24][25][26][27]. However, there is some evidence that combination of aspirin with one or more NSAIDs may increase the risk of bleeding after polypectomy; therefore discontinuation of NSIADs 2-3 days before polypectomy is recommended in patients receiving aspirin [24][25][26][27]. Also, use of clopidogrel alone does not increase risk of postpolypectomy bleeding; however, concomitant use of aspirin or any other NSAIDs increases the risk of bleeding [3,24,25,28].…”

“…Pre-procedure warfarin use increases risk of bleeding after colonoscopy, thus discontinuation of warfarin is recommended 3-5 days before colonoscopy, however bridging with hepa-rin or its equivalents is important in high risk patients for thrombosis such as a mechanical cardiac valve [3,14,24,25,29].…”

“…Then these bacteria may potentially adhere to distant tissue such as endocardium and artificial devices, however clinical infections are rare. Transient bacteremia associated with colonoscopy occurs in average of 4.4% ranging from 0-25% [24,39,40]. However, harmless transient bacteremia occurs in some daily activities such as tooth brushing in 23-68% [24,39,41].…”

“…Transient bacteremia associated with colonoscopy occurs in average of 4.4% ranging from 0-25% [24,39,40]. However, harmless transient bacteremia occurs in some daily activities such as tooth brushing in 23-68% [24,39,41]. These isolated bacteria during colonoscopy are generally believed to have little potential to cause endocarditis.…”