Predictors of Inadequate Bowel Preparation for Colonoscopy

Ness, Reid M.; Manam, Raj; Hoen, Helena; Chalasani, Naga
June 2001
American Journal of Gastroenterology;Jun2001, Vol. 96 Issue 6, p1797
Academic Journal
OBJECTIVE: Inadequate preparation of the bowel for colonoscopy can result in both missed pathological lesions and cancelled procedures. We looked prospectively at the quality of colonic preparation and evaluated potential associations between specific patient characteristics and inadequate colonic preparation. METHODS: Data were gathered on consecutive patients presenting for colonoscopy who received either a polyethylene glycol lavage or oral sodium phosphate bowel preparation. Patient demographic and medical history information was gathered before scheduled colonoscopy. The endoscopist evaluated the preparation quality during the procedure. Complete data were gathered on 649 of 714 eligible patients (90.8%). Possible predictors of inadequate colonic preparation were analyzed using univariate statistics and multivariate logistic regression models. RESULTS: An inadequate colonic preparation was reported in 21.7% of observed colonoscopies. Only 18% of patients with an inadequate colonic preparation reported a failure to adequately follow preparation instructions. A later colonoscopy starting time, a reported failure to follow preparation instructions, inpatient status, a procedural indication of constipation, taking tricyclic antidepressants, male gender, and a history of cirrhosis, stroke or dementia were all independent predictors of an inadequate colon preparation (all p < 0.05). A procedural indication of previous polypectomy was a negative predictor of inadequate colonic preparation (p < 0.05). CONCLUSION: Several patient characteristics were significantly associated with colonic preparation quality independent of preparation type, compliance with preparation instructions, and procedure starting time. This information may help to identify patients at an increased risk for inadequate colonic preparation for whom alternative preparation protocols would be appropriate.


Related Articles

  • Editorial: A Light Breakfast, a Jug of Salt Water, and Bowel. Balaban, David H. // American Journal of Gastroenterology;Sep2009, Vol. 104 Issue 9, p2285 

    Successful colonoscopy is predicated on achieving adequate colon cleansing. An ideal bowel preparation would be low in volume, acceptable to patients, reliable in cleansing efficacy, and safe. The study by Di Palma et al. in this issue shows that a novel, low-volume (960 ml) preparation of mixed...

  • A Randomized Clinical Study Evaluating the Safety and Efficacy of a New, Reduced-Volume, Oral Sulfate Colon-Cleansing Preparation for Colonoscopy. Di Palma, Jack A.; Rodriguez, Reynaldo; McGowan, John; Cleveland, Mark vB. // American Journal of Gastroenterology;Sep2009, Vol. 104 Issue 9, p2275 

    OBJECTIVES:We sought to evaluate a new, low-volume, oral sulfate solution as a bowel preparation for colonoscopy in adult patients.METHODS:The investigations were designed as two multicenter, single-blind, randomized, non-inferiority studies to show that the sulfate regimen would effect...

  • Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial. Schanz, S.; Kruis, W.; Mickisch, O.; Küppers, B.; Berg, P.; Frick, B.; Heiland, G.; D. Hüppe; Schenck, B.; Horstkotte, H.; Winkler, A. // Diagnostic & Therapeutic Endoscopy;2008, p1 

    Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP) and polyethylene glycol-based lavage (PEG-ELS) are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of...

  • Importance of the Time Interval between Bowel Preparation and Colonoscopy in Determining the Quality of Bowel Preparation for Full-Dose Polyethylene Glycol Preparation. Tae Kyung Kim; Hyung Wook Kim; Su Jin Kim; Jong Kun Ha; Hyung Ha Jang; Young Mi Hong; Su Bum Park; Cheol Woong Choi; Dae Hwan Kang // Gut & Liver;Nov2014, Vol. 8 Issue 6, p625 

    Background/Aims: The quality of bowel preparation (QBP) is the important factor in performing a successful colonoscopy. Several factors influencing QBP have been reported; however, some factors, such as the optimal preparation-tocolonoscopy time interval, remain controversial. This study aimed...

  • Predictive factors for inadequate colon preparation before colonoscopy. Cheng, R.-W.; Chiu, Y.-C.; Wu, K.-L.; Rayner, C.; Tai, W.-C.; Hu, M.-L.; Chou, Y.-P.; Chuah, S.-K.; Liang, C.-M.; Lu, L.-S. // Techniques in Coloproctology;Feb2015, Vol. 19 Issue 2, p111 

    Background: It could be helpful to ascertain which patients are at risk of poor bowel preparation prior to performing sedated colonoscopy. The aim of the present study was to identify the predictive factors for poor colon preparation prior to colonoscopy. Methods: A prospective study was...

  • Colonoscopic Perforation and Bleeding of the Colon Can Be Treated Safely Without Surgery. Ker, Tim S.; Wasserberg, Nir; Beart, Robert W. // American Surgeon;Oct2004, Vol. 70 Issue 10, p922 

    The incidence of colonoscopic perforation of colon is about 0.3 per cent. The incidence of colonoscopic bleeding is about 0.6 per cent. Many of those patients undergo unnecessary operations. In order to assess the outcome of nonoperative management of those patients with postcolonoscopic...

  • Clinical Experiences with Colonoscopy. Dagradi, Angelo E.; Alaama, Abdulmouti; Ruiz, Ricardo // American Journal of Gastroenterology;May1975, Vol. 63 Issue 5, p408 

    Our experiences with 100 colonoscopic examinations are described. The clinical value of the procedure is outlined and the minimal degree of attendant morbidity, when performed by a competent endoscopist, are emphasized. The indications and contraindications for this relatively recently devised...

  • Delayed ("Blow-out") Perforation of Sigmoid Following Diagnostic Colonoscopy. Dagradi, Angelo E.; Norris, Mary E.; Weingarten, Zelman G. // American Journal of Gastroenterology;Sep1978, Vol. 70 Issue 3, p317 

    A case has been described in which perforation of the sigmoid colon occurred three days following simple diagnostic colonoscopic examination. The desirability is indicated for including the possibility of this occurrence in the informed consent. Administration of stool softener and use of...

  • The Impact of the Quality of Colon Preparation on Follow-Up Colonoscopy Recommendations. Larsen, Michael; Hills, Nancy; Terdiman, Jonathan // American Journal of Gastroenterology;Dec2011, Vol. 106 Issue 12, p2058 

    OBJECTIVES:Published guidelines for timing of follow-up colonoscopy assume that the entire colon mucosa is visualized and provide no guidance in the case of poor preparations. We aimed to determine how preparation quality during screening colonoscopy affects gastroenterologists' recommendations...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics