scholarly journals Factors Affecting Proximal Colon Cleansing Based on Bowel Movement Kinetics: A Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Dae Bum Kim ◽  
Kang-Moon Lee ◽  
Sung-Goo Kang ◽  
Sung Hoon Jung
Keyword(s):  
Waist Circumference ◽  
Bowel Preparation ◽  
Female Gender ◽  
Distal Colon ◽  
Proximal Colon ◽  
Screening Colonoscopy ◽  
Factors Affecting ◽  
Colon Cleansing ◽  
Fair Poor

Background. Previous studies have suggested that relatively poor bowel preparation in the proximal colon, compared to that in the distal colon, could decrease the usefulness of colonoscopy. The aim of this study was to determine whether the “first defecation time” after polyethylene glycol (PEG) administration affects the cleansing quality in the proximal colon. Methods. A total of 425 individuals who were scheduled to undergo a screening colonoscopy were enrolled prospectively at the healthcare center of St. Vincent’s Hospital, Suwon, Korea, between April 2015 and March 2016. Bowel cleansing was performed using 4 L of PEG. Surveys were conducted to obtain information regarding the “first defecation time.” Endoscopists assessed the quality of bowel preparation in each bowel segment. Results. We investigated 425 consecutive eligible cases. The mean “first defecation time” after PEG administration was 54.35 min. The quality of bowel preparation was poorer in the proximal colon than that in the distal colon. The adequate (excellent, good) and inadequate (fair, poor) proximal colon preparation groups comprised 360 (84.7%) and 65 (15.3%) patients, respectively. A multivariate analysis revealed that female gender (P=0.029), small waist circumference (P=0.027), and the long “first defecation time” (P=0.034) were independently associated with inadequate bowel preparation in the proximal colon. Conclusion. Our data document that the “first defecation time,” female gender, and a small waist circumference affect the quality of preparation in the proximal colon. Inadequate preparation in the proximal colon was more common in females. Patients with these factors undergoing colonoscopy should be monitored carefully.

scholarly journals The Impact of Patient Education with a Smartphone Application on the Quality of Bowel Preparation for Screening Colonoscopy

2017 ◽  
Vol 50 (5) ◽  
pp. 479-485 ◽  
Author(s):  
JeongHyeon Cho ◽  
SeungHee Lee ◽  
Jung A Shin ◽  
Jeong Ho Kim ◽  
Hong Sub Lee
Keyword(s):  
Patient Education ◽  
Bowel Preparation ◽  
Smartphone Application ◽  
Screening Colonoscopy ◽  
The Impact

Clinical Factors Affecting Condition-Specific Quality-of-Life Domains in Pediatric Patients after Repair of Esophageal Atresia: The Swedish-German EA-QOL Study

2019 ◽  
Vol 30 (01) ◽  
pp. 096-103 ◽  
Author(s):  
Michaela Dellenmark-Blom ◽  
Julia Quitmann ◽  
Jens Dingemann ◽  
Stefanie Witt ◽  
Benno M. Ure ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Atresia ◽  
Primary Anastomosis ◽  
Female Gender ◽  
Parent Report ◽  
Clinical Factors ◽  
Child Report ◽  
Factors Affecting ◽  
Airway Infections

Abstract Introduction We aimed to identify clinical factors affecting condition-specific health related quality of life (HRQOL) domains in children born with esophageal atresia (EA). This can facilitate preventive care to risk groups of HRQOL impairments. Materials and Methods A total of 124 Swedish and German families of EA children answered the validated EA-QOL questionnaires (response rate 68%), for evaluation of three HRQOL domains in children 2 to 7 years old (53 parents) and four HRQOL domains in children 8 to 17 years old (62 children/71 parents). Clinical data were collected through medical records and a questionnaire. Statistics included between—group analysis, univariable and stepwise multivariable regression analysis, p < 0.05. Results Between 2 to 7 years, no primary anastomosis (p = 0.022) and female gender (p = 0.026) predicted worse scores related to “physical health and treatment,” and gastrostomy insertion related to “eating” (p = 0.0001), and “social isolation and stress” (p = 0.001). Between 8 to 17 years, no primary anastomosis (child report), prematurity, esophageal dilatation (parent report) predicted poor HRQOL related to “eating” (p < 0.05), associated anomalies to “body perception” (p = 0.031, parent report), female gender (p = 0.018, child report) and severe EA (p = 0.011 child report, p = 0.004 parent report) to “social relationships,” and severe EA predicted worse “health and well-being” scores (p = 0.004, parent report). An increased number of digestive symptoms (difficulty swallowing food, heartburn, and vomiting), lowered all EA-QOL domain scores in both age groups (p < 0.001). An increased number of respiratory problems (cough, wheezing, airway infections. breathlessness, and chest tightness), lowered scores in two HRQOL domains among children 2 to 7 years (p < 0.05). Conclusion Impairments within condition-specific HRQOL domains in EA children are found in congenital and surgical subgroups, and notably related to digestive symptoms throughout childhood.

scholarly journals Adenoma and Polyp Detection Rates in Colonoscopy according to Indication

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Erika S. Boroff ◽  
Molly Disbrow ◽  
Michael D. Crowell ◽  
Francisco C. Ramirez
Keyword(s):  
Distal Colon ◽  
Proximal Colon ◽  
Screening Colonoscopy ◽  
Bowel Habit ◽  
Polyp Detection ◽  
Age And Gender ◽  
Detection Rates ◽  
Adenoma Detection ◽  
And Gender ◽  
Colon Data

Background. Adenoma detection rate (ADR) is a validated quality measure for screening colonoscopy, but there are little data for other indications. The distribution of adenomas is not well described for these indications. Aim. To describe ADR and the adenoma distribution in the proximal and distal colon based on colonoscopy indication. Methods. Outpatient colonoscopies are subdivided by indication. PDR and ADR for the entire colon and for proximal and distal colon. Data were compared using generalized estimating equations to adjust for clustering amongst endoscopists while controlling for patient age and gender. Results. 3436 colonoscopies were reviewed (51.2%: men (n=1759)). Indications are screening 49.2%, surveillance 29.3%, change in bowel habit 8.4%, bleeding 5.8%, colitides 3.0%, pain 2.8%, and miscellaneous 1.5%. Overall ADR was 37% proximal ADR 28%, and distal ADR 17%. PDR and ADR were significantly higher in surveillance than in screening (PDR: 69% versus 51%; ADR: 50% versus 33%; p=0.0001). Adenomas were more often detected in the proximal than in the distal colon, for all indications. Conclusions. Prevalence of polyps and adenomas differs based on colonoscopy indication. Adenoma detection is highest in surveillance and more commonly detected in the proximal colon. For quality assurance, distinct ADR and PDR targets may need to be established for different colonoscopy indications.

scholarly journals Surveying ADR knowledge and practices among US gastroenterologists

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Michael Peng ◽  
Douglas Rex, MD, MACG
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Online Survey ◽  
Screening Colonoscopy ◽  
Current Evidence ◽  
Serrated Polyps ◽  
The Past ◽  
Adenoma Detection ◽  
Age And Sex

Background:   The adenoma detection rate (ADR) is of primary importance to the quality of screening colonoscopy. An online survey was conducted to assess knowledge and practices on ADR.  Methods:  Paid questionnaire distributed by email. Eligible respondents were board certified gastroenterologists who perform >80 colonoscopies per month with 3 to 35 years after fellowship.  Results:  39% were unaware that ADR applies only to screening colonoscopies and 76% incorrectly answered that ADR includes sessile serrated polyps/adenomas.  51% of respondents incorrectly believe the threshold is set at 25% because 25% is a national ADR average. Many also believe the threshold depends on the patient population (current evidence suggests adjusting ADR for factors other than age and sex is unnecessary). 75% ranked ADR as highly important. 80% reported tracking ADR. A busy practice was the most common reason for not tracking ADR. Caps, chromoendoscopy, and good bowel preparation were viewed as valuable for improving ADR (this is true except for caps). HD colonoscopes and education were considered less valuable (although evidence suggests HD and education are associated with improved ADR). 57% reported not sharing ADR information with their patients, and 59% reported no patients in the past 6 months asking for their ADR. Conclusion:  The importance of ADR as a validated quality measure is well understood, but there are misconceptions among gastroenterologists regarding the definition and measurement of ADR and which methods are proven to increase ADR.  Patients are having very little impact on ADR measurement.

scholarly journals The impact of low- versus standard-volume bowel preparation on participation in primary screening colonoscopy: a randomized health services study

Endoscopy ◽  
2019 ◽  
Vol 51 (03) ◽  
pp. 227-236 ◽  
Author(s):  
Małgorzata Pisera ◽  
Robert Franczyk ◽  
Paulina Wieszczy ◽  
Marcin Polkowski ◽  
Maciej Rupinski ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Participation Rate ◽  
Proximal Colon ◽  
Lesion Detection ◽  
Screening Colonoscopy ◽  
Detection Rates ◽  
Volume Group ◽  
Sodium Picosulfate ◽  
Low Volume ◽  
The Impact

Abstract Background The aim of this study was to evaluate the impact of low-volume vs. standard-volume bowel preparation on participation in screening colonoscopy, bowel preparation quality, and lesion detection rates. Methods This was a multicenter, randomized, health services study within the population-based primary colonoscopy screening program in Poland. Individuals aged 55 – 62 years were randomized in a 1:1 ratio to bowel preparation with a low-volume (0.3 L sodium picosulfate with magnesium citrate) or standard-volume (4 L polyethylene glycol) regimen and then invited to participate in screening colonoscopy. The primary outcome measure was the rate of participation in screening colonoscopy. Compliance with the assigned bowel preparation, bowel preparation quality, and lesion detection rates were also evaluated. Results A total of 13 621 individuals were randomized and 13 497 were analyzed (6752 in the low-volume group and 6745 in the standard-volume group). The participation rate (16.6 % vs. 15.5 %; P = 0.08) and compliance rate (93.3 % vs. 94.1 %; P = 0.39) did not differ significantly between the groups. In the low-volume group, fewer participants had adequate bowel preparation compared with the standard-volume group (whole colon 79.0 % vs. 86.4 %, P < 0.001; proximal colon 80.1 % vs. 87.3 %, P < 0.001). Detection rates of advanced adenoma (AADR) and advanced serrated polyps (ASPDR) were lower in the low-volume group than in the standard-volume group (AADR in the proximal colon 2.6 % vs. 4.3 %, P = 0.02; ASPDR in the whole colon 2.0 % vs. 3.3 %, P = 0.04; ASPDR in the proximal colon 1.0 % vs. 1.9 %, P = 0.048). Conclusion When compared with a standard-volume bowel preparation with polyethylene glycol, low-volume bowel preparation with sodium picosulfate/magnesium citrate did not improve participation rate or lesion detection rates, and negatively affected bowel preparation quality.

Effect of Video Aid on the Quality of Bowel Preparation Among Outpatient Screening Colonoscopy Cohort

2017 ◽  
Vol 112 ◽  
pp. S272
Author(s):  
Sanna Fatima ◽  
Deepanshu Jain ◽  
Sujani Yadlapati ◽  
Maria V. Bandres ◽  
Christopher Hibbard
Keyword(s):  
Bowel Preparation ◽  
Screening Colonoscopy
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