Real-Life Colonoscopy Preparation
DOI:
https://doi.org/10.22516/25007440.1153Keywords:
Bowel preparation, Colonoscopy, Polyethylene glycol, Sodium picosulfate, Sodium-Potassium-Magnesium SulfateAbstract
Introduction: The quality of a colonoscopy is a key factor in clinical outcomes and largely depends on the bowel cleanliness achieved through proper preparation. The type of agent, adherence, and tolerability are factors that can influence the quality of bowel preparation and, consequently, the results of the procedure. This study aims to evaluate the factors that determine the choice of preparation agent and its impact on the quality of colonoscopy.
Methodology: A cross-sectional observational study was conducted with a sample of 530 patients. Agents evaluated included polyethylene glycol (PEG), sodium picosulfate, and sodium-potassium-magnesium sulfate (Na-K-Mg sulfate), with their continuous and split-dose regimens, depending on the case. The reasons for selection and tolerability were assessed through a survey. Bowel cleanliness was determined by the endoscopist using the Boston scale.
Results: The average age was 52.7 years (±13.4), with 60% being women. The most selected agent was PEG (81.9%) in the full-dose regimen (74.5%). The main determining factor was the availability of the drug, at 42.6%. Unwanted symptoms were reported in 62.6% of patients, however, 99.4% achieved adequate preparation (Boston ≥6).
Conclusion: The primary factor related to the selection of the bowel preparation agent is availability. Objective tolerability does not significantly affect the quality of bowel cleanliness or the success of the procedure.
Downloads
References
Zhang J, Chen G, Li Z, Zhang P, Li X, Gan D, et al. Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis. J Cancer. 2020;11(20):5953-70. https://doi.org/10.7150/jca.46661
Rex DK. Key quality indicators in colonoscopy. Gastroenterol Rep (Oxf). 2023;11:goad009. https://doi.org/10.1093/gastro/goad009
Sharara AI, Abou Mrad RR. The modern bowel preparation in colonoscopy. Gastroenterol Clin North Am. 2013;42(3):577-98. https://doi.org/10.1016/j.gtc.2013.05.010
Altamirano Castañeda ML, Hernández Mondragón ÓV, Blanco Velasco G, Blancas Valencia JM. Comparación de 2 tipos de preparación intestinal para la realización de colonoscopia en un hospital de tercer nivel. Endoscopia. 2015;27(4):168-74. https://doi.org/10.1016/j.endomx.2015.12.004
Park SS, Sinn DH, Kim YH, Lim YJ, Sun Y, Lee JH, et al. Efficacy and Tolerability of Split-Dose Magnesium Citrate: Low-Volume (2 Liters) Polyethylene Glycol vs. Single- or Split-Dose Polyethylene Glycol Bowel Preparation for Morning Colonoscopy. Am J Gastroenterol. 2010;105(6):1319-26. https://doi.org/10.1038/ajg.2010.79
Carvajal Patiño GD, Aponte Marín DM, Ibáñez Pinilla M, Prieto-Ortíz RG, Castañeda-Orjuela C, González Salazar CA, et al. Eficacia y seguridad de 3 esquemas para la preparación del colon para colonoscopia (Polietilenglicol (PEG) 4 litros (dosis única) vs PEG 4 litros dividido (2 L+2 L) vs PEG 2 litros dividido volumen bajo (1 L + 1 L): ensayo clínico controlado aleatorizado. Rev Colomb Gastroenterol. 2019;34(2):144-51. https://doi.org/10.22516/25007440.393
Cheng J, Tao K, Shuai X, Gao J. Sodium phosphate versus polyethylene glycol for colonoscopy bowel preparation: an updated meta-analysis of randomized controlled trials. Surg Endosc. 2016;30(9):4033-41. https://doi.org/10.1007/s00464-015-4716-6
Adamcewicz M, Bearelly D, Porat G, Friedenberg FK. Mechanism of action and toxicities of purgatives used for colonoscopy preparation. Expert Opin Drug Metab Toxicol. 2011;7(1):89-101. https://doi.org/10.1517/17425255.2011.542411
Cohen LB. Advances in Bowel Preparation for Colonoscopy. Gastrointest Endosc Clin N Am. 2015;25(2):183-97. https://doi.org/10.1016/j.giec.2014.11.003
Lai EJ, Calderwood AH, Doros G, Fix OK, Jacobson BC. The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research. Gastrointest Endosc. 2009;69(3):620-5. https://doi.org/10.1016/j.gie.2008.05.057
Forero E, Cardona H, Reyes G, Abello H, Rosas M, Sánchez C. Preparación intestinal para colonoscopia; comparación entre polietilenglicol y manitol: Estudio de costo efectividad, doble ciego aleatorizado. Rev Colomb Gastroenterol. 2005;20(4):60-71.
Radaelli F, Meucci G, Imperiali G, Spinzi G, Strocchi E, Terruzzi V. High-Dose Senna Compared with Conventional PEG-ES Lavage as Bowel Preparation for Elective Colonoscopy: A Prospective, Randomized, Investigator-Blinded Trial. Am J Gastroenterol. 2005;100(12):2674-80. https://doi.org/10.1111/j.1572-0241.2005.00335.x
Juluri R, Eckert G, Imperiale TF. Meta-analysis: randomized controlled trials of 4-L polyethylene glycol and sodium phosphate solution as bowel preparation for colonoscopy. Aliment Pharmacol Ther. 2010;32(2):171-81. https://doi.org/10.1111/j.1365-2036.2010.04326.x
Aoun E, Abdul-Baki H, Azar C, Mourad F, Barada K, Berro Z, et al. A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation. Gastrointest Endosc. 2005;62(2):213-8. https://doi.org/10.1016/s0016-5107(05)00371-8
Murcio-Pérez E, Téllez-Ávila. F. Opciones de preparación para colonoscopia. Endoscopia. 2012;24(1):23-31.
Roldán Molina LF, Roldán Delfino LM, León Ramírez SM, Nuñez Cabarcas EE, Pérez Useche HM, Restrepo Peláez AJ, et al. Efectividad y tolerabilidad de tres tipos de productos de preparación para colonoscopia. Rev Colomb Gastroenterol. 2021;36(3):334-40. https://doi.org/10.22516/25007440.679
Quaresma AB, Briancini G, Chiesa T, Monteiro SO, Mergener RA. Intestinal preparations for colonoscopy. Comparative study: mannitol, picosulphate and macrogol. J Coloproctol (Rio J). 2018;38(2):105-10. https://doi.org/10.1016/j.jcol.2017.12.001
López S, Vargas C, López C. Eficacia y tolerabilidad de la reducción del volumen de polietilenglicol para la preparación para colonoscopia. Rev Med Chil. 2019;147(8):977-982. https://doi.org/10.4067/S0034-98872019000800977
Johnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Gastroenterology. 2014;147(4):903-24. https://doi.org/10.1053/j.gastro.2014.07.002
Barreto Noratto CP, Limas Solano LM, González CA. Calidad en colonoscopía: experiencia en un centro de endoscopía de Boyacá, Colombia. Acta Gastroenterol Latinoam. 2023;53(1):68-75.
Gómez Rodríguez AMPKT. Caracterización clínica y endoscópica de los pacientes llevados a Colonoscopia en el Hospital Universitario Samaritana 2017-2018. Bogotá: Universidad del Rosario; 2020.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista colombiana de Gastroenterología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.
Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
