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The Timing of Bowel Preparation Is More Important than the Timing of Colonoscopy in Determining the Quality of Bowel Cleansing

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Abstract

Aims

We aimed to compare the quality of bowel preparation and cecal intubation rates between morning and afternoon colonoscopies and to evaluate the difference in quality of bowel preparation according to the intervals between starting and ending intake of bowel preparation agent and the initiation of colonoscopy.

Methods

In this prospective study, 300 outpatients were instructed to drink PEG solution starting either at 5:00 a.m. (morning group) or at 8:00 a.m. (afternoon group) on the same day. The time when PEG intake was started and completed, and when colonoscopy was begun were recorded. The quality of bowel preparation was assessed using the Ottawa bowel preparation scale.

Results

There was no significant difference in the Ottawa scale between the morning and the afternoon groups (p = 0.14). Patients with intervals of 7 h or less between the initiation of PEG intake and the start of colonoscopy had a better quality of bowel preparation than those with intervals of more than 7 h (p = 0.03). In addition, patients with intervals of 4 h or less between the end of PEG intake and the start of colonoscopy had a better quality of bowel preparation than those with intervals of more than 4 h (p = 0.02).

Conclusions

The time of day at which colonoscopy is performed, whether during the morning or the afternoon, does not have a significant impact on the quality of bowel preparation. The quality of bowel preparation is significantly better in patients with a shorter time between bowel preparation and the start of colonoscopy.

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References

  1. Bernstein C, Thorn M, Monsees K, Spell R, O’Connor JB. A prospective study of factors that determine cecal intubation time at colonoscopy. Gastrointest Endosc. 2005;61:72–75.

    Article  PubMed  Google Scholar 

  2. Rex DK, Bond JH, Winawer S, et al. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-society task force on colorectal cancer. Am J Gastroenterol. 2002;97:1296–1308.

    Article  PubMed  Google Scholar 

  3. Kolts BE, Lyles WE, Achem SR, et al. A comparison of the effectiveness and patient tolerance of oral sodium phosphate, castor oil, and standard electrolyte lavage for colonoscopy or sigmoidoscopy preparation. Am J Gastroenterol. 1993;88:1218–1223.

    CAS  PubMed  Google Scholar 

  4. Marshall JB, Pineda JJ, Barthel JS, King PD. Prospective, randomized trial comparing sodium phosphate solution with polyethylene glycol-electrolyte lavage for colonoscopy preparation. Gastrointest Endosc. 1993;39:631–634.

    Article  CAS  PubMed  Google Scholar 

  5. Golub RW, Kerner BA, Wise WE Jr, et al. Colonoscopic bowel preparations—which one? A blinded, prospective, randomized trial. Dis Colon Rectum. 1995;38:594–599.

    Article  CAS  PubMed  Google Scholar 

  6. Henderson JM, Barnett JL, Turgeon DK, et al. Single-day, divided-dose oral sodium phosphate laxative versus intestinal lavage as preparation for colonoscopy: efficacy and patient tolerance. Gastrointest Endosc. 1995;42:238–243.

    Article  CAS  PubMed  Google Scholar 

  7. Clarkston WK, Tsen TN, Dies DF, et al. Oral sodium phosphate versus sulfate-free polyethylene glycol electrolyte lavage solution in outpatient preparation for colonoscopy: a prospective comparison. Gastrointest Endosc. 1996;43:42–48.

    CAS  PubMed  Google Scholar 

  8. Hsu CW, Imperiale TF. Meta-analysis and cost comparison of polyethylene glycol lavage versus sodium phosphate for colonoscopy preparation. Gastrointest Endosc. 1998;48:276–282.

    Article  CAS  PubMed  Google Scholar 

  9. Ness RM, Manam R, Hoen H, Chalasani N. Predictors of inadequate bowel preparation for colonoscopy. Am J Gastroenterol. 2001;96:1797–1802.

    Article  CAS  PubMed  Google Scholar 

  10. Chung YW, Han DS, Park KH, et al. Patient factors predictive of inadequate bowel preparation using polyethylene glycol: a prospective study in Korea. J Clin Gastroenterol. 2009;43:448–452.

    Article  PubMed  Google Scholar 

  11. Sanaka MR, Shah N, Mullen KD, et al. Afternoon colonoscopies have higher failure rates than morning colonoscopies. Am J Gastroenterol. 2006;101:2726–2730.

    Article  PubMed  Google Scholar 

  12. Wells CD, Heigh RI, Sharma VK, et al. Comparison of morning versus afternoon cecal intubation rates. BMC Gastroenterol. 2007;7:19.

    Article  PubMed  Google Scholar 

  13. Siddiqui AA, Yang K, Spechler SJ, et al. Duration of the interval between the completion of bowel preparation and the start of colonoscopy predicts bowel-preparation quality. Gastrointest Endosc. 2009;69:700–706.

    Article  PubMed  Google Scholar 

  14. Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc. 2004;59:482–486.

    Article  PubMed  Google Scholar 

  15. Church JM. Effectiveness of polyethylene glycol antegrade gut lavage bowel preparation for colonoscopy—timing is the key! Dis Colon Rectum. 1998;41:1223–1225.

    Article  CAS  PubMed  Google Scholar 

  16. Aoun E, Abdul-Baki H, Azar C, 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;62:213–218.

    Article  PubMed  Google Scholar 

  17. Park JS, Sohn CI, Hwang SJ, et al. Quality and effect of single dose versus split dose of polyethylene glycol bowel preparation for early-morning colonoscopy. Endoscopy. 2007;39:616–619.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the research fund of Hanyang University (HY-2007-N).

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Authors and Affiliations

  1. Department of Internal Medicine, Hanyang University Guri Hospital, 249-1, Gyomoon-Dong, Guri-Si, Gyeonggi-Do, 471-701, Korea

    Chang Soo Eun, Dong Soo Han, Yil Sik Hyun, Joong Ho Bae, Hye Sun Park, Tae Yeob Kim, Yong Cheol Jeon & Joo Hyun Sohn

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  1. Chang Soo Eun
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  2. Dong Soo Han
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  3. Yil Sik Hyun
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  4. Joong Ho Bae
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Correspondence to Dong Soo Han.

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Eun, C.S., Han, D.S., Hyun, Y.S. et al. The Timing of Bowel Preparation Is More Important than the Timing of Colonoscopy in Determining the Quality of Bowel Cleansing. Dig Dis Sci 56, 539–544 (2011). https://doi.org/10.1007/s10620-010-1457-1

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  • DOI: https://doi.org/10.1007/s10620-010-1457-1

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