Assessment of the adequacy of bowel preparation in patients undergoing colonoscopy: a retrospective study


Submitted: 5 April 2024
Accepted: 30 April 2024
Published: 7 June 2024
Abstract Views: 3778
PDF: 1190
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Authors

  • Roberta Di Matteo SC Research Training Innovation Infrastructure, Integrated Activities, Research, Innovation Department (DAIRI), Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. https://orcid.org/0000-0001-8249-8284
  • Claudia Gota Department of Internal Medicine and Emergency and Admissions, SS of High Complexity Digestive Endoscopy, SC Gastroenterology, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Claudia Bina Department of Internal Medicine and Emergency and Admissions, SS of High Complexity Digestive Endoscopy, SC Gastroenterology, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Lorenzo Martino Department of Internal Medicine and Emergency and Admissions, SS of High Complexity Digestive Endoscopy, SC Gastroenterology, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Rossana Perciante Department of Internal Medicine and Emergency and Admissions, SS of High Complexity Digestive Endoscopy, SC Gastroenterology, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Giovanna Condino Department of Internal Medicine and Emergency and Admissions, SS of High Complexity Digestive Endoscopy, SC Gastroenterology, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Simona Arcidiacono SC Directorate of Health Professions, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy.
  • Menada Gardalini SC Research Training Innovation Infrastructure, Integrated Activities, Research, Innovation Department (DAIRI), Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Antonella Cassinari SC Research Training Innovation Infrastructure, Integrated Activities, Research, Innovation Department (DAIRI), Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Tatiana Bolgeo SC Research Training Innovation Infrastructure, Integrated Activities, Research, Innovation Department (DAIRI), Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Antonio Maconi SC Research Training Innovation Infrastructure, Integrated Activities, Research, Innovation Department (DAIRI), Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.

Background: a colonoscopy is crucial for detecting Colorectal Cancer (CRC), and its success is reliant on various fac- tors, notably colon cleansing. Investigating the frequency of procedure interruptions due to inadequate bowel prepara- tion and associated predictive factors could inform targeted interventions. This study aimed to retrospectively assess inadequate bowel preparation rates in outpatient and inpatient settings. Materials and Methods: this observational, retrospective, and single-center study examines patient records from a sin- gle hospital in northern Italy. This investigation involves individuals who underwent colonoscopies from January 1, 2021, to December 31, 2021, regardless of whether they were receiving outpatient or inpatient care. Results: this study included 1977 participants. The median age of all participants was 64 years, with ages ranging from 41 to 86. Among males, the median age was 65 years, varying from 56 to 74, whereas for females, it was 64 years, rang- ing from 55 to 74. The majority (78.7%) of participants came from their homes. The type of product used for colon preparation was evaluated in 1783 patients: 92% of them used an osmotic action product (55.7% high volume, 36.3% low volume). The adequacy of the colon preparation for the procedure, assessed using the Boston Bowel Preparation Scale, was found to be poor (score≤5) for 24.2% of the participants, with 13.5% scoring 0. Conclusions: the study suggests healthcare providers should enhance patient education for colonoscopy preparation, especially focusing on hospitalized patients with higher rates of inadequate preparation. Strategies should align with guidelines but also prioritize personalized approaches.


Yang J, Gurudu SR, Koptiuch C, et al. American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in familial adenomatous polyposis syndromes. Gastrointest Endosc. 2020;91:963-82.e2. DOI: https://doi.org/10.1016/j.gie.2020.01.028

Kaltenbach T, Anderson JC, Burke CA, et al. Endoscopic removal of colorectal lesions—recommendations by the US Multi-Society Task Force on Colorectal Cancer. Gastrointest Endosc. 2020;91:486-519. DOI: https://doi.org/10.1016/j.gie.2020.01.029

Naveed M, Jamil LH, Fujii-Lau LL, et al. American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of acute colonic pseudo-obstruction and colonic volvulus. Gastrointest Endosc. 2020;91:228-35. DOI: https://doi.org/10.1016/j.gie.2019.09.007

Rutherford CC, Calderwood AH. Update on bowel preparation for colonoscopy. Curr Treat Options Gastroenterol. 2018;16:165-81. DOI: https://doi.org/10.1007/s11938-018-0165-3

Bechtold ML, Mir F, Puli SR, Nguyen DL. Optimizing bowel preparation for colonoscopy: a guide to enhance quality of visualization. Ann Gastroenterol Q Publ Hell Soc Gastroenterol. 2016;29:137. DOI: https://doi.org/10.20524/aog.2016.0005

Sweetser S, Baron TH. Optimizing bowel cleansing for colonoscopy. Mayo Clin Proc. 2015;90:520-6. DOI: https://doi.org/10.1016/j.mayocp.2015.01.015

Cavicchi M, Tharsis G, Burtin P, et al. Difference in physician- and patient-dependent factors contributing to adenoma detection rate and serrated polyp detection rate. Dig Dis Sci. 2019;64:3579-88. DOI: https://doi.org/10.1007/s10620-019-05808-y

Hassan C, East J, Radaelli F, et al. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019. Endoscopy. 2019;51:775-94. DOI: https://doi.org/10.1055/a-0959-0505

Kluge MA, Williams JL, Wu CK, et al. Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy. Gastrointest Endosc. 2018;87:744-51. DOI: https://doi.org/10.1016/j.gie.2017.06.012

Clark BT, Laine L. High-quality bowel preparation is required for detection of sessile serrated polyps. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2016;14:1155-62. DOI: https://doi.org/10.1016/j.cgh.2016.03.044

Alvarez-Gonzalez MA, Flores-Le Roux JA, Seoane A, et al. Efficacy of a multifactorial strategy for bowel preparation in diabetic patients undergoing colonoscopy: a randomized trial. Endoscopy. 2016;48:1003-9. DOI: https://doi.org/10.1055/s-0042-111320

Chokshi RV, Hovis CE, Hollander T, et al. Prevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy. Gastrointest Endosc. 2012;75:1197-203. DOI: https://doi.org/10.1016/j.gie.2012.01.005

Hassan C, Fuccio L, Bruno M, et al. A predictive model identifies patients most likely to have inadequate bowel preparation for colonoscopy. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2012;10:501-6. DOI: https://doi.org/10.1016/j.cgh.2012.03.003

Mahmood S, Farooqui SM, Madhoun MF. Predictors of inadequate bowel preparation for colonoscopy: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2018;30:819-26. DOI: https://doi.org/10.1097/MEG.0000000000001175

Sharma P, Burke CA, Johnson DA, Cash BD. The importance of colonoscopy bowel preparation for the detection of colorectal lesions and colorectal cancer prevention. Endosc Int Open. 2020;8:E673-83. DOI: https://doi.org/10.1055/a-1127-3144

Bisschops R, Manning J, Clayton LB, et al. Colon cleansing efficacy and safety with 1 L NER1006 versus 2 L polyethylene glycol + ascorbate: a randomized phase 3 trial. Endoscopy. 2019;51:60-72. DOI: https://doi.org/10.1055/a-0638-8125

DeMicco MP, Clayton LB, Pilot J, et al. Novel 1 L polyethylene glycol-based bowel preparation NER1006 for overall and right-sided colon cleansing: a randomized controlled phase 3 trial versus trisulfate. Gastrointest Endosc. 2018;87:677-87.e3. DOI: https://doi.org/10.1016/j.gie.2017.07.047

Pan H, Zheng XL, Fang CY, et al. Same-day single-dose vs large-volume split-dose regimens of polyethylene glycol for bowel preparation: A systematic review and meta-analysis. World J Clin Cases. 2022;10:7844-58. DOI: https://doi.org/10.12998/wjcc.v10.i22.7844

Yadlapati R, Johnston ER, Gregory DL, et al. Predictors of inadequate inpatient colonoscopy preparation and its association with hospital length of stay and costs. Dig Dis Sci. 2015;60:3482-90. DOI: https://doi.org/10.1007/s10620-015-3761-2

Fuccio L, Frazzoni L, Spada C, et al. factors that affect adequacy of colon cleansing for colonoscopy in hospitalized patients. Clin Gastroenterol Hepatol. 2021;19:339-48.e7.

Di Matteo, R., Gota, C., Bina, C., Martino, L., Perciante, R., Condino, G., Arcidiacono, S., Gardalini, M., Cassinari, A., Bolgeo, T., & Maconi, A. (2024). Assessment of the adequacy of bowel preparation in patients undergoing colonoscopy: a retrospective study. Working Paper of Public Health, 12(1). https://doi.org/10.4081/wpph.2024.10009

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