TBA (16S166)

Comparision of bowel preparation quality between in inpatients and outpatients colonoscopy, attending University Hospital Limerick

Author(s)

Hamid Yousuf, Denise Brennan , Imran ul Haq ,Magzoub Ahmed, Maeve Skelly 

Department(s)/Institutions

 Gastroentrology Department, University Hospital Limerick

Gastroenterology Department, AMNCH Tallaght Hospital, Dublin 24

Introduction

Adequate bowel cleansing is essential for complete examination of the colon mucosa during colonoscopy. Adverse consequences of ineffective bowel preparation include lower adenoma detection rates, longer procedural time, lower caecal intubation rates and shorter intervals between examinations. 

Aims/Background

To assess the quality of bowel preparation for colonoscopy in inpatients vs outpatients at University Hospital Limerick.

Method

Total of 86 patients with median age of 55.5 yrs(range 22 to 89), 43% male (n=37)included  in this prospective study . The quality of bowel preparation was assessed by the endoscopist, who performed the procedure. Bowel preparation was assessed using The Harefield Cleansing Scale . Kleen Prep is used as standard bowl cleanser in majority of patients. A successful bowel preparation was defined as caecal intubation with a cleansing scale grade of A or B. 

Results

Of total, 86/ 41 (48%) were in patients and 45 (52%) were out patients. Colonoscopy in inpatients was performed due to unexplained anaemia in 32% (n=13) of cases, altered bowel habit and/or diarrhoea in 17% (n=7) and 51% (n=21) were due to other concerning indications (per rectal bleed, polyp surveillance, abnormal CT scan etc). Colonoscopies performed in outpatients were due to unexplained anaemia in 20% (n=9), altered bowel habit and/or diarrhoea in 38% (n=17) and 42% (n=19) were due to other concerning reasons.Overall, the caecal intubation rate was 99% (n= 85), however according to the Harefield cleansing criteria, only 70% (n= 60) of procedures were determined to have successful bowel preparation (Grade A or B). Successful bowel preparation was achieved in 66% (n= 27) of inpatients and 73% (n= 33) of outpatients.

Conclusions

The proportion of inpatients who achieve successful bowel preparations when undergoing colonoscopy is lower than that of outpatients (66% vs 73%). Despite a higher proportion of females in outpatients group (62% vs 40%), a higher rate of successful bowel preparation is observed. The reasons for poor inpatient prep are complex, but may include existing ill health, reduced mobility and poorer adherence to bowel preparation and oral hydration.