Usefulness of Personal Bowel Habits as a Predictive Factor for Inadequate Bowel Preparation for Colonoscopy: A Prospective Questionnaire-Based Observational Study
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: The quality of bowel preparation is important for optimal colonoscopy. It is influenced by medical and personal factors. We aimed to evaluate the effect of bowel habit on the quality of bowel preparation and to identify predictors of inadequate bowel preparation among bowel habit factors. Methods: From June 2017 to September 2017, 90 volunteers were enrolled in this study. Each participant answered a questionnaire consisting of multiple questions about personal bowel habits, including stool form, frequency of bowel movements per week, duration, and degree of straining for bowel movement. Then, all volunteers underwent colonoscopic exam. Eleven endoscopists performed colonoscopies and used the Boston Bowel Preparation Scale (BBPS) as the index for bowel preparation. Two expert endoscopists simultaneously reviewed all colonoscopic images to confirm the final BBPS. Univariate and multivariate logistic regression analyses were performed to verify the correlation between bowel preparation adequacy and bowel habit. Results: Among the 90 participants, 20 (22.2%) had inadequate bowel preparation (total BBPS ≤6 or any segmental BBPS ≤1). In univariate analysis, infrequent bowel movement (0–2/week) (odds ratio [OR], 12.60; 95% confidence interval [CI], 1.22 to 129, p=0.03) and moderate straining (more than 1/4 of defecations) (OR, 4.40; 95% CI, 1.44 to 13.39; p=0.01) were significantly associated with inadequate bowel preparation. However, only moderate straining was significantly associated with inadequate bowel preparation in multivariate analysis (OR, 3.99; 95% CI, 1.26 to 12.65; p=0.02). Conclusions: Straining is a significant predictor for inadequate bowel preparation. For patients with straining during bowel movements, an intensified preparation regimen should be considered.
Abstract
Background/Aims: The quality of bowel preparation is important for optimal colonoscopy. It is influenced by medical and personal factors. We aimed to evaluate the effect of bowel habit on the quality of bowel preparation and to identify predictors of inadequate bowel preparation among bowel habit factors. Methods: From June 2017 to September 2017, 90 volunteers were enrolled in this study. Each participant answered a questionnaire consisting of multiple questions about personal bowel habits, including stool form, frequency of bowel movements per week, duration, and degree of straining for bowel movement. Then, all volunteers underwent colonoscopic exam. Eleven endoscopists performed colonoscopies and used the Boston Bowel Preparation Scale (BBPS) as the index for bowel preparation. Two expert endoscopists simultaneously reviewed all colonoscopic images to confirm the final BBPS. Univariate and multivariate logistic regression analyses were performed to verify the correlation between bowel preparation adequacy and bowel habit. Results: Among the 90 participants, 20 (22.2%) had inadequate bowel preparation (total BBPS ≤6 or any segmental BBPS ≤1). In univariate analysis, infrequent bowel movement (0–2/week) (odds ratio [OR], 12.60; 95% confidence interval [CI], 1.22 to 129, p=0.03) and moderate straining (more than 1/4 of defecations) (OR, 4.40; 95% CI, 1.44 to 13.39; p=0.01) were significantly associated with inadequate bowel preparation. However, only moderate straining was significantly associated with inadequate bowel preparation in multivariate analysis (OR, 3.99; 95% CI, 1.26 to 12.65; p=0.02). Conclusions: Straining is a significant predictor for inadequate bowel preparation. For patients with straining during bowel movements, an intensified preparation regimen should be considered.
참고문헌 (21)
- 이보인, "대장암 선별과 대장폴립 진단검사 가이드라인", 대한소화기학회지, 59(2), pp.65~84 (2012), 대한소화기학회
- Winawer SJ, "Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup", N Engl J Med, 328, pp.901~906 (1993)
- Lebwohl B, "The impact of suboptimal bowel preparation on adenoma miss rates and the factors associated with early repeat colonoscopy", Gastrointest Endosc, 73, pp.1207~1214 (2011)
- Dik VK, "Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation : development and validation of a prediction score", Gastrointest Endosc, 81, pp.665~672 (2015)
- 박홍준, "Colon Transit Time May Predict Inadequate Bowel Preparation in Patients With Chronic Constipation", Intestinal research, 13(4), pp.339~345 (2015), 대한장연구학회
- Rex DK, "Impact of bowel preparation on efficiency and cost of colonoscopy", Am J Gastroenterol, 97, pp.1696~1700 (2002)
- Sherer EA, "The effect of colonoscopy preparation quality on adenoma detection rates", Gastrointest Endosc, 75, pp.545~553 (2012)
- Kaminski MF, "Quality indicators for colonoscopy and the risk of interval cancer", N Engl J Med, 362, pp.1795~1803 (2010)
- Fang J, "Constipation, fiber intake and noncompliance contribute to inadequate colonoscopy bowel preparation : a prospective cohort study", J Dig Dis, 17, pp.458~463 (2016)
- Lee DW, "Association between bowel habits and quality of bowel preparation for colonoscopy", Medicine (Baltimore), 96, pp.e7319~ (2017)
- Chung YW, "Patient factors predictive of inadequate bowel preparation using polyethylene glycol : a prospective study in Korea", J Clin Gastroenterol, 43, pp.448~452 (2009)
- Ness RM, "Predictors of inadequate bowel preparation for colonoscopy", Am J Gastroenterol, 96, pp.1797~1802 (2001)
- Mearin F, "Clinical practice guideline : irritable bowel syndrome with constipation and functional constipation in the adult", Rev Esp Enferm Dig, 108, pp.332~363 (2016)
- Malhotra A, "Use of Bristol Stool Form Scale to predict the adequacy of bowel preparation : a prospective study", Colorectal Dis, 18, pp.200~204 (2016)
- Cheng CL, "Predictors of suboptimal bowel preparation using 3-l of polyethylene glycol for an outpatient colonoscopy : a prospective observational study", Dig Dis Sci, 62, pp.345~351 (2017)
- Saad RJ, "Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls", Am J Gastroenterol, 105, pp.403~411 (2010)
- Schaefer DC, "Constipation in the elderly", Am Fam Physician, 58, pp.907~914 (1998)
- Nurko S, "Coexistence of constipation and incontinence in children and adults", Best Pract Res Clin Gastroenterol, 25, pp.29~41 (2011)
- Coletta M, "Discrepancy between recalled and recorded bowel habits in irritable bowel syndrome", Aliment Pharmacol Ther, 32, pp.282~288 (2010)
- Patimah AW, "Frequency patterns of core constipation symptoms among the Asian adults : a systematic review", BMC Gastroenterol, 17, pp.115~ (2017)
- Corleto VD, "Efficacy of Prucalopride in bowel cleansing before colonoscopy : results of a pilot study", World J Gastrointest Endosc, 9, pp.558~560 (2017)