The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
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Formulation and Management of Poor Bowel Preparation: A Survey Study

불량한 장정결에서의 장정결제와 치료: 설문조사

  • Seong, Jae Ho (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Yoo, Jin Sae (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Kyong Joo (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Park, Hong Jun (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Hee Man (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Jae Woo (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Hyun-Soo (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine)
  • 성재호 (연세대학교 원주의과대학 내과학교실 소화기내과) ;
  • 유진세 (연세대학교 원주의과대학 내과학교실 소화기내과) ;
  • 이경주 (연세대학교 원주의과대학 내과학교실 소화기내과) ;
  • 박홍준 (연세대학교 원주의과대학 내과학교실 소화기내과) ;
  • 김희만 (연세대학교 원주의과대학 내과학교실 소화기내과) ;
  • 김재우 (연세대학교 원주의과대학 내과학교실 소화기내과) ;
  • 김현수 (연세대학교 원주의과대학 내과학교실 소화기내과)
  • Received : 2016.06.13
  • Accepted : 2016.07.19
  • Published : 2016.08.01
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Abstract

Background/Aims: There are no established guidelines for bowel preparation formulation for bowel cleansing, nor is there an optimal method of dealing with inadequate bowel cleansing. This study investigated bowel preparation formulation preferences and responses to bowel preparation situations using surveys. Methods: The study surveyed 221 Korean lower gastrointestinal endoscopists from January to March 2015 and assessed their responses. Results: The analysis indicated that 2-L polyethylene glycol (PEG) plus ascorbic acid (Asc) was the preferred method (76.5%) and most responders expressed satisfaction with the formulation in both potency and safety. To address poor bowel preparation on the day of colonoscopy, the majority of physicians chose to order ingestion of additional preparations and proceed with the colonoscopy as scheduled (56.6%). In addition, concerns about renal safety and electrolyte stability were raised regarding oral sodium phosphate. Conclusions: This study found that 2-L PEG+Asc was preferred for potency and safety, and that Korean endoscopists preferred to proceed with colonoscopy in poor bowel preparation situations rather than choose an alternate diagnostic modality.

Keywords

References

  1. Rex DK, Johnson DA, Lieberman DA, Burt RW, Sonnenberg A. Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology. American College of Gastroenterology. Am J Gastroenterol 2000;95:868-877.
  2. Kim SE, Hong SP, Kim HS, et al. A Korean national survey for colorectal cancer screening and polyp diagnosis methods using web-based survey. Korean J Gastroenterol 2012;60:26-35. https://doi.org/10.4166/kjg.2012.60.1.26
  3. American Society of Colon and Rectal Surgeons (ASCRS); American Society for Gastrointestinal Endoscopy (ASGE); Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), et al. A consensus document on bowel preparation before colonoscopy: prepared by a Task Force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Surg Endosc 2006;20:1161. https://doi.org/10.1007/s00464-006-3037-1
  4. Adler M, Quenon M, Even-Adin D, et al. Whole gut lavage for colonoscopy--a comparison between two solutions. Gastrointest Endosc 1984;30:65-67. https://doi.org/10.1016/S0016-5107(84)72318-2
  5. Ell C, Fischbach W, Keller R, et al. A randomized, blinded, prospective trial to compare the safety and efficacy of three bowel- cleansing solutions for colonoscopy (HSG-01*). Endoscopy 2003;35:300-304. https://doi.org/10.1055/s-2003-38150
  6. Park S, Lim YJ. Adjuncts to colonic cleansing before colonoscopy. World J Gastroenterol 2014;20:2735-2740. https://doi.org/10.3748/wjg.v20.i11.2735
  7. Moon CM, Park DI, Choe YG, et al. Randomized trial of 2-L polyethylene glycol ＋ ascorbic acid versus 4-L polyethylene glycol as bowel cleansing for colonoscopy in an optimal setting. J Gastroenterol Hepatol 2014;29:1223-1228. https://doi.org/10.1111/jgh.12521
  8. Hookey LC, Depew WT, Vanner SJ. A prospective randomized trial comparing low-dose oral sodium phosphate plus stimulant laxatives with large volume polyethylene glycol solution for colon cleansing. Am J Gastroenterol 2004;99:2217-2222. https://doi.org/10.1111/j.1572-0241.2004.40482.x
  9. Hookey LC, Vanner S. Recognizing the clinical contraindications to the use of oral sodium phosphate for colon cleansing: a case study. Can J Gastroenterol 2004;18:455-458. https://doi.org/10.1155/2004/787515
  10. Rahman A, Vanner SJ, Baranchuk A, Hookey LC. Serial monitoring of the physiological effects of the standard Pico-$Salax^{(R)}$ regimen for colon cleansing in healthy volunteers. Can J Gastroenterol 2012;26:424-428. https://doi.org/10.1155/2012/757583
  11. Jung YS, Lee CK, Kim HJ, Eun CS, Han DS, Park DI. Randomized controlled trial of sodium phosphate tablets vs polyethylene glycol solution for colonoscopy bowel cleansing. World J Gastroenterol 2014;20:15845-15851. https://doi.org/10.3748/wjg.v20.i42.15845
  12. Ball JE, Osbourne J, Jowett S, Pellen M, Welfare MR. Quality improvement programme to achieve acceptable colonoscopy completion rates: prospective before and after study. BMJ 2004; 329:665-667. https://doi.org/10.1136/bmj.329.7467.665
  13. Soweid AM, Kobeissy AA, Jamali FR, et al. A randomized single-blind trial of standard diet versus fiber-free diet with polyethylene glycol electrolyte solution for colonoscopy preparation. Endoscopy 2010;42:633-638. https://doi.org/10.1055/s-0029-1244236
  14. Bang KB, Jeong EH, Jeong WS, et al. Efficacy of bisacodyl given as part of a polyethylene glycol-based bowel preparation prior to colonoscopy in hospitalized patients: a prospective ramdomized trial. Korean J Gastroenterol 2014;64:268-277. https://doi.org/10.4166/kjg.2014.64.5.268
  15. Horiuchi A, Nakayama Y, Kajiyama M, et al. Colonoscopic enema as rescue for inadequate bowel preparation before colonoscopy: a prospective, observational study. Colorectal Dis 2012;14: e735-e739. https://doi.org/10.1111/j.1463-1318.2012.03107.x
  16. Singh K, Narula AK, Thukral CL, Singh NR, Singh A, Kaur H. Role of CT colonography in colonic lesions and its correlation with conventional colonoscopic findings. J Clin Diagn Res 2015;9: TC14-TC18. https://doi.org/10.1111/crj.12098
  17. Park JB, Lee YK, Yang CH. The evolution of bowel preparation and new developments. Korean J Gastroenterol 2014;63:268-275. https://doi.org/10.4166/kjg.2014.63.5.268
  18. Lee YH, Jeong SY, Kim YS, et al. Randomized controlled trial of sodium phosphate tablets versus 2 L polyethylene glycol solution for bowel cleansing prior to colonoscopy. Korean J Gastroenterol 2015;65:27-34. https://doi.org/10.4166/kjg.2015.65.1.27

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