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. 2016 Apr;4(2):314-8.
doi: 10.1177/2050640615594550. Epub 2015 Jul 3.

The burden of bowel preparations in patients undergoing elective colonoscopy

Ala I Sharara  1 , Zeinab D El Reda  1 , Ali H Harb  1 , Carla G Abou Fadel  1 , Fayez S Sarkis  1 , Jean M Chalhoub  1 , Rachel Abou Mrad  1
Affiliations

The burden of bowel preparations in patients undergoing elective colonoscopy

Ala I Sharara et al. United European Gastroenterol J. 2016 Apr.

Abstract

Background: An adequate bowel preparation is an important quality measure for optimal colonoscopy.

Aims: The aim of this article is to study the burden of bowel preparations by examining seven specific variables (hunger, taste, volume, sleep, social, work, and adverse events (AEs)).

Methods: Ambulatory patients undergoing elective colonoscopy completed a questionnaire regarding their experience with the prescribed preparation. The seven study variables were graded using a numerical scale of 0-10 (best to worst). A score >6 was considered to indicate a significant impact and used as primary outcome. Patients were also asked to grade in descending order what they perceived as the worst aspect of the preparation.

Results: A total of 216 patients completed the survey. Preparations consisted of split-dose sodium picosulfate (SPS) (n = 49), split-dose 4 l PEG ± menthol (n = 49), full-dose PEG (n = 68), and 2 l split-dose PEG + ascorbic acid (n = 50). Except for work and AEs, all variables were considered to have a negative impact by >20% of patients (range 20.4-34.2). SPS was superior to PEG regimens in taste (4.1% vs. 35.9%) and volume (0% vs. 44.9%) (p < 0.05 for both) but inferior for hunger (30.6% vs. 19.2%; p = 0.09). The addition of menthol to PEG significantly improved taste (22.4% vs. 41.5%; p = 0.02). Sleep disturbances were most common with SPS and least with split-dose PEG (30.6% vs. 17.4%; p < 0.05). Overall, patients ranked volume, taste, and hunger as most burdensome.

Conclusions: The burden of bowel preparation is substantial. An informed personalized choice of preparation may improve adherence, tolerability and colon cleansing.

Keywords: Colonoscopy; acceptability; adherence; bowel preparation; quality of life; tolerability.

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Figures

Figure 1.
Figure 1.
Patients with scores >6 for the burden of taste, volume, and hunger in split-dose sodium picosulfate (SPS) vs. all PEG-based preparations.
Figure 2.
Figure 2.
Sleep disturbance reported by patients in split-dose sodium picosulfate (SPS) vs. split-dose polyethylene glycol (PEG)-based preparations.
Figure 3.
Figure 3.
Mean scores for taste, hunger, volume, and sleep according to descending order of most burdensome variable irrespective of preparation type.
Figure 4.
Figure 4.
Radar chart of average scores for taste, volume, hunger, and sleep for all bowel preparations. (AscPEG = polyethylene glycol (PEG) + ascorbic acid (MoviPrep®); M = menthol).
Figure 5.
Figure 5.
Radar chart showing percentage of individuals reporting scores >6 for taste, volume, hunger, and sleep in each bowel preparation group. (AscPEG = polyethylene glycol (PEG) ascorbic acid (MoviPrep®); M = menthol).
See this image and copyright information in PMC

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