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Review
. 2018 Jul 14;24(26):2833-2843.
doi: 10.3748/wjg.v24.i26.2833.

Bowel preparation quality scales for colonoscopy

David Kastenberg  1 , Gerald Bertiger  2 , Stuart Brogadir  3
Affiliations
Review

Bowel preparation quality scales for colonoscopy

David Kastenberg et al. World J Gastroenterol. .

Abstract

Colorectal cancer (CRC) is the third most common cancer and second leading cause of cancer-related death in the United States. Colonoscopy is widely preferred for CRC screening and is the most commonly used method in the United States. Adequate bowel preparation is essential for successful colonoscopy CRC screening. However, up to one-quarter of colonoscopies are associated with inadequate bowel preparation, which may result in reduced polyp and adenoma detection rates, unsuccessful screens, and an increased likelihood of repeat procedure. In addition, standardized criteria and assessment scales for bowel preparation quality are lacking. While several bowel preparation quality scales are referred to in the literature, these differ greatly in grading methodology and categorization criteria. Published reliability and validity data are available for five bowel preparation quality assessment scales, which vary in several key attributes. However, clinicians and researchers continue to use a variety of bowel preparation quality measures, including nonvalidated scales, leading to potential confusion and difficulty when comparing quality results among clinicians and across clinical trials. Optimal clinical criteria for bowel preparation quality remain controversial. The use of validated bowel preparation quality scales with stringent but simple scoring criteria would help clarify clinical trial data as well as the performance of colonoscopy in clinical practice related to quality measurements.

Keywords: Aronchick scale; Boston Bowel Preparation Scale; Bowel preparation; Colonoscopy; Ottawa Bowel Preparation Scale.

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Conflict of interest statement

Conflict-of-interest statement: David Kastenberg has received research support from and served as a consultant for Medtronic, and is on the advisory boards of Ferring Pharmaceuticals Inc. and Salix Pharmaceuticals. Gerald Bertiger has served as a consultant and has been a part of the speakers bureau for Ferring Pharmaceuticals Inc. Stuart Brogadir is an employee of Ferring Pharmaceuticals Inc. Editorial support was provided by The Curry Rockefeller Group, LLC, which was funded by Ferring Pharmaceuticals.

Figures

Figure 1
Figure 1
Bowel preparation quality scale segments. Depiction of bowel segments from validation study of Ottawa Bowel Preparation Scale[50]. Before washing or suctioning, each segment is scored on a scale of 0-4 for cleansing, and the total colon is scored for fluid quantity on a scale of 0-2. The total score ranges from 0 (excellent) to 14 (inadequate).
Figure 2
Figure 2
Percentage of screening colonoscopy examinations in which 10-year follow-up was recommended after a negative colonoscopy, stratified by total Boston Bowel Preparation Scale Score[44].
See this image and copyright information in PMC

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