- Fecal Incontinence
|Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease
Megna B1, Weiss J2, Ley D1, Saha S2, Pfau P2, Grimes I2, Li Z3, Caldera F4. Gastrointest Endosc. 2018 Oct 16. pii: S0016-5107(18)33167-5. doi: 10.1016/j.gie.2018.09.039. [Epub ahead of print]
1 University of Wisconsin-Madison, School of Medicine and Public Health.
2 Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin-Madison, School of Medicine & Public Health.
3 Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, School of Medicine & Public Health.
4 Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin-Madison, School of Medicine & Public Health. Electronic address: firstname.lastname@example.org.
BACKGROUND AND AIMS: Chromoendoscopy (CE) has been shown to generate both a superior diagnostic yield and dysplasia detection rate than conventional white-light endoscopy and requires a high-quality bowel preparation. The aim of this study was to identify predictors of the ability to perform CE in patients with inflammatory bowel disease (IBD).
METHODS: We performed an observational study of patients with IBD undergoing colorectal cancer surveillance examinations with CE. Same day colonoscopy surveys were used to collect patient and procedural variables. Multivariate logistical regression was used to establish odds ratios (OR) of successful completion of CE.
RESULTS: Eighty-eight patients with IBD were enrolled. We found that patients that did not follow a clear liquid diet before colonoscopy had much lower odds of being able to undergo CE (OR, 0.106; 95% CI, 0.013-0.845; p<0.034). Further, we found that previously identified risk factors (older age, history of diabetes mellitus, the timing and split-dosing of preparation solution, and procedure time (AM or PM), chronic narcotic use, and history of constipation) for inadequate bowel preparation were not associated with the ability to perform CE.
CONCLUSIONS: Following a clear liquid diet the entire day before procedure was highly predictive of the ability to perform CE. However, established risk factors for inadequate bowel preparation did not inhibit the ability to perform CE in our population. Endoscopists performing CE should consider recommending patients to follow a clear liquid diet the entire day before their examination.