Endoscopy 2020; 52(S 01): S278
DOI: 10.1055/s-0040-1704881
ESGE Days 2020 ePoster presentations
Colon and rectum 09:00–17:00 Thursday, April 23, 2020 ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

IBD PATIENTS EQUALLY TOLERATE BOWEL PREPARATION BUT NEED HIGHER DOSES OF SEDATION DURING COLONOSCOPY: RESULTS FROM A PROSPECTIVE, CASE-CONTROL, SINGLE-CENTRE STUDY

C Bezzio
1   ASST Rhodense, Rho, Italy
,
P Andreozzi
2   Marcianise Hospital, Marcianise, Italy
,
M Schettino
1   ASST Rhodense, Rho, Italy
,
I Arena
1   ASST Rhodense, Rho, Italy
,
C Della Corte
1   ASST Rhodense, Rho, Italy
,
M Devani
3   ASST Rhodense, Gastroenterology Unit, Rho, Italy
,
G Manes
1   ASST Rhodense, Rho, Italy
,
B Omazzi
1   ASST Rhodense, Rho, Italy
,
S Saibeni
1   ASST Rhodense, Rho, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims IBD patients are intended to undergo several times colonoscopy. To prospectively evaluate tolerability of bowel preparation and colonoscopy in UC and CD patients compared to subjects participating in a colorectal cancer population screening program.

Methods we consecutively enrolled CD and UC patients and screening subjects (SS). Bowel preparation was done by macrogol 4.000 + simethicone + sodium-sulphate-anhydrous. Cleansing was assessed by Boston Bowel Preparation Scale (BBPS, from 0 to 9, the best); sedation dose and need to increase the initial doses of midazolam (3.0 mg) and fentanyl (0.05 mg). Tolerability of bowel preparation, discomfort and pain during colonoscopy were assessed by Visual Analogue Scale (VAS) from 0 to 100 mm.

Results 65 UC (26 women, mean age 50.6 ± 15.4 yrs), 65 CD (29 women, mean age 44.7 ± 3.9) and 94 SS (47 women, mean age 61.9 ± 6.9) enrolled. Bowel preparation was similarly tolerated in UC (70.3 ± 17.7 mm), CD (73.1 ± 12.7 mm) and SS (73.2 ± 12.6 mm) (p = 0.397). Complete colonoscopy was similarly done in UC (61/65, 93.8%), CD (60/65, 92.3%) and SS (91/94, 96.8%) (p = 0.364). BBPS did not show significant differences between UC (6.5 ± 1.0), CD (6.4 ± 1.1) and SS (6.4 ± 1.0) (p = 0.824). The need to increase sedation doses was significantly higher in CD (26/65, 40.0%) and UC (16/65, 24.6%) than in SS (4/94, 4.3%) (p < 0.0001). The mean increases in midazolam and fentanyl doses were significantly higher in CD (0.446 ± 0.660 mg and 0.009 ± 0.019 mg) and UC (0.300 ± 0.620 and 0.008 ± 0.018 mg) than in SS (0.042 ± 0.250 mg and 0.001 ± 0.007 mg) (p < 0.0001 in both cases). Discomfort and pain during colonoscopy were similar in UC (35.0 ± 23.0 mm and 27.6 ± 24.6 mm), CD (37.5 ± 22.2 mm and 28.8 ± 22.5 mm) and SS (33.7 ± 18.7 and 26.9 ± 19.8 mm) (p = 0.530 and p = 0.866).

Conclusions in IBD patients, higher sedation doses are needed in order to warrant a tolerated colonoscopy. Bowel preparation is equally tolerated and efficacious in IBD patients and in screening subjects.