POSSIBLE INFLUENCING FACTORS OF BOWEL CLEANLINESS DURING COLONOSCOPY

Aims:

Many independent factors can lead to inadequate colon cleanliness which can cause difficulty in observing lesions during colonoscopy. The aim of this study was to evaluate the bowel preparation level using Boston bowel preparation scale (BBPS) in patients with different possible influencing factors.

Methods:

Patients who underwent colonoscopy from January to December 2016 were included into this study. The possible influencing factors affecting colon cleanliness were age, in- or out-patient status, diabetes mellitus (DM), neurological diseases (Parkinson's disease, myasthenia gravis and stroke), hypothyreodism, body mass index (BMI), previous colonic surgery and drugs (calcium channel blockers (CCB) and benzodiazepines). The data of these patients were retrospectively collected and analyzed.

Results:

A total of 1117 patients were included in this study, with a BBPS scale from 0 to 9. A total of 2.41% (27/1117) colonoscopies were incomplete. The mean age of the patients were 58.6 years, 43.86% were male. The distribution of BBPS scale was 0 – 3 in 8.05% (90), 4 – 6 in 37.86% (423), and 7 – 9 in 54.07% (604) of the cases with a mean BBPS score of 6.8. From these 54.96% (614) were out-patients, 45.04% (503) in-patients, 14.05% (157) have presented with DM, 4.38% with neurological diseases, 8.77% (98) with previous colonic surgery, 4.38% (49) hypothyreodism, 12.98% (145) and 7.07% (79) was taking CCB and benzodiazepine, respectively.

Conclusions:

Some factors such as DM, neurological diseases, previous colonic surgery, and CCB medication could slightly lower the BBPS resulting in a poor quality of colonoscopic examination with possible missed lesions, while other factors like hypothyreodism and BMI have no influence on BBPS. To validate these results further prospective and larger cohort studies are needed.