AN 18 MONTH REVIEW OF BOWEL PREPARATION QUALITY AMONG IN-PATIENT LEFT-SIDED COLONOSCOPIES

Aims Left-sided colonoscopies (LCs) are commonly performed for investigation of lower gastrointestinal symptoms such as fresh rectal bleeding among in-patients. Their success depends on effective cleansing of the bowel contents usually with a laxative enema. This study aimed to assess the quality of bowel preparation reported on all in-patient LCs performed over an 18-month period in MMUH.

Methods A retrospective chart review of all in-patient LC reports at MMUH from January 2020 – May 2021. Preparation quality was defined by the automatic reporting parameters of either “excellent/good”, “adequate/satisfactory”, “poor” or “failed due to poor prep” as entered on the Endorad reporting system.

Results 321 in-patient LCs were performed in the stated timeframe at MMUH. The most common method of bowel preparation was phosphate enema, used in 79.8% of LCs. The reported quality of bowel preparation across all LCs showed 20.9% as “excellent/good”, 48.3% as “adequate/satisfactory”, 28.3% as “poor”, and 2.5% as “failed due to poor prep”. Therefore 69.2% of LCs were adequate/satisfactory or above. 4.1% of all LCs were booked for repeat due to inadequate bowel preparation.

Conclusions This study showed that>1/3 of in-patient LCs had poor preparation or failed due to poor preparation. Given the intercurrent pressures on endoscopy waiting lists, this is an area which could be targeted for improvement to avoid further investigations. Rigorous patient pre-assessment for fitness for procedure and adequate evaluation of response to initial enema with a view to repeating preparation if inadequate response are two such methods which could be implemented.

Publication History

Article published online:
14 April 2022