Abstract
Background
During bowel preparation for colonoscopy, stools transition from solid to watery.
In Japan, toilets typically offer large and small flush options. This study aimed
to evaluate whether encouraging the use of small flushes for watery stools could reduce
water consumption.
Methods
This single-center prospective observational study included a total of 220 patients
undergoing colonoscopy. Over 10 months, 111 patients who received standard instructions
during the early period of the study, before the intervention, formed the pre-intervention
water-usage (PW) group, while 109 patients in the later period of the study who received
the interventional infographic poster promoting small flushes formed the green water-usage
(GW) group.
Results
The GW group had significantly lower median (interquartile range) total water usage
for bowel preparation (31.5 L [27.9–39.6]) compared with the PW group (35.0 L [30.4–44.6];
P = 0.002), suggesting a reduction of approximately 3.5 L per colonoscopy. No significant
differences were observed in fluid intake or bowel cleansing quality.
Conclusions
The educational poster intervention promoting appropriate flush selection during bowel
preparation may be a simple option for reducing water consumption, leading to greener
endoscopy.
