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Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease - 21/01/19

Doi : 10.1016/j.gie.2018.09.039 
Bryant Megna, MD 1, Jennifer Weiss, MD, MS 2, Dana Ley, MD 1, Sumona Saha, MD, MS 2, Patrick Pfau, MD 2, Ian Grimes, MD, MS 2, Zhanhai Li, PhD 3, Freddy Caldera, DO, MS 2,
1 University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA 
2 Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA 
3 Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA 

Reprint requests: Freddy Caldera, DO, MS, 1685 Highland Avenue, Madison, WI 53705-2281.1685 Highland AvenueMadisonWI53705-2281

Abstract

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 logistic regression was used to establish odds ratios of successful completion of CE.

Results

Eighty-eight patients with IBD were enrolled. We found that patients who did not follow a clear liquid diet before colonoscopy had much lower odds of being able to undergo CE (odds ratio, 0.106; 95% confidence interval, 0.013-0.845; P < .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 the 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 that patients follow a clear liquid diet the entire day before their examination.

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Abbreviations : BBPS, BMI, CE, CI, CRC, IBD, OR, SCENIC


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 DISCLOSURE: Dr Saha is a consultant with UCB Biosciences. All other authors disclosed no financial relationships relevant to this publication.
 If you would like to chat with an author of this article, you may contact Dr Caldera at fcaldera@medicine.wisc.edu.


© 2019  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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