PHOENIX—While there is little doubt concerning the effectiveness of colonoscopy procedures to detect colon cancer, a new study presented at the American College of Gastroenterology’s 74th Annual Scientific Meeting in San Diego places new emphasis on the importance of adequate bowel preparation prior to procedure. The findings come at a time when clinicians are evaluating new bowel preparation solutions to replace the popular over the counter phosphosoda formulations recently withdrawn from the market.
In a retrospective study performed at the VA Medical Center in Phoenix, AZ, Dr. Nooman Gilani, Dr. Veronika Karasek and their team evaluated the impact of inadequate bowel preparation on the follow-up interval recommended by the endoscopist. After studying records on some 788 patients, the researchers concluded that inadequate bowel preparation by the patient before the procedure resulted in a recommended follow-up colonoscopy 17.1 months earlier than average. By comparison, finding an adenoma during the procedure resulted in a recommended follow-up examination 17.2 months earlier than average.
“Endoscopists’ ability to detect colonic legions, especially the flat or depressed ones, is greatly linked to the quality of bowel preparation. For years, we have emphasized the importance of adequate bowel preparation for patients to help ensure the detection of adenomas during colonoscopy, especially on the right side of the colon,” explains Dr. Karasek. “This new finding suggests that endoscopists are taking into consideration the quality of preparation when recommending a follow-up interval, regardless of the findings of the examination.
“Emphasizing better bowel preparation, and making it easier and more palatable for patients, may not only make colonoscopy less intimidating, for some it may mean an extra year and a half between follow-up procedures.”
