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bowel preparation experiences and needs before follow-up colonoscopy in older adult postoperative colorectal cancer patients: A qualitative study

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2968-2978页

作者： Bin He Yi Xin Rui Li Fu-Cai Lin Guang-Ming Zhang Hai-Jing Zhu Wuxi Medical College The Jiangnan UniversityWuxi 214122Jiangsu ProvinceChina Department of Nursing The Tongren Hospital Shanghai Jiao Tong University School of MedicineShanghai 200335China Department of Anesthesiology The Tongren Hospital Shanghai Jiao Tong University School of MedicineShanghai 200335China Department of Endoscopy The Tongren Hospital Shanghai Jiao Tong University School of MedicineShanghai 200335China

BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the ***-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)*** studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel ***,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC *** To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up *** Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November *** phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the ***'s seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview *** The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'kn

关键词： Older people Colorectal cancer Colonoscopy bowel preparation Health promotion Nursing Qualitative research

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Research Progress of bowel preparation for Colonoscopy

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Journal of Biosciences and Medicines 2024年第5期12卷 10-18页

作者： Yongquan Huang Xiaoping Tan Medical College of Yangtze University Jingzhou China Department of Gastroenterology Zhuhai Fifth People&#8217s Hospital Zhuhai China

Colorectal cancer ranks third in the global cancer data in 2020. Colorectal scope is the most effective method to diagnose colorectal diseases such as benign and malignant colorectal tumors. The poor quality of intestinal preparation causes an increased rate of missed diagnosis of colorectal tumors, reduces the rate of cecal intubation for colorectal examination, increases the discomfort, and reduces the compliance of re-examination. Therefore, we should try our best to improve the quality of intestinal preparation. This study reviewed the latest advances related to the preoperative preparation for colonoscopy. Recent research shows that smartphone apps can provide more detailed education and guidance on bowel preparation;Pre-packaged foods are more suitable as a way to eat before colonoscopy. The use of smaller doses, better taste of cathartic agents, and some auxiliary measures, combined with the patient’s situation to provide personalized intestinal preparation measures to improve the quality of intestinal preparation. Starting from the quality of colonoscopy bowel preparation, continuous improvement of patients’ tolerance to bowel preparation, continuous improvement of bowel preparation plan based on individual factors’ needs, and better communication with examined subjects by using existing scientific information technology, may be the hot spot of colonoscopy bowel preparation research in the next few years.

关键词： Colonoscopy bowel preparation Preoperative Education Quality of bowel preparation Polyethylene Glycol

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Magnesium citrate with a single dose of sodium phosphate for colonoscopy bowel preparation

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World Journal of Gastroenterology 2011年第2期17卷 242-248页

作者： Yong Sung Choi Jung Pil Suh Jong Kyu Kim In Taek Lee Eui Gon Youk Doo Seok Lee Do Sun Kim Doo Han Lee Department of Gastroenterology Daehang Hospital Department of Surgery Daehang Hospital

AIM:To evaluate the efficacy and acceptability of magnesium citrate and a single dose of oral sodium phosphate(45 mL) solution for morning colonoscopy bowel preparation. METHODS:A total of 159 patients were randomly assigned to receive two split doses of 90 mg of sodium phosphate(GroupⅠ,n=79) or magnesium citrate(250 mL,the day before the procedure) followed by 45 mL of sodium phosphate(the day of procedure,GroupⅡ,n= 80) .The quality of bowel cleansing and the acceptability of each regimen were compared,including the satisfaction,taste,willing to repeat and adverse effects of each regimen. RESULTS:The quality of bowel cleansing of GroupⅡ was as good as that of GroupⅠ(An Aronchick scale score of good or excellent:70.9%vs 81.0%,respectively,P=0.34;the Ottawa system score:4.4±2.6 vs 3.8 ±3.0,respectively,P=0.76) .There was no statisticallysignificant difference between both groups with regard to acceptability,including the satisfaction,taste and willingness to repeat the regimen.A significantly greater number of older patients(over 65 years old) in Group Ⅱgraded the overall satisfaction as satisfactory(48.1% vs 78.1%,respectively;GroupⅠvs GroupⅡ,P=0.01) . There were no significant adverse reactions. CONCLUSION:Magnesium citrate and a single dose of sodium phosphate was as effective and tolerable as the conventional sodium phosphate regimen and is a satisfactory option.

关键词： Colonoscopy bowel preparation Efficacy Acceptability Magnesium citrate Sodium phosphate

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Effect of small bowel preparation with simethicone on capsule endoscopy

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2009年第1期10卷 46-51页

作者： You-hong FANG Chun-xiao CHEN Bing-ling ZHANG The Children's Hospital School of Medicine Zhejiang University Hangzhou 310003 China Department of Gastroenterology the First Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310003 China

Background： Capsule endoscopy is a novel non-invasive method for visualization of the entire small bowel. The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. To date, there is no standardized protocol for bowel preparation before capsule endoscopy. The addition of simethicone in the bowel preparation for the purpose of reducing air bubbles in the intestinal lumen had only been studied by a few investigators. Methods： Sixty-four participants were randomly divided into two groups to receive a bowel preparation of polyethylene glycol （PEG） solution （Group 1） and both PEG solution and simethicone （Group 2）. The PEG solution and sime- thicone were taken the night before and 20 rain prior to capsule endoscopy, respectively. Frames taken in the small intestine were examined and scored for luminal bubbles by two professional capsule endoscopists. Gastric emptying time and small bowel transit time were also recorded. Results： Simethicone significantly reduced luminal bubbles both in the proximal and distal small intes- tines. The mean time proportions with slight bubbles in the proximal and distal intestines in Group 2 were 97.1% and 99.0%, respectively, compared with 67.2% （P〈0.001） and 68.8% （P〈0.001） in Group 1. Simethicone had no effect on mean gastric emptying time, 32.08 rain in Group 2 compared with 30.88 min in Group 1 （P=0.868）, but it did increase mean small intestinal transit time from 227.28 to 281.84 rnin （P=0.003）. Conclusion： bowel preparation with both PEG and simethicone significantly reduced bubbles in the intestinal lumen and improved the visualization of the small bowel by capsule endoscopy without any side effects observed.

关键词： Capsule endoscopy bowel preparation Simethicone Polyethylene glycol (PEG) Visualization Air bubbles

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Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation

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World Journal of Gastroenterology 2009年第24期15卷 3032-3037页

作者： Sasinee Tongprasert Abhasnee Sobhonslidsuk Sasivimol Rattanasiri Division of Gastroenterology Department of MedicineFaculty of Medicine Ramathibodi HospitalMahidol University Clinical Epidemiological Unit Faculty of Medicine Ramathibodi HospitalMahidol University

AIM： To evaluate the effectiveness of simethicone in enhancing visibility and efficacy during colonoscopy.METHODS： A prospective, double-blind, randomized, placebo-controlled study was conducted. One hundred and twenty-four patients were allocated to receive 2 doses of sodium phosphate plus 240 mg of tablet simethicone or placebo as bowel preparation. Visibility was blindly assessed for the amount of air bubbles and adequacy of colon preparation. Total colonoscopic time, side effects of the medication, endoscopist and patient satisfaction were also compared.RESULTS： Sodium phosphate plus simethicone, compared to sodium phosphate plus placebo, improved visibility by diminishing air bubbles （100.00% vs 42.37%, P 〈 0.0002） but simethicone failed to demonstrate improvement in adequacy of colon preparation （90.16% vs 81.36%, P = 0.17）. Endoscopist and patient satisfaction were increased significantly in the simethicone group. However, there was no difference in the total duration of colonoscopy and side effects of the medication.CONCLUSION： The addition of simethicone is of benefit for colonoscopic bowel preparation by diminishing air bubbles, which results in enhanced visibility. Endoscopist and patient satisfaction is also increased.

关键词： Simethicone Colonoscopy bowel preparation

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Randomized clinical trial comparing fixed-time split dosing and split dosing of oral Picosulfate regimen for bowel preparation

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World Journal of Gastroenterology 2017年第32期23卷 5986-5993页

作者： Jae Hyuck Jun Koon Hee Han Jong Kyu Park Hyun Il Seo Young Don Kim Sang Jin Lee Baek Gyu Jun Min Sik Hwang Yoon Kyoo Park Myeong Jong Kim Gab Jin Cheon Department of Internal Medicine Gangneung Asan Hospital University of Ulsan College of Medicine Catholic Kwandong University

AIM To compare the efficacy of fixed-time split dose and split dose of an oral sodium picosulfate for bowel *** This is study was prospective, randomized controlled study performed at a single Institution(2013-058). A total of 204 subjects were assigned to receive one of two sodium picosulfate regimens(i.e., fixed-time split or split) prior to colonoscopy. Main outcome measurements were bowel preparation quality and subject *** There was no statistical difference between the fixedtime split dose regimen group and the split dose regimen group(Ottawa score mean 2.57 ± 1.91 vs 2.80 ± 2.51, P = 0.457). Cecal intubation time and physician's satisfaction of inspection were not significantly different between the two groups(P = 0.428, P = 0.489). On subgroup analysis, for afternoon procedures, the fixed-time split dose regimen was equally effective as compared with the split dose regimen(Ottawa score mean 2.56 ± 1.78 vs 2.59 ± 2.27, P = 0.932). There was no difference in tolerability or compliance between the two groups. Nausea was 21.2% in the fixed-time split dose group and 14.3% in the split dose group(P = 0.136). Vomiting was 7.1% and 2.9%(P = 0.164), abdominal discomfort 7.1% and 4.8%(P = 0.484), dizziness 1% and 4.8%(P = 0.113), cold sweating 1% and 0%(P = 0.302) and palpitation 0% and 1%(P = 0.330), respectively. Sleep disturbance was two(2%) patients in the fixed-time split dose group and zero(0%) patient in the split dose preparation(P = 0.143) *** A fixed-time split dose regimen with sodium picosulfate is not inferior to a split dose regimen for bowel preparation and equally effective for afternoon colonoscopy.

关键词： Colonoscopy bowel preparation Split dose preparation Sodium picosulfate Ottawa bowel preparation Scale

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Same-day single-dose vs large-volume split-dose regimens of polyethylene glycol for bowel preparation:A systematic review and meta-analysis

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World Journal of Clinical Cases 2022年第22期10卷 7844-7858页

作者： Hui Pan Xiao-Ling Zheng Chao-Ying Fang Lan-Zai Liu Jian-Su Chen Chao Wang Yu-Dai Chen Jian-Min Huang Yu-Shen Zhou Li-Ping He Gastrointestinal Endoscopy Center Fujian Provincial HospitalThe Shengli Clinical Medical CollegeFujian Medical UniversityFuzhou 350001Fujian ProvinceChina Gastrointestinal Endoscopy Center Fujian Provincial Hospital South BranchFuzhou 350001Fujian ProvinceChina

BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep disturbance associated with night ***,the same-day single-dose regimens(SSDs)of PEG has been recommended as an alternative;however,its superiority compared to other regimens is a matter of *** To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel *** We searched MEDLINE/PubMed,the Cochrane Library,RCA,EMBASE and Science Citation Index Expanded for randomized trials comparing(2 L/4 L)SSDs to large-volume(4 L/3 L)SpDs PEG-based regimens,regardless of adjuvant laxative *** pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness,sleep disturbance,willingness to repeat the procedure using the same preparation and adverse effects.A random effects model or fixed-effects model was chosen based on heterogeneity analysis among *** A total of 18 studies were *** was no statistically significant difference of adequate bowel preparation(relative risk=0.97;95%CI:0.92-1.02)(14 trials),right colon Boston bowel preparation Scale(mean difference=0.00;95%CI:-0.04,0.03)(9 trials)and right colon Ottawa bowel preparation Scale(mean difference=0.04;95%CI:-0.27,0.34)(5 trials)between(2 L/4 L)SSDs and large-volume(4 L/3 L)SpDs,regardless of adjuvant laxative *** pooled analysis favored the use of SSDs with less sleep disturbance(relative risk=0.52;95%CI:0.40,0.68)and lower incidence of abdominal pain(relative risk=0.75;95%CI:0.62,0.90).During subgroup analysis,patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation than SpDs(P0.05).CONCLUSION Regardless of adju

关键词： bowel preparation Colonoscopy Polyethylene glycol Same-day single-dose Split-dose Metaanalysis

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Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients:Evidence from the literature

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World Journal of Gastroenterology 2023年第11期29卷 1685-1707页

作者： Endrit Shahini Emanuele Sinagra Alessandro Vitello Rocco Ranaldo Antonella Contaldo Antonio Facciorusso Marcello Maida Gastroenterology Unit National Institute of Gastroenterology-IRCCS“Saverio de Bellis”Castellana GrotteBari 70013Italy Gastroenterology and Endoscopy Unit Fondazione Istituto G.GiglioCefalù90015Italy Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy Department of Internal Medicine “Mazzolani-Vandini”HospitalDigestive EndoscopyFerrara 744011Italy Gastroenterology Unit National Institute of Gastroenterology“S de Bellis”Research HospitalBari 70013Italy Department of Medical Sciences University of FoggiaSection of GastroenterologyFoggia 71122Italy

Adequate bowel cleansing is critical for a high-quality colonoscopy because it affects diagnostic accuracy and adenoma ***,almost a quarter of procedures are still carried out with suboptimal preparation,resulting in longer procedure times,higher risk of complications,and higher likelihood of missing *** guidelines recommend high-volume or low-volume polyethylene glycol(PEG)/non-PEG-based split-dose *** patients who have had insufficient bowel cleansing,the colonoscopy should be repeated the same day or the next day with additional bowel cleansing as a salvage option.A strategy that includes a prolonged low-fiber diet,a split preparation regimen,and a colonoscopy within 5 h of the end of preparation may increase cleansing success rates in the ***,even though no specific product is specifically recommended in the other cases for difficult-to-prepare patients,clinical evidence suggests that 1-L PEG plus ascorbic acid preparation are associated with higher cleansing success in hospitalized and inflammatory bowel disease *** with severe renal insufficiency(creatinine clearancebowel preparation,especially in patients undergoing resection of left colon lesions,where intestinal preparation has a poor *** purpose of this review was to summarize the evidence on the risk factors influencing the quality of bowel cleansing in difficult-to-prepare patients,as well as strategies to improve colonoscopy preparation in these patients.

关键词： Colorectal cancer Colonoscopy Adenoma detection rate bowel preparation Polyethylene glycol

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Low-volume plus ascorbic acid vs high-volume plus simethicone bowel preparation before colonoscopy

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World Journal of Gastroenterology 2011年第42期17卷 4689-4695页

作者： Stefano Pontone Rita Angelini Monica Standoli Gregorio Patrizi Franco Culasso Paolo Pontone Adriano Redler Department of Surgical Sciences "Sapienza" University of Rome Department of Medical Statistics "Sapienza"University of Rome

AIM： To investigate the effectiveness of low-volume plus ascorbic acid [polyethylene glycol plus ascorbic acid （PEG ＋ Asc）] and high-volume plus simethicone [polyethylene glycol plus simethicone （PEG ＋ Sim）] bowel preparations. METHODS： A total of one hundred and forty-four outpatients （76 males）, aged from 20 to 84 years （median age 59.5 years）, who attended our Department, were divided into two groups, age and sex matched, and underwent colonoscopy. Two questionnaires, one for patients reporting acceptability and the other for endoscopists evaluating bowel cleansing effectiveness according to validated scales, were completed. Indications, timing of examination and endoscopical findings were recorded. Biopsy forceps were used as a measuring tool in order to determine polyp endoscopic sizeestimation. Difficulty in completing the preparation was rated in a 5-point Likert scale （1 = easy to 5 = unable）. Adverse experiences （fullness, cramps, nausea, vomiting, abdominal pain, headache and insomnia）, number of evacuations and types of activities performed during preparation （walking or resting in bed） were also investigated. RESULTS： Seventy-two patients were selected for each group. The two groups were age and sex matched as well as being comparable in terms of medical history and drug therapies taken. Fourteen patients dropped out from the trial because they did not complete the preparation procedure. Ratings of global bowel cleansing examinations were considered to be adequate in 91% of PEG ＋ Asc and 88% of PEG ＋ Sim patients. Residual Stool Score indicated similar levels of amount and consistency of residual stool; there was a significant difference in the percentage of bowel wall visualization in favour of PEG ＋ Sim patients. In the PEG ＋ Sire group, 12 adenomas≤ 10 mm diameter （5/left colon ＋ 7/right colon） vs 9 （8/left colon ＋ 1/right colon） in the PEG ＋ Asc group were diagnosed. Visualization of small lesions seems to be one of the primary advantages of the PEG

关键词： bowel preparation Polyethylene glycol Ascorbic acid Colonoscopy Simethicone

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Effect of quality of bowel preparation on quality indicators of adenoma detection rates and colonoscopy completion rates

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Gastroenterology Report 2016年第2期4卷 148-153,I0003页

作者： Tarun Rai Udayakumar Navaneethan Tushar Gohel Amareshwar Podugu Prashanthi N.Thota Ravi P.Kiran Rocio Lopez Madhusudhan R.Sanaka Digestive Disease Institute The Cleveland ClinicClevelandOHUSA

Background and aim:Adequate bowel preparation is important for safe and effective *** indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at least 25%in average-risk men and 15%in average-risk women aged over *** aim was to investigate the impact of bowel preparation on ADR and colonoscopy completion ***:This retrospective cohort study included patients who underwent colonoscopy between January 2008 and December *** main outcome measurements were ADR and colonoscopy completion rates to the ***:A total of 2519 patients was included;1030(41.0%)had excellent preparation,1145(45.5%)good-,240(9.5%)fair-,and 104(4.1%)poor *** completion rates were significantly lower in patients with poor or fair preparation(72.1%and 75.4%,respectively)than in those with good and excellent preparation(99.7%and 99.9%,respectively;Ppreparation(excellent,good,fair and poor)at 24.2%vs.26.8%vs.32.1%vs.22.1%,respectively;P¼*** the groups had ADR above the QI(25%for men and 15%for women)with evidence of significantly higher ADR in the women with excellent or good preparation and in men with excellent,good or fair *** multivariate analysis,male gender was significantly associated with increased ADR(Pbowel preparation did not influence ***:Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good ***,there was no difference in ADR between the different grades of preparation.

关键词： bowel preparation adenoma detection rate colonoscopy completion rate quality indicators

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