SAN DIEGO — Poor bowel preparation before colonoscopy influenced physicians to recommend follow-up colonoscopies 17 months sooner than they suggested for patients with adequate bowel preparation in a retrospective cohort study of 788 patients.
A 17-month shortening of the follow-up interval also occurred when colonoscopists found an adenoma, suggesting that colonoscopists considered the quality of bowel preparation to be an important factor when determining the follow-up interval, Dr. Veronika Karasek said in a poster presentation at the annual meeting of the American College of Gastroenterology.
The retrospective study included 788 patients with a mean age of 62 years and an average follow-up interval of 60 months. The follow-up interval was shortened by 2.5 months on average for each polyp found, and by 17.2 months on average if an adenoma was found, reported Dr. Karasek of the Veterans Affairs Medical Center, Phoenix and her colleagues. Adenomas were found in 42% of cases, and polyps were found in 60%. Colonoscopy detected a mean of 1.7 polyps per patient.
Bowel preparation was reported as adequate in 75% of colonoscopies. If bowel prep was inadequate, “17.1 months were subtracted from average follow-up time,” the authors said.
Good bowel preparation became more challenging in December 2008 when the Food and Drug Administration removed a commonly used, over-the-counter bowel preparation method containing Phospho-soda from the market.
In a separate poster at the meeting, two non–Phospho-soda bowel preparations for colonoscopy—an over-the-counter magnesium citrate solution or 2 L of polyethylene glycol plus ascorbic acid (MoviPrep)—provided good to excellent colon cleansing in a randomized pilot study of 87 patients.
The adequacy of bowel preparation was rated higher in patients who got the split-dose regimen, compared with whole-dose administration, reported Dr. Ron Palmon of Mount Sinai School of Medicine, New York, and his associates
Disclosures: Dr. Karasek reported having no relevant conflicts of interest related to her study. Dr. Palmon's study was funded by Salix Pharmaceuticals Ltd., which markets MoviPrep.
The quality of bowel preparation was seen as important for determining the follow-up interval.
Source DR. KARASEK