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Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2018-10-16 , DOI: 10.1016/j.gie.2018.09.039
Bryant Megna , Jennifer Weiss , Dana Ley , Sumona Saha , Patrick Pfau , Ian Grimes , Zhanhai Li , Freddy Caldera

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.



中文翻译:

肠道准备前的流质饮食可预测炎症性肠病患者的成功内镜检查

背景和目标

与常规的白光内窥镜相比,内窥镜检查(CE)已显示出更高的诊断率和异常增生检出率,并且需要高质量的肠准备。这项研究的目的是确定炎症性肠病(IBD)患者进行CE的能力的预测因子。

方法

我们对正在接受CE的大肠癌监测检查的IBD患者进行了一项观察性研究。当日结肠镜检查用于收集患者和程序变量。多元逻辑回归用于建立成功完成CE的优势比。

结果

招募了88名IBD患者。我们发现,在结肠镜检查之前未遵循清洁流质饮食的患者进行CE的几率要低得多(优势比为0.106; 95%置信区间为0.013-0.845;P  < .034 )。此外,我们发现先前发现的肠道准备不足的危险因素(年龄较大,糖尿病史,制备溶液的时机和分装剂量,以及手术时间(AM或PM),长期麻醉药使用和便秘的历史)是与执行CE的能力无关。

结论

在手术前一整天接受清澈的流质饮食可高度预测执行CE的能力。但是,已建立的肠道准备不足的危险因素并未抑制我们人群中进行CE的能力。进行CE的内镜医师应考虑建议患者在检查前一整天都遵循清澈的流质饮食。

更新日期:2018-10-16
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