General Endoscopy

42 - A Randomized Control Trial Comparing the Tolerance of Colon Prep: Same Day Colonoscopy Prep to Split Dose Prep for Afternoon Endoscopy

Tuesday, October 9
3:05 PM - 3:15 PM
Location: Terrace Ballroom 4 (level 400)

Category: General Endoscopy
Isabel Manzanillo-DeVore, DO1, Joshua A. Rosenbloom, DO2, Zuie Wakade, DO3, Olga Klyuchnikova, DO 1, Cale Sebald, DO1, Stephen Hoffman, DO 1, Ronald Rasansky, DO 1, Rene Peleman, MD 4
1Ascension St. John Providence, Madison Heights, MI; 2Gastro Center of Maryland, Columbia, MD; 3Ascension St. John Providence, Royal Oak, MI; 4Henry Ford, Clinton Township, MI

Award: Fellows-in-Training Award (General Endoscopy Category)

Introduction: Colonoscopies remain the most frequently used tool to screen for and diagnose serious conditions such as colorectal cancer, Inflammatory Bowel Disease, and diverticulitis. The current US Multi-Society Task Force on Colorectal Cancer recommendations and the American Society of Gastrointestinal Endoscopists (ASGE) recommendations indicate both split day and same day bowel prep as acceptable for colonoscopy. Recent studies have provided mixed results in determining one method superior to the other for morning procedures. A gap in research remains to determine the efficacy and compliance of prep methods for routine outpatient colonoscopies conducted during the afternoon. Informal polling at St. John Oakland Hospital suggested that same day prep may be preferred. The aim was to investigate whether same day bowel prep is better tolerated and more efficacious for afternoon colonoscopy procedures.

Methods: A randomized control trial of routine colonoscopy patients comparing same day or split bowel prep was conducted for afternoon colonoscopies. A standardized survey measured patient compliance, experience and tolerability of taking prep. The Boston Prep Score was used during the colonoscopy procedure to assess efficacy of the prep.

Results: A total of 262 patients’ data was analyzed, with 131 patients in the split day dosing arm, and 131 in the same day dosing arm. Our evaluation showed highly significant difference between the split dose and same day preparations within the context of the Boston Prep Score, ease of consumption, overall experience, and whether or not the patients would ask for the same colon preparation. The same day preparation showed statistically significant evidence of having higher objective and subjective efficacy in this study.

Discussion: This study was performed in the community- based hospital and revealed a significant difference in the efficacy of bowel cleansing and patient tolerance of the same day preparation. This information can provide valuable evidence to support same day bowel cleansing to improve the experience of patients and the quality of adenomatous detection.

Table 1. Same Day vs. Split Day dosing results

Disclosures:
Isabel Manzanillo-DeVore indicated no relevant financial relationships.
Joshua Rosenbloom indicated no relevant financial relationships.
Zuie Wakade indicated no relevant financial relationships.
Olga Klyuchnikova indicated no relevant financial relationships.
Cale Sebald indicated no relevant financial relationships.
Stephen Hoffman indicated no relevant financial relationships.
Ronald Rasansky indicated no relevant financial relationships.
Rene Peleman indicated no relevant financial relationships.

Isabel Manzanillo-DeVore

Ascension St. John Providence
Madison Heights, Michigan

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