None listed
Conditions
Brief summary
Poor bowel preparation is common in inflammatory bowel disease (IBD) and can lead to incomplete colonoscopic assessments and missed pathology. As such the patients are required to undergo either a second colonoscopy or earlier surveillance colonoscopies. This creates cumulative risks of colonoscopies (double the anesthetic and procedural risks), increased burden to the health care system (extra resources and colonoscopy spots used that could be used by other patients) and the patient (more inconvenience of further bowel prep and missed work for the procedure) as well as financial costs both to the health care system as well as the patient in multiple ways. Being able to assess the patient's bowel preparation before giving them anaesthetic and more importantly, being able to know their prep is poor and given them extra bowel prep and have their procedure delayed by a few hours (put at the end of the endoscopy list) would be of huge benefit for both the patient and the health care system. Our aim is to show that randomisation to the rapid ultrasound assessment (no radiation and no risks to the patient) that focuses on a few specific areas of the bowel to assess bowel preparation quality and allow for intervention (extra bowel prep) if required will be superior to the current standards (no ultrasound assessment) and can avoid the detrimental effects of poor bowel prep.
Interventions
Whether transabdominal ultrasound can accurately assess bowel preparation quality will be determined with our other observational trial (PAUSE). This part of the trial (RCT) will have two groups of patients scheduled for colonoscopies (who have followed their written and verbal standard bowel preparation instructions): 1)those that will go ahead with their colonoscopies without ultrasound assessment (control) and 2) those that will have transabdominal ultrasound assessment (30minutes prior to th
Whether transabdominal ultrasound can accurately assess bowel preparation quality will be determined with our other observational trial (PAUSE). This part of the trial (RCT) will have two groups of patients scheduled for colonoscopies (who have followed their written and verbal standard bowel preparation instructions): 1)those that will go ahead with their colonoscopies without ultrasound assessment (control) and 2) those that will have transabdominal ultrasound assessment (30minutes prior to their colonoscopy, a focused transabdominal ultrasound to assess bowel preparation quality will be performed) and If needed (poor or inadequate bowel preparation as per their ultrasound score- score 0, 1 or 2 - similar to Boston Bowel prep lower scores are worse prep) one extra bowel cleanse (small volume oral bowel cleanse (as per treating clinician discretion) such as Picoprep: Sodium picosulfate; Magnesium oxide; Citric acid) will be had right away and 4 hours later the colonoscopy (intervention).
Sponsors
Concord Hospital Gastroenterology Department
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
English speaking, Have followed the standard bowel cleansing instructions prior to their colonoscopy, Have inflammatory Bowel Disease (such as Crohn's disease or ulcerative colitis).
Exclusion criteria
Cannot understand or give informed consent. Self reported bowel preparation quality is poor.
Outcome results
None listed