Patienten die opgenomen worden voor klinische voorbereiding voor een colonoscopie, ongeacht aandoening Colon adenomas Intestinal polyps
Conditions
Interventions
Patients who receive polyethylene glycol preparation will receive a regimen
according to standard care in the Elisabeth-TweeSteden Hospital at the
Gastroenterology Ward. The regimen is as follows: f
Colonoscopy
Polyethylene glycol
Preparation
Sponsors
TweeSteden ziekenhuis
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: All adults (> 18 years of age) seen at the outpatient clinic to be admitted for planned preparation for colonoscopy at the Elisabeth-TweeSteden Hospital in Tilburg were eligible for inclusion in this study.
Exclusion criteria
Exclusion criteria: Gastro-intestinal obstruction Bowel perforation Gastric outlet obstruction Toxic colitis or toxic megacolon Hyperemesis Severe dehydration Congestive heart failure Ascites Severe kidney insufficientie (GFR
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measures for this study are the quality of bowel preparation measured using the Boston Bowel Preparation Scale (BBPS), amount of preparatory regimen received on the ward, and adenoma detection rate. The BBPS is a validated scale which applies a four-point scoring system to each of the three regions of the colon, namely the right colon (including cecum and ascending colon), the transverse colon (including the hepatic and splenic flexures), and the left colon (including the descending colon, sigmoid colon and the rectum). A score of 0 is assigned to an unprepared colon segment with mucosa that was not seen due to solid stool which was unable to be cleared. A point of 1 is assigned to mucosa which can be partially seen, where a portion of the mucosa segment was observed, but other areas of the colon segment could not be seen due to staining, residual stool and/or opaque liquid. A score of 2 is attributed when a minor amount of residual staining is present, with small fragments of stool and/or opaque liquid, but the mucosa of the colon segment was able to be seen well. Finally, a score of 3 is accredited to bowel preparation in which the entire mucosa of the colon segment is seen well, with no residual staining, small stool fragments or opaque liquid. Each region as described above receives a score between 0 and 3 and are summed to a total BBPS score ranging between 0 and 9 (Lai et al 2009). Adenoma detection rates are determined according to diagnosis by pathological evaluation. Adenomas will be classified following the guidelines of the European Society of Gastrointestinal Endoscopy (ESGE). The adenoma detection rate is defined as the proportion of patients with diagnosis of at least one adenomatous lesion. Polyp detection rate will also be recorded, as well as the number of polyps removed during endoscopy. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcome measures are: kidney function measured using blood tests, cecal intubation, the amount of preparatory regimen required in Liters, adverse side-effects (including disturbed sleep), patient rating of their experience with the preparatory regimen, the need for a nasal gastric tube, and the amount of laxative regime required Cecal intubation will be noted at endoscopy and recorded as an outcome measure to evaluate the quality of colonoscopy. Furthermore, patient experience of the bowel preparation will be assessed using a questionnaire administered following endoscopy at the first following out-patient visit. Patients will grade their experience of bowel preparation, and will be asked to report on any adverse events experienced, as well as disturbed sleep during the bowel preparation period. Furthermore, kidney function will be assessed using blood tests before and after drinking of the preparatory regimen. The amount of preparatory regimen required for adequate bowel cleansing, as evaluated by an experienced ward nurse, will be analysed and compared across intervention groups. Furthermore, if patients required administration of the preparatory regimen via a nasal-gastric tube, this will also be included as a secondary outcome parameter. Finally, blood tests will be performed before and after bowel preparation and colonoscopy, to evaluate kidney function and electrolytes, confirming that no significant change occurs in either parameter. | — |
Countries
The Netherlands
Outcome results
None listed