The following is a summary of “Risk Factors for Inadequate Bowel Preparation in Colonoscopy: A Comprehensive Systematic Review and Meta-Analysis,” published in the December 2024 issue of Gastroenterology by Beran et al.
Inadequate bowel preparation (IBP) before colonoscopy is a common issue that can impact the quality of the procedure and outcomes. Identifying risk factors can help improve preparation methods.
Researchers conducted a retrospective study to identify risk factors for IBP in colonoscopy.
They searched multiple databases for studies reporting adjusted odds ratios (OR) for risk factors of IBP. A random-effects model was used, and pooled ORs were calculated for risk factors found in at least 3 studies.
The results showed 154 studies with 358,257 participants, sociodemographic factors associated with IBP included Medicaid insurance, obesity, tobacco use, age 65 years or older, Black race, low education level, male sex, and unmarried status. Comorbidities like psychiatric diseases, cirrhosis, American Society of Anesthesiologists (ASA) class 3 or higher, poor functional status, constipation, diabetes, previous abdominal surgery, and hematochezia also predicted IBP. Medication-related factors included tricyclic antidepressants, antidepressants, opioids, and calcium channel blockers. Procedure-related factors included incomplete bowel preparation, lack of split-dose preparation, and nonadherence to dietary instructions. After subgroup analysis of prospective studies, no significant association was found with afternoon colonoscopy.
They concluded that sociodemographic, comorbidity, medication, and procedure-related factors contribute to IBP in colonoscopy. Identifying these risk factors could improve outcomes and reduce healthcare costs.
Source: journals.lww.com/ajg/fulltext/2024/12000/risk_factors_for_inadequate_bowel_preparation_in.16.aspx
