Outcomes of Next-Day Versus Non-next-Day Colonoscopy After an Initial Inadequate Bowel Preparation

Christopher John Murphy, N. Jewel Samadder, Kristen Cox, Ronak Iqbal, Brian So, Daniel Croxford, John C. Fang

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Inadequate bowel preparation is the most common cause of failed colonoscopy, and repeat failure occurs in more than 20 % of follow-up attempts. Limited data suggest that next-day follow-up may reduce the risk for repeat inadequate preparation. Objective: Evaluate differences in prep quality with next-day follow-up after initial inadequate preparation. Design: Retrospective study. Setting: Academic center. Patients: Outpatient screening and surveillance colonoscopies between 7/2002 and 6/2007. Intervention: Comparison of next-day versus any other day (“non-next-day”) repeat colonoscopy outcomes. Main Outcome Measurements: Aronchick scale, polyp and adenoma detection rates. Results: Of 20,798 initial colonoscopies, 857 (4.1 %) had inadequate preparation. 460 (54 %) were lost to follow-up. One hundred and fourteen (13 %) had next-day and 283 (33 %) had non-next-day colonoscopy with mean follow-up of 8.8 months. On follow-up examination, 29.8 % of next-day and 23.3 % of non-next-day colonoscopies had inadequate bowel preparation (p = 0.48). The adenoma detection rate for the next-day group improved from 3.5 to 38.6 % on follow-up, compared to 20.5 and 36.8 % in the non-next-day group. There was no significant difference between groups in detection of total adenoma (p = 0.73) or advanced adenomas (p = 0.20) on follow-up examinations. Limitations: Retrospective design, differences in baseline colonoscopy characteristics. Conclusion: The results confirm the need for repeat examination after a colonoscopy with inadequate bowel prep, as there was substantial increase in adenoma detection on follow-up. There were no differences in outcomes between next-day versus non-next-day colonoscopy. These data support repeating after inadequate colonoscopy within 1 year as convenient for patient and physician.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalDigestive diseases and sciences
Volume61
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Colon cancer screening
  • Colonoscopy
  • Colonoscopy preparation
  • Inadequate bowel preparation

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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