EGD-assisted Bowel Preparation for Colonoscopy

Study Overview
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Brief Summary
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Adequate bowel preparation is of critical importance for colonoscopy. Particularly among hospitalized patients, inadequate bowel preparation for colonoscopy may arise due to patient intolerance to prescribed laxative regimen, elderly population, and co-existing conditions that impair the ability to ingest a large-volume laxative regimen. Improvements in bowel preparation for colonoscopy in hospitalized patients would likely improve patient care and reduce hospital costs. The purpose of this study is to determine if administering a portion of the bowel purgative via EGD could improve colonoscopy preparation in hospitalized patients.

Detailed Description
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In this randomized controlled trial in hospitalized patients, patients in whom colonoscopy was anticipated the day following EGD were consented and randomized to either standard prep by mouth (split-dose PEG) or intervention group (instillation of the first 2 liters of Nulytely solution through the channel of the endoscope into the duodenal bulb, then continue standard prep). Data is collected on quality of prep and patient satisfaction in both groups.

Official Title
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EGD-assisted Bowel Preparation for Colonoscopy

Conditions
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Esophagoscopy Techniques, Colonoscopy

Intervention / Treatment
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* Procedure: EGD-assisted administration of colonoscopy prep
* Procedure: Control Group received standard prep by oral administration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: hospitalized patients having EGD and expected to have colonoscopy the following day written informed consent Exclusion Criteria: unable to tolerate EGD-assisted prep administration
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: EGD-assisted colonoscopy prep<br>2 liters of polyethylene glycol instilled through the channel of the endoscope during EGD when colonoscopy expected the following day. Patients follow a clear liquid diet, then ingest an addition 1 liter polyethylene glycol 4 hours prior to colonoscopy. Patients are also given a tap water enema 1 hour prior to colonoscopy. | Procedure: EGD-assisted administration of colonoscopy prep<br>* Interventional group receive the first 2 liters of prep solution during EGD through the scope channel if colonoscopy expected the following day.<br>|
| Active Comparator: Standard Colonoscopy Prep<br>Split-dose polyethylene glycol (2 liters pm prior to colonoscopy, 1 liter 4 hours prior to colonoscopy)), clear liquid diet, metoclopramide 10 mg IV 30 minutes prior to procedure, tap water enema 1 hr prior to colonoscopy | Procedure: Control Group received standard prep by oral administration<br>* Control group receive standard oral colonoscopy prep.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of bowel preparation | Quality of prep was assessed using the Ottawa bowel preparation scale (Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest endosc 2004;59:482-6) | Twenty four to 48 hours - from time of consent prior to EGD until end of colonoscopy performed the following day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient tolerance of bowel preparation | Patients in both groups were asked to indicate if the bowel prep was easy, slightly difficult, moderately difficult, extremely difficult, or if they were unable to complete the prep as directed. | administered just prior to sedation for colonoscopy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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colonoscopy, bowel preparation, tolerability, EGD-assisted