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

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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.

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Abbreviations

CRC:

Colorectal cancer

OR:

Odds ratio

US-MSFT:

US multi-society task force

PDR:

Polyp detection rate

PPP:

Polyps per procedure

ADR:

Adenoma detection rate

APP:

Adenomas per procedure

PEG:

Polyethylene glycol

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Authors and Affiliations

  1. University of Utah Health Sciences Center, Salt Lake City, UT, USA

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

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  1. Christopher John Murphy
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  2. N. Jewel Samadder
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  3. Kristen Cox
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  4. Ronak Iqbal
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  6. Daniel Croxford
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Correspondence to John C. Fang.

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Murphy, C.J., Jewel Samadder, N., Cox, K. et al. Outcomes of Next-Day Versus Non-next-Day Colonoscopy After an Initial Inadequate Bowel Preparation. Dig Dis Sci 61, 46–52 (2016). https://doi.org/10.1007/s10620-015-3833-3

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  • DOI: https://doi.org/10.1007/s10620-015-3833-3

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