The impact of educational level on the adequacy of bowel preparation before colonoscopy

Year 2026, Volume: 7 Issue: 2, 369 - 374, 27.03.2026

Fırat Canlıkarakaya , Serhat Ocaklı , İbrahim Doğan , Sezai Kantar , Hüseyin Turap

https://izlik.org/JA25HE44UW

Abstract

Aims: Adequate bowel preparation is crucial for effective and accurate colonoscopy, which plays a key role in the early detection and treatment of colorectal cancer (CRC). However, inadequate preparation remains a common issue influenced by various factors. This study aims to evaluate the impact of patients’ educational level on the adequacy of bowel preparation prior to colonoscopy.
Methods: A total of 525 patients who underwent colonoscopy between January 1, 2024 and December 31, 2024 were evaluated retrospectively. The education levels of the patients were classified into 6 groups. Bowel preparation quality was assessed using the Marden Bowel Preparation Classification. p<0.05 was accepted as a statistically significant value.
Results: A total of 11 (2.1%) patients were in group 1, 39 (7.4%) were in group 2, 120 (22.9%) were in group 3, 170 (32.4%) were in group 4, 131 (25%) were in group 5, and 54 (10.3%) were in group 6. According to the Marden Bowel Preparation Classification, 75 (14.3%) were grade 4, 43 (8.2%) grade 3, 112 (21.3%) grade 2, and 295 (56.3%) grade 1. A statistically significant association between educational level and bowel preparation grade was observed in unadjusted analysis (Kruskal-Wallis test, p<0.001). Post-hoc pairwise comparisons (Dunn’s test with Bonferroni correction) showed no significant difference between groups 1-2 and groups 5-6 (p>0.05). However, in multivariable logistic regression analysis adjusted for age, sex, ASA score, comorbidity status, and colonoscopy indication, educational level was not an independent predictor of inadequate bowel preparation (Marden grade 4).
Conclusion: Although bowel preparation quality differed across educational groups in unadjusted analysis, educational level was not independently associated with inadequate bowel preparation after adjustment for potential confounders. These findings suggest that bowel preparation adequacy may be influenced by multiple clinical and demographic factors beyond educational level alone.

Keywords

Colonoscopy , bowel preparation , education level

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