Compliance and Tolerance Level of Inpatients to Colonic Preparations Before Colonoscopy

Yıl 2011, , 135 - 139, 01.12.2011

Kübra Yetemen Görücü İhsan Uslan Gürsel Acartürk

https://doi.org/10.5505/sakaryamj.2011.64935

Cited By: 2

Öz

Objective: Colonoscopy is an important part of the management of colorectal diseases, and adequate preparation before a colonoscopy is required for the success of effective intervention. Bowel preparations of in hospitalized patients are less adequate than outpatients' preparations. It is not known the reasons of poor colonic preparations. In this study, we have investigated the factors causing inadequate bowel preparation in hospitalized patients underwent standard bowel preparation. Materials and Methods: The consecutive 66 patients scheduled for a colonoscopy and received liquid sodium phosphate for standard bowel preparation were included in the study. Before colonoscopy, the patients were surveyed associated with their demographic and clinical characteristics, and bowel preparation data. After the procedure, the patient's adequacy of bowel preparation for colonoscopy was evaluated by asking questions to the colonoscopist.Results: Of 66 patients, 23 were hospitalized patients and 43 were outpatients. Between the groups, while drug compliance was similar, compliance with clear liquid diet was better in outpatient setting (p 0.05). Adequate bowel preparation was lower in hospitalized patients than ambulatory patients, and only 6 inpatients had inadequate preparation. There was a negative correlation between inadequate bowel preparation and compliance to clear liquid diet (rho = -0,351, p = 0.004). Conclusion Bowel preparation is inadequate in hospitalized patients according to ambulatory patients. One of the reasons of inadequate bowel preparation in this group of patients seems to be incompliance to clear liquid diet. Therefore, the methods should be developed to increase patient compliance with clear diet.

Anahtar Kelimeler

Bowel preparation, inpatient, colonoscopy

Yatan Hastalarda Kolonoskopi Öncesi Barsak Hazırlığı Talimatlarına Hastaların Uyumu Ve Tolerans Düzeyi

Öz

Amaç: Kolorektal hastalıklarının tanı ve tedavisinde önemli yer tutan kolonoskopi işleminin başarısı için kolonoskopi öncesi barsak hazırlığının yeterli olması gereklidir. Hastanede yatan hastalarda barsak hazırlığı ayaktan hastalara göre daha yetersiz olup bunun nedenleri belirlenmiş değildir. Bu çalışmada; standart barsak hazırlığı uygulanan yatan hastalarda barsak hazırlığının yetersizliğine neden olan faktörleri araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya kolonoskopi planlanan ve barsak hazırlığı standart sıvı sodyum fosfat ile yapılan ardışık 66 hasta alındı. Kolonoskopi öncesi hastalara demografik, klinik ve barsak hazırlığına ilişkin verileri ile ilişkili anket yapıldı. İşlem sonrasında hastanın barsak hazırlığı yeterliliği için kolonoskopiyi yapan hekime yönelik sorularla değerlendirme yapıldı. Bulgular: 66 hastanın 23'ü yatan, 43'ü ayaktan tedavi gören hasta idi. Gruplar arasında hazırlık ilaçlarına uyum benzer iken ayaktan hastalarda berrak sıvı diyete uyum daha iyi idi (p0,05). Yatan hastalarda yeterli barsak hazırlığı ayaktan hastalara göre daha düşüktü ve sadece 6 yatan hastada yetersiz barsak hazırlığı saptandı. Yetersiz barsak hazırlığı ile berrak diyete uyum arasında negatif yönde bir ilişkili saptandı (rho= -0.351 p=0.004).Sonuç: Yatan hastalarda ayaktan hastalara göre barsak hazırlığı yetersizdir. Bu hasta grubunda yetersiz barsak hazırlığı nedenlerinden biri berrak diyete uyumsuzluk olarak gözükmektedir. Bu nedenle, yatan hastanın berrak diyete uyumunu artırıcı yöntemler geliştirilmelidir.

Anahtar Kelimeler

barsak hazırlığı, yatan hasta, kolonoskopi

Kaynakça

• Froehlich F, Wietlisbach V, Gonvers JJ, Burnand B, Vader JP. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005;61:378-84.
• Rex DK, Imperiale TF, Latinovich DR, Bratcher LL. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol. 2002;97:1696-1700.
• Davis GR, Santa Ana CA, Morawski SG, Fordtran JS. Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology. 1980;78:991-995.
• Kolts BE, Lyles WE, Achem SR, Burton L, Geller AJ, MacMath T. A comparison of the effectiveness and patient tolerance of oral sodium phosphate, castor oil, and standard electrolyte lavage for colonoscopy or sigmoidoscopy preparation. Am J Gastroenterol. 1993; 88:1218-1223.
• Ness RM, Manam R, Hoen H, Chalasani N. Predictors of inadequate bowel preparation for colonoscopy. Am J Gastroenterol. 2001;96:1797-1802.
• Borg BB, Gupta NK, Zuckerman GR, Banerjee B, Gyawali CP. Impact of obesity on bowel preparation for colonoscopy. Clin Gastroenterol Hepatol. 2009;7:670-675.
• Bİrkje B, Pedersen R, Lund GM, Enehaug JS, Berstad A. Effectiveness and acceptability of three bowel cleansing regimens. Scand J Gastroenterol. 1991;26:162-166.
• Hendry PO, Jenkins JT, Diament RH. The impact of poor bowel preparation on colonoscopy: a prospective single centre study of 10,571 colonoscopies. Colorectal Dis. 2007;9:745-748.
• Reilly T, Walker G. Reasons for poor colonic preparation with inpatients. Gastroenterol Nurs 2004;27:115-117.
• Hsu CW, Imperiale TF. Meta-analysis and cost comparison of polyethylene glycol lavage versus sodium phosphate for colonoscopy preparation. Gastrointest Endosc 1998; 48:276-282.
• Mathus-Vliegen EM, Kemble UM. A prospective randomized blinded comparison of sodium phosphate and polyethylene glycol- electrolyte solution for safe bowel cleansing.Aliment Pharmacol Ther. 2006;23:543-552.
• Scott SR, Raymond PL, Thompson WO, Galt DJ. Efficacy and tolerance of sodium phosphates oral solution after diet liberalization. Gastroenterol Nurs 2005;28:133-139.
• Allaire J, Thompson WO, Cash BD, Galt DJ. A quality improvement project comparing two regimens of medication for colonoscopy preparation. Gastroenterol Nurs 2004;27:3-8.
• Aronchick CA, Lipshutz WH, Wright SH, Dufrayne F, Bergman G. A novel tableted purgative for colonoscopic preparation: efficacy and safety comparisons with Colyte and Fleet Phospho-Soda. Gastrointest Endosc 2000;52:346-352.
• Seinela L, Pehkonen E, Laasanen T, Ahvenainen J. Bowel preparation for colonoscopy in very old patients: a randomized prospective trial comparing oral sodium phosphate and polyethylene glycol electrolyte lavage solution. Scand J Gastroenterol 2003;38:216-220.
• Hwang KL, Chen WT, Hsiao KH, Chen HC, Huang TM, Chiu CM, et al. Prospective randomized comparison of oral sodium phosphate and polyethylene glycol lavage for colonoscopy preparation. World J Gastroenterol 2005;11:7486-7493.
• Habr-Gama A, Bringel RW, Nahas SC, Araşjo SE, Souza Junior AH, Calache JE, et al. Bowel preparation for colonoscopy: comparison of mannitol and sodium phosphate. Results of a prospective randomized study. Rev Hosp Clin Fac Med S Paulo. 1999;54:187- 192.
• Yoong KK, Heymann T. Colonoscopy in the very old: why bother? Postgrad Med J 2005;81:196-197.
• Mitchell RM, McCallion K, Gardiner KR, Watson RG, Collins JS. Successful colonoscopy; completion rates and reasons for incompletion. Ulster Med J 2002;71:34-37.
• Greenwald B. Inpatient bowel preparation order set: a means to enhance patient completion of bowel preparation medication. Gastroenterol Nurs 2003;26:238-241.