Identification of diverticular bleeding needs early colonoscopy rather than preparation

Area of Science:

• Gastroenterology
• Endoscopy

Background:

• Acute colonic diverticulum bleeding (CDB) necessitates prompt colonoscopy to identify stigmata of recent hemorrhage (SRH).
• Standard bowel preparation regimens can cause significant delays in diagnostic procedures.

Purpose of the Study:

• To evaluate the impact of bowel preparation versus no preparation on the time to identify SRH during colonoscopy in patients with CDB.
• To determine if the timing of colonoscopy influences SRH identification rates.

Main Methods:

• Retrospective analysis of 433 patients with CDB undergoing colonoscopy.
• Comparison of SRH identification rates between a prepared group (266 patients) and an unprepared group (60 patients).
• Analysis of the association between time from admission to colonoscopy (TMS) and SRH identification using chi-square tests.

Main Results:

• A total colonoscopy was achieved in 80% of unprepared patients, with decreased time to SRH identification.
• SRH identification rates were higher when colonoscopy was performed within 12 hours of admission (42.3%) compared to after 12 hours (20.9%), irrespective of preparation.
• No significant difference in SRH identification was found between prepared and unprepared groups overall, but timing was crucial.

Conclusions:

• Bowel preparation method is an independent variable affecting SRH identification success in CDB patients.
• Performing colonoscopy within 12 hours of admission is critical for improving SRH identification in acute colonic diverticulum bleeding.
• Streamlining the pre-colonoscopy process by potentially omitting preparation can expedite diagnosis in acute bleeding scenarios.