Graphical education and appropriate time before elective colonoscopy make better bowel preparation

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Inadequate bowel preparation compromises colonoscopy quality, reducing polyp detection and increasing procedure time.
• Lack of consensus exists regarding optimal bowel preparation standards.
• This study investigated the impact of graphical education and preparation timing on colonoscopy quality.

Purpose of the Study:

• To evaluate the effectiveness of graphical patient education for bowel preparation.
• To determine the optimal time interval between bowel preparation and colonoscopy.
• To improve polyp detection rates and overall colonoscopy quality.

Main Methods:

• Secondary analysis of 738 patients from a national colorectal cancer screening program.
• Patients received either graphical or text-only preparation instructions.
• Analysis of bowel preparation quality using the Boston Bowel Preparation Scale (BBPS) based on timing intervals (6-8h, 9-12h, 13-17h).

Main Results:

• Graphical preparation instructions significantly improved bowel preparation quality compared to text-only (P < 0.001).
• Shorter intervals (6-8h and 9-12h) showed significantly higher BBPS scores than longer intervals (13-17h).
• Optimal BBPS scores (≥6) were achieved with intervals less than 10 hours, with a peak at approximately 6.5 hours.

Conclusions:

• High-quality bowel preparation is associated with graphical patient education and appropriate timing.
• A colonoscopy interval of less than 10 hours, ideally around 6.5 hours, is recommended for optimal bowel preparation.
• Further prospective multicenter research is needed to confirm optimal bowel preparation strategies.