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Is bowel preparation necessary for early colonoscopy in patients with suspected colonic diverticular bleeding?: A

Takahiro Gonai1,2, Yosuke Toya1, Norihiko Kudara3

  • 1Division of Gastroenterology and Hepatology Department of Internal Medicine Iwate Medical University School of Medicine Iwate Japan.

DEN Open
|November 6, 2023
PubMed

Insights

Polyethylene glycol lavage (PEL) preparation for early colonoscopy in patients with suspected colonic diverticular bleeding (CDB) significantly reduces hospital stay and improves cecal intubation rates. PEL may be preferred for better outcomes in CDB patients undergoing urgent colonoscopy.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Colorectal Surgery

Background:

  • Colonic diverticular bleeding (CDB) is a common cause of lower gastrointestinal bleeding.
  • Optimal bowel preparation for early colonoscopy in CDB patients is not well-established.
  • Few studies have investigated the impact of specific bowel preparations on colonoscopy outcomes in CDB.

Purpose of the Study:

  • To evaluate the effectiveness of polyethylene glycol lavage (PEL) for bowel preparation in patients undergoing early colonoscopy for suspected CDB.
  • To compare outcomes between patients prepared with PEL and those without PEL.

Main Methods:

  • Retrospective, multicenter cohort study involving 10 institutions.
  • Analysis of clinical features and colonoscopy outcomes in patients with suspected CDB undergoing early colonoscopy (within 24 hours).
  • Comparison of outcomes between patients receiving PEL and those not receiving PEL, utilizing propensity score matching.

Main Results:

  • Patients receiving PEL were younger, had fewer comorbidities, and better performance status.
  • After propensity score matching, the PEL group showed a significantly shorter hospital stay (7.9 vs. 10.1 days) and higher cecal intubation rates (91.1% vs. 50.0%).
  • No significant differences were observed in adverse events, identification of stigmata of recent hemorrhage, or endoscopic hemostatic treatment frequency.

Conclusions:

  • Polyethylene glycol lavage (PEL) preparation is associated with improved outcomes for early colonoscopy in patients with suspected colonic diverticular bleeding.
  • PEL may be the preferred bowel preparation method for enhancing colonoscopy efficiency and patient recovery in this specific clinical scenario.
Abstract

Keywords:
colonic diverticular hemorrhageacute lower gastrointestinal bleedingcolonic diverticular bleedingdiverticular diseaseearly colonoscopy

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