Risk Factors for Inadequate Bowel Preparation Before Colonoscopy in Patients with Ulcerative Colitis in Clinical and...

Area of Science:

• Gastroenterology
• Colorectal Cancer Screening
• Inflammatory Bowel Disease Management

Background:

• Adequate bowel preparation (BP) is essential for effective colorectal cancer (CRC) surveillance in ulcerative colitis (UC) patients.
• While active inflammation impacts BP quality, predictors in UC patients with inactive disease are less understood.
• This study focuses on identifying risk factors for inadequate BP in UC patients in clinical/endoscopic remission.

Purpose of the Study:

• Investigate risk factors for inadequate bowel preparation in UC patients during remission.
• Compare the efficacy of 1L-PEG-ASC versus 2L-PEG bowel preparation regimens.
• Assess the impact of disease status on bowel preparation quality for CRC surveillance.

Main Methods:

• Multicenter, retrospective cohort study of 379 adult UC outpatients in endoscopic and clinical remission.
• Assessment of bowel preparation quality using the Boston Bowel Preparation Scale (BBPS).
• Univariable and multivariable logistic regression analyses to identify risk factors and compare PEG regimens.

Main Results:

• Overall adequate BP rate was 90.5%; traditional risk factors were not predictive in remission.
• 1L-PEG-ASC showed significantly higher median BBPS scores (8 vs. 6) and exam completion rates (99.5% vs. 95.7%) versus 2L-PEG.
• 2L-PEG was independently associated with lower odds of achieving higher BBPS scores (OR 0.30).

Conclusions:

• Bowel preparation adequacy rates are high in UC patients in remission, similar to the general population.
• Traditional IBD-related risk factors appear less relevant when active inflammation is absent.
• 1L-PEG-ASC demonstrates superior cleansing quality and exam completion, supporting its use for optimizing CRC surveillance in UC.