Determinants of symptom burden related to bowel preparation for colonoscopy.

Female Humans Cathartics / adverse effects Prospective Studies Medically Unexplained Symptoms Polyethylene Glycols Colonoscopy / adverse effects

Bowel cleansing Bowel preparation Colonoscopy Endoscopy Full-dose Split-dose Symptoms Tolerability

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

ISSN: 1878-3562

Titre abrégé: Dig Liver Dis

Pays: Netherlands

ID NLM: 100958385

Informations de publication

Date de publication:
11 2022

Historique:

received: 15 03 2022

revised: 11 05 2022

accepted: 07 06 2022

pubmed: 2 7 2022

medline: 2 11 2022

entrez: 1 7 2022

Statut: ppublish

Résumé

Symptoms developing during bowel preparation are major concerns among subjects who refuse the procedure. We aimed to explore the determinants of symptoms occurring during preparation among patients undergoing elective colonoscopy. This is a prospective multicenter study conducted in 10 Italian hospitals. A multidimensional approach collecting socio-demographic, clinical, psychological and occupational information before colonoscopy through validated instruments was used. Outcome was a four-category cumulative score based on symptoms occurring during preparation, according to the Mayo Clinic Bowel Prep Tolerability Questionnaire, weighted by intensity. Missing values were addressed through multiple imputation. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through multivariate logistic regression models. 1137 subjects were enrolled. Severe symptoms were associated with female sex (OR=3.64, 95%CI 1.94-6.83), heavier working hours (OR=1.13, 95% CI=1.01-1.25), previous gastrointestinal symptoms (OR=7.81, 95% CI 2.36-25.8 for high score), somatic symptoms (OR=2.19, 95% CI=1.06-4.49 for multiple symptoms), day-before regimen (OR=2.71, 95%CI 1.28-5.73). On the other hand, age ≥60 years (OR=0.10, 95% CI 0.02-0.44) and good mood (p=0.042) were protective factors. A high-risk profile was identified, including women with low mood and somatic symptoms (OR=15.5, 95%CI 4.56-52.7). We identified previously unreported determinants of symptoms burdening bowel preparation and identified a particularly vulnerable phenotype. Symptoms during preparation especially impact heavier working activity.

Sections du résumé

BACKGROUND

Symptoms developing during bowel preparation are major concerns among subjects who refuse the procedure.

AIMS

We aimed to explore the determinants of symptoms occurring during preparation among patients undergoing elective colonoscopy.

METHODS

This is a prospective multicenter study conducted in 10 Italian hospitals. A multidimensional approach collecting socio-demographic, clinical, psychological and occupational information before colonoscopy through validated instruments was used. Outcome was a four-category cumulative score based on symptoms occurring during preparation, according to the Mayo Clinic Bowel Prep Tolerability Questionnaire, weighted by intensity. Missing values were addressed through multiple imputation. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through multivariate logistic regression models.

RESULTS

1137 subjects were enrolled. Severe symptoms were associated with female sex (OR=3.64, 95%CI 1.94-6.83), heavier working hours (OR=1.13, 95% CI=1.01-1.25), previous gastrointestinal symptoms (OR=7.81, 95% CI 2.36-25.8 for high score), somatic symptoms (OR=2.19, 95% CI=1.06-4.49 for multiple symptoms), day-before regimen (OR=2.71, 95%CI 1.28-5.73). On the other hand, age ≥60 years (OR=0.10, 95% CI 0.02-0.44) and good mood (p=0.042) were protective factors. A high-risk profile was identified, including women with low mood and somatic symptoms (OR=15.5, 95%CI 4.56-52.7).

CONCLUSIONS

We identified previously unreported determinants of symptoms burdening bowel preparation and identified a particularly vulnerable phenotype. Symptoms during preparation especially impact heavier working activity.

Identifiants

DOI: 10.1016/j.dld.2022.06.005 PMID: 35778229

pubmed: 35778229

pii: S1590-8658(22)00544-8

doi: 10.1016/j.dld.2022.06.005

pii:

doi:

Substances chimiques

Cathartics 0

Polyethylene Glycols 3WJQ0SDW1A

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

1554-1560

Informations de copyright

Déclaration de conflit d'intérêts

Conflict of interest AR received consulting fees from ERBE, Fujifilm, Boston Scientific, Norgine, Olympus, Medtronic, Cosmo, EndoStart; payment or honoraria for lectures, presentations, speaker's bureau, manuscript writing or educational events from: Norgine, Boston Scientific, Fujifilm, Medtronic, ERBE, 3D- Matrix. LFu received consulting fees and honoraria for lectures from Norgine and AlfaSigma. All other authors declared no competing interest.