Analysis Of Influencing Factors Of Inadequate Bowel Preparation For Colonoscopy

Objective : Exploring the influence factors of inadequate bowel preparation before colonoscopy to provide valuable reference for clinical individualized bowel preparation programs and remedial measures.Methods : This study prospectively analysed questionnaire data from May 2017 to October 2017 of Endoscopy center of Lanzhou General Hospital.The questionnaire including age,sex,body mass index(BMI),subject to the source(outpatient and inpatient),education level,smoking history,drinking history,history of colonoscopy,attendance reason(constipation and diarrhea,abdominal bloating,abdominal pain),basic diseases(hypertension,diabetes),abdominal / pelvic surgery history,frequency of taking oral purgatives(single-dose,split-dose),the exercise during bowel preparation,adverse reactions after taking the drugs,the total number of defecation times and the last stool character after taking medicine,the interval time from taking the last purgative to the colonoscopy(waiting time),colonoscopy time(morning or afternoon).The quality of bowel preparation was evaluated with BBPS standard.The univariate analysis and multivariate analysis were carried out to evaluate the factors and the quality of the preparation,to assess the risk factors affecting the bowel preparation.Results:1.A total of 414 patients were included in this study,of which 252 patients(60.9%)of adequate bowel preparation,162 patients(39.1%)of inadequate bowel preparation.In the left side of the colon,there were 338 cases(81.6%)with adequate bowel preparation,and 76cases(18.4%)were inadequate.In the transverse section of the colon,329 cases(79.5%)were adequate bowel preparation,and 85 cases(20.5%)were inadequate.In the right side of the colon,there were 276 cases(66.7%)with adequate bowel preparation,and 138 cases(33.3%)were inadequate.Compared with the left side of the colon and the transverse section of the colon,the right side of the colon is an important intestinal of the inadequate bowel preparation(P<0.001).2.Result of univariate analysis show that constipation(P=0.032),diabetes(P=0.041),abdominal / pelvic surgery(P=0.005),no walking exercise during the period of medicine(P<0.001),fewer defecation times after taking medicine(P=0.003),the last stool with yellow or dregs or paste(P=0.023),waiting time(P=0.009)were risk factors of inadequate bowel preparation.3.Result of multivariate analysis show that constipation(OR=2.324,95% CI:1.310-4.118,P=0.004),abdominal/pelvic surgery(OR=2.044,95% CI:1.122-3.724,P=0.019),a longer waiting time(OR=1.913,95% CI:1.630-2.247,P=0.003),fewer defecation times after taking medicine(OR=2.586,95% CI:1.282-5.216,P=0.012)were independent risk factors of inadequate bowel preparation.Conclusions:1.The inadequate bowel preparation often occurs in the right side of the colon.2.Constipation,the history of abdominal / pelvic surgery,a longer waiting time,and the total number of defecation after taking medicine are the independent risk factors affecting the inadequate bowel preparation.