Gender, Mood Among Factors Predicting Severe Symptoms With Bowel Preparation

Gender, Mood Among Factors Predicting Severe Symptoms With Bowel Preparation

Douglas K. Rex, MD, MASGE, reviewing Collatuzzo G, et al. Dig Liver Dis 2022 Jun 28.

In a study performed in 10 Italian centers, 1137 colonoscopy patients completed validated questionnaires prior to colonoscopy and had symptoms from bowel preparation tracked. Overall, symptoms were considered moderate in 26.4% of patients and severe in 9.7%. Severe symptoms occurred in 12% of those receiving a high-volume preparation versus 7% of those receiving a low-volume preparation. In multivariable analyses, predictors of severe symptoms included female sex (odds ratio [OR], 3.64), history of GI symptoms (OR, 7.81), history of somatic symptoms (OR, 2.80), chronic intake of multiple medications (OR, 2.09), and spending more time at work (OR, 1.13). A lower chance of severe symptoms was associated with positive mood (OR, 0.30) and age of 60 years or older (OR, 0.10). 

Compared with split-dose regimens, full-dose day-before regimens had an OR of 2.71 for severe symptoms and full-dose same-day regimens had an OR of 1.80, but the latter was a trend that did not reach significance.

Compared with males with good mood and no somatic symptoms (the low-risk group), the risk of severe symptoms from preparation was highest in women with low mood and somatic symptoms (OR, 15.5). The intermediate-risk group, which included males and females with low mood and somatic symptoms, had an OR of 5.21 for severe symptoms compared with the low-risk group.

Douglas K. Rex, MD, FASGE

COMMENT

This detailed analysis of bowel preparation tolerance suggests profiles that could benefit from increased navigation through preparation.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Collatuzzo G, Fuccio L, Frazzoni L, et al. Determinants of symptom burden related to bowel preparation for colonoscopy. Dig Liver Dis 2022 Jun 28. (Epub ahead of print) (https://doi.org/10.1016/j.dld.2022.06.005)

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