Improving Quality and Safety In Your Endoscopy Unit: Live and Virtual | October 2022-Optimizing Bowel Preparation in Your Endoscopy Unit

Video Transcription

Video Summary

In this video, Dr. Tiara Levin discusses optimizing bowel preparation in endoscopy units. She starts by acknowledging the transition from telehealth to optimizing bowel prep and emphasizes the importance of having a plan to achieve adequate preps. Dr. Levin explains that bowel prep includes the purgative, medication, timing, dietary changes, managing medications, physical and mental preparation, and logistical preparation. She highlights that inadequate bowel prep leads to longer procedures, decreased cecal intubation rate, the need for repeat procedures, decreased cost-effectiveness, increased risk to patients, decreased patient experience, lower adenoma detection, and unhappy providers. Risk factors for poor prep include older age, male sex, higher BMI, inpatients, patients on multiple medications, diabetes, impaired mobility, and prior GI surgical resections. She discusses various options for patient education, such as booklets, videos, text messages, smartphone apps, and robocalls. Dr. Levin then explains different bowel prep options, including full-volume, iso-osmotic low-volume, hyper-osmotic low-volume, and over-the-counter preps. She emphasizes the need to personalize the regimen to improve satisfaction and adherence. She also suggests strategies for addressing specific challenges in special populations. Dr. Levin mentions the importance of assessing bowel prep quality using the Boston bowel prep scale or the Uroncic scale. She explains the impact of inadequate preps on follow-up colonoscopies and discusses salvage options. Finally, she provides take-home points, including the use of split dosing, consideration of a low residue diet, grading bowel prep after cleaning, monitoring and improving adequacy, and using standardized scoring systems.

Asset Subtitle

T.R. Levin, MD

Keywords

optimizing bowel preparation

adequate preps

inadequate bowel prep

patient education

bowel prep options

personalizing regimen