A safe and effective multi–day colonoscopy bowel preparation for individuals with spinal cord injuries

The Journal of Spinal Cord Medicine, 2018 · DOI: 10.1080/10790268.2016.1258968 · Published: March 1, 2018

Simple Explanation

The study investigates a bowel preparation method for colonoscopies in patients with spinal cord injuries (SCI). Patients with SCI often have issues with standard bowel prep, leading to inadequate colonoscopies. The study examines the safety, tolerability, and effectiveness of a multi-day inpatient bowel preparation regimen. The goal is to improve colonoscopy outcomes in this population. The inpatient bowel preparation regimen was found to be safe and effective for SCI patients. It helps to adequately cleanse the bowel for colonoscopy.

Study Duration

19 Months

Participants

53 patients with SCI

Evidence Level

Retrospective case series

Key Findings

1
The full bowel preparation was tolerated by 91% of inpatients, indicating good tolerability of the regimen.
2
89% of patients had adequate quality of bowel preparation at colonoscopy, demonstrating the effectiveness of the regimen.
3
Mild, asymptomatic hypophosphatemia and hypocalcemia were observed but did not require treatment, suggesting the regimen is safe regarding electrolyte balance.

Research Summary

This study demonstrates that a multi–day, inpatient bowel preparation regimen is a tolerable, safe method of achieving a high percentage of adequate-quality bowel preparations in a population of patients with SCI with varied bowel programs. The bowel preparation regimen appears to be effective across AIS classification, level of injury, bowel care method, and bowel care frequency. This regimen represents an important tool in improving colorectal cancer screening in the SCI population.

Practical Implications

Improved CRC Screening

The regimen enhances the quality of bowel preparation, leading to better detection of precancerous lesions during colonoscopy, thereby improving colorectal cancer (CRC) screening in SCI patients.

Inpatient Bowel Preparation

Suggests the benefit of inpatient bowel preparation for SCI patients due to close medical supervision, which helps to manage complications and ensures compliance.

Electrolyte Monitoring

Recommends selective electrolyte monitoring for SCI patients with pre-existing conditions or those on medications known to affect electrolyte balance to ensure safety during bowel preparation.

Study Limitations

1
Small number of patients with inadequate bowel preparation limited statistical power.
2
Study conducted primarily on male veterans, limiting generalizability to females.
3
Results were obtained in an inpatient setting, which may not be feasible for all patients with SCI.

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