P158 Disease and non-disease-related risk factors for inadequate bowel preparation in patients with inflammatory bowel disease: should the strategy be different?
Capela, T.(1);Macedo Silva, V.(1);Freitas , M.(1);Sousa Magalhães, R.(1);Cúrdia Gonçalves, T.(1);Dias de Castro, F.(1);Moreira, M.J.(1);Cotter, J.(1);
(1)Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal;
Background
Colonoscopy is of utmost importance in the management of inflammatory bowel disease (IBD) and is a critical tool for diagnostic and therapeutic decision-making. The quality of bowel preparation is important for the efficacy of colonoscopy and inadequate bowel preparation (IBP) is associated with increased costs and inconvenience. Most studies on IBP have not specifically evaluated the impact of concomitant conditions, such as IBD, on the quality of bowel preparation. We aimed to identify disease and non-disease related factors for IBP in patients with IBD submitted to colonoscopy.
Methods
Retrospective cohort-study which included adult IBD patients submitted to colonoscopy between 2016-2021. Patients’ demographic, comorbidities, clinical, biochemical, and colonoscopy data were recorded. IBP was defined as a final Boston Bowel Preparation Scale (BBPS) ≤5 or ≤1 in at least one segment. A univariable analysis tested the association between covariables and the outcome (IBP) in general and considering Crohn’s disease (CD) and ulcerative colitis (UC) patients separately. Statistically significant variables were included in multivariable logistic binary regression.
Results
Of 309 patients, 52.4% were female with a mean age of 43.7±13.7 years. Fifty one percent (n=158) had UC and 48.9% (n=151) had CD. Twenty-seven percent of the patients (n=82) had IBP which was not significantly different between UC and CD patients (40vs42, p=0.699, respectively). The presence of diabetes mellitus (adjusted OR 13.9 [95% CI 1.388–139.624], p<0.05) and antidepressant use (adjusted OR 4.1 [95% CI 1.247–13.625], p<0.05) were independently associated with the outcome in general. In contrast, only previous history of IBP (adjusted OR 3.1 [95% CI 1.184–8.271], p<0.05) was independently associated with the outcome in UC patients. Disease-related factors such as previous surgery, steroids, immunosuppressors or biologics and endoscopic activity were not associated with IBP.
Conclusion
This study demonstrates that the presence of diabetes mellitus and antidepressant use are predictors of inadequate bowel preparation for colonoscopy in patients with inflammatory bowel disease. Disease-related factors seem to have no influence in the quality of bowel preparation suggesting that a specific approach is unnecessary in these patients.