Effect Of Using Bristol Stool Form Scale To Guide Different Bowel Preparation Regimen

Objective: Bowel preparation is a necessary step before colonoscopy;poor bowel preparation will affect the accuracy of the result of colonoscopy and cause the consequence of missed lesions.Bristol stool type scale(BSFS)have been shown to predict the quality of bowel preparation,and Bristol stool form 1 and 2 patients are high-risk population of inadequate bowel preparation.The purpose of this study is to observe the effect of improving the quality of bowel preparation in the whole population by guiding the Bristol stool form 1 and 2 patients which distinguished by BSFS with intensive bowel preparation regimen.Meanwhile,split-does 2 L+2 L polyethylene glycol electrolyte solution(PEG-ES)was designed as the personalized enhancement regimen for patients who belong to Bristol stool form 1 and 2,and its application effect and patient tolerance were observed within the process.Methods: A randomized,single blind,prospective study was performed,the patients who prepare to undergoing colonoscopy from February 2017 to July 2017 were randomly assigned into group A and group B.BSFS was used to identify patients who were Bristol stool form 1 and 2 as well as Bristol stool form 3 to 7 of the two groups and record it,in this study Bristol stool form 1 and 2 in the group A were given 2 L+2L PEG-ES regimen,the specific method is taking 2L PEG-ES at night the day before the colonoscopy,and taking another 2 L PEG-ES at the morning of colonoscopy;The patients of Bristol stool form 3 to 7 were given 2 L PEG-ES regimen,the specific method is taking 2 L PEG-ES at the morning of colonoscopy.All patients in group B were given 2 L PEG-ES regimen.The colonoscopy will start within 4 h-5 h after the administration.The quality of bowel preparation was assessed on the basis of the Boston bowel preparation scale(BBPS).At the same time,a questionnaire was designed to assess the subjective feelings during the preparation.Results: A total of 310 outpatients were enrolled in this study finally.There was no statistical difference between the general information,medical history,cause of medical treatment,dietary preference and the number of Bristol stool form 1 and 2patients of two groups.The bowel preparation success rates,BBPS score,polyp detection rates and cecal intubation rates of patients in group A were all better than group B,the difference was statistically significant.In the distribution of polyps,the number of polyps in the right colon in the group A was significantly more than group B.In the classification of polyps,the number of Yamada type I polyps in group A was significantly more than group B.On the size of polyps,there was no significant difference between two groups.The Bristol stool form 1 and 2 patients in group A and group B were classified and defined as group a and group c,the Bristol stool form 3 to 7 patients in group A and group B were defined as group b and group d.In the above four indicators,there was statistically difference between the four groups.The main difference was in the group a and group c as well as group c and group d,while the group a and group b as well as group b and group d were no statistically different.During the administration,for the patients with Bristol stool form 1 and 2,the times of defecation and clear liquid stools rates of last stool in group A were significantly more than group B,there were no significant difference in retake willingness,time interval of first defecation and adverse reactions between two groups.Conclusion: Use BSFS to distinguish the patients who have the high-risk factors of inadequate bowel preparation,the bowel preparation quality of the whole population can be improved effectively by instructing these people to use personalized bowel preparation regimen.Meanwhile,the 2 L + 2 L PEG-ES regimen can get satisfactory bowel cleaning effect and tolerance as the personalized bowel preparation regimen for the patients with Bristol stool form 1 and 2.