Aims
The objective of this study was to identify clinical and behavioral factors associated with adequate cleansing prior to digestive endoscopic procedures.
Methods
A retrospective observational study was conducted on digestive endoscopies performed at our center over one trimester in 2025. Variables analyzed included medical history, body mass index (BMI), abdominal circumference, alcohol consumption, physical activity on the day of the procedure, habitual bowel habits, use of laxatives and/or prokinetics, ASA classification, and fasting hours for liquids and solids.
Results
A total of 411 patients were included (205 esophagogastroduodenoscopies and 206 colonoscopies). Suboptimal visualization was observed in 13 gastric and 8 colonic procedures. In esophagogastroduodenoscopies, significant differences were found regarding BMI, abdominal circumference, and fasting duration for both liquids and solids.In colonoscopies, differences were associated with physical activity on the procedure day, patient comorbidity (ASA classification), fasting duration for liquids, and timing of completion of the second/final dose of the cleansing solution.
Table. Comparison of Clinical and Procedural Variables According to Preparation Quality in Esophagogastroduodenoscopy (EGD) and Colonoscopy.
|
Variable |
EGD (Total / Good / Poor) |
Colonoscopy (Total / Good / Poor) |
p-value EGD |
p-value Colonoscopy |
|---|---|---|---|---|
|
Sample size (n) |
205 / 192 / 13 |
206 / 198 / 8 |
— |
— |
|
Median BMI |
25.6 — 25.55 — 26.8 |
25.8 — 25.95 — 34.7 |
0.045 |
0.535 |
|
Median abdominal circumference (cm) |
92 — 92 — 97 |
95 — 86.5 — 136 |
0.012 |
0.943 |
|
ASA classification (I–II / III–IV) |
192 / 13 — 179 / 13 — 13 / 0 |
189 / 17 — 184 / 14 — 5 / 3 |
— |
ASA I–II: 0.765; ASA III–IV: 0.040 |
|
Physical activity (None / Walking / Aerobic) |
143 / 53 / 9 — 134 / 50 / 8 — 9 / 3 / 1 |
186 / 18 / 2 — 179 / 17 / 1 — 5 / 1 / 1 |
0.906 |
0.008 |
|
Cleansing solution |
XXX |
Pleinvue / Citrafleet / Bohm: 160 / 37 / 9 |
— |
0.525 |
|
Fasting for liquids (hours) |
8 — 8 — 5.5 |
8 — 9 — 11.5 |
0.003 |
0.0276 |
|
Fasting for solids (hours) |
9 — 10 — 6.5 |
28 — 29 — 24 |
0.023 |
0.9007 |
|
Days on low-residue diet |
XXX |
3 — 2.5 — 2 |
— |
0.312 |
|
Days on liquid diet |
XXX |
1 — 1 — 1 |
— |
0.790 |
|
Time of completion of first dose |
XXX |
13.5 — 18 — 12.5 |
— |
0.275 |
|
Time of completion of second dose |
XXX |
9.5 — 10 — 12 |
— |
0.0182 |
Conclusions
In addition to fasting, independent factors such as BMI, abdominal circumference, physical activity, lower comorbidity, and the timing of bowel preparation may significantly influence the adequacy of digestive endoscopic cleansing.