Early identification of adenomatous polyps is crucial in colorectal cancer prevention. Inadequate bowel preparation results in lower diagnostic yield and is affected by colonic transit. There are insufficient local studies correlating stool form with bowel preparation adequacy. Moreover, there’s limited study correlating stool form with colonoscopy outcome. This study aims to test the association between Bristol Stool Form Scale (BSFS), bowel preparation adequacy and colonoscopy outcome.Methods
We studied a prospective cohort of 260 consecutive outpatients at East Avenue Medical Centre (EAMC) undergoing screening colonoscopy who were prescribed similar bowel preparation and diet. BSFS and comorbidities were collected prior to colonoscopy. Patients were grouped according to BSFS: Group 1 for type 1–2; Group 2 for type 3–5; Group 3 for type 6–7. An investigator, blinded to all information, recorded Boston Bowel Preparation Score (BBPS), Polyp detection rate (PDR), cecal intubation and withdrew time for all patients. Chi-Square, ANOVA and logistic regression were the analysis used.Results
260 were included in the analysis. Group 1 compared to Groups 2 and 3, was significantly associated with inadequate bowel preparation (24.3% vs 0% vs 9.1%; p=0.004), low cecal intubation rate (87% vs 100% vs 97%; p<0.001), low PDR (11% vs 32% vs 24%; p=0.004), and prolonged withdrawal time (9.41 min; p<0.001). Higher BSFS score (3–7) would have 157% higher odds of adequate bowel preparation. Diabetes have a likelihood of only 24% adequate bowel preparation.Conclusions
It’s important to identify patients with constipated stool form to guide proper bowel preparation regimen since they are significantly associated with inadequate bowel preparation, decreased cecal intubation rate, PDR, and increased withdrawal time.