World Journal of Gastroenterology, Hepatology and Endoscopy

A Service Evaluation of Patient Educational Bowel Preparation Videos- Improving the Quality of Bowel Preparation for Colonoscopy

Natarajan B*, Landy J and Purkis E

Department of Gastroenterology, Watford General Hospital, Vicarage Road, Watford, WD18 0H0, United Kingdom

Corresponding Author: Brenavan Natarajan, Department of Gastroenterology, Watford General Hospital, Vicarage Road, Watford, WD18 0H0, United Kingdom, E-mail: [email protected]


Citation: Natarajan B (2020) A Service Evaluation of Patient Educational Bowel Preparation Videos- Improving the Quality of Bowel Preparation for Colonoscopy World Journal of Gastroenterology, Hepatology and Endoscopy Research.Vol (3): Issue (3): 1-4.


Copyright : ©2020 Natarajan B et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially.



1.1. Objective: Effective bowel preparation is critical for efficient colonoscopy. We present evaluation of the impact educational bowel preparation videos had upon our service.

1.2. Methods: All patients undergoing colonoscopy with Moviprep were included over an eighteen-week period. Links and QR codes to online educational videos were sent to patients, along with written instructions for bowel perp prior to procedure. Endoscopy nurses recorded whether patients had watched the videos on the day of procedure. Bowel cleanliness was graded by the Endoscopist using Boston bowel preparation (BBPS) and Aron chick scores.

1.3. Results: 1645 patients were included in total (51% male, average age 63). 11.8% (194) watched the educational videos (54% males, average age 59).

There was a statistically significant difference comparing video to non-video groups in those that had a good/excellent (85% v 79%; p=0.047) and excellent (33% v 24%, p<0.01) preparation compared with non-video group. The mean BBPS was higher in the video group overall (7.1 v 6.7; p<0.01) and for all colonic segments including the right colon (p=0.02).

There were no significant differences between the bowel preparation scores of those rated inadequate, poor, fair or good preparation.

There was no significant difference for caecal intubation rate

or polyp detection rate.


1.4. Discussion: In our evaluation, video education improved bowel preparation in all bowel segments but did not impact upon key performance indicators. Uptake of use of the online video resource was low. We believe use of complimentary online videos can improve bowel preparation quality which may improve colonoscopy service outcomes.

A Service Evaluation of Patient Educational Bowel Preparation videos- improving the quality of bowel preparation for colonoscopy Natarajan B, Purkis E, Landy J.


KEYWORDS: Colonoscopy, Colorectal cancer screening.




Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008; 134(5): 1570-95.

Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc. 2003; 58(1): 76-9.

Gavin DR, Valori RM, Anderson JT, Donnelly MT, Williams JG, Swarbrick ET. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut. 2013; 62(2): 242-9.

Johnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Gastroenterology. [Meta-Analysis Practice Guideline Research Support, Non-U.S. Gov’t Review]. 2014; 147(4): 903-24.

Froehlich F, Wietlisbach V, Gonvers JJ, Burnand B, Vader JP. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: The European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005; 61(3): 378-84.

Clark BT, Protiva P, Nagar A, Imaeda A, Ciarleglio MM, Deng Y, et al. Quantification of Adequate Bowel Preparation for Screening orSurveillance Colonoscopy in Men. Gastroenterology. 2016; 150(2): 396-405.

Radaelli F, Paggi S, Hassan C, Senore C, Fasoli R, Anderloni A, et al. Split-dose preparation for colonoscopy increases adenoma detection rate: a randomised controlled trial in an organised screening programme. Gut. [Multicenter Study Randomized Controlled Trial]. 2017; 66(2): 270-77. Rex DK, Imperiale TF, Latinovich DR, Bratcher LL. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol. 2002; 97(7): 1696-700.

Sweetser S, Baron TH. Optimizing bowel cleansing for colonoscopy. Mayo Clinic proceedings. [Review]. 2015; 90(4): 520-6.

Ness RM, Manam R, Hoen H, Chalasani N. Predictors of inadequate bowel preparation for colonoscopy. Am J Gastroenterol. 2001; 96(6): 1797-802.

Verma S, Fogel J, Beyda DJ, Bernstein B, Notar-Francesco V, Mohanty SR. Chronic methadone use, poor bowel visualization and failed colonoscopy: a preliminary study. World J Gastroenterol. 2012; 18(32): 4350-6.

uyen DL, Jamal MM, Nguyen ET, Puli SR, Bechtold ML. Low-residue versus clear liquid diet before colonoscopy: a meta- analysis of randomized, controlled trials. Gastrointest Endosc. [Meta-Analysis Review]. 2016; 83(3): 499-507.

Bucci C, Rotondano G, Hassan C, Rea M, Bianco MA, Cipolletta L, et al. Optimal bowel cleansing for colonoscopy: split the dose! A series of meta-analyses of controlled studies. Gastrointest Endosc. [Meta-Analysis Review]. 2014; 80(4): 566-76.

Guo X, Yang Z, Zhao L, Leung F, Luo H, Kang X, et al. Enhanced instructions improve the quality of bowel preparation for colonoscopy: a meta-analysis of randomized controlled trials. Gastrointest Endosc. 2017; 85(1): 90-7.

Abuksis G, Mor M, Segal N, Shemesh I, Morad I, Plaut S, et al. A patient education program is cost-effective for preventing failure of endoscopic procedures in a gastroenterology department. Am J Gastroenterol. 2001; 96(6): 1786-90.

Liu X, Luo H, Zhang L, Leung FW, Liu Z, Wang X, et al. Telephone- based re-education on the day before colonoscopy improves the quality of bowel preparation and the polyp detection rate: a prospective, colonoscopist-blinded, randomised, controlled study. Gut. [Randomized Controlled Trial Research Support, Non-U.S. Gov’t]. 2014; 63(1): 125-30.

Walter B, Klare P, Strehle K, Aschenbeck J, Ludwig L, Dikopoulos N, et al. Improving the quality and acceptance of colonoscopy preparation by reinforced patient education with short message service: results from a randomized, multicenter study (PERICLES-II). Gastrointest

Endosc. 2019; 89(3): 506-13.

Rice SC, Higginbotham T, Dean MJ, Slaughter JC, Yachimski PS, Obstein KL. Video on Diet Before Outpatient Colonoscopy Does Not Improve Quality of Bowel Preparation: A Prospective, Randomized, Controlled Trial. Am J Gastroenterol. 2016; 111(11): 1564-71.

Park JS, Kim MS, Kim H, Kim SI, Shin CH, Lee HJ, et al. A randomized controlled trial of an educational video to improve quality of bowel preparation for colonoscopy. BMC gastroenterology. [Randomized Controlled Trial]. 2016; 16(1): 64.

Prakash SR, Verma S, McGowan J, Smith BE, Shroff A, Gibson GH, et al. Improving the quality of colonoscopy bowel preparation using an educational video. Can J Gastroenterol. 2013; 27(12): 696-700.

Lai EJ, Calderwood AH, Doros G, Fix OK, Jacobson BC. The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy- oriented research. Gastrointest Endosc. 2009; 69(3 Pt 2): 620-5.

Aronchick CA. Bowel preparation scale. Gastrointest Endosc. 2004; 60(6): 1037-8.



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