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Poor Colonoscopy Prep Hides Polyps

Poor Colonoscopy Prep Hides Polyps

What happens on the day before a colonoscopy may be just as important as the test itself.

Gastroenterologists at Washington University School of Medicine have found that when patients don’t adequately prep for the test by cleansing their colon, doctors often can’t see potentially dangerous precancerous lesions.

Reporting in the journal Gastrointestinal Endoscopy, the researchers say that doctors often missed at least one precancerous growth in about one-third of patients who did not properly prepare. Those growths were only discovered months later when patients had their next colonoscopy. The new study is the first to point out the potential consequences of poor bowel preparation in outpatients at average risk.

This research also suggests that if a physician is having difficulty seeing the colon due to inadequate prep, the test should be stopped and rescheduled.

“We often can detect preparation problems during the first few minutes of the procedure,” says first author Reena Chokshi, MD, a gastroenterology fellow at Washington University.

“And based on this study, we would say that rather than subjecting a patient to the potential risks of a test that may not be able to detect growths, it may be better to bring that patient back as soon as possible for a repeat procedure with better bowel prep.”

“Many patients say that preparation is the worst part of the test, but it’s also very important because in order to see polyps or cancers, we have to be able to see the entire wall of the colon,” says senior author Jean Wang, MD, PhD, Washington University gastroenterologist at Barnes-Jewish Hospital. “Inadequate preparation makes that very difficult.”

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