Aims IBD patients are intended to undergo several times colonoscopy. To prospectively
evaluate tolerability of bowel preparation and colonoscopy in UC and CD patients compared
to subjects participating in a colorectal cancer population screening program.
Methods we consecutively enrolled CD and UC patients and screening subjects (SS). Bowel preparation
was done by macrogol 4.000 + simethicone + sodium-sulphate-anhydrous. Cleansing was
assessed by Boston Bowel Preparation Scale (BBPS, from 0 to 9, the best); sedation
dose and need to increase the initial doses of midazolam (3.0 mg) and fentanyl (0.05 mg).
Tolerability of bowel preparation, discomfort and pain during colonoscopy were assessed
by Visual Analogue Scale (VAS) from 0 to 100 mm.
Results 65 UC (26 women, mean age 50.6 ± 15.4 yrs), 65 CD (29 women, mean age 44.7 ± 3.9)
and 94 SS (47 women, mean age 61.9 ± 6.9) enrolled. Bowel preparation was similarly
tolerated in UC (70.3 ± 17.7 mm), CD (73.1 ± 12.7 mm) and SS (73.2 ± 12.6 mm) (p = 0.397).
Complete colonoscopy was similarly done in UC (61/65, 93.8%), CD (60/65, 92.3%) and
SS (91/94, 96.8%) (p = 0.364). BBPS did not show significant differences between UC
(6.5 ± 1.0), CD (6.4 ± 1.1) and SS (6.4 ± 1.0) (p = 0.824). The need to increase sedation
doses was significantly higher in CD (26/65, 40.0%) and UC (16/65, 24.6%) than in
SS (4/94, 4.3%) (p < 0.0001). The mean increases in midazolam and fentanyl doses were
significantly higher in CD (0.446 ± 0.660 mg and 0.009 ± 0.019 mg) and UC (0.300 ± 0.620
and 0.008 ± 0.018 mg) than in SS (0.042 ± 0.250 mg and 0.001 ± 0.007 mg) (p < 0.0001
in both cases). Discomfort and pain during colonoscopy were similar in UC (35.0 ± 23.0 mm
and 27.6 ± 24.6 mm), CD (37.5 ± 22.2 mm and 28.8 ± 22.5 mm) and SS (33.7 ± 18.7 and
26.9 ± 19.8 mm) (p = 0.530 and p = 0.866).
Conclusions in IBD patients, higher sedation doses are needed in order to warrant a tolerated
colonoscopy. Bowel preparation is equally tolerated and efficacious in IBD patients
and in screening subjects.
