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P131. The minimal role of enema preparation for sigmoidoscopy in active ulcerative colitis patients

E.S. Kim1, Y.T. Jeen1, B. Keum1, B.J. Lee1, J.S. Koo1, R.S. Choung1, J.H. Choi1, 1Korea University College of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul, South Korea

Background

Sigmoidoscopy are very useful in the diagnosis, differential diagnosis, and management of inflammatory bowel disease. However, the optimal bowel preparation of sigmoidoscopy for with ulcerative colitis (UC) patients is not defined. Also the efficacy of enema for preparation of UC patients is controvercial. The aim of this study was to investigate the efficacy of bowel preparation for sigmoidoscopy in active UC patient.

Methods

From January 2010 to July 2012, UC patients scheduled for flexible sigmoidoscopy were retrospectively enrolled to 2 groups: group 1: one enema 2h pre-procedure; group 2: no enema for procedure. The endosocopic images were reviewed by two expert endoscopists. The two endoscopists assessed the quality of bowel preparation and endoscopic disease activity by Mayo UC endoscopic score.

Results

For this study, 105 patients were reviewed (group 1 = 50, group 2 = 55). No difference was noted between the groups with regard to age, gender. The disease activity of UC in group 2 (no enema) was more severe (Mayo score 8.4) than group 1 (one enema, Mayo score 3, p = 0.04). There was no significant in bowel cleansing grade between groups 1 and 2 (p = 0.12). There was no significant difference between the groups in terms of depth of insertion (p = 0.42). Inter-observer variations (k value) on endoscopic activity of UC are similar (0.73 in group 1 and 0.70 in group 2).

Conclusion

In moderate and severe disease patients, the enema preparations were not needed. The enema gives no significant improvement in efficacy of bowel preparation in active disease status UC patients.