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Initiative to improve bowel prep outcomes

St. Mark’s clears the way

A noticeable number of bowel investigations that proved ineffective because patients weren’t adhering to their pre-bowel preparation has given cancers nurses food for thought at St Marks Hospital.

The hospital carries out thousands of colonoscopies a year checking for ulceration, polyps and possible signs of cancer in the large bowel with the aid of a camera passed through the anus.

If pre-bowel preparation isn’t followed before the procedure, food and faecal matter left in the bowel can restrict what the camera can see.

This hampers how effective the procedure is and the need for a further colonoscopy which costs more than £300. Potential issues include a longer procedure, missing evidence of disease, delayed diagnosis and risk of perforation

A five-month audit of 1,219 straight-to-test patients found 22% of patients  failed their bowel prep.

In response, nurses worked with endoscopy lead Dr Adam Humphries to introduce some simple but effective methods to improve bowel prep outcomes.

This included updating patient leaflets with simpler information about medication, dietary and bowel preparation instructions, access to an instructional video and, most significantly, increasing procedure notification time from five to ten days. Leaflets are also being translated into different languages

The service has subsequently saw a 16% reduction in poor bowel preparation.

St Marks’ is hosting its annual Frontiers conference this week bringing together the foremost authorities on colorectal and intestinal disease for three days of debate and discussion.

Free online tickets are still available for the last day (Friday) and you can find these and more information about the event here .



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