Good bowel preparation is very important to see the inside of the colon clearly during a colonoscopy. If there is still stool or the cleaning is not clear, doctors might miss growths or early signs of cancer. Studies show that poor bowel preparation leads to missing important findings, which lowers the test’s value.
The United States Multi-Society Task Force (USMSTF), made up of experts from several groups, suggests that doctors and clinics aim for at least 90% of patients to have good bowel preparation. Hitting this goal makes cancer screening better and reduces the need for extra colonoscopies.
Usually, doctors check bowel preparation quality by looking during the procedure and using visual scales like the New Hampshire Colonoscopy Registry scale. But this depends on the doctor’s opinion and can differ between providers.
It can be hard to judge bowel preparation quality before a colonoscopy. Patients do not always follow cleaning instructions due to how hard or unpleasant they find the process. Low-volume split-dose preparations (2 liters or less) are now popular because they clean just as well as larger volumes and patients like them more. Using these can help find more growths.
Even with improvements, some people still have a high chance of poor cleaning. This includes those with constipation, past poor prep, or other health problems. Usual ways to help include better teaching before the test, diet changes starting 2-3 days ahead, medicines to help bowel movement, and phone or electronic reminders.
Still, guessing who will have poor bowel prep before the test day is hard. Wrong guesses can cause cancellations or rescheduling, which wastes time and annoys patients.
AI tools now offer new ways to check bowel preparation quality more quickly and fairly. A recent study by Zhu Y. and others in 2023 showed how AI can look at photos of stool taken before the colonoscopy. These tools decide how clean the bowel is and predict if the prep might be poor.
AI uses image recognition to study stool pictures sent by patients through smartphones. This lets doctors spot patients who need stronger prep plans or extra help before their scheduled test.
Finding high-risk patients early lets clinics send reminders or give more instructions to improve cleaning. This helps lower cancellations, makes patients follow instructions better, and cuts down on repeat exams.
Besides before the test, AI helps during the colonoscopy too. While this mainly helps spot growths, AI also improves how well the doctor can see by helping find small or hidden lesions.
AI can also help check how clean the bowel is during the procedure. This matters because the USMSTF says that if the prep might be poor, doctors must check at least up to the sigmoid colon before stopping the exam. AI can make these checks more consistent and clear, reducing differences between doctors and helping with records.
Better Patient Results: AI can help check bowel prep more accurately, leading to clearer views and finding more growths. This helps lower rates of colorectal cancer.
Fewer Cancellations and Reschedules: By spotting poor prep before the day of the test, clinics can change prep plans or have extra sessions. This cuts down on last-minute changes.
Increased Efficiency: Better prep means fewer repeated colonoscopies. This frees up time slots and reduces waste.
Consistent Reporting: AI tools provide clear and objective records of bowel cleanliness using known scores and photos. This improves communication among healthcare teams and helps track quality.
Patient Support: Smartphone apps with AI can remind patients about prep instructions and give feedback to help patients follow directions better.
Beyond checking bowel prep, AI can help automate many office and back-office tasks in clinics. This makes work smoother and patients happier. For example, companies like Simbo AI make phone systems that answer calls automatically, which is useful for busy clinics.
Endoscopy units must handle patient appointments, answer questions about the colonoscopy, and give prep instructions. AI can take care of routine calls and messages. This lets staff focus on harder tasks and patient care.
U.S. clinics often have many patients, few staff, and strict rules about patient communication and records. AI phone automation helps by:
Some companies build AI phone systems made just for healthcare. These can work with medical record software and schedule systems to keep all patient information connected and workflows smooth.
Managing patients at high risk for poor bowel prep is important for a good colonoscopy. The USMSTF says these patients do better with extra help, like:
AI tools help these efforts by finding these patients early, sending reminders, tracking how well they follow instructions, and alerting care teams for extra help.
Medical clinics wanting to use AI for bowel prep checks and workflow automation should think about these points:
In short, AI plays a growing role in checking bowel preparation before colonoscopy. AI can analyze stool photos before the test to find patients who might have poor prep. This helps doctors give extra help to those patients and improve how well patients follow instructions. This leads to better test results.
During the colonoscopy, AI also assists by checking bowel cleanliness and helping record this clearly. Combined with AI tools that automate office work, medical clinics in the U.S. can become more efficient, improve patient communication, and follow recommendations better.
Clinics aiming to reach the USMSTF goal of 90% or better bowel prep quality may find AI tools useful as part of their plan to improve colonoscopy tests and patient safety.
Research in this area includes work by Joseph C. Anderson, MD, FACG, and Rachael Hagen, DO, who updated the USMSTF guidelines on bowel preparation.
Zhu Y and team showed how AI can analyze stool images to predict bowel prep quality.
Researchers at the University of British Columbia such as Hyun Jae Kim, Nasim Parsa, and Michael F. Byrne studied how AI is expanding roles in colonoscopy quality and detection.
For U.S. medical leaders, investing in AI and technology for both clinical and office tasks offers a clear way to improve colonoscopy care, reduce problems, and make the experience better for patients and providers.
Key interventions include assessing the patient’s medical history, tailoring bowel preparation regimens to individual preferences and comorbidities, providing written and verbal guidance, and utilizing patient navigators to reinforce instructions.
Bowel purgative selections should favor low-volume solutions (≤2 L), with split-dose regimens preferred to enhance tolerability and effectiveness, while the routine use of adjuncts other than oral simethicone is discouraged.
AI-driven tools have been developed to evaluate bowel preparation quality by analyzing images of stool, aiding in identifying patients at high risk for inadequate preparation.
High-quality bowel preparation is essential for effective colonoscopy, as suboptimal preparation can lead to missed adenomas and poor procedural outcomes.
Endoscopy units should aim for at least a 90% rate of adequate bowel preparation to improve quality metrics and patient outcomes.
Proactive measures include enhanced patient communication, dietary modifications starting 2-3 days prior, and using promotility agents to prevent constipation.
Dietary restrictions should be minimized to the day before the procedure, with flexibility allowed to improve patient comfort and compliance.
Preparation quality should be evaluated endoscopically and documented using standardized scoring systems to ensure clarity for subsequent review by other healthcare providers.
Inadequate preparation often necessitates rescheduling procedures and may prevent proper screening or surveillance, highlighting the importance of thorough pre-procedure communication.
Future studies should focus on enhancing bowel preparation tolerability and effectiveness, evaluating the impact of new adjuncts, and exploring same-day dosing options for morning colonoscopies.
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