title: Use of automated irrigation pumps improves quality of bowel preparation for colonoscopy.
abstract: OBJECTIVE
  To evaluate the effectiveness of automated irrigation pumps (AIPs) in improving the quality of the bowel preparation and the yield of colonoscopy.
  
  
  METHODS
  A retrospective observational study was conducted at a single medical center. Outpatient colonoscopies performed during a 4-mo time period when AIPs were not in use, were compared to colonoscopies performed during control period. The main outcomes measured were quality of bowel preparation, procedures aborted due to poor preparation, recommendations to repeat at short interval due to sub-optimal bowel preparation and adenoma detection rates.
  
  
  RESULTS
  One thousand and thirty-seven colonoscopies were included. A higher proportion of cases did not achieve a satisfactory bowel preparation when AIPs were not used (24.4% vs 10.3%, P < 0.01). The number of procedures aborted due to inadequate preparation was not significantly different, however a repeat procedure at a short interval was recommended in a higher proportion of cases when AIPs were not used (21.3% vs 6.9%, P < 0.01). Good or excellent preparation was 2.91 (95%CI: 2.04-4.15) times more likely when AIPs were used. Detection of polyps and adenomas was not significantly different.
  
  
  CONCLUSIONS
  AIP use during colonoscopy results in a higher proportion of colonic preparation rated as satisfactory, although polyp detection rate is not significantly affected. Recommendations for repeat colonoscopy at shorter interval significantly decrease with the use of AIPs. This study supports the use of the irrigation pumps in endoscopy units to improve the quality of colonoscopy.
authors.affiliation: Sujan Ravi, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, United States.
authors.forename: Sujan
authors.initials: S
authors.lastname: Ravi
authors.affiliation: Sujan Ravi, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, United States.
authors.forename: Rana
authors.initials: R
authors.lastname: Sabbagh
authors.affiliation: Sujan Ravi, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, United States.
authors.forename: Fadi
authors.initials: F
authors.lastname: Antaki
keywords: Adenoma; Automated irrigation pumps; Bowel preparation; Colonoscopy; Polyps; Quality; Surveillance interval