title: Diabetics on Narcotics Are Less Likely to Achieve Excellent Bowel Preparation Than Are Patients with Either Condition.
abstract: Diabetes and chronic narcotic use negatively affect the quality of bowel preparation before colonoscopy.
  
  
  
  To investigate whether narcotic use and diabetes have an additive negative impact on bowel preparation.
  
  
  
  We performed a retrospective study of 2841 patients (mean age 61 ± 10.2; 94% male) who received outpatient colonoscopies at our Veterans Affairs Medical Center between June 2012 and December 2014. We collected information related to demographics, body mass index, indications, and medical/surgical history (diabetes mellitus, stroke, cirrhosis, dementia, constipation, hypothyroidism, and use of narcotics or antidepressants/anxiolytics for more than three months). Patients were classified into four groups: (1) diabetics on narcotics, (2) diabetics only, (3) on narcotics only, and (4) neither diabetic nor using narcotics. Quality of the bowel preparation was scored using the Boston Bowel Preparation Scale (BBPS) and categorized as either excellent (BBPS ≥7, with no individual segment scoring <2) or not excellent (BBPS <7). Multivariate logistic regression analysis was performed to identify the combined impact of narcotic use and diabetes on bowel preparation.
  
  
  
  Bowel preparation quality was excellent in 49%. Thirty-eight percent of patients with diabetes who were using narcotics (adjusted OR 0.6, CI [0.4, 0.8]) achieved excellent bowel preparation compared with 44% (adjusted OR 0.7, CI [0.6, 0.9]) of patients on narcotics only, 48% (adjusted OR 0.8, CI [0.7, 0.9]) of diabetics only, and 54% of patients with neither condition.
  
  
  
  Concomitant narcotic use and diabetes have a compounding effect on the quality of bowel preparation prior to colonoscopy.
authors.affiliation: Veterans Affairs Medical Center, Oklahoma City, OK, USA. mohammad-madhoun@ouhsc.edu.|Deapartment of Internal Medicine, Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA. mohammad-madhoun@ouhsc.edu.
authors.forename: Mohammad F
authors.initials: MF
authors.lastname: Madhoun
authors.affiliation: Veterans Affairs Medical Center, Oklahoma City, OK, USA.|Deapartment of Internal Medicine, Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA.
authors.forename: Hussein
authors.initials: H
authors.lastname: Bitar
authors.affiliation: Veterans Affairs Medical Center, Oklahoma City, OK, USA.|Deapartment of Internal Medicine, Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA.
authors.forename: Owais
authors.initials: O
authors.lastname: Bhatti
authors.affiliation: Veterans Affairs Medical Center, Oklahoma City, OK, USA.|Deapartment of Internal Medicine, Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA.
authors.forename: Hassaan
authors.initials: H
authors.lastname: Zia
authors.affiliation: Veterans Affairs Medical Center, Oklahoma City, OK, USA.|Deapartment of Internal Medicine, Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA.
authors.forename: Pratyusha
authors.initials: P
authors.lastname: Parava
authors.affiliation: Veterans Affairs Medical Center, Oklahoma City, OK, USA.|Deapartment of Internal Medicine, Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA.
authors.forename: Muhammad H
authors.initials: MH
authors.lastname: Bashir
mesh_terms: D000368:Aged; D002400:Cathartics / Q000494:pharmacology*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology; D063868:Patient Outcome Assessment; D011092:Polyethylene Glycols / Q000494:pharmacology; D014481:United States / Q000453:epidemiology; D058014:Veterans Health / Q000706:statistics & numerical data
chemical_list: D002400:Cathartics; D009294:Narcotics; D011092:Polyethylene Glycols
keywords: Bowel preparation; Colonoscopy; Diabetes; Narcotics