Construction and application of a bowel preparation drinking water program for colonoscopy based on the characteristics of gastric emptying in the elderly

doi:10.3761/j.issn.0254-1769.2025.20.006

Abstract

Abstract:

Objective To explore the characteristics of gastric emptying in the whole process of drinking water for colonoscopy in the elderly，and to develop an elderly-friendly drinking water program，thereby improving the comfort and the quality of bowel preparation. Methods From April to September 2024，gastric ultrasound was used to monitor gastric emptying indicators in the whole process of drinking water for colonoscopy in the elderly，summarizing its physiological features. On this basis，in October 2024，through literature review and expert argumentation，a bowel preparation drinking water program that meets the characteristics of gastric emptying in the elderly was developed. A convenience sample of 90 elderly patients scheduled for colonoscopy at 2 tertiary hospitals in Beijing was enrolled from November 2024 to January 2025. A non-concurrent controlled trial was conducted：an experimental group from December 2024 to January 2025 received the new elderly-friendly drinking water program，while a control group in November 2024 followed the conventional program. Outcomes included drinking comfort assessed via Visual Analogue Scale（VAS），adverse events，total fluid intake volume and bowel preparation quality via Boston Bowel Preparation Scale（BBPS）. Results The experimental group demonstrated superior VAS score（P<0.05），bowel preparation quality（P<0.05），total fluid intake（P<0.05），and higher compliance with optimal stool consistency（P<0.05），compared to the control group. The experimental group also exhibited a lower incidence of adverse events（P<0.05）. No significant difference was observed in total bowel preparation duration between 2 groups（P>0.05）. Conclusion The bowel preparation drinking water program based on the characteristics of gastric emptying in the elderly improved solution intake tolerance and bowel preparation quality，with practical implications for clinical implementation.

Key words: Aged, Colonoscopy, Bowel Preparation, Drink Water, Ultrasonography, Gastric Emptying, Nursing Care

摘要：

目的了解老年人结肠镜检查肠道准备饮水全程中的胃排空特点，构建结肠镜检查肠道准备饮水方案，旨在提高老年人饮水舒适度和肠道准备质量。方法 2024年4—9月应用胃超声技术监测老年人在肠道准备饮水全程中的胃排空指标，总结胃排空特点；2024年10月结合文献回顾及专家论证，构建基于老年人胃排空特点的肠道准备饮水方案。采用便利抽样法，选取2024年11月—2025年1月入住北京市2所三级甲等综合医院行结肠镜检查的90例老年人作为研究对象，2024年12月—2025年1月入组老年人为试验组，实施基于老年人胃排空特点的肠道准备饮水方案；2024年11月入组老年人为对照组，实施常规肠道准备饮水方案。比较两组饮水舒适度视觉模拟评分、不良反应发生例数、饮水总量、肠道准备质量波士顿评分等指标的差异。结果试验组饮水舒适度视觉模拟评分、饮水总量、末次大便性状合格率、肠道准备质量均优于对照组（P<0.05），试验组恶心、腹胀发生例数低于对照组（P<0.05），两组肠道准备总时长比较，差异无统计学意义（P>0.05）。结论基于老年人胃排空特点的肠道准备饮水方案适应老年人生理特点，可提高其饮水耐受性和舒适度，同时提升肠道准备质量。

关键词: 老年人, 结肠镜检查, 肠道准备, 饮水, 胃超声, 胃排空, 护理

ZHANG Lijuan, LIU Ying, WANG Bei, SHI Haiyan, LI Ting, MA Yanlan. Construction and application of a bowel preparation drinking water program for colonoscopy based on the characteristics of gastric emptying in the elderly[J]. Chinese Journal of Nursing, 2025, 60(20): 2472-2478.

张丽娟, 刘莹, 王贝, 石海燕, 李婷, 马燕兰. 基于老年人胃排空特点的结肠镜检查肠道准备饮水方案的构建及应用研究[J]. 中华护理杂志, 2025, 60(20): 2472-2478.

Figures/Tables 5

Figure 1 Fasting CSA and immediate CSA after each cup of drinking water in a 75-year-old man

Table 1 Bowel preparation drinking water program based on the characteristics of gastric emptying in the elderly

Table 2 Comparison of general information between the 2 groups（n=90）

Table 3 Comparison of total water intake，drinking comfort scores，and incidence of adverse reactions between 2 groups before and after intervention

Table 4 Comparison of total bowel movements，bowel preparation duration，and preparation quality between 2 groups before and after intervention

References 27

[1]	Fadelu T, Zhang S, Niedzwiecki D, et al. Nut consumption and survival in patients with stage Ⅲ colon cancer:results from CALGB 89803(alliance)[J]. J Clin Oncol, 2018, 36(11):1112-1120.
[2]	中国医师协会内镜医师分会消化内镜专业委员会, 中国抗癌协会肿瘤内镜学专业委员会. 中国消化内镜诊疗相关肠道准备指南(2019,上海)[J]. 中华医学杂志,2019, 99(26):2024-2035.
	Digestive Endoscopy Special Committee of Endoscopic Physicians Branch of Chinese Medical Association,Cancer Endoscopy Committee of China AntiCancer Association. Chinese guideline for bowel preparation for colonoscopy(2019,Shanghai)[J]. Natl Med J China,2019, 99(26):2024-2035.
[3]	杨文博, 李红, 何利平. 结肠镜检查等待时间对患者肠道准备质量的影响研究[J]. 中华护理杂志, 2020, 55(10):1452-1457. DOI
	Yang WB, Li H, He LP. An observational multicenter study on the relationship between preparation to colonoscopy interval and the intestinal preparation quality[J]. Chin J Nurs, 2020, 55(10):1452-1457.
[4]	葛伏林, 吴文娟, 王鸣, 等. 硫酸镁溶液不同口服方法在老年人肠道准备中的应用效果及安全性分析[J]. 中华胃肠内镜电子杂志, 2021, 8(2):68-71.
	Ge FL, Wu WJ, Wang M, et al. Application effect and safety analysis of different oral methods of magnesium sulfate solution in bowel preparation for colonscopy in elderly patients[J]. Chin J Gastrointest Endosc Electron Ed, 2021, 8(2):68-71.
[5]	Wang L, Zhang Y, Li J, et al. Efficacy of polyethylene glycol electrolyte powder combined with linaclotide for colon cleansing in patients with chronic constipation undergoing colonoscopy:a multicenter,single-blinded,randomized controlled trial[J]. Clin Transl Gastroenterol, 2024, 15(6):e1.
[6]	李谦, 王建荣. 老年患者结肠镜检查术前准备情况调查及影响因素分析[J]. 现代消化及介入诊疗, 2017, 22(4):500-503.
	Li Q, Wang JR. Investigation on preoperative preparation of elderly patients for colonoscopy and analysis of its influencing factors[J]. Mod Dig Interv, 2017, 22(4):500-503.
[7]	Shin HJ, Koo BW, Lim D, et al. Ultrasound assessment of gastric volume in older adults after drinking carbohydrate-containing fluids:a prospective,nonrandomized,and noninferiority comparative study[J]. Can J Anaesth, 2022, 69(9):1160-1166.
[8]	中华医学会消化内镜学分会结直肠学组. 结肠镜检查肠道准备专家共识意见(2023,广州)[J]. 中华消化内镜杂志,2023, 40(6):421-430.
	Colorectal Group, Digestive Endoscopy Branch of Chinese Medical Association. Consensus on bowel preparation for colonoscopy(2023,Guangzhou)[J]. Chin J Dig Endosc,2023, 40(6):421-430.
[9]	葛伏林, 苏斌斌, 李婷婷, 等. 硫酸镁溶液分次口服法在老年人结肠镜检查肠道准备中的应用研究[J]. 中华内科杂志, 2019, 58(3):181-184.
	Ge FL, Su BB, Li TT, et al. Study on the application of oral magnesium sulfate solution in split doses as bowel preparation for colonoscopy in elderly patients[J]. Chin J Intern Med, 2019, 58(3):181-184. DOI PMID
[10]	Ge FL, Kang XY, Wang ZY, et al. Low-dose of magnesium sulfate solution was not inferior to standard regime of polyethylene glycol for bowel preparation in elderly patients:a randomized,controlled study[J]. Scand J Gastroenterol, 2023, 58(1):94-100.
[11]	蔡丽华, 李红, 何利平, 等. 糖尿病患者结肠镜检查肠道准备护理方案的构建与应用[J]. 中华护理杂志, 2022, 57(5):555-562. DOI
	Cai LH, Li H, He LP, et al. Construction and application of a nursing plan for diabetic patients with bowel preparation quality[J]. Chin J Nurs, 2022, 57(5):555-562. DOI
[12]	李谦, 王建荣. 果味补液盐联合硫酸镁用于老年病人结肠镜检查前肠道准备的效果评价[J]. 护理研究, 2018, 32(17):2704-2709.
	Li Q, Wang JR. Effect evaluation on fruit-like rehydration salt combined with magnesium sulfate on bowel preparation before colonoscopy in elderly patients[J]. Chin Nurs Res, 2018, 32(17):2704-2709.
[13]	高倩, 侯曦露, 余森源, 等. 老年患者结肠镜检查前不同肠道准备效果观察[J]. 临床军医杂志, 2017, 45(10):1042-1045.
	Gao Q, Hou XL, Yu SY, et al. Different intestinal preparations of colonoscopy in elderly patients[J]. Clin J Med Offic, 2017, 45(10):1042-1045.
[14]	王吉, 胡智, 伏婷婷, 等. 三种方法用于高龄男性结肠镜检查前肠道准备效果观察[J]. 人民军医, 2016, 59(2):153-155.
	Wang J, Hu Z, Fu TT, et al. Observation on the effect of three methods on intestinal preparation before colonoscopy in elderly men[J]. People’s Mil Surg, 2016, 59(2):153-155.
[15]	徐苗苗, 付秀荣, 张娜, 等. 老年结肠镜检查患者肠道准备失败风险评分模型的构建及验证[J]. 中华护理杂志, 2022, 57(11):1337-1344. DOI
	Xu MM, Fu XR, Zhang N, et al. Development and validation of a risk score model for inadequate bowel preparation for colonoscopy in elderly patients[J]. Chin J Nurs, 2022, 57(11):1337-1344. DOI
[16]	姚健凤, 张伟, 陈洁, 等. 老年人大肠镜检查前肠道准备的优化[J]. 中华老年多器官疾病杂志, 2012, 11(5):329-332.
	Yao JF, Zhang W, Chen J, et al. Optimization of bowel preparation before colonoscopy in the elderly[J]. Chin J Mult Organ Dis Elder, 2012, 11(5):329-332.
[17]	王霞, 许行, 高萌, 等. 不同药物用于老年患者结肠镜检查前肠道准备的临床观察[J]. 中华保健医学杂志, 2008, 10(5):356-358.
	Wang X, Xu H, Gao M, et al. Clinical observation of different drugs for bowel preparation before colonoscopy in the senile patients[J]. Chin J Health Care Med, 2008, 10(5):356-358.
[18]	李晓松. 卫生统计学[M]. 8版. 北京: 人民卫生出版社,2021:300-301.
	Li XS. Health statistics[M]. 8th ed. Beijing: People’s Medical Publishing House,2021:300-301.
[19]	孙建华, 张青, 李欣, 等. 重症超声临床操作技术的护理规范[J]. 中华现代护理杂志, 2023, 29(16):2101-2112.
	Sun JH, Zhang Q, Li X, et al. Nursing standards of clinical practice of critical care ultrasonography[J]. Chin J Mod Nurs, 2023, 29(16):2101-2112.
[20]	Lai EJ, Calderwood AH, Doros G, et al. The Boston Bowel Preparation Scale:a valid and reliable instrument for colono-scopy-oriented research[J]. Gastrointest Endosc, 2009, 69(3):620-625.
[21]	Gao Y, Lin JS, Zhang HD, et al. Pilot validation of the Boston Bowel Preparation Scale in China[J]. Dig Endosc, 2013, 25(2):67-173.
[22]	Boyett B, Wiest K, McLeod LD, et a. Assessment of craving in opioid use disorder:psychometric evaluation and predictive validity of the opioid craving VAS[J]. Drug Alcohol Depend, 2021, 229(Pt B):109057.
[23]	Stoyanova Ⅱ. Ghrelin:a link between ageing,metabolism and neurodegenerative disorder[J]. Neurobiol Dis, 2014,72 Pt A:72-83.
[24]	刘娅, 刘晓晴, 杨雪凝, 等. 结肠镜检查患者肠道准备失败风险预测模型的构建及验证[J]. 中华护理杂志, 2024, 59(9):1091-1098.
	Liu Y, Liu XQ, Yang XN, et al. Construction and validation of a risk predictive model for the bowel preparation failure in colonoscopy patients[J]. Chin J Nurs, 2024, 59(9):1091-1098.
[25]	Stillhart C, Asteriadis A, Bocharova E, et al. The impact of advanced ageon gastrointestinal characteristics that are relevant to oral drug absorption:an AGePOP review[J]. Eur J Pharm Sci, 2023, 187:106452.
[26]	张晓丽, 袁鹏. 人体解剖生理学[M]. 北京: 化学工业出版社,2024:184-189.
	Zhang XL, Yuan P. Human anatomy physiology[M]. Beijing: Chemical Industry Press,2024:184-189.
[27]	Haramgatti A, Sharma S, Kumar A, et al. Comparison of ultrasound-guided residual gastric volume measurement between diabetic and non-diabetic patients scheduled for elective surgery under general anesthesia[J]. Saudi J Anaesth, 2022, 16(3):355-360. DOI PMID