Effect of Counseling and Education on Mechanical Bowel Preparation

Efficacy of Enhanced Focused Education and Counseling on Adequacy of Mechanical Bowel Preparation Among High-Risk Patients: A Randomized Clinical Trial

The goal of this clinical trial is to learn whether enhanced education and counseling can improve bowel preparation before colonoscopy in high-risk patients. The main questions it aims to answer are:

Does enhanced education lead to better bowel cleansing as measured by the Boston Bowel Preparation Scale (BBPS)?

Does it improve patient satisfaction, compliance with instructions, and procedure efficiency?

Researchers will compare an enhanced education program (including counseling, video, booklet, and mobile app) to standard written instructions typically given before colonoscopy.

Participants will:

Be randomly assigned to either the enhanced education group or the standard instruction group

Undergo routine colonoscopy after following the assigned preparation method

Complete short questionnaires about their experience, satisfaction, and willingness to repeat the process

This study is being done at two hospitals in Palestine.

Inclusion Criteria:

Age 18 years or older

Undergoing elective colonoscopy

Considered high-risk for inadequate bowel preparation, including at least one of the following:

Prior abdominal or pelvic surgery

Chronic constipation (fewer than 3 bowel movements per week)

Use of constipating medications (e.g., opioids, tricyclic antidepressants, calcium channel blockers)

Age >65 years

Multiple comorbidities (e.g., diabetes, neurologic disorders affecting motility)

----------------------------------------------------

Exclusion Criteria:

Known allergy or intolerance to bowel preparation agents

Pregnancy

Severe comorbidities (e.g., decompensated liver disease, severe heart failure)

Cognitive impairment or illiteracy preventing understanding of instructions

Emergency colonoscopy or known obstructive colorectal disease