scholarly journals The Efficacy of Short-Duration Polyethylene Glycol plus Electrolytes for Improving Bowel Preparation of Colonoscopy in Patients with Chronic Constipation

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Naohisa Yoshida ◽  
Yoshikazu Inagaki ◽  
Kohei Fukumoto ◽  
Hiroyuki Yoriki ◽  
Yutaka Inada ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Adverse Events ◽  
Short Duration ◽  
Bowel Preparation ◽  
Chronic Constipation ◽  
Performance Status ◽  
Stool Consistency ◽  
Related Factors ◽  
Improvement Rate ◽  
Bowel Movements

Backgrounds and Aims. Sachets of polyethylene glycol plus electrolytes (PEG+E: Movicol: EA Pharma, Tokyo, Japan) are used for chronic constipation, and its efficacy is reported only for female and nonelderly people. Chronic constipation is one of the reasons of poor colonoscopic bowel preparation (BP). We analyzed its efficacy in improving chronic constipation and poor colonoscopic BP related to it, including male and elderly people. Materials and Methods. This multicenter retrospective study was conducted from September 2019 to September 2020 at 5 related institutions among patients ≥ 20 years old diagnosed with chronic constipation whose previous colonoscopic BP had had a fair or poor Aronchick score. Two or four sachets of PEG+E (13.7 or 27.4 g/day) were prescribed for 1 week before colonoscopy. We analyzed the rate of improvement in BP, effect-related factors, spontaneous bowel movements (SBMs), stool consistency, improvement of constipation symptoms, and adverse events. Results. We evaluated 106 cases (56 males) with an average age of 69.5 ± 9.4 years old (≤74 years old: 68 cases, ≥75 years old: 38 cases). The improvement rate of BP was 72.6%, and the insertion time and pain score also improved. A performance status of 1 or 2 was associated with poor BP. SBMs (times/week) increased from 4.0 ± 1.9 to 6.1 ± 2.6 ( p < 0.001 ). The overall improvement rates of SBMs, stool consistency, symptoms of constipation, and rate of adverse events were 58.5%, 90.6%, 59.4%, and 6.6%, respectively, showing no significant differences with regard to age or gender. Conclusions. Short-duration PEG+E was effective for improving poor BP and chronic constipation.

scholarly journals The Efficacy and Safety of Elobixibat for the Elderly with Chronic Constipation: A Multicenter Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Akira Tomie ◽  
Naohisa Yoshida ◽  
Munehiro Kugai ◽  
Ryohei Hirose ◽  
Osamu Dohi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Chronic Constipation ◽  
Retrospective Cohort ◽  
The Elderly ◽  
Stool Consistency ◽  
Related Factors ◽  
Improvement Rate ◽  
Short Period ◽  
Bowel Movements

Backgrounds and Aims. Elobixibat is a bile acid transporter inhibitor indicated for constipation. Previous studies were performed mainly for the nonelderly and were biased to female. We analyzed the efficacy of elobixibat also for the elderly and male. Materials and Methods. This was a multicenter retrospective cohort study. The subjects were patients aged ≥20 years treated for chronic constipation from May 2018 to November 2019 at 12 related institutions. Patients were divided into ≤74 years and ≥75 years old. Elobixibat at 10 mg/day was prescribed for two weeks. We then analyzed the discontinuation due to ineffectiveness, change of spontaneous bowel movements (SBM), stool consistency, the time until the first SBM, adverse events, and effect-related factors. Results. There were 140 cases (61 males) evaluated, with an average age of 72.1±13.6 years (≤74 years: 71 cases; ≥75 years: 69 cases). The discontinuation rate was 7.9%. The SBM (times/week) increased from 2.86 to 6.08 (p<0.001). The overall SBM improvement rate was 74.0% (≤74 years: 78.2% vs. ≥75 years: 68.9%, p=0.31; male: 75.0% vs. female: 73.3%, p=0.78). The overall improvement rate of stool consistency was 59.6% (≤74 years: 62.9%, ≥75 years: 56.1%, p=0.42). The time until the first SBM (hours) for those ≤74 years and ≥75 years was 17.2±14.3 and 11.2±8.4 (p=0.04). Adverse event rates for those ≤74 years and ≥75 years were 28.2% and 10.1% (p<0.01). There were no significant effect-related factors for gender, age, and use of laxatives. Conclusions. Short-period elobixibat is shown to be effective also for the elderly and male.

scholarly journals Efficacy of Macrogol 4000 Plus Electrolytes in Bowel Preparation for Colonoscopy in Patients with Chronic Constipation

2021 ◽  
Author(s):  
Ryoji Ichijima ◽  
Sho Suzuki ◽  
Mitsuru Esaki ◽  
Tomomi Sugita ◽  
Kanako Ogura ◽  
...  
Keyword(s):  
Adverse Events ◽  
Bowel Preparation ◽  
Chronic Constipation ◽  
Detection Rate ◽  
Observation Time ◽  
Insertion Time ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Polyp Detection Rate ◽  
Adenoma Detection

Abstract Background: Chronic constipation is a significant factor in poor bowel preparation for colonoscopy. Macrogol 4000 plus electrolytes (Movicol, EA Pharma, Tokyo, Japan), containing polyethylene glycol (PEG) and electrolytes, have been used recently to treat patients with constipation. However, prospective studies on the use of macrogol 4000 for bowel cleansing for colonoscopy are lacking. This study aimed to investigate the efficacy and safety of macrogol 4000 in addition to PEG administered in patients with chronic constipation.Methods: This single-center, single-arm prospective study enrolled patients with chronic constipation who were scheduled to undergo colonoscopy. The primary endpoint was the proportion of good bowel preparation assessed using the Boston Bowel Preparation Scale (BBPS) (6 or more points). The secondary endpoints were the time from when pPEG (MoviPrep, EA Pharma, Tokyo, Japan) was taken until colonoscopy could be started, amount of PEG taken, number of defecations, whether additional PEG doses were taken, and adverse events. Endoscopy-related endpoints included cecal intubation rate, insertion time, observation time, adenoma detection rate (ADR), and polyp detection rate (PDR). The tolerability of PEG and macrogol 4000 was assessed using a questionnaire.Results: Forty patients were included in the analysis. The median BBPS was 7 (range, (3–9)) and ³6 points in 37 cases (92.5%). The median time until colonoscopy can be started was 210 min (90–360 min), the median volume of PEG taken was 1500 mL (1000–2000 mL), and the median number of defecations was 7 (3-20). No adverse events were observed. Fourteen patients required an additional dose of PEG. Cecal intubation was achieved in all cases, the median insertion time was 6.0 min (range, 2.3–22 min), and the median observation time was 8.8 min (range, 4.0–16.0 min). The ADR and PDR were 60.0% and 75.0%, respectively. A greater proportion of patients rated the tolerability of macrogol 4000 as good compared with that of PEG (95.0% vs. 50.0%, p < 0.01).Conclusions: Intake of macrogol 4000 in addition to PEG is effective and safe for colonoscopy in patients with chronic constipation.

scholarly journals Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial

2008 ◽  
Vol 2008 ◽  
pp. 1-6 ◽  
Author(s):  
S. Schanz ◽  
W. Kruis ◽  
O. Mickisch ◽  
B. Küppers ◽  
P. Berg ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Adverse Events ◽  
Bowel Preparation ◽  
Sodium Phosphate ◽  
Vital Signs ◽  
Multicenter Trial ◽  
Phosphate Solution ◽  
Blinded Study ◽  
Sodium Phosphate Solution ◽  
Oral Sodium Phosphate

Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP) and polyethylene glycol-based lavage (PEG-ELS) are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of this randomized multicenter observer blinded study was to compare three groups of cleansing (NaP, NaP + sennosides, PEG-ELS + sennosides) in reference to tolerability, acceptance, and cleanliness. Patient and Methods: 355 outpatients between 18 and 75 years were randomized into three groups (A, B, C) receiving NaP = A, NaP, and sennosides = B or PEG-ELS and sennosides = C. Gastroenterologists performing colonoscopies were blinded to the type of preparation. All patients documented tolerance and adverse events. Vital signs, premedication, completeness, discomfort, and complications were recorded. A quality score (0–4) of cleanliness was generated. Results: The three groups were similar with regard to age, sex, BMI, indication for colonoscopy, and comorbidity. Drinking volumes (L) (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71) were in favor of NaP (P = .005). Discomfort from ingested fluid was recorded in A = 39.8% (versus C: P = .015), B = 46.6% (versus C: P = .147), and C = 54.6%. Differences in tolerability and acceptance between the three groups were statistically not significant. No differences in adverse events and the cleanliness effects occurred in the three groups (P = .113). The cleanliness quality scores 0–2 were calculated in A: 77.7%, B: 86.7%, and C: 85.2%. Conclusions: These data fail to demonstrate significant differences in tolerability, acceptance, and preparation quality between the three types of bowel preparation for colonoscopy. Cleansing with NaP was not superior to PEG-ELS.

scholarly journals Is Oral Sulfate Tablet Effective and Safe for Bowel Preparation Before Colonoscopy in Elderly People 65 Years of Age and Older?

2021 ◽  
Author(s):  
Jae Hyun Kim ◽  
Yong Eun Park ◽  
Tae Oh Kim ◽  
Jongha Park ◽  
Won Moon ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Polyethylene Glycol ◽  
Adverse Events ◽  
Elderly Patients ◽  
Elderly People ◽  
Patient Compliance ◽  
Bowel Preparation ◽  
Abdominal Distension ◽  
Efficacy And Safety ◽  
Better Than

Abstract Background Recently, a novel oral sulfate tablet (OST) has been introduced for bowel preparation before colonoscopy. However, whether elderly patients can take OST is not yet clear, as OST consists of 28 tablets. We aimed to compare the efficacy and safety of OST and polyethylene glycol (PEG) for bowel preparation for colonoscopy according to age. Method: We randomly divided subjects into a OST group and a PEG group and compared Boston bowel preparation score (BBPS), bubble score, patient compliance and satisfaction, and safety between the two groups according to age (under 65 years of age vs. 65 years of age and older). Results Among the 179 participants, sixty-one were 65 years of age and older. The BBPS and bubble score of the OST group were better than that of the PEG group, regardless of age. The satisfaction of the OST group was better than that the PEG group, regardless of age. The compliance was not different between the two groups, however, the OST group under 65 years of age had a higher rate of completing the dose within 2 h compared with the PEG group under 65 years of age. Adverse events including abdominal distension, abdominal pain, nausea or vomiting were not different between the two groups. Conclusion The use of OST for bowel preparation before colonoscopy is as effective and safe as PEG, and these results were consistent in elderly people 65 years of age and older.

Effect of Coffee Added to a Polyethylene glycol plus Ascorbic acid Solution for Bowel Preparation prior to Colonoscopy

2016 ◽  
Vol 25 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Sung Won Jung ◽  
In Ho Moh ◽  
Hana Yoo ◽  
Sung Ill Jang ◽  
Su Rin Shin ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Polyethylene Glycol ◽  
Adverse Events ◽  
Acid Solution ◽  
Bowel Preparation ◽  
Patient Comfort ◽  
Clinical Indication ◽  
Polyp Detection ◽  
Ascorbic Acid Solution ◽  
Polyp Detection Rate

Background & Aims: Conventional bowel cleansers for colonoscopy have an unpleasant taste and a large volume of solution must be ingested. Coffee increases bowel motility and has an intense flavor. The addition of coffee to a polyethylene glycol+ascorbic acid solution reduces the volume of the solution to be consumed without reducing efficacy, improves the taste of the solution and enhances patient comfort. Methods: Outpatients with clinical indication or people who wanted screening for cancer were considered eligible. Control group (PEGAS group) consumed a 1-L solution of polyethylene glycol+ascorbic acid twice. Study group (COF group) consumed 750 mL of coffee+polyethylene glycol+ascorbic acid twice. Bowel cleansing was rated using the Aronchick, Ottawa scale, polyp detection rate and colonoscopic insertion time. Tolerability, acceptability, preference, and adverse events were investigated by questionnaires. Results: The COF group had non-inferiority in efficacy (non-inferiority margin, -15 %; lower limit of 95 % confidence interval for difference between success rates, – 4.7 % and –8.4 % from both scales, respectively). Polyp detection rates were 0.48 and 0.60, respectively (P=0.067). Colonoscopic insertion times were 323.6±166.8 s and 330.7±243.6 s, respectively (P=0.831). Significant improvement was observed with respect to ease of drinking (P=0.012), taste (P=0.026) and preference (P=0.046) in the COF group. Adverse events occurred in 52.4 % and 60.4 % in the two groups, respectively (P = 0.251). Conclusion: The addition of coffee to polyethylene glycol+ascorbic acid solution reduces the required volume for bowel preparation without reduced efficacy and enhances patient comfort in coffee-drinkers. Abbreviations: ASC: ascorbic acid; PEG: polyethylene glycol; AE: adverse event; PP: per protocol; ITT: intention-to-treat; PICO: sodium picosulfate.

Su1522 The Timing of Onset of Bowel Movements During 4L-Polyethylene Glycol Bowel Preparation Predicts Bowel Preparation Quality: a Prospective Observational Study

2015 ◽  
Vol 81 (5) ◽  
pp. AB314
Author(s):  
John A. Karagiannis ◽  
Konstantina D. Paraskeva ◽  
Nikoletta Mathou ◽  
Athanasios Giannakopoulos ◽  
Ekaterini Evgenidi ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Observational Study ◽  
Bowel Preparation ◽  
Prospective Observational Study ◽  
Bowel Movements ◽  
Timing Of Onset

scholarly journals The Effectiveness, Tolerability, and Safety of Different 1-Day Bowel Preparation Regimens for Pediatric Colonoscopy

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Anna Szaflarska-Popławska ◽  
Dominika Tunowska ◽  
Ola Sobieska-Poszwa ◽  
Anna Gorecka ◽  
Aneta Krogulska
Keyword(s):  
Polyethylene Glycol ◽  
Adverse Events ◽  
Bowel Preparation ◽  
Similar Efficacy ◽  
Serious Adverse Events ◽  
Preparation Methods ◽  
Sodium Picosulphate ◽  
Bowel Cleansing ◽  
Patient Reported ◽  
Colonoscopy Preparation

Background. Currently, there is no generally accepted universal protocol for bowel preparation before colonoscopy in children. Aim. The aim of the study was to compare three different 1-day bowel preparation methods for a pediatric elective colonoscopy in terms of their efficacy, safety, and patient-reported tolerability. Material and Methods. The study was randomized, prospective, and investigator-blinded. All children aged 10 to 18 years consecutively referred to the tertiary pediatric gastroenterology unit were enrolled. The participants were randomized to receive polyethylene glycol 3350 combined with bisacodyl (PEG-bisacodyl group), or polyethylene glycol 4000 with electrolytes (PEG-ELS group), or sodium picosulphate plus magnesium oxide plus citric acid (NaPico+MgCit group). Bowel preparation was assessed according to the Boston Bowel Preparation Scale (BBPS). For patient tolerability and acceptability, questionnaires were obtained. Results. One hundred twenty-three children were allocated to three age- and sex-matched groups. All of the patients completed colonoscopies with visualization of the cecum. There was no difference among the groups for the mean BBPS score. A total of 73 patients (59.3%) experienced minor adverse events. No serious adverse events occurred in any group. Nausea was the only symptom more frequent in the PEG-ELS group compared to the NaPico+MgCit group (p=0.04), and apathy was the only symptom more frequent in PEG-bisacodyl than in the NaPico+MgCit group (p=0.04). All of the patients were able to complete 75% or more of the study protocol, and 85.4% were able to complete the full regimen. The acceptability was the highest in the NaPico+MgCit group with respect to the patient’s grade for palatability, low volume of the solution, and willingness to repeat the same protocol. Conclusion. All bowel cleansing methods show similar efficacy. However, because of the higher tolerability and acceptability profile, the NaPico+MgCit-based regimen appears to be the most proper for colonoscopy preparation in children.

scholarly journals The Effect of Arabinoxylan on Gastrointestinal Tolerance in Generally Healthy Adults: A Randomized, Placebo-Controlled, Crossover Study

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 304-304
Author(s):  
Oliver Chen ◽  
Traci Blonquist ◽  
Kristen Sanoshy ◽  
Kathleen Kelley ◽  
Eunice Mah
Keyword(s):  
Adverse Events ◽  
Stool Consistency ◽  
Double Blind ◽  
Glucose Levels ◽  
Severity Rating ◽  
Bowel Habits ◽  
Funding Sources ◽  
Gi Symptoms ◽  
Bowel Movements ◽  
Bristol Stool Scale

Abstract Objectives Arabinoxylan (AX) is a non-digestible carbohydrate composed of (1→4)-β-D-xylan polymers that contain arabinose and varying uronic acid residues. AX was formally identified as a dietary fiber by the U.S. FDA for its effect on maintenance of healthy blood glucose levels. The primary objectives of this human trial were to examine the effects of a novel prebiotic AX wheat fiber extract (87.9% AX) produced by upcycling crop leftovers, such as wheat straw, on gastrointestinal (GI) tolerance, bowel habits, and stool consistency in adults. Methods A randomized, double-blind, placebo-controlled, crossover trial with three test periods separated by 2-week washout periods was conducted. Forty-five subjects (M/F: 29/16, aged 47.8 ± 9.6 y, 27.9 ± 4.4 kg/m2) were randomly assigned to consume maltodextrin placebo (PLA) or AX wheat fiber extracts providing 6.37 g AX/d (LAX) or 12.74 g AX/d (HAX) for 3 weeks. Study products were mixed thoroughly with 16 oz. water and consumed twice a day, once each in the morning and evening, with or without food. During the 7 days prior to the start of any intervention (baseline) and prior to the end of each test period, GI symptoms, as well as bowel movement ratings and stool consistency and frequency, were evaluated using the GI Tolerability Questionnaire (GITQ), which assesses abdominal cramping, bloating, burping, flatulence, nausea, reflex, and stomach rumbling, and the Bowel Habits Diary with Bristol Stool Scale. Results There were no statistically significant differences between PLA, LAX, and HAX in the area under curve of the GITQ composite score, as well as severity rating of individual symptoms (P &gt; 0.05). Additionally, stool frequency (median ranging 7.5–8.0 over 7 days), stool consistency (median ranging 3.71–3.84), straining during bowel movements, discomfort during bowel movements, and sensation of incomplete evacuation did not differ between interventions (P &gt; 0.05). There were no reported adverse events that were judged to be related to the AX wheat fiber extract product. Conclusions Consumption of prebiotic AX wheat fiber extract product containing 6.37 or 12.74 g AX per day for 3 weeks did not affect GI tolerance symptom severity and bowel habits and stool consistency in adults and did not result in related adverse events, suggesting that the product is safe and well-tolerated. Funding Sources Comet Bio.

scholarly journals Preparation regimen is more important than patient-related factors: a randomized trial comparing a standard bowel preparation before colonoscopy with an individualized approach

2017 ◽  
Vol 55 (1) ◽  
pp. 36-43 ◽  
Author(s):  
T. Voiosu ◽  
Alina Tanţău ◽  
A. Voiosu ◽  
Andreea Benguş ◽  
Cristina Mocanu ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Multivariable Analysis ◽  
Standard Group ◽  
Related Factors ◽  
Split Dose ◽  
Bowel Cleansing ◽  
Significant Difference ◽  
Bowel Prep

Abstract Background. Optimal bowel preparation is one of the most important factors affecting the quality of colonoscopy. Several patient-related factors are known to influence the quality of bowel cleansing but randomized trials in this area are lacking. We aimed to compare an individualized bowel prep strategy based on patient characteristics to a standard preparation regimen. Material and Methods. We conducted an endoscopist-blinded multicenter randomized control-trial. The Boston Bowel Prep Score (BBPS) was used to assess quality of bowel preparation and a 10 point visual analogue scale to assess patient comfort during bowel prep. Patients were randomised to either the standard regimens of split-dose 4L polyethylene-glycol (group A), split-dose sodium picosulphate/magnesium citrate (group B) or to either of the two depending on their responses to a 3-item questionnaire (individualized preparation, group C). Results. 185 patients were randomized during the study period and 143 patients were included in the final analysis. Patients in the individualized group had a median BBPS of 7 compared to a median of 6 in the standard group (p = 0.7). Also, there was no significant difference in patients’ comfort scores, irrespective of study group or laxative regimen. However, on multivariable analysis, a split-dose 4L polyethylene-glycol was an independent predictor for achieving a BBPS>6 (OR 3.7, 95% CI 1.4-9.8), regardless of patient-related factors. Conclusion. The choice of laxative seems to be more important than patient-related factors in predicting bowel cleansing. Comfort during bowel prep is not influenced by the type of strategy used.

scholarly journals Effectiveness of a Probiotic for Functional Chronic Constipation: A Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Xiaobin Wu
Keyword(s):  
Randomized Controlled Trials ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Meta Analysis ◽  
Stool Consistency ◽  
Metabolic Effects ◽  
Controlled Trials ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Bowel Movements

Context: The metabolic effects of Lactobacillus reuteri DSM 17938 administration in the treatment of functional chronic constipation are unknown. Objectives: The purpose of this review is to investigate the function of L. reuteri DSM 17938 in bowel movements and stool consistency in children and adults diagnosed with functional chronic constipation. Methods: Five electronic databases were used to search for the English version of Randomized Controlled Trials (RCTs) published between 2000 and 2018 that investigated the metabolic functions of 4–8 weeks of a dietary L. reuteri DSM 17938 intervention in children and adults diagnosed with functional chronic constipation. The risk of bias was evaluated in eligible studies, and a random-effects model was used to perform a meta-analysis for qualitative and quantitative analyses. Results: Five high-quality RCTs involving 737 participants were included in the review. L. reuteri DSM 17938 supplementation was effective in increasing bowel movements (mean difference = 1.12; 95% CI 0.85, 1.39, P < 0.00001) in patients with functional chronic constipation. However, no significant differences in stool consistency from baseline were observed following L. reuteri DSM 17938 supplementation (0.98; 95% CI 0.66, 1.44, P = 0.90). Conclusions: There were significant differences in bowel movements between the experimental and placebo groups, and no significant differences in stool consistency. In addition, there were no adverse effects of the L. reuteri DSM 17938 treatment reported. These results demonstrate the beneficial effects of L. reuteri DSM 17938 in functional chronic constipation patients in comparison with placebo.

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