scholarly journals BOWEL PREPARATION BEFORE COLONOSCOPY FOR CHILDREN: comparison of efficacy of three different methods

2015 ◽  
Vol 52 (4) ◽  
pp. 311-314
Author(s):  
Seyed Mohsen DEHGHANI ◽  
Hazhir JAVAHERIZADEH ◽  
Mahmood HAGHIGHAT ◽  
Mohammad-Hadi IMANIEH ◽  
Saeed GHANBARI
Keyword(s):  
Data Analysis ◽  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Normal Saline ◽  
Therapeutic Procedure ◽  
Previous Surgery ◽  
Exclusion Criteria ◽  
Significant Difference ◽  
History Of

Background - Colonoscopy is an important diagnostic and therapeutic procedure. Adequate bowel preparation is mandatory. Several regimens were discussed in the literature. Among the drugs which has recently used, polyethylene glycol is one of the most popular agents. Objectives - The aim of this study was to compare efficacy of three different methods for 1 day preparation before colonoscopy. Methods - This study included children with the range of ages (2-21) who had an indication of colonoscopy. Exclusion criteria were based on the history of previous surgery, parental disagreement, and patients who did not use preparation protocol. Three methods for bowel preparation were studied: 1- Polyethylene glycol only; 2- Polyethylene glycol and bisacodyl suppositories; 3- Polyethylene glycol plus normal saline enema. Boston Bowel Preparation Score was used for evaluation of preparation. SPSS version 16.0 (Chicago, IL, USA) were used for data analysis. Results - In this study 83 cases completed the bowel preparation completely. Acceptable bowel preparation was seen in 24 (85.71%), 36 (94.73%), and 14 (82.35%) of cases in PEG, PEG + bisacodyl, and PEG + normal saline enema groups respectively. PEG + bisacodyl suppositories was more effective than PEG + normal saline for the preparation of the first segment ( P=0.05). For second and third segment of colon, BPPS score was higher in PEG + bisacodyl suppositories compared to other regimens, but this difference was not statistically significant. Conclusion - There was no significant difference between 1 day colonoscopy regimens in terms of bowel preparation score. Lowest score was seen in PEG + enema group compared to other group.

scholarly journals A Randomized, Endoscopist-Blinded, Prospective Trial to Compare the Efficacy and Patient Tolerability between Bowel Preparation Protocols Using Sodium Picosulfate Magnesium Citrate and Polyethylene-Glycol (1 L and 2 L) for Colonoscopy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Sang Hoon Kim ◽  
Ji Hyeong Kim ◽  
Bora Keum ◽  
Han Jo Jeon ◽  
Se Hyun Jang ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Patient Compliance ◽  
Bowel Preparation ◽  
Prospective Trial ◽  
Liquid Sodium ◽  
Magnesium Citrate ◽  
Patients Satisfaction ◽  
Significant Difference ◽  
Blinded Study ◽  
Sodium Picosulfate

Patient compliance during bowel preparation is important for successful colonoscopy. Bowel preparation with polyethylene glycol (PEG), the most commonly used solution for cleansing, involves the unpleasant ingestion of a large amount of liquid. Sodium picosulfate magnesium citrate (SP-MC) solution is an alternative option with better palatability than PEG. Therefore, in this study, we compared the efficacy and patient tolerability among the following three bowel preparation protocols: 2 L PEG-ascorbic acid (ASc), 1 L PEG-ASc plus bisacodyl, and SP-MC 340 mL plus bisacodyl. We conducted a randomized prospective endoscopist-blinded study between August 2018 and January 2019. A total of 311 patients were randomly classified into three groups according to the above-described bowel preparation protocols. To evaluate the efficacy of bowel cleansing, we used the Boston Bowel Preparation Scale. The degree of symptoms and the patients’ satisfaction with each bowel preparation method were investigated using a questionnaire completed before sedation for colonoscopy. The baseline characteristics were similar among the three groups. There was no significant difference in the bowel preparation quality among the three groups. However, the incidence of symptoms, such as abdominal fullness and pain, was significantly lower (P=0.006 and 0.027, respectively) while the patients’ satisfaction rate was significantly higher (P=0.012) in the SP-MC plus bisacodyl group than in the two PEG groups. In this study, the efficacy of the SP-MC plus bisacodyl solution was similar to that of the PEG solutions. However, patient tolerability and satisfaction were better in the SP-MC plus bisacodyl group than in the other groups. In conclusion, the use of SP-MC plus bisacodyl bowel preparation solution might be a better method for providing good intestinal cleansing and improving patient compliance.

scholarly journals Chewing Duration Time Of Various Food Textures In Young Adults

10.3823/2312 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Raísa Coutinho Vitcel ◽  
José Fagny Fernandes de Oliveira ◽  
Ciro Santos ◽  
Emerson Soares Pontes ◽  
Danilo Augusto De Holanda Ferreira ◽  
...  
Keyword(s):  
Young Adults ◽  
Data Analysis ◽  
Reference Values ◽  
Clinical Assessment ◽  
Descriptive Study ◽  
Quantitative Approach ◽  
Degenerative Diseases ◽  
Exclusion Criteria ◽  
Significant Difference ◽  
Mandibular Movements

OBJECTIVE: To obtain reference values of chewing time of several food textures in young adults. METHOD: descriptive study with a quantitative approach that was developed in a clinical reference, being the population composed of 40 young adults between 18-30 years of age, of both genres. As exclusion criteria: those with neuromuscular and / or degenerative diseases or consequences thereof, as well as subjects who were making use of any orthodontic / orthopedic resource. We conducted a dental evaluation, followed by a clinical assessment. One at a time, the following foods were offered: French bread, wafer biscuit, roasted cashews, for voluntary chewing.  To measure the food chewing time, we used a stopwatch, and this collection procedure was filmed. Data analysis was performed by means of the SPSS statistics 20.0 (IBM®) program. RESULTS: There was a statistically significant difference (p < 0.05) between the medians of chewing time of French bread, wafer biscuit and cashew nuts, which were 33.0s (interquartile amplitude 29.0 - 40.0), 10.0s (interquartile amplitude 8.25-12.0) and 18.5s (interquartile amplitude 15.0-23.75), respectively. CONCLUSION: The texture of foods influences the length of mastication. The more rigid is the food, the more cycles and mandibular movements, and therefore the longer the duration of chewing.

scholarly journals Randomized Controlled Trial of Polyethylene Glycol versus Oral Sodium Phosphate for Bowel Preparation in Unsedated Colonoscopy

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Dong Yang ◽  
Ke Tao ◽  
Geng Chen ◽  
Luping Zhang ◽  
Qingying He ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Sodium Phosphate ◽  
Controlled Trial ◽  
Insertion Time ◽  
Phosphate Solution ◽  
Cleaning Efficiency ◽  
Significant Difference ◽  
Oral Sodium Phosphate ◽  
Oral Sodium

Aim. To identify the most effective laxative for bowel preparation in unsedated colonoscopy. Methods. Between April 2019 and April 2020, a total of 586 outpatients scheduled for unsedated colonoscopy at the First Hospital of Jilin University (Changchun, China) were randomized into one of two groups, namely, the polyethylene glycol (PEG) group or the oral sodium phosphate solution (OSP) group. The cleaning efficiency and other relevant clinical parameters were compared between the two groups. Results. Each group consisted of 293 patients. There were no significant differences in gender, body mass index, and history of abdominal surgery between the two groups. There were more cases of laxative intolerance in the PEG group than in the OSP group (7.5% vs. 0.7%, P<0.05). After tube insertion, we found that the cleaning efficiency of OSP was better than that of PEG (P<0.05). After cleaning, there was no significant difference in bowel cleanliness between the two groups (P>0.05). The colonoscopic insertion time of the PEG group was significantly shorter than that of the OSP group (10.0 vs. 12.0 min, P=0.002), and colonoscopic insertion was more difficult in the OSP group than in the PEG group (P=0.036). The VAS score of the PEG group patients was significantly lower than that of OSP group patients (4.0±1.3 vs. 5.2±1.7, P≤0.001). There were no significant differences in the cecal intubation rate and the detection rate of polyps and ulcers/erosion between the two groups. Conclusion. The cleaning efficiency and tolerability of OSP were preferable to those of PEG, but there was no significant difference in bowel cleanliness after washing the colon and suctioning the fluid. Compared with patients of the OSP group, those of the PEG group required a shorter colonoscopic insertion time and reported a more comfortable experience. Therefore, for cases that are tolerant of PEG, PEG is a better choice for unsedated colonoscopy.

scholarly journals Outcome of Fecal Incontinence in Patients with Rectal Prolapse Undergoing the Altemeier Procedure with or without Posterior Levatorplasty

2021 ◽  
Vol 41 (01) ◽  
pp. 052-057
Author(s):  
Alimohammad Bananzadeh ◽  
Hamed Shariat Razavi ◽  
Shahin Khodaei ◽  
Maytham Hameed Al-Qanbar ◽  
Seyed Mohammad Kazem Tadayon ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Rectal Prolapse ◽  
Rectal Surgery ◽  
Complete Rectal Prolapse ◽  
Exclusion Criteria ◽  
The Social ◽  
Significant Difference ◽  
History Of ◽  
Altemeier Procedure ◽  
Baseline Values

Abstract Objective To compare the fecal incontinence status of patients submitted to theAltemeier procedure with or without posterior levatorplasty. Materials and Methods Medical records of the patients who underwent the Altemeier procedure at Shahid Faghihi Hospital (in Shiraz, Iran) from 2014 to 2018 were retrospectively studied. Patients older than 17 years of age who underwent the Altemeier procedure due to complete rectal prolapse were considered. In some cases, the operation was performed with posterior levatorplasty. Rectal prolapse due to collagen or connective tissue disorders, anal/sacral anomalies, immunodeficiency, history of rectal surgery, and pelvic radiotherapy were the exclusion criteria of the present study. In addition to the demographics (including age, gender, and body mass index), the fecal incontinence status of each case was determined through the Wexner scale preoperatively and 12 months after the surgery. The incontinence scores were then compared against the baseline values of the two groups of patients: those with and those without posterior levatorplasty. The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY, US), software, version 21. Results In total, 53 patients (17 men and 36 women) with a mean age of 55.23 ± 18.24 years were analyzed. The comparison of the pre- and postoperative scores on the Wexner scale between the two groups revealed no statistically significant difference (p >0.05). Conclusion Posterior levatorplasty during the Altemeier procedure did not result in significant improvement of the fecal incontinence outcome of the patients.

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 Severe symptomatic hyponatremia associated with the use of polyethylene glycol-based bowel preparation

2017 ◽  
Vol 2017 ◽  
Author(s):  
Navira Samad ◽  
Ian Fraser
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Polyethylene Glycol ◽  
Kidney Disease ◽  
Bowel Preparation ◽  
Thiazide Diuretics ◽  
Osmotic Demyelination Syndrome ◽  
Osmotic Demyelination ◽  
Bowel Cleansing ◽  
History Of

Summary Colonoscopy is a useful tool in modern medicine and is increasingly employed for both diagnostic and treatment reasons. However, its effectiveness is highly reliant on the quality of bowel cleansing. Among different bowel-cleansing agents available, PEG (polyethylene glycol) is considered to be the safest cleansing agent, especially in relation to fluid and electrolyte problems. We present here a case of severe symptomatic hyponatremia that developed after the use of PEG for an elective colonoscopy. This case highlights that despite the use of PEG-based preparations, life-threatening fluid and electrolyte disturbances can still occur in patients with risk factors, such as old age, use of thiazide diuretics and SSRIs, chronic kidney disease, heart failure and a history of electrolyte problems. These patients should be closely monitored when undertaking bowel cleansing and should receive prompt care in the event of complications, to avoid permanent neurological sequelae and death. Rapid correction of sodium levels in patients requiring treatment of hyponatremia should be avoided to prevent complications such as osmotic demyelination syndrome. Learning points: PEG is considered to be the safest bowel-cleansing agents among different options available, but it can still cause significant side effects in susceptible individuals. Those at risk of developing adverse events include elderly individuals, patients with chronic kidney disease, heart failure or previous history of electrolyte problems and those taking thiazide diuretics and SSRIs. All such patients should be closely monitored i.e. have their metabolic profile checked prior to the commencement of bowel cleansing and a low threshold should be kept for the initiation of investigations and treatment in case of development of symptoms. Medications with a potential of causing fluid and electrolytes such as thiazide diuretics and SSRIs should be withheld while patient is undertaking bowel preparation. Hyponatremia in a hospitalized patient can be multifactorial, and the treatment principles are based on duration of onset, presence of symptoms and patients volume status. Overzealous correction of sodium levels during treatment of hyponatremia can result in serious complications such as osmotic demyelination syndrome.

scholarly journals The Effectiveness of Personalized Bowel Preparation Using a Smartphone Camera Application: A Randomized Pilot Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Jae won Jung ◽  
Jongha Park ◽  
Gi Jung Jeon ◽  
Young Soo Moon ◽  
Sung Yuon Yang ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Pilot Study ◽  
Bowel Preparation ◽  
Primary Outcome ◽  
Smartphone Application ◽  
Optimal Dosage ◽  
Significant Difference ◽  
The Mean ◽  
Group 5

Background. We aimed to investigate the effectiveness of a smartphone application that analyzes and judges the optimal dosage of polyethylene glycol (PEG) for bowel preparation. Methods. Patients were assigned to use the smartphone camera application (app group) or written instructions (non-app group). The smartphone camera application was programmed to analyze the bowel preparation quality and automatically determine the dosage of PEG from an analysis of stool images. In contrast, the non-app group consumed PEG solution according to the manual. Results. The primary outcome was the quality of the bowel preparation based on blinded ratings using the Ottawa bowel preparation scale (OBPS). There was no statistically significant difference in the mean OBPS scores between the two groups (P=0.950). However, the app group consumed a lower dose of PEG than the non-app group (mean dosage (mL): 3713.2 ± 405.8 versus 3979.2 ± 102.06, P=0.001). The app group (5-point Likert scale; mean score 4.37 ± 0.895) had high acceptance of the application. Conclusions. Although the app group consumed a lower PEG dose, the bowel preparation quality was similar in the two groups. Moreover, use of the smartphone camera application enhanced compliance with the bowel preparation.

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