EPCS permanently stopped variceal bleeding, rarely became occluded, was accomplished with a low incidence of portal-systemic encephalopathy, and compared with EST, produced greater longterm survival. The widespread practice of using surgical procedures mainly as salvage for failure of endoscopic therapy is not supported by the results of this trial (clinicaltrials.gov #NCT00690027).

In contrast to EST, EPCS permanently controlled variceal bleeding, resulted in significantly greater long-term survival, and was followed by a relatively low (15%) incidence of PSE. These results were facilitated by rigorous, frequent, and lifelong follow-up that included regular counseling on dietary protein restriction and abstinence from alcohol, and by long-term patency of the portacaval shunt in 98% of patients. Furthermore, these results call into question the practice of avoiding portacaval shunt because of fear of PSE, and thereby foregoing the lifesaving advantage achieved by surgical control of bleeding. (clinicaltrials.gov NCT00690027).

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The adherence to the required clear liquid diet and a high-volume bowel cleansing solution prior to colonoscopy often leads to poor patient compliance and inadequate exams. This study evaluated the efficacy and patient tolerance of three bowel preparation regimens prior to colonoscopy. One hundred fourteen patients were randomized to one of three preparations. Group 1 was assigned a clear liquid diet/magnesium citrate and bisacodyl prep; group 2 was assigned to receive a diet kit/magnesium citrate and bisacodyl prep; and group 3 received a diet kit/polyethylene glycol electrolyte prep. The adequacy of bowel preparation was graded by the endoscopists performing the procedures. The preparations were rated by patients for tolerance, compliance, and side effects. The three methods of preparation did not prove to be significantly different in regards to efficacy of colon cleansing or patient tolerability. There was also no difference in compliance between the three regimens. There were no reported side effects in any of the study groups. This study suggests that a low-residue diet kit, given in conjunction with polyethylene glycol electrolyte or magnesium citrate and bisacodyl, produces adequate colon cleansing and patient tolerability.

No abstract