Intestinal preparations for colonoscopy. Comparative study: mannitol, picosulphate and macrogol

Abstract

Bowel preparation is mandatory prior to elective colonoscopy and their effectiveness is closely related to the quality of the examination. There are many preparations on the market and there is no consensus on which is best. This study aimed to compare three solutions for colon preparation in patients undergoing colonoscopy. We conducted a prospective study with 61 patients divided randomly into three groups: one that received a standard dose of macrogol, another received a standard dose of 10% mannitol and another received a standard dose of sodium picosulphate. Patients and examining endoscopists responded to questionnaires for compiling data. In the results we noticed that 10% mannitol, despite being less tolerated by the patient when compared to sodium picosulphate, presents better results in colonic cleaning, being therefore superior in this regard. Macrogol was considered as an intermediate in relation to the other two preparations. As for tolerability, preference is given to sodium picosulphate as best tolerated, followed by mannitol and by macrogol, which is poorly tolerated by the patient. We conclude that as the main objective of bowel preparation in colonoscopy is the quality of colonic cleaning, 10% mannitol was superior to the other preparations studied.

Tripling the Bioavailability of Rosuvastatin Calcium Through Development and Optimization of an In-Situ Forming Nanovesicular System

“…On the other hand, the mean AUC 0–∞ in the case of the optimized formula containing mannitol (OFM) was not significantly different from the market product with a p -value of 0.230. This insignificant increase in the AUC values could be attributed to the possible reduction in the GIT transit time in the presence of mannitol which could counteract the increase in the drug dissolution rate [73,74]. It was previously reported that mannitol in small concentrations could reduce the bioavailability of drugs, especially those absorbed from the small intestine [75,76].…”

Preparo intestinal com picossulfato de sódio ou polietilenoglicol para colonoscopia eletiva em pacientes adultos ambulatoriais: revisão sistemática e metanálise

“…Ao final, foram incluídos 23 estudos na metanálise (Quadro 1). Seis estudos comparam regimes de preparo no dia anterior (Regev et al, 1998;Katz et al, 2013;Kim et al, 2014a;Kojecky et al, 2018;Quaresma et al, 2018;Kojecky et al, 2019) enquanto dez estudos compararam regimes de preparo fracionado (Kim et al, 2014b;Leitao et al, 2014;Jeon et al, 2015;Kim et al, 2015;Munsterman et al, 2015;Yoo et al, 2015;Kojecky et al, 2018;Mathus-Vliegen et al, 2018;Seo et al, 2018;Kojecky et al, 2019). Nenhum dos estudos incluídos comparou regimes de preparo exclusivamente no mesmo dia.…”

“…O citrato de magnésio também foi utilizado separado do picossulfato de sódio em um estudo (Kao et al, 2011). resíduos, respectivamente, por mais um, dois, dois e três dias adicionais (Regev et al, 1998;Kao et al, 2011;Lawarence et al, 2011;Katz et al, 2013;Rex et al, 2013;Muñoz et al, 2018;Quaresma et al, 2018;Seo et al, 2018;Rostom et al, 2019). Os demais quatorze estudos fizeram uso de dietas com baixo teor de resíduos ou pobre em fibra por períodos que variaram de um a sete dia antes (Manes et al, 2013;Kang et al, 2014;Kim et al, 2014a;Kim et al, 2014b;Jeon et al, 2015;Kim et al, 2015;Leitao et al, 2014;Munsterman et al, 2015;Pohl et al, 2015;Yoo et al, 2015Kojecky et al, 2018Mathus-Vliegen et al, 2018;Pisera et al, 2018;Seo et al, 2018;Kojecky et al, 2019).…”

“…Vinte e dois estudos avaliaram a eficácia do preparo intestinal medida por cinco diferentes escalas de preparo: escala de 4 categorias (Regev et al, 1998;Quaresma et al, 2018), escala de Aronchick (Katz et al, 2013;Rex et al, 2013;Kim et al, 2014a;Kim et al, 2014b;Yoo et al, 2015;Kojecky et al, 2018;Seo et al, 2018;Kojecky et al, 2019), escala de preparo intestinal de Boston (Manes et al, 2013;Jeon et al, 2015;Kim et al, 2015;Munsterman et al, 2015;Yoo et al, 2015;Muñoz et al, 2018;Mathus-Vliegen et al, 2018;Pisera et al, 2019), escala de…”

“…Dezesseis estudos, correspondendo a dezenove comparações, demonstraram eficácia semelhante entre o PSCM e o PEG para o preparo intestinal (Regev et al, 1998;Kao et al, 2011;Lawrance et al, 2011;Katz et al, 2013;Manes et al, 2013;Kang et al, 2014;Kim et al, 2014b;Jeon et al, 2015;Kim et al, 2015;Kojecky et al, 2018;Mathus-Vliegen et al, 2018;Muñoz et al, 2018;Seo et al, 2018;Kojecky et al, 2019). Enquanto em dois estudos o PSCM foi superior ao PEG para o preparo intestinal (Rex et al, 2013;Kim et al, 2014a), em quatro o PEG foi superior ao PSCM (Pohl et al, 2015;Quaresma et al, 2018;Pisera et al, 2019;Rostom et al, 2019).…”