New Bowel Preparation Technique for Colonoscopy: Clinical Trial Comparing Aquanet and Mannitol

Kaiser-Júnior, Roberto Luiz; DE-Quadros, Luiz Gustavo; Flamini-Júnior, Mário; Faria, Mikaell Alexandre Gouvêa; Campo, Juan Carlos Ochoa; DE-Oliveira, Vera Lúcia; Zotarelli-Filho, Idiberto José

doi:10.1590/0102-672020180001e1393

Cited by 6 publications

(8 citation statements)

References 19 publications

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“…Using mechanical bowel cleansing before or during colonoscopy is proposed as an alternative to oral laxatives in selected patient groups. 103 , 104 , 105 , 106 , 107 Preprocedural devices work through retrograde bowel lavage using pressurized water one hour before colonoscopy, 108 , 109 , 110 while intraprocedural devices can be used during colonoscopy providing water‐pressured cleansing. 107 , 111 , 112 , 113 Feasibility studies have shown a clear potential, with adequate bowel preparation achieved in 97.9–100% and 68.8–91.1% of patients in whom intraprocedural devices 107 , 111 , 112 , 113 or preprocedural devices, 108 , 109 , 110 respectively, were used.…”

Section: Discussionmentioning

confidence: 99%

“…103 , 104 , 105 , 106 , 107 Preprocedural devices work through retrograde bowel lavage using pressurized water one hour before colonoscopy, 108 , 109 , 110 while intraprocedural devices can be used during colonoscopy providing water‐pressured cleansing. 107 , 111 , 112 , 113 Feasibility studies have shown a clear potential, with adequate bowel preparation achieved in 97.9–100% and 68.8–91.1% of patients in whom intraprocedural devices 107 , 111 , 112 , 113 or preprocedural devices, 108 , 109 , 110 respectively, were used. Nonetheless, the use of intraprocedural devices adds significantly to the total procedure time, and preprocedural devices require a specialized nurse to operate the system.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of ultra‐low volume (≤1 L) bowel preparation fluids: Systematic review and meta‐analysis

Riswijk¹,

Keulen²,

Siersema³

2021

Digestive Endoscopy

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Background and Aims: High-quality bowel preparation is paramount for the diagnostic accuracy and safety of colonoscopy; however, it is often difficult for patients to adhere to high-volume laxatives, which may contribute to poor bowel preparation. This review aims to assess the efficacy of bowel preparation fluids of 1 L or less (≤1 L).Methods: We performed a systematic review including all relevant randomized controlled trials on ultra-low volume (≤1 L) bowel preparation fluids for colonoscopy published since 2015. Primary endpoint was the percentage of adequately prepared patients. Secondary endpoints included adenoma detection rate (ADR) and safety.Results: Bowel preparation with sodium picosulfate/magnesium citrate (SPMC; 19 trials, n = 10,287), 1L-polyethylene glycol with ascorbate (PEGA; 10 trials, n = 1717), sodium phosphate (NaP; 2 trials, n = 621), and oral sulfate solution (OSS; 3 trials, n = 597) was adequate in 75.2%, 82.9%, 81.9%, and 92.1%, respectively, of patients; however, heterogeneity between studies was considerable (I 2 range: 86-98%). Pooled ADRs were 31.1% with SPMC, 32.3% with 1L-PEGA, 30.4% with NaP, and 40.9% with OSS. Temporary electrolyte changes were seen with all ultra-low volume bowel preparation fluid solutions but without sustained effects in most patients. Conclusion:Ultra-low volume bowel preparation fluids do not always meet the 90% quality standard for adequate bowel preparation as defined by current guidelines. Nonetheless, they may be considered in patients intolerant for higher-volume laxatives and without risk factors for inadequate bowel preparation or dehydration-related complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of ultra‐low volume (≤1 L) bowel preparation fluids: Systematic review and meta‐analysis

Riswijk¹,

Keulen²,

Siersema³

2021

Digestive Endoscopy

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“…In the choice of intestinal cleansers, polyethylene glycol is still the most widely used at home and abroad [18], and recent metaanalysis shows sodium picosulfate/magnesium citrate with better tolerability and less frequent adverse events demonstrated non-inferior bowel cleaning efficacy than that of the polyethylene glycol [19]. In addition to active oral intestinal laxative preparations, in recent years, passive intestinal cleaning methods such as Aquanet EC-2000 have also been developed, with effects similar to oral sodium matrine sulfate and mannitol oral solutions [20,21]. In actual clinical work, the preparation situation is not optimistic.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

Zhou

Zhang

Yang

2020

Gastroenterology Research and Practice

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Objective. To analyze the correlation of intestinal cleanliness in each segment of the Boston Intestinal Preparation Scale. Methods. From February 2017 to October 2019, the data of patients who underwent colonoscopy in the Department of Gastroenterology, Hangzhou First People’s Hospital, Zhejiang University School of Medicine, were collected. Statistical analysis was performed according to the Boston Intestinal Preparation Scale score, and the correlation of intestinal cleanliness in each region was obtained. Results. A total of 1739 patients were included. The overall score of BBPS was 6.77±1.88. The scores of each region were 2.04±0.84 (right lateral colon), 2.25±0.68 (transverse colon), and 2.48±0.64 (left colon). The difference between the regions was statistically significant (P<0.05). The bowel cleanliness showed a gradual deterioration trend, and there was a positive correlation between colon cleanliness in each region. The accuracy of the transverse colon in predicting the right colon (AUC=0.809) is higher than that of the left colon (AUC=0.735), and the accuracy of predicting the cleanliness of the right colon intestinal tract by the cleanliness of the left colon intestinal tract is relatively low. Conclusion. Intestinal cleanliness gradually deteriorates from the direction of the insert. It is not reliable to predict the right side of poor cleanliness by using the left colon intestinal cleanliness (BBPS 0-1 score). It should continue to further endoscopy. When the cleanliness of the transverse colon is poor, then stopping further endoscopy is considered.

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“…Colonic irrigation as an alternative method has been reported and was described as safe, effective and well tolerated. In addition, bowel cleansing quality of colonic irrigation is considered comparable to oral purgative regimes but with less side effects and high patient satisfaction 8 9 10 11 12 13 14 15 16 17 . Furthermore, colonic irrigation in the form of colon hydrotherapy is described by Parekh et al as the “future direction of bowel preparation” 18 .…”

Section: Introductionmentioning

confidence: 99%

Bowel preparation prior to colonoscopy with a new colonic irrigation device: Results of a prospective observational study

et al. 2022

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Background and study aims The success of colonoscopy is mainly dependent on the effectiveness of prior bowel preparation (BP). Patients often consider BP to be the most burdensome part of colonoscopy, which might be a main barrier to the procedure. The aim of this study was to evaluate safety and effectiveness of colonic irrigation with a new colon hydrotherapy (CHT) device as an alternative to traditional oral BP. Patients and methods A prospective, non-randomized observational study was conducted to evaluate the quality of BP. A BP was considered effective if a score of 6 or better through the Boston Bowel Preparation Scale (BBPS) could be reached. Colonoscopy was performed immediately following colonic irrigation. For safety analysis, data on adverse events (AEs) were collected. Among the secondary outcomes, the BBPS assessed in each bowel segment and cecal intubation rate were analyzed. Results Twenty-eight consecutive patients (11 male [39.3%] and 17 [60.7 %] female) undergoing screening/surveillance or diagnostic colonoscopy were enrolled. Mean age was 54 ± 12.4 years (range 19–80). The evaluated mean BBPS was 7.8 ± 1.5. Twenty-five patients (89.3 %) had a BBPS score of 6 or above. Colonic irrigation was performed without any complications and no AEs were reported within 30 days. The cecal intubation rate was 100 %. Conclusions Colonic irrigation with a new CHT device is an effective and low-risk alternative to traditional oral preparation prior to colonoscopy.

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New Bowel Preparation Technique for Colonoscopy: Clinical Trial Comparing Aquanet and Mannitol

Cited by 6 publications

References 19 publications

Efficacy of ultra‐low volume (≤1 L) bowel preparation fluids: Systematic review and meta‐analysis

Efficacy of ultra‐low volume (≤1 L) bowel preparation fluids: Systematic review and meta‐analysis

Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

Bowel preparation prior to colonoscopy with a new colonic irrigation device: Results of a prospective observational study

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