A Comparative Study of four Oral Contrast Agents for Small Bowel Distension with Computed Tomography Enterography

Abstract

Lactulose achieves better small bowel distension for CT enterography studies than the other 3 agents and, therefore, is the preferred oral regimen at our institution.

CT enterography: Mannitol versus VoLumen

“…Several studies have compared different neutral oral contrast agents in CTE and MRE . In CTE, Megibow et al .…”

“…reported better results with milk than water. More recent studies demonstrate that lactulose achieves the best small bowel distension when compared to water, metamucil and polyethylene glycol in CTE . In MRE, Lauenstein et al .…”

“…Images were assessed in soft tissue windows on a workstation via a picture archiving and communication system (AGFA Impax). The following format is similar to some previous studies which enables ease of comparison . The abdomen was divided into four quadrants using a line through the umbilicus to divide the abdomen into left and right and a line through the level of the iliac crests divided it into upper and lower divisions.…”

“…In light of this, multiple studies have been conducted using different neutral oral contrast agents to ascertain the most suitable agent. The MRE and CTE have trialled polyethylene glycol, Mannitol, psyllium fibre, VoLumen, lactulose, milk and water …”

Evaluation of the performance of two neutral oral contrast agents in computed tomography enterography: A randomized controlled trial

“…Several studies have compared the performances of various neutral contrast agents used in CTE, including water, whole milk, methylcellulose, polyethylene glycol (PEG), mannitol, lactulose and low‐concentration barium . Excellent imaging quality combined with a good taste makes mannitol one of the most widely used neutral contrast agents in CTE .…”