Bowel preparation before colonoscopy

Saltzman, John R.; Cash, Brooks D.; Pasha, Shabana F.; Early, Dayna S.; Muthusamy, V. Raman; Khashab, Mouen A.; Chathadi, Krishnavel V.; Fanelli, Robert D.; Chandrasekhara, Vinay; Lightdale, Jenifer R.; Fonkalsrud, Lisa; Shergill, Amandeep K.; Hwang, Joo Ha; Decker, G. Anton; Jue, Terry L.; Sharaf, Ravi; Fisher, Deborah A.; Evans, John A.; Foley, Kimberly; Shaukat, Aasma; Eloubeidi, Mohamad A.; Faulx, Ashley L.; Wang, Amy; Acosta, Ruben D.

doi:10.1016/j.gie.2014.09.048

Cited by 352 publications

(297 citation statements)

References 129 publications

Supporting

Mentioning

287

Contrasting

Unclassified

Order By: Relevance

“…Therefore, we found it important to assess possible predictors of inadequate bowel preparation that can help guide future improvement in institutional procedure planning. In our cohort of hospitalized patients, 43% had inadequate bowel preparation, which is a high rate compared with previous studies, and this contributed to a low cecal intubation rate of 52% and polyp detection not meeting guideline recommendations (2,4,(12)(13)(14). We found that patients having colonoscopy in the afternoon were less likely to have successful bowel preparation (OR=0.32, 95% CI=0.14-0.74, p=0.007).…”

Section: Discussionmentioning

confidence: 41%

Predictors of inadequate bowel preparation for inpatient colonoscopy

Jawa

Mosli²,

Alsamadani³

et al. 2017

Turk J Gastroenterol

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 41%

Predictors of inadequate bowel preparation for inpatient colonoscopy

Jawa

Mosli²,

Alsamadani³

et al. 2017

Turk J Gastroenterol

View full text Add to dashboard Cite

“…Splitting the dose of either PEG or SPMC is preferred by patients and increases the quality of the bowel preparation compared with day‐before regimens 12, 27. A split‐dose bowel preparation for all patients or same day preparation for afternoon colonoscopy has been recommended in recent guidelines 28. Although well tolerated and safe in most, there is a small increased risk of hyponatremia with SPMC in the elderly29 and, therefore, PEG‐based bowel preparation may be more appropriate in these patients.…”

Section: Discussionmentioning

confidence: 99%

White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

et al. 2017

View full text Add to dashboard Cite

Background and AimBowel preparations with polyethylene glycol (PEG) and clear fluids are often poorly tolerated. We compared an innovative low‐residue White Diet and low‐volume, split‐dose Picosalax with the standard preparation at our institution of day‐before clear fluids and combination PEG plus sodium picosulfate/magnesium citrate (SPMC).MethodsAdults undergoing morning colonoscopy were randomized to either the White Diet and split‐dose, two sachets of Picosalax (WD/PICO) or day‐before clear fluids and 1‐L PEG plus two sachets of SPMC (CF/PEG + SPMC). The primary endpoint was successful bowel preparation defined by an Ottawa bowel preparation score ≤ 6. An intention‐to‐treat analysis with a predefined non‐inferiority margin of 15% was used to compare efficacy.ResultsA total of 250 patients were randomized (125 WD/PICO and 125 CF/PEG + SPMC). WD/PICO was non‐inferior to CF/PEG + SPMC for successful bowel preparation by intention‐to‐treat analysis (58% WD/PICO vs 62% CF/PEG + SPMC, 95%CI: −14.2 to 6.2%) and per‐protocol analysis (64% WD/PICO vs 65% CF/PEG + SPMC, 95%CI: −11.3 to 9.4%). Patients in the WD/PICO group reported greater satisfaction with the diet (P < 0.001), greater ease of following the diet (P < 0.001), and improved experience compared with prior colonoscopy (P < 0.0001), less bloating (P = 0.02), less weakness (P = 0.046), less hunger (P < 0.0001), and less interference with daily activities (P = 0.001). Procedure/withdrawal times and adenoma detection rates were similar between groups.ConclusionBowel preparation with the White Diet and low‐volume, split‐dose Picosalax was preferred and better tolerated without detriment to bowel preparation success compared with clear fluids and combination PEG plus SPMC for morning colonoscopy.

show abstract

“…3 Although usually safe it may be associated with severe complications. 2,4 The ideal bowel preparation should be easy to drink while achieving excellent bowel cleansing and minimizing adverse impact over the gastrointestinal tract mucosa and electrolyte balance in order to increase the patient's adherence and safety. 5 The most common solutions for colonoscopy preparation include polyethylene glycol (PEG), sodium phosphate (NaP) and MC-SP complex.…”

Section: Discussionmentioning

confidence: 99%

“…1 The risk of these electrolyte imbalances seems to be related to the type of bowel cleansing solution, age of the patient and comorbidities. 2 The authors report two cases of symptomatic hyponatremia after bowel preparation for colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

Symptomatic Hyponatremia after Bowel Preparation: Report of Two Cases and Literature Review

Costa

Soares

2017

Acta Med Port

View full text Add to dashboard Cite

RESUMOIntrodução: A preparação intestinal para colonoscopia e/ou cirurgia coloretal pode induzir alterações hidro-eletrolíticas. O risco destas alterações parece estar relacionado com o tipo de preparação intestinal, idade e comorbilidades dos doentes. Caso Clínico: Os autores apresentam dois casos de hiponatrémia sintomática (sinais neurológicos focais e coma) após preparação intestinal com picossulfato de sódio/citrato de magnésio para colonoscopia. Em ambos os casos, verificou-se resolução completa e rápida do quadro clínico depois da correção da hiponatrémia com solução intravenosa de NaCl a 3%. Discussão: Os distúrbios eletrolíticos são mais frequentes nas preparações à base de fosfato de sódio e picossulfato de sódio/ citrato de magnésio, nos doentes com mais de 65 anos ou medicados com diuréticos tiazídicos, inibidores da enzima de conversão da angiotensina, beta-bloqueantes e antidepressivos e em doentes gastrectomizados. Nestes doentes devemos preferir preparações intestinais à base de macrogol (polyethylene glycol). Conclusão: Em doentes de risco (idade superior a 65 anos, medicados com diuréticos tiazídicos, IECAs, beta-bloqueantes e antidepressivos, e antecedentes de gastrectomia) recomendamos soluções à base de macrogol. Palavras-chave: Catárticos/efeitos adversos; Colonoscopia; Hiponatrémia ABSTRACT Introduction: Bowel preparation for colonoscopy and/or colorectal surgery can cause electrolyte imbalances. The risk of electrolyte imbalances seems to be related to the type of bowel cleansing solution, age of patients and comorbidities. Case Report: We report two cases of symptomatic hyponatremia (focal neurological signs and coma) after bowel preparation with sodium picosulfate/magnesium citrate for colonoscopy. In both cases, symptoms related to hyponatremia rapidly disappeared after sodium level correction with intravenous administration of hypertonic saline (3% NaCl). Discussion: Electrolyte imbalances are more common with sodium phosphate-based solutions (NaP) and sodium picosulfate/ magnesium citrate, in patients older than 65, in patients treated with thiazide diuretics, angiotensin-converting-enzyme inhibitor, betablockers or antidepressants and in gastrectomized patients. These patients should use macrogol-based solutions (polyethylene glycol). Conclusion:In patients at risk (patient > 65 years old, patients taking thiazide diuretics, angiotensin-converting-enzyme inhibitors, beta-blockers and antidepressants and with previous gastrectomy) we recommend macrogol-based solutions.

show abstract

Bowel preparation before colonoscopy

Cited by 352 publications

References 129 publications

Predictors of inadequate bowel preparation for inpatient colonoscopy

Predictors of inadequate bowel preparation for inpatient colonoscopy

White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

Symptomatic Hyponatremia after Bowel Preparation: Report of Two Cases and Literature Review

Contact Info

Product

Resources

About