Cleansing ability and tolerance of three bowel preparations for colonoscopy

Frommer, D.

doi:10.1007/bf02055690

Cited by 161 publications

(119 citation statements)

References 6 publications

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“…Prior studies have demonstrated that split dosing not only to improves patient acceptability, but also cleans the colon better [8] . Of 13 prospective, randomized studies done previously, 12 showed superior cleansing when whole or part of the bowel preparation was given in the morning of the scheduled colonoscopy [9][10][11][12][13][14][15][16][17][18][19][20][21] . However colonoscopies are often scheduled in the afternoon, and split dosing may not leave a clean colon by afternoon.…”

Section: Introductionmentioning

confidence: 99%

Comparison of split-dosingvsnon-split (morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

Shah

Desai

Samant

et al. 2014

WJGE

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AIM: To compare (using the Ottawa Bowel PreparationScale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval. METHODS:Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens (split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability. RESULTS:Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawa score mean 5.52 (SD 1.23) vs 6.02 (1.34); P = 0.017].On subgroup analysis, for afternoon procedures, both the preparations were equally effective (P = 0.756). There was no difference in tolerability and compliance between the two regimens. CONCLUSION:Overall, previous evening -same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient. Key words: Bowel preparation; Colonoscopy; Morning preparation; Split dose preparation; Preparation to colonoscopy interval Core tip: Split bowel reparation compared to single dose morning preparation resulted in a better bowel cleansing using the Ottawa Bowel Preparation Scale. The average score (± SD) using the Ottawa Scale was 6.02 ± 1.34 when morning preparation was given and 5.52 ± 1.23 when split preparation was given (P = 0.017). However, there was no statistical difference in the mean Ottawa score when the procedures were done in the afternoon with either the morning or the split preparation (6.09 vs 5.94, P = 0.756). Hence, AM only dosing is as effective as split dosing for patients scheduled for a colonoscopy in the afternoon.

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Section: Introductionmentioning

confidence: 99%

Comparison of split-dosingvsnon-split (morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

Shah

Desai

Samant

et al. 2014

WJGE

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“…Given the presumed antiproliferative effect of polyethylene glycol, colonic cleansing before colonoscopy was obtained using sodium phosphate, using a divided-dose regimen, the first the evening before the procedure and the second 10 to 12 hours later, as previously described (35).…”

Section: Treatment Plan and Study Proceduresmentioning

confidence: 99%

A Randomized, Placebo-Controlled, Preoperative Trial of Allopurinol in Subjects with Colorectal Adenoma

Puntoni

Branchi

Argusti

et al. 2013

Cancer Prevention Research

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Inflammation and oxidative stress play a crucial role in the development of colorectal cancer (CRC) and interference with these mechanisms represents a strategy in CRC chemoprevention. Allopurinol, a safe molecular scavenger largely used as antigout agent, has been shown to increase survival of patients with advanced CRC and to reduce CRC incidence in long-term gout users in epidemiologic studies. We conducted a randomized, double-blind, placebo-controlled preoperative trial in subjects with colorectal adenomatous polyps to assess the activity of allopurinol on biomarkers of colorectal carcinogenesis.After complete colonoscopy and biopsy of the index polyp, 73 subjects with colorectal adenomas were assigned to either placebo or one of two doses of allopurinol (100 mg or 300 mg) and treated for four weeks before polyp removal. Change of Ki-67 labeling index in adenomatous tissue was the primary endpoint. Secondary endpoints were the immunohistochemical (IHC) expression of NF-kB, b-catenin, topoisomerase-II-a, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) in adenomatous polyps and normal adjacent colonic tissue.Compared with placebo, Ki-67 levels were not significantly modulated by allopurinol, whereas b-catenin and NF-kB expression levels decreased significantly in adenomatous tissue, with a mean change from baseline of À10.6%, 95% confidence interval (CI), À20.5 to À0.7, and À8.1%, 95% CI, À22.7 to 6.5, respectively. NF-kB also decreased significantly in normal adjacent tissue (À16.4%; 95% CI, À29.0 to À3.8).No dose-response relationship was noted, except for NF-kB expression in normal tissue.Allopurinol can inhibit biomarkers of oxidative activation in colon adenomatous polyps and normal adjacent tissue. Further studies should define its potential chemopreventive activity. Cancer Prev Res; 6(2); 74-81. Ó2012 AACR.

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“…20 tablets are taken the night before the colonoscopy, 4 tablets every 15 minutes followed by 8 oz clear liquids and the remaining 12-20 tablets on the morning of the colonoscopy within 3-5 hours of the procedure. A split-dose NaP schedule, with one dose taken the day before and one on the day of the procedure separated by 12 hours, was also found to be superior relative to a single dose (Frommer, 1997). All NaP regimens should be taken with a minimum of 2 L of clear liquids.…”

Section: Hyperosmotic Bowel Preparationsmentioning

confidence: 99%

Preparing for Colonoscopy

Deepak¹,

Sifuentes²,

Sherid³

et al. 2011

Endoscopic Procedures in Colon and Rectum

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Endoscopic Procedures in Colon and Rectum 18 followed by repeated procedures. In a study of 200 consecutive outpatient colonoscopies, imperfect bowel preparation resulted in a 12% increase in costs at a university hospital and 22% increase in costs at a public hospital (Rex et al., 2002). Types of bowel preparationsThe ideal colon preparation should rapidly and reliably cleanse the colon of fecal material while having no effect on the gross or microscopic appearance of the colon (Wexner et al., 2006). It should require a short period for ingestion and evacuation, cause no discomfort, and produce no significant fluid or electrolyte shifts while also being palatable, simple, and inexpensive. Agents used for bowel preparation can be divided into three main categories according to their mechanism of action, these being isosmotic, hyperosmotic, and adjunctive preparations. Polyethylene glycol-electrolyte lavage solutions (PEG-ELSs) and sodium phosphate (NaP) formulations are among the most commonly used. 2.2

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Cleansing ability and tolerance of three bowel preparations for colonoscopy

Cited by 161 publications

References 6 publications

Comparison of split-dosingvsnon-split (morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

Comparison of split-dosingvsnon-split (morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

A Randomized, Placebo-Controlled, Preoperative Trial of Allopurinol in Subjects with Colorectal Adenoma

Preparing for Colonoscopy

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