Pilot study on efficacy of reduced cathartic bowel preparation with polyethylene glycol and bisacodyl

Chen, Zhi-yuan

doi:10.3748/wjg.v19.i4.561

Cited by 4 publications

(5 citation statements)

References 34 publications

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“…In a previous experience, we found similar results by administering three sachets/day of a Macrogol 3350-based mild laxative starting 2 days before CTC (4.4% of insufficiently marked segments) [ 13 ]. Iafrate et al [ 8 ] reported 2.6% of colon segments with insufficient preparation using a 1L PEG solution associated with a stimulant agent (bisacodyl) that is correlated with a higher stool cleansing ability [ 14 ]. Both in our experience and in that of the two above-mentioned studies, FT quality decreased in the distal colonic segments.…”

Section: Discussionmentioning

confidence: 99%

“…Polyethylene glycol (PEG) is a hydrophilic and iso-osmolar laxative that has few side effects since it is non-absorbable and does not alter the patient's electrolyte balance. PEG has been proposed in low-volume solutions either in a single or fractionated dose [10][11][12][13][14][15][16][17]. A variable amount of residual fluid is usually present in the large bowel following PEG administration that can easily be tagged by oral intake of iodinated contrast media, which has been extensively evaluated [13,[18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Effect of dose splitting of a low-volume bowel preparation macrogol-based solution on CT colonography tagging quality

et al. 2022

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Purpose To compare examination quality and acceptability of three different low-volume bowel preparation regimens differing in scheduling of the oral administration of a Macrogol-based solution, in patients undergoing computed tomographic colonography (CTC). The secondary aim was to compare CTC quality according to anatomical and patient variables (dolichocolon, colonic diverticulosis, functional and secondary constipation). Methods One-hundred-eighty patients were randomized into one of three regimens where PEG was administered, respectively: in a single dose the day prior to (A), or in a fractionated dose 2 (B) and 3 days (C) before the examination. Two experienced radiologists evaluated fecal tagging (FT) density and homogeneity both qualitatively and quantitatively by assessing mean segment density (MSD) and relative standard deviation (RSD). Tolerance to the regimens and patient variables were also recorded. Results Compared to B and C, regimen A showed a lower percentage of segments with inadequate FT and a significantly higher median FT density and/or homogeneity scores as well as significantly higher MSD values in some colonic segments. No statistically significant differences were found in tolerance of the preparations. A higher number of inadequate segments were observed in patients with dolichocolon (p < 0.01) and secondary constipation (p < 0.01). Interobserver agreement was high for the assessment of both FT density (k = 0.887) and homogeneity (k = 0.852). Conclusion The best examination quality was obtained when PEG was administered the day before CTC in a single session. The presence of dolichocolon and secondary constipation represent a risk factor for the presence of inadequately tagged colonic segments.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of dose splitting of a low-volume bowel preparation macrogol-based solution on CT colonography tagging quality

et al. 2022

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“…CTC has been shown to be a new effective tool for colorectal cancer screening, due to its non-invasiveness and high sensitivity for polyp and neoplasia detection [ 12 – 16 ]. However, its hazard of ionizing radiation is a major concern to the public [ 17 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

Pilot Study on Image Quality and Radiation Dose of CT Colonography with Adaptive Iterative Dose Reduction Three-Dimensional

et al. 2015

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ObjectiveTo investigate image quality and radiation dose of CT colonography (CTC) with adaptive iterative dose reduction three-dimensional (AIDR3D).MethodsTen segments of porcine colon phantom were collected, and 30 pedunculate polyps with diameters ranging from 1 to 15 mm were simulated on each segment. Image data were acquired with tube voltage of 120 kVp, and current doses of 10 mAs, 20 mAs, 30 mAs, 40 mAs, 50 mAs, respectively. CTC images were reconstructed using filtered back projection (FBP) and AIDR3D. Two radiologists blindly evaluated image quality. Quantitative evaluation of image quality included image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Qualitative image quality was evaluated with a five-score scale. Radiation dose was calculated based on dose-length product. Ten volunteers were examined supine 50 mAs with FBP and prone 20 mAs with AIDR3D, and image qualities were assessed. Paired t test was performed for statistical analysis.ResultsFor 20 mAs with AIDR3D and 50 mAs with FBP, image noise, SNRs and CNRs were (16.4 ± 1.6) HU vs. (16.8 ± 2.6) HU, 1.9 ± 0.2 vs. 1.9 ± 0.4, and 62.3 ± 6.8 vs. 62.0 ± 6.2, respectively; qualitative image quality scores were 4.1 and 4.3, respectively; their differences were all not statistically significant. Compared with 50 mAs with FBP, radiation dose (1.62 mSv) of 20 mAs with AIDR3D was decreased by 60.0%. There was no statistically significant difference in image noise, SNRs, CNRs and qualitative image quality scores between prone 20 mAs with AIDR3D and supine 50 mAs with FBP in 10 volunteers, the former reduced radiation dose by 61.1%.ConclusionImage quality of CTC using 20 mAs with AIDR3D could be comparable to standard 50 mAs with FBP, radiation dose of the former reduced by about 60.0% and was only 1.62 mSv.

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“…The iso-osmotic bowel cleansing agent polyethylene glycol-4000 (PEG-4000) causes diarrhea by increasing the local osmotic pressure, which generates mechanical movement of water ions to clean the intestinal tract, achieving a good bowel cleansing effect. Furthermore, PEG-4000 is widely used in clinical practice because of its good reliability and safety (Di Nardo et al 2014 ; Chen et al 2013 ; Abe et al 2021 ). However, PEG-4000 has a poor taste and requires a large intake of liquid, which may cause discomfort to patients, including nausea, vomiting, bloating, and electrolyte and intestinal microbiota disorders (Nyberg et al 2010 ; Yoshioka et al 2017 ; Chaussade and Minić 2003 ).…”

Section: Introductionmentioning

confidence: 99%

“…221,104) was purchased from Staidson Biopharmaceuticals Co., Ltd., Beijing, China. The syrup was purchased from Yingzhihao Biotechnology Co., Liaoning, China (Chen 2011, Chen 2012Chen et al 2013). The food production license number and product standard code of the syrup in China are SC10637148204742 and GB7101, respectively.…”

Section: Introductionmentioning

confidence: 99%

A syrup containing l-arabinose and d-xylose appears superior to PEG-4000 as a bowel cleansing agent

Wang,

Liao,

Zhang

et al. 2024

AMB Expr

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Adequate bowel cleansing is crucial for endoscopic diagnosis and treatment, and the recovery of gut microbiota after intestinal cleansing is also important. A hypertonic syrup predominantly comprising l-arabinose and d-xylose (20% xylo-oligosaccharides) can be extracted from the hemicellulose of corn husks and cobs. l-Arabinose and xylo-oligosaccharides have been reported to relieve constipation and improve the gut microbial environment. This study evaluated the bowel cleansing effect of the aforementioned syrup and its influence on the organism and intestinal microbiota after cleansing in comparison with polyethylene glycol-4000 (PEG-4000) in mice. Bowel cleansing was performed using syrup or PEG-4000 in C57BL/6J mice, and the effect of intestinal preparation and its influence on serum electrolytes and gut microbiota after bowel cleansing were evaluated. The volume of intestinal residual feces in the syrup group was significantly lower than that in the PEG-4000 group. Additionally, syrup disturbed serum electrolytes more mildly than PEG-4000. Alpha diversity in the gut microbiota was significantly higher in the syrup group than in the PEG-4000 group on the first day after bowel cleansing. However, no difference in beta diversity was observed between the two groups. Syrup increased the abundance of Bifidobacteria and Christensenella and decreased the abundance of Akkermansia in comparison with PEG-4000 on the first day after bowel cleansing. Thus, this syrup has potential clinical use as a bowel cleansing agent given the above effects, its benefits and safety, and better taste and acceptability.

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Pilot study on efficacy of reduced cathartic bowel preparation with polyethylene glycol and bisacodyl

Cited by 4 publications

References 34 publications

Effect of dose splitting of a low-volume bowel preparation macrogol-based solution on CT colonography tagging quality

Effect of dose splitting of a low-volume bowel preparation macrogol-based solution on CT colonography tagging quality

Pilot Study on Image Quality and Radiation Dose of CT Colonography with Adaptive Iterative Dose Reduction Three-Dimensional

A syrup containing l-arabinose and d-xylose appears superior to PEG-4000 as a bowel cleansing agent

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