The Effect of Glucagon on Barium-Enema Examination

Meeroff, J. C.; Jorgens, Joseph; Isenberg, Jon I.

doi:10.1148/115.1.5

Cited by 41 publications

(7 citation statements)

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“…Whereas several studies have reported decreased discomfort and bowel spasm during and after barium enema as well as better bowel relaxation, and patient preference when glucagon is administered beforehand [16,21], the results regarding colonic distention and diagnostic accuracy are less favorable. Bova et al [21] found that the degree of colonic distention at both single-and double-contrast barium enema examination was not significantly improved by the administration of glucagon 1 mg i.v., whereas Goei et al [22] found that butyl scopolamine (Buscopan) 20 mg i.v.…”

Section: Discussionmentioning

confidence: 96%

“…It is widely used in gastrointestinal radiology and endoscopy because of its relaxant effects on the smooth muscle of the stomach, duodenum, small bowel and colon, and its reported effectiveness and fewer side effects when compared with anticholinergic agents such as atropine, hyoscyamine, or scopolamine [14,15,16,17]. Recommendations for the minimum effective dose are 10 µg/kg intravenously, or, more practically, 0.75-1.00 mg in an adult of average weight [18].…”

Section: Discussionmentioning

confidence: 99%

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CT colonography: colonic distention improved by dual positioning but not intravenous glucagon

et al. 2002

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The aim of this study was to determine whether intravenous (IV) glucagon and dual positioning administered prior to CT colonography enhances colonic distention. We assessed the effect of dual positioning and IV glucagon on colonic distention in 96 patients who underwent CT colonography examinations. The CT colonography was performed in both supine and prone positions. Seventy-four patients received glucagon (1 mg i.v.) immediately prior to CT scanning and 22 patients did not. The bowel was divided into ten segments and colonic distention was scored by two radiologists in the supine, prone, and combined supine/prone positions using a five-point scale: 1=collapsed; 2=poorly visualized; > or = 3=adequate distention; 4=entire segment visualized and well distended; 5=excellent distention). A combined segmental and overall supine/prone distention score was calculated based on the sum of the mean score for each position. There was no significant difference in the degree of colonic distention between patients who received glucagon and those who did not [supine/prone distention score (mean +/- SE): 3.63 +/- 0.2 vs 3.85 +/- 0.2; p=n.s.]. The degree of colonic distention was greater in the prone position in both the glucagon (3.87 +/- 0.2 vs 3.38 +/- 0.2; p<0.05) and non-glucagon groups (4.01 +/- 0.2 vs 3.69 +/- 0.2; p=N.S.) particularly in the proximal colon. There was almost perfect agreement between both radiologists in their scoring of colonic distention on a per-patient basis ( k=0.9; p<0.001). Of 1480 bowel segments, 1261 (85.2%) were adequately distended in the glucagon group compared with 370 of 440 bowel segments (84%) in the non-glucagon group ( p=n.s.) Colonic distention at CT colonography is improved by dual positioning but not by the administration of intravenous glucagon. While our results suggest that other smooth muscle relaxants, including butyl scopolamine, may only have a limited role in improving colonic distention in CT colonography, further studies are required.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

CT colonography: colonic distention improved by dual positioning but not intravenous glucagon

et al. 2002

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“…In comparison with anticholinergic agents, glucagon at the low doses used, is virtually free of side effects, and does not interfere with transit through the small bowel [5,12,[18][19][20][21].…”

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confidence: 99%

The hypotonic effect of intranasal and intravenous glucagon in gastrointestinal radiology

et al. 1995

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In the present study, following a double-blind, double placebo protocol vs. placebo, we compared the hypotonic effect of intranasal and intravenous glucagon during a double-contrast barium meal examination of the stomach. We found a statistically significant difference between placebo and intranasal or intravenous glucagon in inducing gastric hypomotility, with no significant differences between IN and IV glucagon. The intranasal administration of glucagon has the advantage of being noninvasive and well tolerated by the patients, and might be a valuable aid in upper gastrointestinal examination as well as in CT scan or magnetic resonance imaging of the abdomen.

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“…Unlike the studies of the duodenum [19,20], there was little measurable difference in the diameter of the normal colon before and after the active drugs were given. The effectiveness of glucagon to relax the colon has been confirmed in further studies in patients by Meerhoff et al [34] and Harned et al [35]. Daniel et al [36] have used glucagon as an antispasmodic in the treatment of acute diverticulitis with excellent results.…”

Section: Hypotonic Colon Examinationsmentioning

confidence: 86%

Gastrointestinal radiography with glucagon

Miller

Chernish

Brunelle

1979

Gastrointest Radiol

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This report summarizes the results of nine diagnostic radiographic studies done double blind crossover comparing glucagon to placebo and to anticholinergic drugs in volunteers. In seven studies the subjects were administered drug intramuscularly and in two studies intravenously. There were five diagnostic studies of the upper gastrointestinal tract, one for esophageal varices and three of the colon. The results indicate that glucagon can be given intramuscularly and intravenously. When given intravenously it has a rapid onset and predictable length of action depending on the dose given. Reports of side effects were few consisting primarily of nausea and or vomiting. These results indicate that glucagon is the drug of choice for hypotonic diagnostic examinations.

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The Effect of Glucagon on Barium-Enema Examination

Cited by 41 publications

References 1 publication

CT colonography: colonic distention improved by dual positioning but not intravenous glucagon

CT colonography: colonic distention improved by dual positioning but not intravenous glucagon

The hypotonic effect of intranasal and intravenous glucagon in gastrointestinal radiology

Gastrointestinal radiography with glucagon

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