Abstract
OBJECTIVES:Our goal was to compare the hydrogen potential (pH) and residual gastric volume (RGV) of patients undergoing colonoscopy after 3 and 6 hours of colon preparation with mannitol.METHODS:We described a prospective randomized trial with a 50:50 allocation rate of two distinct times of colonoscopy after colon preparation with 10% mannitol. We included outpatients aged over 18 years, with no history of gastric surgeries and an American Society of Anesthesiologists (ASA)-rated anesthetic risk below III. Colonoscopy was performed after upper digestive endoscopy at two different times: 3 versus 6-hour after mannitol ingestion. During upper gastrointestinal endoscopy, we measured RGV and evaluated pH with a digital pH meter. Clinical trials.gov: 71123317.9.3001.0065RESULTS:We randomized a total of 100 participants to the 3 and 6-hour groups, with the patients in the 6-hour group being younger and presenting a higher body mass index (BMI). The intervention did not result in any statistically significant differences between the two groups, neither for the RGV (p=0.98) or the pH (p=0.732). However, the subgroup of patients with diabetes mellitus showed statistically significant higher RGV values in the 3-hour group.CONCLUSION:There was no difference between RGV and pH values at 3 versus 6-hour after bowel preparation with mannitol, except for RGV in diabetic patients at 3 hours. As prolonged fasting protocols may result in adverse events such as dehydration and electrolyte imbalance, we can infer that colonic preparation with mannitol in shorter fasting periods, such as 3 hours, can be adopted safely and routinely.
Highlights
Healthcare providers and the research community consider colonoscopy as a gold-standard for conditions requiring the mucosal imaging of the entire colon, playing an essential role in the diagnosis and treatment of colonic disorders
Our results indicated a balance between the randomized arms for all measured baseline variables, except for age and body mass index (BMI)
The analysis reports no significant differences in the levels of residual gastric volume (RGV) and pH for bowel preparation with mannitol administered at 3 and 6 hours before the colonoscopy procedure (Figure 3)
Summary
Healthcare providers and the research community consider colonoscopy as a gold-standard for conditions requiring the mucosal imaging of the entire colon, playing an essential role in the diagnosis and treatment of colonic disorders. Known as bowel preparation, is critical for the complete visualization of the colonic mucosa, increasing its diagnostic accuracy [1]. Insufficient cleansing or preparation is associated with a low diagnostic yield, a higher rate of canceled procedures, corresponding increased costs, lengthy procedures, and a higher risk of complications. Received for publication on March 11, 2020. Accepted for publication on August 18, 2020
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