Bowel Preparation Agents Research Articles

The Role of Bowel Preparation and Pro-Kinetic Agents in Capsule Endoscopy - A Prospective Randomized Controlled Trial

Introduction: The diagnostic accuracy and patient acceptablity of Capsule Endoscopy (CE) has led to an exponential increase in its use since its introduction in 2002. However, accuracy may be limited by poor luminal views and incomplete small bowel transit. Standard preparation consists of clear fluids from 12 pm the day prior and then nil-by-mouth from midnight. Bowel preparations and pro-kinetic agents have been studied but the results are in-conclusive and the trials often limited by small numbers and retrospective design.

Comparison of two small-volume colonoscopy bowel-preparation agents

Comparison of two small-volume colonoscopy bowel-preparation agents

Which is the optimal bowel preparation for colonoscopy – a meta‐analysis

To assess which bowel preparation agent is most effective. A search of randomized trials between January 1990 and July 2005 was obtained, using MEDLINE and PubMed databases, and the Cochrane Central Register of Controlled Trials. Meta-analysis was performed using the Forest plot review. Sodium phosphate (NaP) was more effective in bowel cleansing than polyethylene glycol (PEG) - odds ratio 0.75 (95%CI: 0.65-0.88; P = 0.0004); and sodium picosulphate (SPS) - odds ratio 0.52 (95%CI: 0.34-0.81; P = 0.004). PEG and SPS were comparable in bowel cleansing ability, odds ratio 1.69 (95%CI: 0.92-3.13; P = 0.09). NaP was more easily completed by patients compared to PEG, odds ratio 0.16 (95%CI: 0.09-0.29; P < 0.00001). More patients were able to complete SPS than PEG, but this was not statistically significant - odds ratio 0.56 (95%CI: 0.28-1.13; P = 0.11). NaP and PEG were comparable in terms of adverse events, odds ratio 0.98 (95%CI: 0.82-1.17; P = 0.81), although NaP resulted in more asymptomatic hypokalaemia and hyperphosphataemia. NaP and SPS appeared to have similar incidence of adverse events. PEG resulted in more adverse events than SPS, odds ratio 3.82 (95%CI: 1.60-9.15; P = 0.003). NaP was more effective in bowel cleansing than PEG or SPS and was comparable in terms of adverse events. Patients have more difficulty completing PEG than NaP and SPS. Biochemical changes associated with a small-volume preparation like NaP, albeit largely asymptomatic, mandate caution in patients with cardiovascular or renal impairment.

Oral Sodium Phosphate (Fleet®) is a Superior Colonoscopy Preparation to Picoprep®(Sodium Picosulfate-Based Preparation)

Small-volume bowel preparation is better tolerated than 4-liter polyethylene glycol lavage. However, the efficacy of various small-volume bowel preparation agents for colonoscopy has not been clearly defined. This randomized, controlled trial was designed to compare oral sodium phosphate (Fleet) with Picoprep (sodium picosulfate-based preparation). Two hundred twenty-five outpatients, aged 65 years or younger, who would undergo colonoscopy by two endoscopists were randomized to receive two bottles of oral sodium phosphate or three sachets of Picoprep. A standardized questionnaire was completed by all patients and the endoscopists. The endoscopists were blinded to the preparation used. One hundred three patients were randomized to oral sodium phosphate (Fleet) (Group 1) and 122 patients to Picoprep (Group 2). Three patients were excluded because of colonic strictures. The groups were similar in age and gender, indications for colonoscopy, and previous colonic surgery. The quality of bowel cleansing in patients taking oral sodium phosphate (Fleet) was significantly better than Picoprep as assessed by the endoscopists (P = 0.0014). Both types of bowel preparation were associated with similar incidence of nausea (P = 0.4927), dizziness (P= 0.9663), abdominal cramps (P = 0.7157), and patient acceptability (P = 0.0767). Equal majority from either group would use the same bowel preparation again (91 percent of oral sodium phosphate (Fleet) and 93 percent of Picoprep group; P = 0.6172). Although Picoprep was better tasting (P = 0.0273), oral sodium phosphate (Fleet)was perceived to be a good preparation agent by a greater (although not significant) proportion of patients (P = 0.0853). Oral sodium phosphate (Fleet) is more effective in bowel cleansing than Picoprep as a bowel preparation agent. Both agents have similar side effects and patient acceptance.

A Randomized Prospective Trial Comparing Oral Sodium Phosphate with Magnesium citrate in Preparing of Patients for Double Contrast Barium Enema

Purpose: The purpose of this study was to compare two bowel preparation agents, sodium phosphate solution with magnesium citrate solution. Materials and Methods: A total of 94 subjects that underwent a double-contrast barium enema were included in this study. Bowel preparation before performing the barium study was done by using a sodium phosphate solution in 47 subjects and by using a magnesium citrate solution in the other 47subjects. We evaluated the presence or absence of side effects when using these bowel preparation agents. Two radiologist who were blinded to the type of bowel preparation evaluated the quality of bowel preparation at the colonic segments (ascending, descending, and sigmoid colon) on the radiographs obtained by double-contrast barium enema, with regard to stool cleansing, water retention, barium coating and bubble formation. Results: The side effects, such as abdominal clamping pain, nausea, hunger pain and chill occurred more frequently in the sodium phosphate group than in the magnesium citrate group (p

Application of MRI for small intestinal diseases.

Until recently, MRI has not been considered to be suitable for the evaluation of the small intestine due to artifacts associated with bowel peristalsis or respiration. However, recent advances of MR techniques enable the acquisition of clear images of the small intestine. Therefore, the purpose of this article is to review the details for the application of MRI in patients with small intestinal diseases. This article discusses bowel preparation and oral contrast agents as well as MR techniques and pulse sequences. Thereafter, the usefulness of MRI for the lesions in the peritoneal cavity or in the gastrointestinal tract are discussed. Small intestinal lesions are categorized into inflammatory, neoplastic, ischemic, and obstructive bowel diseases. In conclusion, MRI can be used as an alternate modality of choice for imaging various diseases of the small intestine.

The effect of oral magnesium-containing bowel preparation agents on mucosal coating by barium sulphate suspensions.

Alteration in the quality of mucosal coating by barium sulphate suspension observed during double-contrast barium enema (DCBE) examinations when an oral magnesium-containing purgative (Picolax) was used as sole bowel preparation has been investigated in vivo. Small amounts of Picolax were found to produce a linear increase in apparent viscosity and thixotropy, due to flocculation. The effect of equivalent concentrations of acid was significantly less (p less than 0.01), and of magnesium chloride was significantly greater (p less than 0.05), whereas magnesium citrate was comparable to Picolax, demonstrating the deflocculating effect of citrate on the flocculating action of magnesium ions. It is suggested that colonic residue from orally ingested magnesium-containing purgatives may contain sufficient magnesium ions to increase viscosity of the barium suspension and visibly affect its coating during DCBE.