Yekta TÜZÜN, Coşkun BEYAZ, Mustafa YAKUT, Şerif YILMAZ, Kadim BAYAN, Mehmet DURSUN, Fikri CANORUÇ

Konstipasyonlu bireylerin kolonoskopi hazırlığında polietilen glikol ile sodyum fosfatın etkinlik ve güvenilirliklerinin karşılaştırılması

Amaç: Polietilen glikol ve oral sodyum fosfat solüsyonları kolonoskopi öncesi barsak temizliği için yaygın kullanılan ajanlardır. Literatürde iki ajanın etkinliğinin karşılaştırıldığı çalışmalar olmasına karşın, bu konu özel bir grup olan konstipasyonlu hastalarda yeterince araştırılmamıştır. Amacımız konstipasyonlu hastalarda polietilen glikol ve oral sodyum fosfat solüsyonlarının etkinlik ve tolarabilite bakımından karşılaştırılmasıdır. Gereç ve Yöntem: Çalışmaya fonksiyonel kabızlık ve kabızlık egemen irritabl barsak sendromlu 57 hasta dâhil edildi. Bunların 28'i polietilen glikol, 29'u sodyum fosfat grubunda yer aldı. Hastalara demografik özellikleri ve kolon hazırlık aşamasında karşılaşılan sorunları içeren bir anket yapıldı. Ayrıca, kolonoskopi işleminde kolonun temizlik ölçüsü skorlandı. Veriler iki grupta karşılaştırıldı. Bulgular: Sodyum fosfat grubunda karın ağrısı ve bulantı daha sık gözlenirken (p=0.04 and 0.012, sırasıyla), polietilen glikol grubunda karında şişkinlik hissi daha sık saptandı (p=0.03). Kolonun temiz görülme oranı her iki grupta istatistiksel anlamlı fark gözetmemesine rağmen, (p=0.180), polietilen glikol grubunda mükemmel hazırlık oranı daha yüksekti (%71.5'a karşı %55.2). Sonuç: Konstipasyonlu hastalarda polietilen glikol ve sodyum fosfat benzer etkinlik ve yan etki profili sergilemektedir. Yan etki bakımından polietilen glikol'de şişkinlik, sodyum fosfat'ta bulantı ve karın ağrısı dominant yansımalardır. Daha güçlü bir sonuca ulaşabilmek için daha geniş serili çalışmalara gereksinim vardır.

Anahtar Kelimeler:

Kolon hazırlığı, PEG, sodyum fosfat, konstipasyon

Comparison of efficacy and safety of polyethylene glycol and sodium phosphate in colon preparation of patients with constipation

Background and Aims: Polyethylene glycol and oral sodium phosphate solutions are widely used agents in colon cleansing. Although there are studies in the literature comparing the efficacy of these agents, this issue has not been evaluated sufficiently in patients with constipation. Our aim was to compare the efficacy and tolerability of polyethylene glycol and oral sodium phosphate in patients with constipation. Materials and Methods: Fifty-seven patients with functional constipation and constipation-dominant irritable bowel syndrome were included. Of these, 28 were in the polyethylene glycol group and 29 were in the sodium phosphate group. A questionnaire including demographic features and problems encountered during the bowel preparation was applied. In addition, the quality of the colonic preparation was scored. Data were compared between groups. Results: Abdominal pain and nausea (p=0.04 and 0.012, respectively) in the sodium phosphate group and abdominal bloating (p=0.03) in the polyethylene glycol group were more common than in the other group, respectively. Although there was no statistically significant difference between groups with respect to the rate of clean colon (p=0.180), the rate of perfect cleansing was higher in the polyethylene glycol group (71.5% vs 55.2%). Conclusions: Polyethylene glycol and sodium phosphate demonstrated a similar efficiency and side effect profile in patients with constipation. Abdominal bloating in the polyethylene glycol group and nausea and abdominal pain in the sodium phosphate group were the dominant side effects. Further studies with wider study populations are needed to reach a more definitive conclusion.

Keywords:

Colon preparation, PEG, sodium phosphate, constipation,

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