Akif ALTINBAŞ, Bariş YILMAZ, Bora AKTAŞ, Fuat EKİZ, Zahide ŞİMŞEK, Ömer BAŞAR, Şahin ÇOBAN, Osman YÜKSEL

What is the main target: a clearer colon with a sennoside-based regime, or adequate bowel cleansing before colonoscopy with a PEG-EL-based regime?

Background/aim: Even though polyethylene glycol-electrolyte lavage (PEG-EL)-based regimes have become the gold standard in recent years, to finish drinking 4 L of PEG-EL solution can be difficult. The quality of sennoside-based bowel-cleansing regimes used in Turkey has been known for some time. Therefore, we aimed to investigate the efficacy of both bowel-cleansing regimes. Materials and methods: Patients over 18 years old undergoing elective colonoscopic procedures between January and March 2011 were included in the study. The patients were divided into 2 groups; in Group 1, 91 patients were given sennoside a + b calcium 500 mg/250 mL (X-M solution, Yenişehir Laboratuarı, Ankara, Turkey), and in Group 2, 94 patients were given 4 L of PEG-EL (Golytely, Boston, MA, USA). Results: The mean age of the patients and the male distribution were similar in the 2 groups. Both inadequate bowel cleansing and the best cleansed bowels were seen in Group 1. The number of inadequate colonoscopies declined when using a whole bowel-cleansing regime from 24.5% to 19.3% in Group 2, but it did not decline in Group 1. Conclusion: The best bowel cleansing can be achieved with sennoside-based regimes, whereas a greater proportion of adequate results via colonoscopy were reached with the PEG-EL-based regimes.

Anahtar Kelimeler:

Precolonoscopic bowel cleansing, polyethylene glycol regime, X-M solution

What is the main target: a clearer colon with a sennoside-based regime, or adequate bowel cleansing before colonoscopy with a PEG-EL-based regime?

Keywords:

Precolonoscopic bowel cleansing, polyethylene glycol regime, X-M solution,

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1. Froehlich F, Wietlisbach V, Gonvers JJ, Burnand B, Vader JP. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc 2005; 61: 378–384.
2. Thomson A, Naidoo P, Crotty B. Bowel preparation for colonoscopy: a randomized prospective trail comparing sodium phosphate and polyethylene glycol in a predominantly elderly population. J Gastroenterol Hepatol 1996; 11: 103–107.
3. Marshall JB, Pineda JJ, Barthel JS, King PD. Prospective, randomized trial comparing sodium phosphate solution with polyethylene glycol-electrolyte lavage for colonoscopy preparation. Gastrointest Endosc 1993; 39: 631–634.
4. Afridi SA, Barthel JS, King PD, Pineda JJ, Marshall JB. Prospective, randomized trial comparing a new sodium phosphate-bisacodyl regimen with conventional PEG-ES lavage for outpatient colonoscopy preparation. Gastrointest Endosc 1995; 41: 485–489.
5. Lieberman DA, Ghormley J, Flora K. Effect of oral sodium phosphate colon preparation on serum electrolytes in patients with normal serum creatinine. Gastrointest Endosc 1996; 43: 467–469.
6. Poon CM, Lee DW, Mak SK, Ko CW, Chan KC, Chan KW, Sin KS, Chan AC. Two liters of polyethylene glycol-electrolyte lavage solution versus sodium phosphate as bowel cleansing regimen for colonoscopy: a prospective randomized controlled trial. Endoscopy 2002; 34: 560–563.
7. Di Palma JA, Rodriguez R, McGowan J, Cleveland MB. A randomized clinical study evaluating the safety and efficacy of a new, reduced-volume, oral sulfate colon-cleansing preparation for colonoscopy. Am J Gastroenterol 2009; 104: 2275–2284.
8. Abut E, Guveli H, Yasar B, Bolukbas C, Bolukbas FF, Ince AT, Kendir T, Dalay AR, Kurdas OO. Administration of olive oil followed by a low volume of polyethylene glycol-electrolyte lavage solution improves patient satisfaction with right-side colonic cleansing over administration of the conventional volume of polyethylene glycol-electrolyte lavage solution for colonoscopy preparation. Gastrointest Endosc 2009; 70: 515– 521.
9. Ell C, Fischbach W, Bronisch HJ, Dertinger S, Layer P, Rünzi M, Schneider T, Kachel G, Grüger J, Köllinger M et al. Randomized trial of low-volume PEG solution versus standard PEG + electrolytes for bowel cleansing before colonoscopy. Am J Gastroenterol 2008; 103: 883–893.
10. El Sayed AM, Kanafani ZA, Mourad FH, Soweid AM, Barada KA, Adorian CS, Nasreddine WA, Sharara AI. A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation. Gastrointest Endosc 2003; 58: 36–40.
11. Beyazit Y, Koklu S, Ozturk ZA, Yüksel O, Ibis M, Arhan M, Gultuna S, Sezer S, Yuksel I, Babali A. Inclusion of a spasmolytic in bowel cleansing: a prospective randomized study. Gastroenterol Nurs 2011; 34: 352–355.
12. Martínek J, Hess J, Delarive J, Jornod P, Blum A, Pantoflickova D, Fischer M, Dorta G. Cisapride does not improve precolonoscopy bowel preparation with either sodium phosphate or polyethylene glycol electrolyte lavage. Gastrointest Endosc 2001; 54: 180–185.
13. Pontone S, Angelini R, Standoli M, Patrizi G, Culasso F, Pontone P, Redler A. Low-volume plus ascorbic acid vs high-volume plus simethicone bowel preparation before colonoscopy. World J Gastroenterol 2011; 17: 4689–4695.
14. Tasci I, Altinli E, Sirin F. Bowel cleansing for diagnostic colonoscopy: which method is preferable? Istanbul experience. Tech Coloproctol 2003; 7: 18–21.
15. Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc 2004; 59: 482–486.
16. Jansen SV, Goedhard JG, Winkens B, van Deursen CT. Preparation before colonoscopy: a randomized controlled trial comparing different regimes. Eur J Gastroenterol Hepatol 2011; 23: 897–902.
17. Altınbas A, Aktas B, Yılmaz B, Ekiz F, Deveci M, Basar O, Simsek Z, Coban S, Tuna Y, Uyar MF et al. Adding pineapple juice to a polyethylene glycol-based bowel cleansing regime improved the quality of colon cleaning. Ann Nutr Metab 2013; 63: 83–87.
18. Yakut M, Çınar K, Seven G, Cetinkaya H, Bahar K. The efficacy and safety of colonoscopy preparation with oral sodium phosphate in elderly patients. Turk J Gastroenterol 2010; 21: 140–145.
19. Ünal S, Doğan ÜB, Öztürk Z, Cindoruk M. A randomized prospective trial comparing 45 and 90-ml oral sodium phosphate with X-Prep in the preparation of patients for colonoscopy. Acta Gastroenterol Belg 1998; 61: 281–284.
20. Korsten MA, Spungen AM, Rosman AR, Ancha HR, Post JB, Shaw S, Hunt KK, Williams R 3rd, Bauman WA. A prospective assessment of renal impairment after preparation for colonoscopy: oral sodium phosphate appears to be safe in well-hydrated subjects with normal renal status. Dig Dis Sci 2010; 55: 2021–2029.
21. Gumurdulu Y, Serin E, Ozer B, Gokcel A, Boyacioglu S. Age as a predictor of hyperphosphatemia after oral phosphosoda administration for colon preparation. J Gastroenterol Hepatol 2004; 19: 68–72.
22. Aronchick CA, Lipshutz WH, Wright SH, Dufrayne F, Bergman G. A novel tableted purgative for colonoscopic preparation: efficacy and safety comparisons with Colyte and Fleet Phospho-Soda. Gastrointest Endosc 2000; 52: 346–352.