Appilication of polyethylene glycol electrolytes powder in bowel preparation before CT virtual endoscopy / 中国基层医药

Objective To investigate the clinical application and value of polyethylene glycol(PEG)electrolyte powder in bowel preparation before CT virtual endoscopy on.Methods 120 cases underwent intestinal CT virtual endoscopy were randomly divided into control group and observation group.The control group (n =60) received oral Mannitol,the observation group (n =60) received oral administration of PEG electrolyte powder.Defecation during medication,bowel preparation for cleanliness,adverse reactions,the amount of water and other aspects were observed in two groups.Results (1) The intestinal preparing total efficiency of the observation group (96.7％) was higher than that of the control group (81.7％),the difference was statistically significant(P ＜ 0.05) ;(2)The patients in the two groups all started defecation in 1 ～5h after taking drugs;(3)In the process of taking the medicine,the incidence rate of adverse reactions such as abdominal distention,nausea and abdominal pain,fatigue and other aspects in the the observation group is lower than that of control group(P ＜ 0.01).Conclusion The clinical effect of PEG electrolyte powder in bowel preparation before CT virtual endoscopy is good.

A Prospective Randomized Trial Comparing Preference of Sulfate Free Polyethylene Glycol with Standard Polyethylene Glycol / 대한소화기내시경학회지

BACKGROUND/AIMS: The standard polyethylene glycol (PEG) solution for colonic cleansing has a salty taste and a large volume of it is required, which can cause failure for the patient to ingest the required dosage. This has been a limitation for its usage. Sulfate free PEG (SF-PEG) has a less salty taste due to removal of the sodium sulfate, but the published studies in western countries about the preference and the degree of patient's satisfaction with these two solutions has shown conflicting results. The object of this study was to compare SF-PEG with PEG solution in regard to preference, the degree of patient's satisfaction and the adverse effects in Korean patients. We also attempted to determine whether these factors were associated with preference. METHODS: Ninety-four patients scheduled for colonoscopy were given one liter of both solutions (SF-PEG and PEG) and then the patients were allowed to select either of the two solutions for the further two liters intake under informed consent. Before colonoscopy, the preferred solution, the degree of patient's satisfaction, the adverse effects and other information were recorded by questionnaire. RESULTS: Fifty-nine patients among the 94 patients (63%) preferred the SF-PEG solution (p<0.05). Especially, the young patients under the age of 35 preferred the SF-PEG solution (83% vs 58%; p=0.045), and patients who had already experienced colonoscopy with PEG solution tended to prefer the SF-PEG (54% vs 78%; p=0.054). CONCLUSIONS: Korean patients preferred the SF-PEG over PEG, and especially young aged patients and the patients who had already taken the PEG solution. Similar results were obtained for both solutions concerning the adverse effects, cleansing quality and compliance, and the degree of satisfaction was not much improved, which was probably due to the same large volume of fluid that is required for colon cleaning.

A Prospective Comparison of Sulfate Free Polyethylene Glycol versus Sodium Phosphate Solution for Precolonoscopic Bowel Preparation / 대한소화기내시경학회지

BACKGROUND/AIMS: Polyethylene glycol (PEG) solution is commonly used for precolonoscopic preparation because of its safety and effectiveness. Sulfate free PEG (SF-PEG) solution was developed to reduce the salty taste by removing the sodium sulfate. The aim of this study was to compare the efficacy and patient compliance of SF-PEG and sodium phosphate (NaP) solutions for preparing the bowel before colonoscopy. METHODS: From February through April in 2007, 534 patients who underwent colonoscopy were prospectively enrolled. The efficacy of bowel cleansing was assessed by a doctor's questionnaire and the patient's compliance was assessed by a patient's questionnaire. RESULTS: There was no significant difference between the groups for the "stools and fluids" assessment of bowel cleansing (2.07 vs. 2.14, respectively, p=0.149). However, SF-PEG was more effective on the "air bubbles" assessment (1.34 vs. 1.71, respectively, p<0.001) and the overall assessment (0.72 vs. 0.91, respectively, p=0.010) than NaP. The patients preferred SF-PEG rather than NaP for "Taste" (1.34 vs. 2.25, respectively, p=0.148). However, the patients significantly preferred NaP rather than SF-PEG for "Quantity" (2.46 vs. 1.18, respectively, p<0.001). CONCLUSIONS: The SF-PEG solution showed more effectiveness for bowel cleansing as compared to the NaP solution. SF-PEG tastes better than NaP, but patients are still required to consume 4 liters for the standard preparing regimen.

Hyponatremic Encephalopathy Following a Sulfate Free Polyethylene Glycol-based Bowel Preparation for Colonoscopy / 대한소화기내시경학회지

Hyponatremia associated with the use of both a sodium phosphate (NaP) and polyethylene glycol (PEG) solution for colonoscopy preparation has been reported in patients with impaired renal handling of water. A PEG solution is believed to affect serum electrolytes less than NaP, but the use of a PEG solution can lead to nausea, vomiting, intestinal hyperactivity and dehydration, often resulting in a raised plasma antidiuretic hormone (ADH) concentration. Non-osmolar stimuli such as pain, stress, nausea, and vomiting can stimulate ADH release. We report a case of severe hyponatremic encephalopathy after sulfate-free PEG ingestion for a colonoscopy in a healthy middle-aged woman. We think that physicians should be familiar with the medical history and current medication schedule of patients prior to bowel preparation. The levels of serum electrolytes should be checked in patients with impaired ability to excrete free water and any mental aberrations before undertaking colonoscopy procedures.