Clinical Value of Controllable Bowel Preparation in Patients With Lower Gastrointestinal Bleeding / 胃肠病学

ABSTRACT

Colonoscopy is an important means to determine the cause of lower gastrointestinal bleeding (LGIB). Bowel preparation before colonoscopy is essential, but may induce or aggravate bleeding. Safe and effective bowel preparation procedure for patients with LGIB is a clinical problem to be explored. Aims: To investigate the value of controllable bowel preparation in patients with LGIB. Methods: Seventy-six patients with LGIB were enrolled from Jan. 2017 to Jul. 2018 at Daping Hospital, Army Military Medical University, and were randomly divided into controllable bowel preparation group and control group. Patients in controllable bowel preparation group were given 20 mL of Lactulose Oral Solution at 1200, 1400, 1600, and 2000 on the day before colonoscopy, and 68.56 g of Polyethylene Glycol Electrolytes Powder was taken orally (dissolved in 2 L of water, taken within 2 hours) at 400-500 on the day of colonoscopy (for the oral intake of lactulose at 1600 and 2000, the time of lactulose intake could be prolonged or shortened depending on the condition of defecation). In control group, conventional bowel preparation procedure was carried out at 400-500 on the day of colonoscopy (137.12 g of Polyethylene Glycol Electrolytes Powder dissolved in 2 L of water, taken orally within 2 hours). The intestinal cleanliness, colonoscopic detection rate, patient's tolerance and adverse reactions were compared between the two groups. Results: The Boston score and colonoscopic detection rate of controllable bowel preparation group were not significantly different from those of the control group (P>0.05). LGIB patients in controllable bowel preparation group suffered less abdominal distension, nausea, rebleeding and exacerbated bleeding than the control group (P<0.05). Conclusions: Controllable bowel preparation is safe and effective for patients with LGIB. It is well tolerated and does not increase the risk of bleeding. The intestinal cleanliness and detection rate are comparable to those of the conventional bowel preparation.