Colonic lavage solutions: plain versus flavored.

Many patients dislike the taste of the oral gastrointestinal lavage solutions utilized prior to colonoscopy. Specifically, patients dislike the salty taste and the quantity of the polyethylene glycol-electrolyte solution that they are required to ingest. In an attempt to reduce the salty taste and potentially improve patient compliance and tolerance of the preparation, flavoring was added to the lavage solution. Fifty-six patients received standard or flavored polyethylene glycol-electrolyte lavage solution in random order prior to colonoscopy. In group I, lemon-flavored Colyte was compared with standard Colyte: 93% (25/27) of subjects preferred the flavored solution. In group II, standard Colyte was compared with lemon/lime-flavored Colyte, and 80% (8/10) of subjects preferred standard Colyte. In group III, lemon-flavored Colyte, standard Colyte, and NuLYTELY were compared. Ninety percent (17/19) of the subjects preferred lemon-flavored Colyte, 10% of the subjects preferred standard Colyte, and none of the subjects preferred NuLYTELY. Overall, patients preferred lemon-flavored solution over other solutions.

Significance of distal polyps detected with flexible sigmoidoscopy in asymptomatic patients.

BACKGROUND: Colorectal cancer is a frequent cause of death from cancer. To reduce the mortality associated with this disease, regular flexible sigmoidoscopy is recommended. However, the significance of diminutive polyps (adenomatous or hyperplastic) detected during flexible sigmoidoscopy remains controversial, as does the appropriate endoscope length (35 vs 60 cm) for colorectal cancer screening. METHODS: One hundred one consecutive patients with no history of colonic disease, gastrointestinal tract symptoms, or positive results of fecal occult blood testing underwent flexible sigmoidoscopy as part of a colorectal cancer screening program. All patients with distal polyps detected during flexible sigmoidoscopy underwent colonoscopy. RESULTS: More than 25% of these asymptomatic, predominantly male subjects had colonic neoplasms or polyps detected. Fifty percent more lesions could be detected with a 60-cm sigmoidoscope than with a 35-cm sigmoidoscope, and detection of any distal polyp, whether adenomatous or hyperplastic, was associated with at least one proximal colon adenoma in 20% of patients. "Extended flexible sigmoidoscopy" for colorectal cancer screening was well tolerated by patients, as evidenced by insertion to the hepatic flexure in 25% of patients, and provided significantly more information than could be obtained with a 35-cm sigmoidoscope. CONCLUSIONS: Colorectal cancer screening should be performed with a 60-cm flexible sigmoidoscope, and distal colonic polyps or neoplasms will be detected in 25% of asymptomatic patients.

Evaluation of antral mast cells in nonulcer dyspepsia.

Two hundred twenty-five patients with the symptoms of nonulcer dyspepsia underwent clinical and endoscopic evaluation including histologic assessment of endoscopic biopsies. Mast cells were counted after special staining with low pH Alcian blue. Of 225 patients, 31 (13%) were found to have 11 or greater mast cells per high-power field. Endoscopic and routine histologic findings were similar between the subset of 31 patients with 11 or more mast cells and the entire group of 225. The 31 patients with increased antral mast cells had failed treatment with standard drug used for peptic ulcer disease. H1-antagonists improved symptoms in the majority of patients (79%) in whom we had adequate follow-up. Patients with increased mast cells on antral biopsy appear to be subset of patients with nonulcer dyspepsia amenable specific treatment with H1-antagonists.