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Bowel preparation

Sean C Rice, Tina Higginbotham, Melanie J Dean, James C Slaughter, Patrick S Yachimski, Keith L Obstein
OBJECTIVES: Successful outpatient colonoscopy (CLS) depends on many factors including the quality of a patient's bowel preparation. Although education on consumption of the pre-CLS purgative can improve bowel preparation quality, no study has evaluated dietary education alone. We have created an educational video on pre-CLS dietary instructions to determine whether dietary education would improve outpatient bowel preparation quality. METHODS: A prospective randomized, blinded, controlled study of patients undergoing outpatient CLS was performed...
October 18, 2016: American Journal of Gastroenterology
Gyeong Bo Kim, Sung Yeon Hwang, Tae Gun Shin, Tae Rim Lee, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
A 59-year-old man presented to the emergency department with a chief complaint of sore throat after swallowing sodium picosulfate/magnesium citrate powder for bowel preparation, without first dissolving it in water. The initial evaluation showed significant mucosal injury involving the oral cavity, pharynx, and epiglottis. Endotracheal intubation was performed for airway protection in the emergency department, because the mucosal swelling resulted in upper airway compromise. After conservative treatment in the intensive care unit, he underwent tracheostomy because stenosis of the supraglottic and subglottic areas was not relieved...
June 2016: Clin Exp Emerg Med
Sunghwan Kim, Jeongmin Choi, Tae Han Kim, Seong-Ho Kong, Yun-Suhk Suh, Jong Pil Im, Hyuk-Joon Lee, Sang Gyun Kim, Seung-Yong Jeong, Joo Sung Kim, Han-Kwang Yang
PURPOSE: The purpose of this study was to determine the effect of a prior gastrectomy on the difficulty of subsequent colonoscopy, and to identify the surgical factors related to difficult colonoscopies. MATERIALS AND METHODS: Patients with a prior gastrectomy who had undergone a colonoscopy between 2011 and 2014 (n=482) were matched (1:6) to patients with no history of gastrectomy (n=2,892). Cecal insertion time, intubation failure, and bowel clearance score were compared between the gastrectomy and control groups, as was a newly generated comprehensive parameter for a difficult/incomplete colonoscopy (cecal intubation failure, cecal insertion time >12...
September 2016: Journal of Gastric Cancer
Dana Duricova, Mathurin Fumery, Vito Annese, Peter L Lakatos, Laurent Peyrin-Biroulet, Corinne Gower-Rousseau
The incidence of Crohn's disease (CD) has been reported to increase. The aim of this review is to perform a comprehensive literature search of population-based studies focused on the natural history of paediatric-onset CD. A literature search of English and non-English language publications listed in the electronic database of MEDLINE (source PUBMED) and EMBASE from 1935 to 2016 was performed. Population-based studies or national cohorts reporting data on the short-term or long-term disease course of paediatric CD were included...
September 29, 2016: European Journal of Gastroenterology & Hepatology
Jui-Hsiang Tang, Chi-Liang Cheng, Yen-Lin Kuo, Yi-Ning Tsui
BACKGROUND/AIMS: Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence of the procedure with carbon dioxide insufflation is not well established. In this study, we investigated the optimal sequence for same-day BDE without polypectomy under moderate sedation and carbon dioxide insufflation in terms of sedation doses and colonoscopy performance. PATIENTS AND METHODS: We performed a prospective observational study of 63 asymptomatic patients who were admitted for physical check-ups...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Adam S Cheifetz, Robert Gianotti, Raphael Luber, Peter R Gibson
Patients and physicians often have many questions regarding the role of complementary and alternative medicines (CAMs), or non-allopathic therapies, for inflammatory bowel diseases (IBD). CAMs of various forms are used by more than half of patients with IBD during some point in their disease course. We summarize the available evidence for the most commonly used and discussed CAMs. We discuss evidence for the effects of herbs (such as cannabis and curcumin), probiotics, acupuncture, exercise, and mind-body therapy...
October 12, 2016: Gastroenterology
Jacob E Kurlander, Arjun R Sondhi, Akbar K Waljee, Stacy B Menees, Cathleen M Connell, Philip S Schoenfeld, Sameer D Saini
BACKGROUND: Bowel preparation is inadequate in a large proportion of colonoscopies, leading to multiple clinical and economic harms. While most patients receive some form of education before colonoscopy, there is no consensus on the best approach. AIMS: This systematic review aimed to evaluate the efficacy of patient education interventions to improve bowel preparation. METHODS: We searched the Cochrane Database, CINAHL, EMBASE, Ovid, and Web of Science...
2016: PloS One
Rupa Banerjee, Hrushikesh Chaudhari, Nirish Shah, Arjunan Saravanan, Manu Tandan, D Nageshwar Reddy
BACKGROUND: Adequate bowel preparation is an essential prerequisite for complete mucosal visualization during colonoscopy. Polyethylene glycol (PEG) solutions are commonly used. However the large volume of the solution is often poorly tolerated. Addition of Lubiprostone (LB) could improve the adequacy of standard PEG preparation & reduce requirement. The aims to assess adequacy of PEG preparation with addition of single dose LB (24mcg) vs placebo and efficacy of reduced dose PEG + LB compared with full dose PEG + LB...
October 13, 2016: BMC Gastroenterology
Theodor Voiosu, Alina Tanțău, A Voiosu, Andreea Benguș, Cristina Mocanu, Bianca Smarandache, C Baicuș, Ioana Vișovan, B Mateescu
BACKGROUND: Optimal bowel preparation is one of the most important factors affecting the quality of colonoscopy. Several patient-related factors are known to influence the quality of bowel cleansing but randomized trials in this area are lacking. We aimed to compare an individualized bowel prep strategy based on patient characteristics to a standard preparation regimen. MATERIAL AND METHODS: We conducted an endoscopist-blinded multicenter randomized control-trial...
October 13, 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Hooman Djaladat, Behrod Katebian, Soroush T Bazargani, Gus Miranda, Jie Cai, Anne K Schuckman, Siamak Daneshmand
PURPOSE: To report 90-day complication rates following radical cystectomy (RC) with enhanced recovery after surgery (ERAS) protocol. METHODS: All consecutive patients who underwent open RC with ERAS protocol from 2012 to 2014 were included. The protocol includes no bowel preparation or NGT, early feeding, predominantly non-narcotic pain management and μ-opioid antagonists. Non-consenting and lost to follow-up patients were excluded. All patients were closely followed up, and 90-day complication (Clavien-Dindo grading), readmission and emergency room (ER) visits were prospectively recorded...
October 12, 2016: World Journal of Urology
Eun Young Ze, Chang Hwan Choi, Jeong Wook Kim
Sodium picosulfate/magnesium citrate (SPMC) is a widely used oral bowel cleansing agent considered to be relatively safe. However, partially dissolved or undissolved SPMC powder may cause severe injuries of the esophagus and stomach. We report a very rare case of acute gastric injury without esophageal damage caused by the ingestion of undissolved SPMC powder. A 69-year-old man experienced epigastric pain after swallowing SPMC powder without dissolving it in water in preparation for a screening colonoscopy...
October 12, 2016: Clinical Endoscopy
Osama Ibrahim Almosallam, Ali Aseeri, Saud Al Shanafey
BACKGROUND: Colostomy is a common part of the management of high anorectal malformation (ARM) in the pediatric population. OBJECTIVE: To evaluate whether the type of colostomy (loop vs divided) has an impact on outcome in patients with ARM. DESIGN: A retrospective study. SETTING: King Faisal Specialist Hospital and Research Center, a tertiary care center. PATIENTS AND METHODS: All patients who were managed with colostomy for ARM and had definitive repair during the period of January 2000 to December 2014...
September 2016: Annals of Saudi Medicine
Shailendra Singh, Manish Dhawan, Monica Chowdhry, Michael Babich, Elie Aoun
BACKGROUND: Colonoscopies performed in the afternoon (PM) have been shown to have lower adenoma detection rates (ADR) compared to those in the morning (AM). Endoscopist fatigue has been suggested as a possible reason. Colonoscopies tend to be technically more challenging in female patients. Furthermore, women have a lower incidence of adenomas then men. The impact of the timing of colonoscopy based on sex has not been studied. We hypothesized that any decrease in ADR in PM colonoscopies would be more pronounced in female patients when compared to male patients...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Alessandra Guarini, Francesca De Marinis, Anna Kohn, Nicoletta Orzes, Renata D'Incà, Teresa Iannone, Antonella Giaquinto, Cinzia Rivara, Lorenzo Ridola, Roberto Lorenzetti, Angelo Zullo
BACKGROUND: Management of inflammatory bowel disease (IBD) patients requires a multidisciplinary approach. Among the working team, the role of IBD nurse is expected to be particularly relevant when managing patients receiving biological therapies. We performed a survey to assess the presence of IBD nurse in centers where patients were receiving biologics. METHODS: For this Italian nationwide survey a specific questionnaire was prepared. IBD nurse was defined as a nurse directly involved in all phases of biological therapy, from pre-therapy screening, administration and monitoring during therapy, to follow up performed by a dedicated helpline, completed a specific training on biological therapy therapy, and observed international guidelines...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Emanuele Rondonotti, Alida Andrealli, Arnaldo Amato, Silvia Paggi, Clara Benedetta Conti, Giancarlo Spinzi, Franco Radaelli
Adenoma detection rate (ADR) is the most robust colonoscopy quality metric and clinical studies have adopted it as the ideal method to assess the impact of technical interventions. Areas covered: We reviewed papers focusing on the impact of colonoscopy technical issues on ADR, including withdrawal time and technique, second evaluation of the right colon, patient positional changes, gastrointestinal assistant participation during colonoscopy, water-aided technique, optimization of bowel preparation and antispasmodic administration...
October 5, 2016: Expert Review of Gastroenterology & Hepatology
Marianthi Chatzikonstantinou, Panagiotis Konstantopoulos, Spyros Stergiopoulos, Konstantinos Kontzoglou, Christos Verikokos, Despina Perrea, Dimitris Dimitroulis
Inflammatory bowel diseases (IBD) are chronic intestinal disorders caused by a number of factors, including external influences, intestinal microbiota and genetics. The two major clinically defined types of IBD are Crohn's disease and ulcerative colitis, each of which is characterized by relapses in the clinical course, thus patients must be under constant observation via regular endoscopies. As endoscopy, which has been used for direct evaluation and diagnosis of IBD, requires uncomfortable and expensive bowel preparation, a non-invasive test was required to reduce the number of patients undergoing unnecessary endoscopy...
October 2016: Biomedical Reports
Yassmin O Samak, Magda El Massik, Allan G A Coombes
Alginate microparticles incorporating hydrocortisone hemisuccinate were produced by aerosolization and homogenization methods to investigate their potential for colonic drug delivery. Microparticle stabilization was achieved by CaCl2 crosslinking solution (0.5 M and 1 M), and drug loading was accomplished by diffusion into blank microparticles or by direct encapsulation. Homogenization method produced smaller microparticles (45-50 μm), compared to aerosolization (65-90 μm). High drug loadings (40% wt/wt) were obtained for diffusion-loaded aerosolized microparticles...
September 29, 2016: Journal of Pharmaceutical Sciences
Christian Schulz, Joachim Müller, Joachim Sauter, Stephan Miehlke, Christoph Schmöcker, Dirk Hartmann, Peter Malfertheiner, Carlos Badiola
BACKGROUND AND AIMS: Split-dose regimens are generally recommended for bowel cleansers. However, other regimens still remain in the summary of product characteristics of some bowel cleansers in Europe. The aim of this study is to compare the efficacy and safety of a split-dose regimen of sodium picosulfate/magnesium citrate (SPMC) with a prior-day schedule (AM/PM). METHODS: Multicenter, randomized (EudraCT no. 2013-001620-20), endoscopist-blinded, parallel study, carried out in subjects 18 years or older undergoing elective colonoscopy...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Lye Huey Shi, Kunasundari Balakrishnan, Kokila Thiagarajah, Nor Ismaliza Mohd Ismail, Ooi Shao Yin
Probiotics are live microorganisms that can be found in fermented foods and cultured milk, and are widely used for the preparation of infant food. They are well-known as "health friendly bacteria", which exhibit various health beneficial properties such as prevention of bowel diseases, improving the immune system, for lactose intolerance and intestinal microbial balance, exhibiting antihypercholesterolemic and antihypertensive effects, alleviation of postmenopausal disorders, and reducing traveller's diarrhoea...
August 2016: Tropical Life Sciences Research
A C Wiestma, C R Estrada, P S Cho, M V Hollis, R N Yu
INTRODUCTION: Bladder augmentation is a common surgical intervention for neuropathic bladder dysfunction, and has conventionally been an open procedure. We present a robotic ileocystoplasty to demonstrate the feasibility of an entirely intracorporeal approach in a pediatric patient. METHODS: The patient was a 6 year old (18.5 kg) boy with a neurogenic bladder secondary to lumbar myelomeningocele. Urodynamics revealed a small capacity and poorly compliant bladder and he was incontinent between frequent catheterizations...
August 21, 2016: Journal of Pediatric Urology
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