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Can nutritional supplements and rectal enema be used as bowel cleansing for colonoscopy?: results of a randomized controlled pilot study
Department of Surgery, Ersta Hospital, Karolinska Institutet, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Ersta Hospital, Karolinska University Hospital, Stockholm, Sweden.
Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Surgery, Örebro University Hospital, Örebro, Sweden.ORCID-id: 0000-0003-2636-4745
Department of Surgery, Ersta Hospital, Karolinska Institutet, Stockholm, Sweden.
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2014 (Engelska)Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 49, nr 4, s. 485-491Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective. Currently available preparations for colonoscopy have low tolerability and may cause fluid and electrolyte shifts. An alternative method of bowel cleansing is required.

Material and methods. Preparation of the gut using oral nutritional supplements (ONS) and rectal enema was tested as an alternative method of bowel cleansing. During 2008-2012, patients were randomized to oral nutritional supplements (n = 27) for 5 days and rectal enema or polyethylene glycol (PEG) (n = 23) prior to colonoscopy. Blinded endoscopists rated the degree of bowel cleansing according to the Ottawa bowel preparation scale (OBS) (primary outcome). Tolerability of either preparation was also assessed (ClinicalTrials.gov. Identifier no: NCT00123456).

Results. Due to a high rate of bowel cleansing failure among patients receiving ONS, the study was interrupted prematurely. Colonoscopies were incomplete due to stools in 6 of 27 patients in the ONS group compared to 1 of 23 in the PEG group (ns). The mean total OBS were 8.3 +/- 3.3 and 5.3 +/- 2.8, respectively (p = 0.002). Four patients (15%) in the ONS group and eight patients (35%) receiving PEG had an OBS score <= 4 (good preparation) (ns). ONS was better tolerated than PEG with more patients reporting acceptable taste (27 of 27 [100%] vs. 15 of 23 [65%], p = 0.001), and fewer reporting difficulties with the intake (0 of 27 [0%] vs. 10 of 23 [43%], p < 0.001) and nausea (5 of 27 [19%] vs. 13 of 23 [57%], p < 0.008).

Conclusions. For routine use, ONS with enema instead of traditional preparation for colonoscopy with PEG cannot be generally recommended.

Ort, förlag, år, upplaga, sidor
London: Informa Healthcare, 2014. Vol. 49, nr 4, s. 485-491
Nyckelord [en]
Bowel preparation, colonoscopy, nutritional drinks
Nationell ämneskategori
Gastroenterologi
Forskningsämne
Medicin
Identifikatorer
URN: urn:nbn:se:oru:diva-34847DOI: 10.3109/00365521.2014.886720ISI: 000333350100012PubMedID: 24495046Scopus ID: 2-s2.0-84896981030OAI: oai:DiVA.org:oru-34847DiVA, id: diva2:714478
Forskningsfinansiär
Vetenskapsrådet
Anmärkning

Funding Agencies:

Stockholm County Council (SLL)

Hans Mellström, Sweden

Familjen Erling-Persson's Foundation

Tillgänglig från: 2014-04-28 Skapad: 2014-04-25 Senast uppdaterad: 2018-06-05Bibliografiskt granskad

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Ljungqvist, Olle

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Institutionen för läkarutbildningRegion Örebro län
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