Series Research About Bowel Preparation Of Intestinal Endoscopic Examination

Background and Objective Capsule endoscopy( CE),colonoscopy and sigmoidoscopy are methods used commonly to diagnose intestinal diseases, but the effect of bowel preparation before endoscopy is an important factor affecting the lesion inspection.At present,there are lack of effective and reasonable research materials about bowel preparation.The aim of this study was to compare the efficacy of polyethylene glycol(PEG) electrolyte solution and polyethylene glycol(PEG) electrolyte solution + simethicone as the purgative bowel depurative on the bowel-cleansing,the transit time of capsule endoscopy through the small intestine,the rate of pathological examination and side effects;to compare the efficacy of bowel-cleansing, patient ’ s compliance, tolerability and side effects of different doses of polyethylene glycol(PEG) electrolyte solution for colonoscopy preparation and to compare the efficacy of Enema Glycerini,Suppositories Glycerol and Fleet enema for bowel preparation before sigmoidoscopy,entry depth and the rate of pathological examination.Methods 1.Bowel preparation of capsule endoscopy:Prospective trial was performed.A total of 60 inpatients undergoing elective capsule endoscopy from September 2012 to September 2014 were randomized into two groups :A group(n=30) and B group(n=30).They were given polyethylene glycol electrolyte solution and polyethylene glycol electrolyte solution + simethicone respectively before capsule endoscopy.According to the collected images,bowel-cleansing efficacy was separately assessed for the amount of bubbles,digestive fluid volume,the cleanliness of digestive fluid and the overall observation effect.And to compare the transit time of capsule endoscopy through the small intestine,the rate of pathological examination and sideeffects.2.Bowel preparation of colonoscopy: Prospective trial was performed.A total of 100 inpatients undergoing elective colonoscopy were randomized into three groups: receiving 4 L PEG(n=35),2 L PEG(n=31) and 2+1 L PEG(n=34) respectively on the day of colonoscopy from May to July 2014. Bowel-cleansing efficacy was separately assessed with the Ottawa Scale for the right, middle, and left colon. Total score was obtained by adding the scores for individual evaluation of the three colon segments with the score of overall fluid in the entire colon. All patients filled in a questionnaire and were interviewed about their compliance to the assigned bowel preparation,tolerance and side effects.3.Bowel preparation of sigmoidoscopy: Prospective trial was performed.A total of 90 inpatients and outpatients undergoing sigmoidoscopy were randomized into three groups from January to February 2015 : group A(n=30), group B(n=30)and group C(n=30).They were given Enema Glycerini,Suppositories Glycerol and Fleet enema for bowel preparation before sigmoidoscopy. Bowel-cleansing efficacy and the score of overall fluid of the rectum and sigmoid colon were assessed with the Ottawa Scale.And to compare the entry depth and the rate of pathological examination.Results 1. The effect of bowel preparation before capsule endoscopy: Patients who did not complete the capsule endoscopy were excluded.55 patients could be included in the analysis:A group(polyethylene glycol electrolyte solution) of 27 cases,B group(polyethylene glycol electrolyte solution + simethicone) of 28 cases.The amount of bubbles,digestive fluid volume and the overall observation effect of patients in group B were better than those of group A on the bowel preparation effect(P <0.05);The two groups were similar in the cleanliness of digestive fluid(P>0.05).There were no differences in the transit time of capsule endoscopy through the small intestine and side effects of both groups(P>0.05).The rate of pathological examination of group B was higher than that of group A(P<0.05).The total number of lesions detected in patients of group B was higher than that of group A(P < 0.05).But in the specific lesions,there wereno differences between the two groups(P>0.05).2. The effect of bowel preparation before colonoscopy:Patients who did not complete the colonoscopy were excluded.91 patients were included in the last analysis: 4L group of 31 cases, 2L group of 30 cases and 2+1 L group of 30 cases. The efficacy of bowel-cleansing of the three groups of patients according to the Ottawa Scale were similar(P>0.05),but the excellent and good rate of cleansing quality of the right colon was higher in 4L group(P<0.05). When compared with 4L group and 2+1 L group, patients in the 2L group had higher compliance and tolerance, as well as lower rate of side effects(P<0.05). 3. The effect of bowel preparation before sigmoidoscopy:All patients completed the sigmoidoscopy.The efficacy of bowel-cleansing of group C( Fleet enema)according to the Ottawa Scale was superior to that of group A(Enema Glycerini) and group B(Suppositories Glycerol)(P<0.05).Group C was also superior to group A and group B in the entry depth(P<0.05). The three groups were similar in the total number of lesions detected(P>0.05).But in the specific lesions, the rate of polyp of group C was higher than that of group A and group B(P<0.05).Conclusion 1.Taking 2L polyethylene glycol electrolyte solution +300 mg simethicone can improve bowel preparation effect and increase the rate of pathological examination before capsule endoscopy and is an ideal method for the preparation of capsule endoscope.2.The efficacy,compliance,tolerance and safety of bowel-cleansing of taking 2L polyethylene glycol electrolyte solution on the day of colonoscopy were good and suitable for use. Taking 4L polyethylene glycol electrolyte solution for bowel preparation on the day of colonoscopy was more suitable for patients who were suspected highly with lesions of the right colon. 3. Using Fleet enema for bowel preparation before sigmoidoscopy could obtain better bowel preparation effect than Enema Glycerini and Suppositories Glycerol which were used commonly.It could also obtain higher detection rate of polyp.