The Effect Of Linaclotide Combined With Compound Polyethylene Glycol Electrolyte Powder In Bowel Preparation For Colonoscopy In Patients With Chronic Constipation

Background and Objective:Colonoscopy is the most important method for the diagnosis and treatment of colorectal diseases.High quality colonoscopy depends on adequate bowel preparation.Chronic constipation is one of the risk factors leading to inadequate bowel preparation and thus affecting the efficacy of colonoscopy.Althoμgh many methods have been clinically applied in bowel preparation for patients with constipation,they still cannot meet the needs of high-quality bowel preparation in patients with chronic constipation.The purpose of this study is to explore the application effect of linaclotide combined with compound polyethylene glycol electrolyte powder in bowel preparation for colonoscopy in patients with chronic constipation.Methods:A total of 227 patients with chronic constipation who underwent colonoscopy in the Department of Gastroenterology of Shenzhen Baoan District People’s Hospital and Shenzhen Baoan District Shiyan People’s Hospital from September 2021 to March 2022 were selected.According to the random number table method,they were divided into 2L PEG group(n=73):2L PEG was given 6h before colonoscopy;Linaclotide combined with 2L PEG group(n=79):290μg linaclotide and 2L PEG were given half an hour before breakfast and 6h before colonoscopy on the day before colonoscopy respectively;3L PEG group(n=75):1L PEG at 20:00 the night before colonoscopy and 2L PEG at 6h before colonoscopy respectively.Intestinal cleansing effect,defecation,cecal intubation rate,colonoscopy entry time,colorectal adenoma and polyp detection rate,and patient tolerance were compared among the three groups.Results:(1)The qualified rate of bowel preparation in the linalotide combined with 2L PEG group was higher than that in the 2L PEG group(86.1%VS 76.7%,p=0.001),but had no significant difference from that in the 3L PEG group(86.1%VS 88.0%,p=0.442).The total colon BBPS score of the linalotide combined with 2L PEG group was higher than that of the 2L PEG group(7.23±1.40 VS 6.27±1.33,p<0.001),but there was no significant difference from that in the 3L PEG group(7.23±1.40 VS 6.93±1.42,p=0.562).For segmented colon,the BBPS score of linalotide combined with 2L PEG group was higher than that of 2L PEG group(p<0.05),but there was no significant difference compared with 3L PEG group(p>0.05).(2)There was no significant difference in the frequency of defecation between the linalotide combined with 2L PEG group and the 2L PEG group(6.03±1.16 VS 6.01±1.92,p>0.05),but the frequency of defecation in the 3L PEG group was higher than that in the 2L PEG group and the linalotide combined 2L PEG group(p<0.05).(3)There was no significant difference among the three groups in cecal intubation rate,colonoscopy entry time,adenoma and polyp detection rates(p>0.05).(4)Patients in the linalotide combined 2L PEG group and the 2L PEG groups had better tolerance(including nausea,vomiting,bloating,abdominal pain complications,willingness to repeat the same bowel preparation,and effect on sleep)than those in the 3L PEG group(p<0.05),but there was no significant difference between the two groups.Conclusions:Linaclotide combined with 2L PEG has the same bowel preparation effect as 3L PEG in patients with chronic constipation before colonoscopy,but the tolerance is better than 3L PEG,and the bowel cleansing effect is better than 2L PEG.Adding 290μg linaclotide to 2L PEG may be a suitable alternative to divided dose 3L PEG,which can reduce water intake,has high safety,good tolerance and low price.It has a good application value in bowel preparation in patients with chronic constipation,and is worthy of clinical application.