Is high-dose senna as effective and tolerable as standard regimens in bowel preparation? Comparison of senna versus PEG and sodium picosulfate regimen
Öz
Background and Aims: The quality of bowel cleansing closely affects diagnostic accuracy and procedural safety. Appropriate selection of bowel cleansing preparations for the patient may increase patient compliance. In this study, it was aimed to compare the efficacy and tolerance of high-dose senna with standard preparations. Materials and Methods: A total of 150 outpatients scheduled for elective colonoscopy were included in the study. Patients were divided into 3 groups as polyethylene glycol, senna and sodium picosulfate magnesium citrate. All patients were given a low fiber diet 2 days before the procedure and a clear liquid diet 1 day before. All procedures were performed under sedoanalgesia before noon. Colon cleansing was graded with the Aronchick bowel preparation scale. Bowel preparation level, side effects, and tolerance to the preparation process were compared between the groups. Results: Excellent/good colon cleansing was achieved in 74% of the patients in the senna group. Colon cleansing levels of senna, polyethylene glycol, and sodium picosulfate magnesium citrate were similar (p = 0.846). The most obvious side effect of the senna regimen was abdominal pain (p < 0.001). Sodium picosulfate magnesium citrate was the best tolerated regimen (p < 0.001). Tolerability was similar in the senna and polyethylene glycol groups. There was no difference between the groups in adenoma detection rate, cecal intubation rate and time to reach the cecum. Conclusions: High-dose senna was found to be effective and tolerable in colonoscopy preparation. It can be considered as an alternative regimen to standard polyethylene glycol and sodium picosulfate magnesium citrate
Anahtar Kelimeler
Kaynakça
- 1. Froehlich F, Wietlisbach V, Gonvers JJ, et al. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005;61(3):378-84.
- 2. Chokshi RV, Hovis CE, Colditz GA, et al. Prevalence of missed adenomas in patients with inadaquate bowel preparartion on screening colonoscopy. Gastrointest Endosc. 2012;75:1197-203.
- 3. Menees SB, Kim HM, Elliott EE, et al. The impact of fair colonoscopy preparation on colonoscopy use and adenoma miss rates in patients undergoing outpatient colonoscopy. Gastrointest Endosc. 2013;78:510-6.
- 4. Enestvedt BK, Tofani C, Laine LA, et al. 4-Liter split-dose polyethyleneglycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2012;10:1225-31.
- 5. Saltzman JR, Cash BD, Pasha SF, et al. Bowel preparation before colonoscopy. Gastrointest Endosc. 2015;81(4):781-94.
- 6. Rex DK, Katz PO, Bertiger G, et al. Split-dose administration of a dual-action, low-volume bowel cleanser for colonoscopy: the SEE CLEAR I study. Gastrointest Endosc. 2013;78:132-41.
- 7. Katz PO, Rex DK, Epstein M, et al. A dual-action, low-volume bowel cleanser administered the day before colonoscopy: results from the SEE CLEAR II study. Am J Gastroenterol. 2013;108:401-9.
- 8. Rao SSC, Brenner DM. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. Am J Gastroenterol. 2021;116(6):1156-81.
- 9. Hassan C, Bretthauer M, Kaminski MF, et al; European Society of Gastrointestinal Endoscopy. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2013;45(2):142-50.
- 10. Radaelli F, Meucci G, Imperiali G, et al. High-dose senna compared with conventional PEG-ES lavage as bowel preparation for elective colonoscopy: a prospective, randomized, investigator-blinded trial. Am J Gastroenterol. 2005;100(12):2674-80.
- 11. Coskun Y, Yuksel I. Polyethylene glycol versus split high-dose senna for bowel preparation: A comparative prospective randomized study. J Gastroenterol Hepatol. 2020;35(11):1923-9.
- 12. Amato A, Radaelli F, Paggi S, Teruzzi V. Half doses of PEG-ES and senna vs. high-dose senna for bowel cleansing before colonoscopy: a randomized, investigator-blinded trial. Am J Gastroenterol. 2010;105(3):675-81.
- 13. Sadeghi A, Rahmani K, Moghadam PK, et al. Low volume polyethylene glycol combined with senna versus high volume polyethylene glycol, which regimen is better for bowel preparation for colonoscopy? A randomized, controlled, and single-blinded trial. Health Sci Rep. 2022;12(5):e829.
- 14. Van Lieshout I, Munsterman ID, Eskes AM, et al. Systematic review and meta-analysis: Sodium picosulphate with magnesium citrate as bowel preparation for colonoscopy. United European Gastroenterol J. 2017;5(7):917-43.
- 15. Unal S, Doğan UB, Oztürk Z, Cindoruk M. A randomized prospective trial comparing 45 and 90-ml oral sodium phosphate with X-Prep in the preparation of patients for colonoscopy. Acta Gastroenterol Belg. 1998;61(3):281-4.
- 16. Poyrazoglu OK, Yalniz M. Two low-dose bowel-cleansing regimens: efficacy and safety of senna and sodium phosphorus solution for colonoscopy. Patient Prefer Adherence. 2015;9:1325-31.
- 17. Kaplan M. Comparison of polyethylene glycol, sodium phosphate, and sennoside for colonoscopy preparation. Endoscopy Gastrointestinal 2018;26(3):74-7.
- 18. Hassan C, East J, Radaelli F, et al. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019. Endoscopy. 2019;51(8):775-94.
- 19. Lawrance IC, Willert RP, Murray K. Bowel cleansing for colonoscopy: prospective randomized assessment of efficacy and of induced mucosal abnormality with three preparation agents. Endoscopy 2011;43(5):412-8.
- 20. Yadlapati R, Johnston ER, Gregory DL et al. Predictors of inadequate inpatient colonoscopy preparation and its association with hospitallength of stay and costs. Dig Dis Sci 2015;60(11):3482-90.
- 21. Rex DK, Imperiale TF, Latinovich DR, Bratcher LL. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol. 2002;97(7):1696-700.
Yüksek doz senna bağırsak hazırlığında standart rejimler kadar etkin ve tolere edilebilir mi? Senna ile PEG ve sodyum pikosülfat rejimlerinin karşılaştırılması
Öz
Giriş ve Amaç: Bağırsak temizliğinin kalitesi tanısal doğruluğu ve işlem güvenliğini yakından etkiler. Bağırsak temizlik preparatlarının hastaya uygun seçilmesi hasta uyumunu arttırabilir. Bu çalışmada, yüksek doz sennanın etkinlik ve tolere edilebilirliğinin standart preparatlar ile karşılaştırılması amaçlandı. Gereç ve Yöntem: Elektif kolonoskopi yapılması planlanan toplam 150 ayaktan hasta çalışmaya dahil edildi. Hastalar polietilen glikol, senna ve sodyum pikosülfat magnezyum sitrat olacak şekilde 3 gruba ayrıldı. Hastaların tümüne işlemden 2 gün önce düşük lifli diyet, 1 gün önce berrak sıvı diyet verildi. İşlem öncesinde hazırlık sürecine olan tolerans ve yan etkiler kayıt edildi. Tüm işlemler öğleden önce sedoanaljezi altında yapıldı. Kolon temizliği Aronchick bağırsak hazırlık skalası ile derecelendirildi. Bağırsak hazırlık düzeyi, yan etkiler ve hazırlık sürecine olan tolerans gruplar arasında karşılaştırıldı. Bulgular: Senna grubundaki hastaların %74’ünde mükemmel/iyi derecede kolon temizliği sağlandı. Senna, polietilen glikol ve sodyum pikosülfat magnezyum sitratın kolon temizlik düzeyleri benzerdi (p = 0.846). Senna rejiminin en belirgin yan etkisi karın ağrısı idi (p < 0.001). Sodyum pikosülfat magnezyum sitrat en iyi tolere edilen rejimdi (p < 0.001). Senna ve polietilen glikol grubunda tolerans benzerdi. Gruplar arasında adenom tespit oranı, çekal entübasyon oranı ve çekuma ulaşma süresinde fark yoktu. Sonuç: Kolonoskopi hazırlığında yüksek doz senna etkili ve tolere edilebilir bulundu. Standart polietilen glikol ve sodyum pikosülfat magnezyum sitrata alternatif bir rejim olarak düşünülebilir.
Anahtar Kelimeler
Kaynakça
- 1. Froehlich F, Wietlisbach V, Gonvers JJ, et al. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005;61(3):378-84.
- 2. Chokshi RV, Hovis CE, Colditz GA, et al. Prevalence of missed adenomas in patients with inadaquate bowel preparartion on screening colonoscopy. Gastrointest Endosc. 2012;75:1197-203.
- 3. Menees SB, Kim HM, Elliott EE, et al. The impact of fair colonoscopy preparation on colonoscopy use and adenoma miss rates in patients undergoing outpatient colonoscopy. Gastrointest Endosc. 2013;78:510-6.
- 4. Enestvedt BK, Tofani C, Laine LA, et al. 4-Liter split-dose polyethyleneglycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2012;10:1225-31.
- 5. Saltzman JR, Cash BD, Pasha SF, et al. Bowel preparation before colonoscopy. Gastrointest Endosc. 2015;81(4):781-94.
- 6. Rex DK, Katz PO, Bertiger G, et al. Split-dose administration of a dual-action, low-volume bowel cleanser for colonoscopy: the SEE CLEAR I study. Gastrointest Endosc. 2013;78:132-41.
- 7. Katz PO, Rex DK, Epstein M, et al. A dual-action, low-volume bowel cleanser administered the day before colonoscopy: results from the SEE CLEAR II study. Am J Gastroenterol. 2013;108:401-9.
- 8. Rao SSC, Brenner DM. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. Am J Gastroenterol. 2021;116(6):1156-81.
- 9. Hassan C, Bretthauer M, Kaminski MF, et al; European Society of Gastrointestinal Endoscopy. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2013;45(2):142-50.
- 10. Radaelli F, Meucci G, Imperiali G, et al. High-dose senna compared with conventional PEG-ES lavage as bowel preparation for elective colonoscopy: a prospective, randomized, investigator-blinded trial. Am J Gastroenterol. 2005;100(12):2674-80.
- 11. Coskun Y, Yuksel I. Polyethylene glycol versus split high-dose senna for bowel preparation: A comparative prospective randomized study. J Gastroenterol Hepatol. 2020;35(11):1923-9.
- 12. Amato A, Radaelli F, Paggi S, Teruzzi V. Half doses of PEG-ES and senna vs. high-dose senna for bowel cleansing before colonoscopy: a randomized, investigator-blinded trial. Am J Gastroenterol. 2010;105(3):675-81.
- 13. Sadeghi A, Rahmani K, Moghadam PK, et al. Low volume polyethylene glycol combined with senna versus high volume polyethylene glycol, which regimen is better for bowel preparation for colonoscopy? A randomized, controlled, and single-blinded trial. Health Sci Rep. 2022;12(5):e829.
- 14. Van Lieshout I, Munsterman ID, Eskes AM, et al. Systematic review and meta-analysis: Sodium picosulphate with magnesium citrate as bowel preparation for colonoscopy. United European Gastroenterol J. 2017;5(7):917-43.
- 15. Unal S, Doğan UB, Oztürk Z, Cindoruk M. A randomized prospective trial comparing 45 and 90-ml oral sodium phosphate with X-Prep in the preparation of patients for colonoscopy. Acta Gastroenterol Belg. 1998;61(3):281-4.
- 16. Poyrazoglu OK, Yalniz M. Two low-dose bowel-cleansing regimens: efficacy and safety of senna and sodium phosphorus solution for colonoscopy. Patient Prefer Adherence. 2015;9:1325-31.
- 17. Kaplan M. Comparison of polyethylene glycol, sodium phosphate, and sennoside for colonoscopy preparation. Endoscopy Gastrointestinal 2018;26(3):74-7.
- 18. Hassan C, East J, Radaelli F, et al. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019. Endoscopy. 2019;51(8):775-94.
- 19. Lawrance IC, Willert RP, Murray K. Bowel cleansing for colonoscopy: prospective randomized assessment of efficacy and of induced mucosal abnormality with three preparation agents. Endoscopy 2011;43(5):412-8.
- 20. Yadlapati R, Johnston ER, Gregory DL et al. Predictors of inadequate inpatient colonoscopy preparation and its association with hospitallength of stay and costs. Dig Dis Sci 2015;60(11):3482-90.
- 21. Rex DK, Imperiale TF, Latinovich DR, Bratcher LL. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol. 2002;97(7):1696-700.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Gastroenteroloji ve Hepatoloji |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 25 Nisan 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 23 Sayı: 1 |
test-5