Effect of four-day psyllium supplementation on bowel preparation for colonoscopy:A prospective double blind randomized trial [ISRCTN76623768]

BMC Gastroenterology

Marc D Basson¹  Walter A Salwen¹ 

[1]Wayne State University, Detroit MI, John D. Dingell VAMC Detroit MI, USA

关键词: polyp;    bowel preparation;    psyllium;    colon cancer screening;    colonoscopy;    fiber;   

Others  :  1230593
DOI  :  10.1186/1471-230X-4-2

 received in 2003-09-16, accepted in 2004-02-02,  发布年份 2004

【 摘 要 】

Background

Patients with new onset constipation or presumed hemorrhoid bleeding frequently require the use of both fiber supplements and diagnostic colonoscopy. We sought to determine whether preliminary fiber supplementation would alter the tolerability or efficacy of a standard bowel preparation for colonoscopy

Methods

A prospective, double blind, randomized trial was designed to compare a short course of a psyllium-based supplement versus placebo prior to a colon lavage. Patients were given an unlabeled canister of powder, and instructed to take 1 tablespoon with 8 oz of water bid for 4 days before colonoscopy. A 4-liter polyethylene based glycol lavage was self-administered over 4 hours on the day prior to colonoscopy. A questionnaire on pre-study bowel habits and side effects was completed. Efficacy of the preparation was visually evaluated on a pre-determined scale.

Results

There were no significant differences between the two groups in gender, race, age, pre-study stool frequency or consistency. Tolerability was equivalent but efficacy of the bowel preparation was worse in the psyllium group compared to placebo (P < 0.05).

Conclusions

In non-constipated patients psyllium based fiber supplementation should not be initiated in the few days prior to endoscopy using a polyethylene glycol preparation.

【 授权许可】

   
2004 Salwen and Basson; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 参考文献 】

• [1]Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ: Cancer statistics, 2003. CA Cancer J Clin 2003, 53:5-26.
• [2]Rex DK, Imperiale TF, Latinovich DR, Bratcher LL: Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol 2002, 97:1696-1700.
• [3]McRorie J, Zorich N, Riccardi K, Bishop L, Filloon T, Wason S, Giannella R: Effects of olestra and sorbitol consumption on objective measures of diarrhea: impact of stool viscosity on common gastrointestinal symptoms. Regul Toxicol Pharmacol 2000, 31:59-67.
• [4]Lee J, McCallion K, Acheson AG, Irwin ST: A prospective randomised study comparing polyethylene glycol and sodium phosphate bowel cleansing solutions for colonoscopy. Ulster Med J 1999, 68:68-72.
• [5]Davis GR, Santa Ana CA, Morawski SG, Fordtran JS: Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology 1980, 78:991-995.
• [6]Reddy DN, Rao GV, Sriram PV: Efficacy and safety of oral sodium phosphate versus polyethylene glycol solution for bowel preparation for colonoscopy. Indian J Gastroenterol 2002, 21:219-221.
• [7]Barclay RL, Depew WT, Vanner SJ: Carbohydrate-electrolyte rehydration protects against intravascular volume contraction during colonic cleansing with orally administered sodium phosphate. Gastrointest Endosc 2002, 56:633-638.
• [8]Poon CM, Lee DW, Mak SK, Ko CW, Chan KC, Chan KW, Sin KS, Chan AC: Two liters of polyethylene glycol-electrolyte lavage solution versus sodium phosphate as bowel cleansing regimen for colonoscopy: a prospective randomized controlled trial. Endoscopy 2002, 34:560-563.
• [9]Ell C, Fischbach W, Keller R, Dehe M, Mayer G, Schneider B, Albrecht U, Schuette W: A randomized, blinded, prospective trial to compare the safety and efficacy of three bowel-cleansing solutions for colonoscopy (HSG-01*). Endoscopy 2003, 35:300-304.
• [10]Adams WJ, Meagher AP, Lubowski DZ, King DW: Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation. Dis Colon Rectum 1994, 37:229-33; discussion 233-4.