Efficacy of prokinetic agents in improving bowel preparation for colonoscopy.
OBJECTIVE
Colonoscopy plays an important role in the diagnosis and treatment of gastrointestinal illness in both Western countries and Japan. However, preparative bowel cleansing for colonoscopy is frequently troublesome for elderly and/or constipated patients, since they must drink larger volumes of lavage solution for adequate cleansing. We investigated the use of prokinetic agents for improving the efficacy and tolerability of bowel cleansing prior to colonoscopy.


METHODS
613 patients were divided into two groups according to oral lavage solution used (polyethylene glycol or magnesium citrate), and were further randomized to receive either vehicle (100 ml water) alone, vehicle with 5 mg mosapride citrate, or vehicle with 50 mg itopride hydrochloride 30 min before administration of lavage solution. Experimental parameters included bowel cleansing quality, times to first defecation and completion of bowel cleansing, and incidence of uncomfortable abdominal symptoms during colonoscopy preparation.


RESULTS
Administration of mosapride citrate or itopride hydrochloride prior to oral lavage solution did not significantly improve bowel cleansing quality. However, statistically significantly fewer uncomfortable abdominal symptoms were found in patients who received mosapride citrate or itopride hydrochloride versus vehicle alone.


CONCLUSIONS
Prokinetic agents effectively decreased the incidence of uncomfortable abdominal symptoms experienced during colonoscopy preparation.
Mishima
Yuko
Y
Department of Gastroenterology and Hepatology, Shimane University, School of Medicine, Izumo, Japan.
Amano
Yuji
Y
Okita
Koichi
K
Takahashi
Yoshiko
Y
Moriyama
Nobuyuki
N
Ishimura
Norihisa
N
Furuta
Kenji
K
Ishihara
Shunji
S
Adachi
Kyoichi
K
Kinoshita
Yoshikazu
Y
D000368:Aged; D000880:Anthraquinones; D001549:Benzamides / Q000494:pharmacology*; D001593:Benzyl Compounds / Q000494:pharmacology*; D002400:Cathartics / Q000494:pharmacology*; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000494:pharmacology*; D011092:Polyethylene Glycols / Q000494:pharmacology; D012676:Senna Extract; D000081226:Sennosides; D007507:Therapeutic Irrigation / Q000379:methods*
D000880:Anthraquinones; D001549:Benzamides; D001593:Benzyl Compounds; D002400:Cathartics; D005765:Gastrointestinal Agents; D009025:Morpholines; D000081226:Sennosides; D011092:Polyethylene Glycols; D012676:Senna Extract; C102254:itopride; C062720:mosapride