title: Comparison between pulsed irrigation enhanced evacuation and polyethylene glycol-electrolyte lavage solution for bowel preparation prior to elective colonoscopy in veterans with spinal cord injury.
abstract: BACKGROUND
  Poor preparation for elective colonoscopy is common in persons with spinal cord injury (SCI). This unsatisfactory outcome is likely due to long-standing difficulty with evacuation and decreased colonic motility. Our objective was to determine the most effective preparation for elective colonoscopy applying a novel and traditional approach to bowel cleansing.
  
  
  METHODS
  Twenty-four subjects with SCI were consented and scheduled to receive one of the two possible arms: pulsed irrigation enhanced evacuation (PIEE) or polyethylene glycol-electrolyte lavage solution (PEG; CoLyte(®)). The quality of the preparation was scored during the colonoscopy by applying the Ottawa scoring system.
  
  
  RESULTS
  Patients with SCI who received PIEE tended to have lower Ottawa scores and a higher percentage of acceptable preparations than did those who received PEG; however, the results were not statistically different.
  
  
  CONCLUSIONS
  In this preliminary study in subjects with SCI, neither PIEE nor PEG produced acceptable bowel preparation for elective colonoscopy. Future studies should confirm our findings and consider studying alternative, more efficacious approaches to bowel cleansing prior to colonoscopic procedures in patients with SCI, which should provide better outcomes. Registration number for clinicaltrials.gov: NCT00745095.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Lyons
authors.forename: Mark A
authors.initials: MA
authors.lastname: Korsten
authors.forename: Ann M
authors.initials: AM
authors.lastname: Spungen
authors.forename: Miroslav
authors.initials: M
authors.lastname: Radulovic
authors.forename: Alan S
authors.initials: AS
authors.lastname: Rosman
authors.forename: Kristel
authors.initials: K
authors.lastname: Hunt
authors.forename: Marinella D
authors.initials: MD
authors.lastname: Galea
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Kornfeld
authors.forename: Christina
authors.initials: C
authors.lastname: Yen
authors.forename: William A
authors.initials: WA
authors.lastname: Bauman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D004573:Electrolytes / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007422:Intestines / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011300:Preoperative Care / Q000379:methods; D013119:Spinal Cord Injuries / Q000150:complications*; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000379:methods; D014728:Veterans
chemical_list: D004573:Electrolytes; C033608:Golytely; D011092:Polyethylene Glycols
keywords: Bowel preparations; Colonoscopy; Paraplegia; Polyethylene glycol; Polyp detection; Tetraplegia
references.citation: Epidemiology. 1999 Jan;10(1):67-72
references.pmid: 9888282
references.citation: Gastroenterology. 1997 Feb;112(2):594-642
references.pmid: 9024315
references.citation: Clin Gastroenterol Hepatol. 2009 May;7(5):537-44
references.pmid: 19418602
references.citation: Am J Gastroenterol. 2003 Jan;98(1):128-34
references.pmid: 12526948
references.citation: Dig Dis Sci. 1998 Aug;43(8):1831-4
references.pmid: 9724176
references.citation: Can J Gastroenterol. 2011 Dec;25(12):657-62
references.pmid: 22175055
references.citation: Gut. 1998 Apr;42(4):560-5
references.pmid: 9616321
references.citation: Am J Gastroenterol. 2008 Apr;103(4):883-93
references.pmid: 18190651
references.citation: Spinal Cord. 2012 Jan;50(1):81-4
references.pmid: 21876549
references.citation: Dis Colon Rectum. 1994 Feb;37(2):161-4
references.pmid: 8306838
references.citation: J Pediatr Gastroenterol Nutr. 1994 Jan;18(1):92-5
references.pmid: 8126626
references.citation: Dis Colon Rectum. 2011 Jul;54(7):876-86
references.pmid: 21654256
references.citation: J Spinal Cord Med. 2005;28(1):43-54
references.pmid: 15832903
references.citation: Gastrointest Endosc. 2006 Oct;64(4):544-52
references.pmid: 16996347
references.citation: Gastrointest Endosc. 1991 Jul-Aug;37(4):444-8
references.pmid: 1916166
references.citation: Am J Gastroenterol. 2005 Jul;100(7):1560-5
references.pmid: 15984982
references.citation: Dig Dis Sci. 2008 Oct;53(10):2710-3
references.pmid: 18338263
references.citation: J Spinal Cord Med. 2009;32(4):404-7
references.pmid: 19777861
references.citation: Gastrointest Endosc. 2000 Sep;52(3):346-52
references.pmid: 10968848
references.citation: N Engl J Med. 2000 Nov 30;343(22):1603-7
references.pmid: 11096167
references.citation: Dis Colon Rectum. 2000 Nov;43(11):1568-71
references.pmid: 11089594
references.citation: Aliment Pharmacol Ther. 2009 Dec 1;30(11-12):1110-7
references.pmid: 19769634
references.citation: N Engl J Med. 2000 Jul 20;343(3):162-8
references.pmid: 10900274