title: Combination could be another tool for bowel preparation?
abstract: Optimal bowel preparation increases the cecal intubation rate and detection of neoplastic lesions while decreasing the procedural time and procedural-related complications. Although high-volume polyethylene glycol (PEG) solution is the most frequently used preparation for bowel cleansing, patients are often unwilling to take PEG solution due to its large volume, poor palatability, and high incidence of adverse events, such as abdominal bloating and nausea. Other purgatives include osmotic agents (e.g., sodium phosphate, magnesium citrate, and sodium sulfate), stimulant agents (e.g., senna, bisacodyl, and sodium picosulfate), and prokinetic agents (e.g., cisapride, mosapride, and itopride). A combination of PEG with an osmotic, stimulant, or prokinetic agent could effectively reduce the PEG solution volume and increase patients' adherence. Some such solutions have been found in several published studies to not be inferior to PEG alone in terms of bowel cleansing quality. Although combination methods showed similar efficacy and safety, the value of these studies is limited by shortcomings in study design. New effective and well-tolerated combination preparations are required, in addition to rigorous new validated studies.
authors.affiliation: Jae Seung Soh, Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, University of Hallym College of Medicine, Anyang 14068, South Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Soh
authors.affiliation: Jae Seung Soh, Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, University of Hallym College of Medicine, Anyang 14068, South Korea.
authors.forename: Kyung-Jo
authors.initials: KJ
authors.lastname: Kim
mesh_terms: D000284:Administration, Oral; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy; D003672:Defecation / Q000187:drug effects*; D004359:Drug Therapy, Combination; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D055118:Medication Adherence; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols
keywords: Bowel preparation; Colonoscopy; Combination methods; Inadequate bowel cleansing; Intolerance