Colon cleansing works better in two stages
All content is checked by medical journalists.MunichBefore a colonoscopy, a thorough cleaning is the order of the day: the bowel is thoroughly emptied with special passage solutions. This is evidently particularly effective when cleaning is carried out in two stages, a large overview study has now shown.
Canadian researchers led by Myriam Martel from McGill University in Montreal compared the results of 47 studies with around 13,500 participants. The volunteers either emptied their bowels using laxatives the day before. Or they had split the laxative dose and taken part the day before the colonoscopy and one the morning before the procedure.
Better cleaning, better vision
As the researchers were able to determine, the split intake worked much better: The intestines were cleaned considerably better and the number of successful bowel preparations was twice as high with this variant as after a single intake.
The reason for the better result was apparently that the time of the last bowel movement was closer to the time of the examination in this way.
The patients apparently also coped better with the split dose: Participants who had prepared for the colonoscopy in this way were more willing to endure the procedure again than those who had emptied their bowels in one go.
This is how colon cleansing works
Two classes of laxatives are suitable for colon cleansing: solutions with polyethylene glycol elyte (PEG) and solutions based on sodium phosphate.
In the case of split colon cleansing with PEG solutions, the German Society for Digestive and Metabolic Diseases recommends eating the last meal at noon on the day before the colonoscopy and purging it for the first time in the evening. The patient then drinks the second portion of the solution in the early morning before the examination. The problem with the use of the PEG solutions is the unpleasant taste and the large amount of drinking that is necessary for the laxative effect. Typically, patients need to drink four liters of saline solution. Newer PEG preparations that are combined with vitamin C are an exception. Two liters of liquid are sufficient for these.
Sodium phosphate solution removes water from the body, so the patient must also drink a lot of fluids. For security reasons, at least in Germany, they are always taken in two parts, at least twelve hours apart. The patient takes the first dose of 45 ml on the morning of the day before the examination. Compared to an intestinal passage with PEG, the patient has to go without food for much longer.
A colonoscopy is done to diagnose bowel disease - especially for the early detection of cancer. Polyps, tumors and other pathological changes can only be reliably detected with the endoscope if the intestine has been thoroughly cleaned beforehand. (cf)
Sources:
Myriam Martel: Split-Dose Preparations are Superior to Day-before Bowel Cleansing Regimens: a Meta-analysis, Gastroenterology, published Online: April 08, 2015
Position paper of the Endoscopy Section of the DGVS on colon cleansing before colonoscopy, 2007
Tags: prevention laboratory values sleep
