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. CONCLUSION: 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.
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. CONCLUSION: 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: S J Winawer; R H Fletcher; L Miller; F Godlee; M H Stolar; C D Mulrow; S H Woolf; S N Glick; T G Ganiats; J H Bond; L Rosen; J G Zapka; S J Olsen; F M Giardiello; J E Sisk; R Van Antwerp; C Brown-Davis; D A Marciniak; R J Mayer Journal: Gastroenterology Date: 1997-02 Impact factor: 22.682
Authors: Mark A Korsten; Alan S Rosman; Anthony Ng; Erdal Cavusoglu; Ann M Spungen; Miroslav Radulovic; Jill Wecht; William A Bauman Journal: Am J Gastroenterol Date: 2005-07 Impact factor: 10.864
Authors: Christian Ell; Wolfgang Fischbach; Hans-Joachim Bronisch; Stefan Dertinger; Peter Layer; Michael Rünzi; Thomas Schneider; Günther Kachel; Jörg Grüger; Michael Köllinger; Waltraud Nagell; Karl-Josel Goerg; Roland Wanitschke; Hans-Jürgen Gruss Journal: Am J Gastroenterol Date: 2008-01-11 Impact factor: 10.864
Authors: W S Atkin; A Hart; R Edwards; P McIntyre; R Aubrey; J Wardle; S Sutton; J Cuzick; J M Northover Journal: Gut Date: 1998-04 Impact factor: 23.059