OBJECTIVE: Current British Society of Gastroenterology (BSG) guidelines suggest that hyoscine-n-butylbromide (Buscopan) should be avoided during colonoscopy in patients with a history of angle-closure glaucoma. Angle-closure glaucoma, however, is not very common, is asymptomatic before onset and is treated definitively by a single laser treatment (if spotted early). Open-angle glaucoma is not affected by hyoscine. The aim of this study was to assess the use of hyoscine among colonoscopists, with particular reference to glaucoma. DESIGN AND SETTING: Following BSG endoscopy subcommittee approval, a short questionnaire was electronically administered to members of the BSG and the Association of Coloproctology of Great Britain and Ireland. MAIN OUTCOME MEASURES: Hyoscine use among colonoscopists, and effect of glaucoma history upon prescribing practice. RESULTS: 188 colonoscopists responded to some or all of the questions. 123/183 (67.2%) of respondents claimed they were aware of the BSG guidelines. 160/187 (85.6%) sometimes or always use hyoscine, while 27/187 (14.4%) never do. 137/177 (77.4%) always enquire about glaucoma history prior to administration, although 147/176 (83.0%) make no differentiation between open-angle or angle-closure forms. 126/178 (70.8%) would (incorrectly) withhold hyoscine if the patient declares a history of any form of glaucoma. 140/179 (78.2%) do not substitute glucagon as an antispasmodic. 4/180 (2.2%) had encountered ophthalmic complications post-administration. CONCLUSIONS: Current BSG guidelines pertaining to hyoscine use and glaucoma are inappropriate; the authors recommend revision. Patients undergoing colonoscopy who have received hyoscine should, instead, be advised to seek urgent medical advice if they develop ophthalmic symptoms.
OBJECTIVE: Current British Society of Gastroenterology (BSG) guidelines suggest that hyoscine-n-butylbromide (Buscopan) should be avoided during colonoscopy in patients with a history of angle-closure glaucoma. Angle-closure glaucoma, however, is not very common, is asymptomatic before onset and is treated definitively by a single laser treatment (if spotted early). Open-angle glaucoma is not affected by hyoscine. The aim of this study was to assess the use of hyoscine among colonoscopists, with particular reference to glaucoma. DESIGN AND SETTING: Following BSG endoscopy subcommittee approval, a short questionnaire was electronically administered to members of the BSG and the Association of Coloproctology of Great Britain and Ireland. MAIN OUTCOME MEASURES: Hyoscine use among colonoscopists, and effect of glaucoma history upon prescribing practice. RESULTS: 188 colonoscopists responded to some or all of the questions. 123/183 (67.2%) of respondents claimed they were aware of the BSG guidelines. 160/187 (85.6%) sometimes or always use hyoscine, while 27/187 (14.4%) never do. 137/177 (77.4%) always enquire about glaucoma history prior to administration, although 147/176 (83.0%) make no differentiation between open-angle or angle-closure forms. 126/178 (70.8%) would (incorrectly) withhold hyoscine if the patient declares a history of any form of glaucoma. 140/179 (78.2%) do not substitute glucagon as an antispasmodic. 4/180 (2.2%) had encountered ophthalmic complications post-administration. CONCLUSIONS: Current BSG guidelines pertaining to hyoscine use and glaucoma are inappropriate; the authors recommend revision. Patients undergoing colonoscopy who have received hyoscine should, instead, be advised to seek urgent medical advice if they develop ophthalmic symptoms.
Authors: Thomas J W Lee; Matthew D Rutter; Roger G Blanks; Sue M Moss; Andrew F Goddard; Andrew Chilton; Claire Nickerson; Richard J Q McNally; Julietta Patnick; Colin J Rees Journal: Gut Date: 2011-09-22 Impact factor: 23.059
Authors: Jung Min Lee; Jae Hee Cheon; Jae Jun Park; Chang Mo Moon; Eun Soo Kim; Tae Il Kim; Won Ho Kim Journal: Hepatogastroenterology Date: 2010 Jan-Feb
Authors: Lik-man Mui; Enders K W Ng; Kang-chung Chan; Calvin S H Ng; Alex C M Au Yeung; Simon K C Chan; Simon K H Wong; S C Sydney Chung Journal: Gastrointest Endosc Date: 2004-01 Impact factor: 9.427