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Related Experiment Videos

Chemical colostomy irrigation with glyceryl trinitrate solution.

A O'Bichere1, C Bossom, S Gangoli

  • 1St. Mark's Hospital and Northwick Park Institute for Medical Research, Harrow, Middlesex, United Kingdom.

Diseases of the Colon and Rectum
|October 5, 2001
PubMed
Summary

Glyceryl trinitrate solution significantly reduces colostomy irrigation time and leakage compared to tap water. While effective, potential side effects like headaches and cramps warrant further investigation of alternative colonoplegic agents.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pharmacology

Background:

  • Colostomy irrigation is crucial for quality of life but is time-intensive.
  • Investigating methods to reduce colostomy irrigation duration is essential for patient adherence and well-being.

Purpose of the Study:

  • To test if glyceryl trinitrate solution can reduce colostomy irrigation time by promoting passive stool expulsion through smooth muscle relaxation.
  • To evaluate the safety and efficacy of glyceryl trinitrate in colostomy irrigation.

Main Methods:

  • A comparative study involving 15 experienced colostomy irrigators using tap water versus a 0.025 mg/kg glyceryl trinitrate solution.
  • Measurements included fluid inflow time, total washout duration, fecal leakage, patient satisfaction, and hemodynamic changes.

Related Experiment Videos

  • Statistical analysis used Wilcoxon's signed-rank test, McNemar's test, and paired t-tests for relevant outcomes.

    • Main Results:

    • Glyceryl trinitrate significantly reduced fluid inflow time (4 vs. 7 min, P=0.001) and total washout time (21 vs. 40 min, P<0.001) compared to tap water.
    • Fecal leakage was significantly reduced (P=0.02) with glyceryl trinitrate, while patient satisfaction remained high (P=0.31).
    • Headaches and cramps were significantly higher with glyceryl trinitrate (93% vs. 7%, P<0.001), with transient hemodynamic changes observed.

    Conclusions:

    • Glyceryl trinitrate solution effectively shortens colostomy irrigation time and reduces leakage, with high patient satisfaction.
    • The observed side effects, such as headaches and cramps, are significant drawbacks.
    • Further research into other colonoplegic agents is recommended to optimize colostomy irrigation protocols.