[The effect of various cleansing methods for total fiber optic colonoscopy]

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Diseases

Background:

• Colorectal cancer incidence is increasing, necessitating early detection through colonoscopy.
• Effective bowel preparation is crucial for accurate colonoscopy and barium enema procedures.
• Various agents exist for colon cleansing, with mechanical cleansing being common.

Purpose of the Study:

• To compare the effectiveness of six different bowel cleansing methods for colonoscopy.
• To evaluate cleansing efficacy, mucosal irritation, and patient-reported symptoms.
• To determine the optimal bowel preparation based on patient characteristics.

Main Methods:

• Six experimental bowel cleansing methods were tested: normal saline enema, castor oil with saline, castor oil with soapsuds, magnesium citrate with saline, magnesium citrate with soapsuds, and Golytely solution.
• Effectiveness was graded by an experienced endoscopist based on ease of procedure (Grades I-II for no difficulty).
• Patient data included age (43±15 years) and sex (133 males, 114 females).
• Mucosal irritation and subjective symptoms (distension, pain, nausea, vomiting) were also assessed.

Main Results:

• Golytely (Method 6) showed 95.9% effectiveness, followed by castor oil with saline (Method 2) at 93.2%.
• Method 6 was most effective for constipated patients, while Methods 2 and 6 were best for normal bowel habits.
• Golytely and normal saline enema caused the least mucosal irritation (100%), but Method 3 had the highest reported symptoms (88.9%).

Conclusions:

• Golytely is the most effective mechanical cleansing solution for fiber optic colonoscopy.
• Optimal bowel preparation choice depends on individual patient conditions and bowel habits.
• Further research may refine bowel preparation protocols for improved colonoscopy outcomes.