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Whole-bowel irrigation for mechanical colon cleansing
Clinical Pharmacy
|July 1, 1985
Summary
Whole-bowel irrigation (WBI) effectively cleanses the bowel using various solutions, with polyethylene glycol-electrolyte lavage solutions (PEG-ELSs) showing promise for safety and efficacy in adults. Faster administration rates can shorten cleansing time, making WBI a viable option before procedures.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
Background:
- Whole-bowel irrigation (WBI) is a method for mechanical bowel cleansing.
- Various solutions and administration rates are used, influencing efficacy and safety.
Purpose of the Study:
- To review the physiology, composition, indications, efficacy, and safety of WBI.
- To evaluate newer polyethylene glycol-electrolyte lavage solutions (PEG-ELSs).
Main Methods:
- Review of existing literature on WBI.
- Analysis of solution composition, administration rates, and patient outcomes.
- Examination of safety data for different patient populations.
Main Results:
- WBI with isotonic solutions induces diarrhea by exceeding intestinal absorption capacity.
- PEG-ELSs are effective and appear safe for elderly and fluid-overload risk patients.
- Gastrointestinal side effects occur in about one-third of patients but are generally manageable.
Conclusions:
- WBI is an effective bowel preparation method for colonoscopy and colorectal surgery.
- PEG-ELSs are preferred due to minimal net water and electrolyte movement.
- Further evaluation is needed for pediatric, pregnant, and inflammatory bowel disease populations.