NDLI: Adjuncts to colonic cleansing before colonoscopy

Content Provider	PubMed Central
Author	Park, Sanghoon Lim, Yun Jeong
Copyright Year	2014
Abstract	Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy. Yet, efficacy of the current gold standard colonic preparation method - high-volume oral administration of purgative agents 12-24 h prior to the procedure - is limited by several factors, such as patient compliance (due to poor palatability and inconvenience of the dosing regimen) and risks of complications (due to drug interactions or intolerance). Attempts to resolve these limitations have included providing adjunctive agents and methods to promote the colonic cleansing ability of the principal purgative agent, with the aim of lessening unpleasant side effects (such as bloating) and reducing the large ingested volume requirement. Several promising adjunctive agents are bisacodyl, magnesium citrate, senna, simethicone, metoclopramide, and prokinetics, and each are being investigated for their potential. This review provides an up to date summary of the reported investigations into the potencies and weaknesses of the key adjuncts currently being applied in clinic as supplements to the traditional bowel preparation agents. While the comparative analysis of these adjuncts showed that no single agent or method has yet achieved the goal of completely overcoming the limitations of the current gold standard preparation method, they at least provide endoscopists with an array of alternatives to help improve the suboptimal efficacy of the main cleansing solutions when used alone. To aid in this clinical endeavor, a subjective grade was assigned to each adjunct to indicate its practical value. In addition, the systematic review of the currently available agents and methods provides insight into the features of each that may be overcome or exploited to create novel drugs and strategies that may become adopted as effective bowel cleansing adjuncts or alternatives.
Related Links	http://dx.doi.org/10.3748/wjg.v20.i11.2735
Ending Page	2740
Page Count	6
Starting Page	2735
File Format	PDF
ISSN	10079327
Journal	World Journal of Gastroenterology : WJG
Issue Number	11
Volume Number	20
Language	English
Publisher	Baishideng Publishing Group Co., Limited
Publisher Date	2014-01-01
Access Restriction	Open
Rights Holder	Baishideng Publishing Group Co., Limited
Subject Keyword	Gastroenterology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Gastroenterology

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