Castor oil as booster for colon capsule endoscopy preparation reduction: A prospective pilot study and patient questionnaire
| Autor: | Konosuke Nakaji, Satoru Hagiwara, Mamoru Takenaka, Yoriaki Komeda, Shigenaga Matsui, Tomohiro Watanabe, Kota Takashima, Masatoshi Kudo, Toshiharu Sakurai, Hiroshi Kashida, Naoshi Nishida, Sho Masaki, Tomoyuki Nagai |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Castor oil
Colorectal diseases medicine.medical_specialty Booster (rocketry) medicine.diagnostic_test business.industry Colon capsule endoscopy Bowel preparation regimen Colonoscopy complex mixtures Surgery law.invention Patient questionnaire Capsule endoscopy law Prospective Study General Earth and Planetary Sciences Medicine business Prospective cohort study General Environmental Science medicine.drug |
| Zdroj: | World Journal of Gastrointestinal Pharmacology and Therapeutics |
| ISSN: | 2150-5349 |
| Popis: | BACKGROUND Preparation for colon capsule endoscopy (CCE) requires a large liquid laxative volume for capsule excretion, which compromises the procedure's tolerability. AIM To assess the safety and utility of castor oil-boosted bowel preparation. METHODS This prospective cohort study including 20 patients (age range, 16-80 years; six men and 14 women) suspected of having colorectal disease was conducted at Kindai University Hospital from September 2017 to August 2019. All patients underwent CCE because of the following inclusion criteria: previous incomplete colonoscopy in other facility (n = 20), history of abdominal surgery (n = 7), or organ abnormalities such as multiple diverticulum (n = 4) and adhesion after surgery (n = 6). The exclusion criteria were as follows: Dysphagia, history of allergic reactions to the drugs used in this study (magnesium citrate, polyethylene glycol, metoclopramide, and castor oil), possibility of pregnancy, possibility of bowel obstruction or stenosis based on symptoms, or scheduled magnetic resonance imaging within 2 wk after CCE. The primary outcome was the capsule excretion rate within the battery life, as evaluated by the total large bowel observation rate, large bowel transit time, and bowel creasing level using a five-grade scale in different colorectal segments. The secondary outcomes were complications, colorectal lesion detection rates, and patients’ tolerability. RESULTS The castor oil-based regimen was implemented in 17 patients. Three patients cancelled CCE because they could tolerate castor oil, but not liquid laxatives. The capsule excretion rate within the battery life was 88% (15/17). The mean large bowel transit time was 236 min. Approximately 70% of patients had satisfactory colon cleansing levels. CCE detected colon polyps (14/17, 82%) and colonic diverticulum (4/12, 33%). The sensitivity, specificity, and diagnostic accuracy rates for detecting colorectal polyps (size ≥ 6 mm) were 76.9%, 75.0%, and 76.4%, respectively. The sensitivity, specificity, and diagnostic accuracy rates for detection of diverticulum were 100% each. Twelve patients (71%) rated CCE as more than “good”, confirming the new regimen’s tolerability. No serious adverse events occurred during this study. CONCLUSION The castor oil-based regimen could reduce bowel preparation dose and improve CCE tolerability. |
| Databáze: | OpenAIRE |
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