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Colon cleansing regimens

A clinical study in 1200 patients

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Abstract

The purgative effect of bisacodyl, anthraquinone glycosides (Cascara), and sodium picosulfate, alone or in combination with a saline purge and a tap water enema, was studied in 1200 patients. The cleansing effect was scored with regard to retained fecal residue evident on double-contrast studies of the colon.

The combination of a contact laxative and a saline purge produced good cleansing effect in 52%–80% of the patients. With an additional tap water enema given 1 hour before the colon examination, however, 96% of the colons were clean.

The taste and the effects of the cleansing systems were tolerated favorably by more than 90% of the patients. However, 17% reported restriction in work capacity on the day of bowel cleansing.

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References

  1. Rosengren JE, åberg T: Cleansing of the colon without enemas.Radiologe 15:421–426, 1975

    Google Scholar 

  2. Schilling Th: Die Doppelkontrasttechnik in der Dickdarm-Diagnostik.RöntgenblÄtter 30:388–399, 1977

    Google Scholar 

  3. Barnes MR: How to get a clean colon — with less effort.Radiology 91:948–949, 1968

    Google Scholar 

  4. Brown GR: A new approach to colon preparation for barium enema: preliminary report.Univ Michigan Med Bull 27:225–230, 1961

    Google Scholar 

  5. Dodds WJ, Scalon GT, Shaw DK, Stewart ET, Youker, JE, Metter GE: An evaluation of colon cleansing regimens.AJR 128:57–59, 1977

    Google Scholar 

  6. Fringl E: Laxatives and Cathartics. In Goodman LS, Gilman A (eds):The Pharmacological Basis of Therapeutics, 5th ed. New York: Macmillan, 1975, pp 976–986

    Google Scholar 

  7. Harvey RF, Read AE: Saline purgatives act by releasing cholecystokinin.Lancet II: 185–187, 1973

    Google Scholar 

  8. Binder HJ, Donowitz M: A new look at laxative action.Gastroenterology 69:1001–1005, 1975

    Google Scholar 

  9. Soliman T:A Manual of Pharmacology and Its Application to Therapeutics and Toxicology, 7th ed. Philadelphia: WB Saunders Co, 1949

    Google Scholar 

  10. Hirschfelder AD: Clinical manifestations of high and low plasma magnesium. Danger of epsom salt purgation in nephritis.JAMA 102:1138–1141, 1934

    Google Scholar 

  11. Smith B: Effect or irritant purgatives on the myenteric plexus in man and the mouse.Gut 9:139–143, 1968

    Google Scholar 

  12. Smith B: Pathologic changes in the colon produced by anthraquinone purgatives.Dis Colon Rectum 16:455–458, 1973

    Google Scholar 

  13. Travell J: Pharmacology of stimulant laxatives.Ann NY Acad Sci 58:416–425, 1954

    Google Scholar 

  14. Nüesch HJ, Clavadetscher P, Jenny S, Deyhle P: Dickdarmvorbereitung für Endoskopie und Radiologie.Ars Med 66:5–6, 1976

    Google Scholar 

  15. Rafsky GA, Newman B, Seidenberg S: Newly isolated active principles of senna: preliminary report.Am J Dig Dis 12: 221–222, 1945

    Google Scholar 

  16. Barbi G, Fici F: Sperimentazione clinica controllata di un nuovo lassativo di sintesi: il picosulfato di sodio. (Note I).Settimana Med 55:987–994, 1967

    Google Scholar 

  17. Barbi G, Fici F: Sperimentazione clinica controllata di un nuova lassativo di sintesi: il picosulfato di sodio. (Note II).Settimana Med 55:997–1004, 1967

    Google Scholar 

  18. Weinberg CR, Baruch EA: Simplified bowel preparation for radiography and genitourinary surgery.J Urol 85:988–992, 1961

    Google Scholar 

  19. Kremer K, Grewe HE: Untersuchungen über die medikamentöse Beeinflussung der Darmperistaltik.Ärztl Wochenschr 10:529–533, 1955

    Google Scholar 

  20. Schmidt L: Pharmakologie und Toxikologie einer neuen Klasse von Verbindungen mit laxierender Wirkung.Arzneim Forsch 3:19–23, 1953

    Google Scholar 

  21. Schmidt L, Fülgraff G: über einen Rectum-Colon-Reflex.Arzneim Forsch 13:217–220, 1963

    Google Scholar 

  22. Jauch R, Hankwitz R, Beschke K, Pelzer H: Bis-(p-hydroxyphenyl)-pyridyl-2-methane: The common laxative principle of Bisacodyl and sodium picosulfate.Arzneim Forsch 25: 1796–1800, 1975

    Google Scholar 

  23. Forth W, Nell G, Rummel W, Andres H: The hydragogue and laxative effect of the sulfuric acid ester and the free diphenol of 4,4′-dihydroxydiphenyl-(pyridyl-2)-methane.Naunyn-Schmiedebergs Arch Pharmacol 274:46–53, 1972

    Google Scholar 

  24. Pala G, Coppi G, Crenscenzi E: On the laxative properties of sulfuric esters of phenols, with particular reference to 4,4′-(2-picolylidene)-bis-phenylsulfuric acid disodium salt (Picosulfol)Arch Int Pharmacodyn Ther 164:356–369, 1966

    Google Scholar 

  25. Saunders DR, Sillery J, Rachmilewitz D, Rubin CE, Tytgat GN: Effect of Bisacodyl on the structure and function of rodent and human intestine.Gastroenterology 72:849–856, 1977

    Google Scholar 

  26. Brown GR: Preparing the colon for radiological study.Mod Med 38:200–201, 1970

    Google Scholar 

  27. Evangelisti GB, Farina O: stipsi cronica abituale (e suo trattamento con il sale bisodico dell'acido 4,4′-(2-picoliliden)- bis-fenilsoforico).La Clinica 27:182–196, 1967

    Google Scholar 

  28. Schürger R: Die Routinelaxation und eine sachgemÄ\e individuelle Behandlung der Obstipation.Therapiewoche 22:1873–1876, 1972

    Google Scholar 

  29. Fischer AW: über die Röntgenuntersuchung des Dickdarmes mit Hilfe einer Kombination von Lufteinblasung und Kontrasteinlauf.Arch Klin Chir 134:209–269, 1925

    Google Scholar 

  30. Welin S: Modern trends in diagnostic roentgenology of the colon.Br J Radiol 31:453–464, 1958

    Google Scholar 

  31. Welin S: über die röntgenologische Untersuchung des Dickdarmes mit der Doppelkontrastmethode. Die Malmömodifikation.Radiologe 2:87–100, 1962

    Google Scholar 

  32. Welin G, Welin S, åberg T: Klyxray: a new preparation for excessive emptying of the colon.Br J Radiol 43:744–746, 1970

    Google Scholar 

  33. Miller RE: The cleansing enema.Radiology 117:483–485, 1975

    Google Scholar 

  34. Miller RE: The clean colon.Gastroenterology 70:289–290, 1976

    Google Scholar 

  35. Diner WC, Dodd D, Riggs OE: The value of Bisacodyl Tannex (Clysodrast) in the radiological examination of the colon.Radiology 104:49–51, 1972

    Google Scholar 

  36. Margulis AR, Goldberg HI: The current state of radiologic technique in the examination of the colon: a survey.Radiol Clin North Am 1:27–42, 1969

    Google Scholar 

  37. Tracht DG, Clemett AR: An evaluation of the “clean colon” technique.Radiology 99:69–70, 1971

    Google Scholar 

  38. Ennis JT, Mitchell AV: Oral laxatives in barium enema preparation.Br J Radiol 43:242–244, 1970

    Google Scholar 

  39. Hewitt J, Rigby J, Reeve J, Cox AG: Whole-gut irrigation in preparation for large-bowel surgery.Lancet II: 337–340, 1973

    Google Scholar 

  40. Levy AG, Benson JW, Hewlett EL, Herdt JR, Doppman JL, Gordon RS: Saline lavage: a rapid, effective, and acceptable method for cleansing the gastrointestinal tract.Gastroenterology 70:157–161, 1976

    Google Scholar 

  41. Skucas J, Cutcliff W, Fischer HW: Whole-gut irrigation as a means of cleaning the colon.Radiology 121:303–305, 1976

    Google Scholar 

  42. Welin S: Closydrast. Observanda Medica, Ferrosan, Sweden, 1955

    Google Scholar 

  43. McAlister HW, Anderson MS, Bloomberg GR, Marguhs AR: Lethal effects of tannic acid in the barium enema. Report of three fatalities and experimental studies.Radiology 80:765–773, 1963

    Google Scholar 

  44. Barnes ME: Clean colons without enemas.Am J Nurs 69:2128–2129, 1969

    Google Scholar 

  45. Cattani E, Pavlica P: Elimination of intestinal gas prior to radiographical examination of the urinary tract.Quad Radiol 34:171–182, 1969

    Google Scholar 

  46. Andrén L, Frieberg S, Welin S: Roentgen diagnosis of small polyps in the colon and rectum.Acta Radiol Diagn 43:201–208, 1955

    Google Scholar 

  47. Laufer I: The double-contrast enema: myths and misconceptions.Gastrointest Radiol 1:19–31, 1976

    Google Scholar 

  48. Sanders RC, Wright FW: Colonic preparation: a controlled trial of Dulcodos, Dulcolax and Senkot DX.Br J Radiol 43:245–241, 1970

    Google Scholar 

  49. Newman DE, Fellows KE Jr: A double-blind study of ipodate and the non-diagnostic cholecystogram.J Can Assoc Radiol 21:149–152, 1970

    Google Scholar 

  50. Mertens H: Beurteilung eines neuen Laxativums (Laxoberal) nach einer multilokulÄren Prüfung.Therapiewoche 22:2956–2960, 1972

    Google Scholar 

  51. Weist FR: Erste klinische Erfahrungen mit einem neuen Laxativums in Tropfenform.Therapiewoche 22:2810–2814, 1972

    Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Malmö General Hospital and University of Lund, Sweden

    Frans -Thomas Fork M.D. & Olle Ekberg

  2. Ferring Pharmaceuticals, Malmö, Sweden

    Göran Nilsson

  3. Department of Pharmacology, University of Lund, Lund, Sweden

    Claes Rerup

  4. Ercopharm, Vedbaek, Denmark

    Annette SkinhØj

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  1. Frans -Thomas Fork M.D.
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  2. Olle Ekberg
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  3. Göran Nilsson
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  4. Claes Rerup
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  5. Annette SkinhØj
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Fork, F.T., Ekberg, O., Nilsson, G. et al. Colon cleansing regimens. Gastrointest Radiol 7, 383–389 (1982). https://doi.org/10.1007/BF01887677

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  • DOI: https://doi.org/10.1007/BF01887677

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