References: Laxative
Gastroenterology. 1984 May;86(5 Pt 1):856-60.
Comparison of colon cleansing methods in preparation for colonoscopy.
DiPalma JA, Brady CE 3rd, Stewart DL, Karlin DA, McKinney MK, Clement DJ, Coleman TW, Pierson WP.
Colonoscopy cleansing regimens were evaluated in 197 patients randomized in two study phases to one of four methods: group 1 (64 patients), 3-day clear liquid diet; group 2 (40 patients), 3-day minimum-residue diet; group 3 (44 patients), 1-day minimum-residue diet; group 4 (49 patients), Golytely. Groups 1-3 also received laxatives and enemas before colonoscopy. Physician assessment by endoscopists unaware of the method of colon cleansing favored group 4 (p less than 0.001), with good to excellent preparations achieved in 69% of group 1, 80% of groups 2 and 3, and 92% of group 4. Group 4 patients also experienced less abdominal distress (p less than 0.01). Breath hydrogen and methane levels were measured in groups 3 and 4 both before and after preparation. The decrease in pre- to postprep levels of hydrogen and methane were not significantly different between the groups and postprep gas concentrations were below combustible levels in both groups. There were no clinically significant differences between the four groups for any of the other measured hematologic or biochemical parameters. It is concluded that Golytely is a safe, effective method of colon cleansing, well tolerated by patients.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6706069&dopt=Abstract constipation laxative colon cleansing
Radiology. 2000 Aug;216(2):492-7.
Malignant colorectal obstruction treated by means of self-expanding metallic stents: effectiveness before surgery and in palliation.
Camunez F, Echenagusia A, Simo G, Turegano F, Vazquez J, Barreiro-Meiro I.
Departments of Radiology and Surgery, Hospital General Universitario "Gregorio Maranon," Madrid, Spain.
PURPOSE: To determine the effectiveness and safety of metallic stents in the treatment of malignant colorectal obstruction before surgery and for palliation. MATERIALS AND METHODS: Eighty patients with acute malignant colorectal obstruction presumed to be malignant were treated by means of implanting self-expanding metallic stents. RESULTS: Stent placement was successful in 70 of the 80 patients and resolved bowel obstruction in 67 patients (96%). Two patients had colonic perforation and developed peritonitis 18 and 24 hours after stent placement; one patient died as a consequence. Thirty-three patients underwent elective surgery after 7 days +/- 3 (SD; range, 4-10 days), and adequate tumoral coverage and cleansing of the colon were observed in all patients. Stent placement was used as final palliative treatment in another 35 patients. Patient follow-up lasted a mean of 138 days +/- 93 (range, 36-334 days). The survival rate for the palliative group was 55% at 3 months, 44% at 6 months, and 25% at 9 months. The estimated primary stent patency rate was 91% at 3 and 6 months. CONCLUSION: Management of colorectal obstruction by using metallic stents was effective and safe, although colonic perforation is a potential complication. In cases of palliation, the method may obviate palliative colostomy.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10924576&dopt=Abstract constipation laxative colon cleansing
Clin Radiol. 1983 Jan;34(1):73-4.
The accuracy of the plain abdominal radiograph in assessing colonic faecal contamination.
de Lacey G, Wilkins R, Cramer B, Benson M, Spencer J, Mitchell R.
A prospective study of 333 out-patients assessed the accuracy of determining colonic cleansing from the plain abdominal radiograph. The results indicate that the amount of colon contaminated with faeces was significantly underestimated and the difference in efficacy between the best and worst preparation regimens could not be detected from the plain film. Nevertheless, plain films have been used in comparative studies of preparation regimens for barium enema. It is suggested that results so obtained are misleading and that comparisons are best made on barium films alone.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6822040&dopt=Abstract constipation laxative colon cleansing
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