References: Laxative
Eur Radiol. 1999;9(5):875-9.
Double-contrast magnetic resonance examination of ulcerative colitis.
Sardanelli F, de Cicco E, Renzetti P, Parodi RC, Calabrese M.
Department of Radiology, University of Genoa School of Medicine, San Martino Hospital, Largo R. Benzi, 10, I-16132 Genova, Italy.
The aim of our work was to propose a double-contrast magnetic resonance examination (DCMRE) in the follow-up of ulcerative colitis (UC), comparing this new technique with X-ray double-contrast barium enema (DCBE). After preparation with colon-cleansing regimen used for DCBE, six UC patients and six control subjects underwent a 1.5-T examination: supine position, coronal and axial fat-spectral-saturation breath-hold gradient-echo T1-weighted sequences after intravenous hypotonization and 1500-2000 cc air insufflation. Without evacuating the primarily insufflated air, the same images were acquired after endorectal administration of negative superparamagnetic contrast agent (600 cc) and intravenous administration of positive paramagnetic contrast agent (0.2 mmol/kg). All patients had undergone DCBE in the four preceding weeks. We found significant increase in wall thickness of UC affected vs apparently unaffected segments (p = 0.0425) and vs CG (p = 0.0447), significant increase in enhancement percent of UC affected vs apparently unaffected segments (p = 0.0161) and vs CG (p = 0.0185), and no significant difference for enhancement percent of UC unaffected segments vs CG. DCMRE and DCBE localized the UC extension at the same sites in all patients. Double-contrast MR examination time was 20-30 min. This new method could be used in follow-up of UC patients.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10369982&dopt=Abstract constipation laxative colon cleansing
Am Surg. 2003 Feb;69(2):150-4.
Trends in preparation for colorectal surgery: survey of the members of the American Society of Colon and Rectal Surgeons.
Zmora O, Wexner SD, Hajjar L, Park T, Efron JE, Nogueras JJ, Weiss EG.
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
The utility of antibiotic and mechanical preparation for colorectal surgery is controversial, and numerous different regimens are used. The aim of this study was to detect trends in preparation for surgery among American colon and rectal surgeons. Members of the American Society of Colon and Rectal Surgeons practicing in the United States were surveyed with a postal questionnaire regarding their routine preparations for colon and rectal surgery. Five hundred fifteen (40%) of the 1295 questionnaires sent were returned. Eighty-one per cent of the respondents had completed an accredited colorectal training program, and the average experience in practice was 13.7 (+/- 8.7) years. Half of the surgeons felt that prophylactic oral antibiotic is essential, 41 per cent felt it was doubtful, and 10 per cent considered oral prophylaxis unnecessary. Despite these statements 75 per cent of the surgeons routinely utilized oral antibiotics (96% of them used a combination of two drugs), 11 per cent used them selectively, and only 13 per cent omitted oral prophylaxis from their practice. Similarly although the usefulness of intravenous antibiotics was questioned by 11 per cent of the surgeons 98 per cent routinely used them. The average number of postoperative doses was two (+/- 1.9). Although 10 per cent of the surgeons questioned the importance of mechanical preparation more than 99 per cent routinely used it. Forty-seven per cent of the surgeons used sodium phosphate, 32 per cent used polyethylene glycol, and 14 per cent alternated between these two options. We conclude that although the use of oral antibiotic prophylaxis for colorectal surgery is controversial among surgeons it is still r
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BACKGROUND: Oral sodium phosphate is currently used for colon preparation prior to colonoscopy or barium enema. Sodium phosphate induces hyperphosphatemia, hypocalcemia, and hypokalemia. Elderly patients are at an increased risk for phosphate intoxication due to decreased glomerular filtration rate, medication use, and systemic and gastrointestinal diseases. We investigated these electrolyte disorders and their correlation with creatinine clearance, coexistent diseases, medications, and functional status. METHODS: Thirty-six hospitalized patients were included in the study. On day 1, patients were administered 2 doses of oral sodium phosphate. Venous blood samples for electrolyte determination were obtained at 7 AM on days 1, 2 (the procedure day), and 3. Urine samples were obtained from 10 patients. RESULTS: An increase in serum phosphorus level was correlated with a decreased creatinine clearance (R = -0.52; P =.001). Hypocalcemia and hypokalemia were present in 21 (58%) and 20 (56%) patients, respectively. Patients with a serum potassium concentration of 3.5 mEq/L or less on day 2 had a lower serum potassium concentration on day 1 vs those with a serum potassium concentration greater than 3.5 mEq/L on day 2 (P =.03). Five (dependent patients) had a serum potassium concentration of 3 mEq/L or less and 2 had severe diarrhea, necessitating treatment. There were more demented patients with hypokalemia compared with normokalemic patients (P<.05). Urinary fractional excretion of phosphorus tripled on day 2 (P =.01). Potassium and sodium fractional excretion remained unchanged. CONCLUSIONS: Sodium phosphate induce
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