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References: Laxative

Leber Magen Darm. 1987 Oct;17(5):305-12.
[Colonoscopy in advanced age: cardiac arrhythmias]

[Article in German]

Moser B.

Marienkrankenhaus Bad Ems, Fachkrankenhaus fur Innere Medizin.

62 in- and outpatients (65-89 years) with an average age of 76 +/- 5.6 years were investigated with Holter-ECG during colonoscopy to find out whether an endoscopy increases the tendency for cardiac arrhythmias. 50 per cent of the inpatients had a compensated cardiac insufficiency and 57.9 per cent had a coronary heart disease. Cascara-Salax and gut lavage were used for cleansing of the gut. 15 patients with a premedication of 5 mg Diazemuls an 50 mg Dolantin got an analysis of the blood gas before and after the premedication from a hyperaemic lobe of the ear. During endoscopy the number of patients with arrhythmias of a high degree was lower compared to the control period. With regard to the ventricular premature beats there was the following observation: (Table: see text). During the control period 6 patients had some supraventricular premature beats, during colonoscopy there were 14 patients with such arrhythmias. One female patient had a transitory atrial fibrillation. Before premedication the pO2 is 76.9 +/- 9 mmHg, afterwards 68.4 +/- 12.0 mmHg. Three patients showed a decrease of the pO2 down to 55 mmHg, three other patients down to 65 mmHg. The colonoscopy in the elderly does not essentially increase the cardiac arrhythmias, the severe premature beats do not increase. It is concluded that the cardiac risk is not increased by the endoscopy. The importance of the preparation for cleansing and the premedication is discussed.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3683073&dopt=Abstract constipation laxative colon cleansing

Gastroenterology. 1986 Jun;90(6):1914-8.
Urinary excretion of polyethylene glycol 3350 and sulfate after gut lavage with a polyethylene glycol electrolyte lavage solution.

Brady CE 3rd, DiPalma JA, Morawski SG, Santa Ana CA, Fordtran JS.

Ingestion of an electrolyte lavage solution containing polyethylene glycol 3350 and sulfate is an effective method of cleansing the colon for diagnostic studies. Polyethylene glycol and sulfate are considered poorly absorbed from the gastrointestinal tract. Because of the quantities administered, concern exists about potential toxicity of absorption of even a small percentage, particularly for polyethylene glycol. We measured the urinary excretion of both polyethylene glycol and sulfate in normal subjects and inflammatory bowel patients. Absorption of polyethylene glycol can be assessed by measuring recovery in urine, as 85%-96% of an intravenous load is excreted in urine. Similarly, appreciable sulfate absorption would exceed renal tubular reabsorption and result in increased urinary excretion. Mean percent polyethylene glycol load recovered in urine was minimal and similar for normal (0.06%) and inflammatory bowel (0.09%) subjects. Urinary sulfate excretion after lavage was also similar for both groups and was not different from baseline. These results do not suggest the likelihood of toxicity due to polyethylene glycol 3350 or sulfate absorption during gut lavage with this solution.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3699408&dopt=Abstract constipation laxative colon cleansing

Am J Gastroenterol. 1986 Aug;81(8):652-5.
Colon cleansing: acceptance by older patients.

DiPalma JA, Brady CE 3rd, Pierson WP.

The influence of age on patient acceptance and adequacy of preparation was evaluated in 557 patients from our previous colon cleansing studies for colonoscopy, barium enema, and elective colon surgery. Since study design was similar for all studies, the patients were combined and stratified to those over age 60 (old) and those 60 or younger (young). Patients were previously randomized in their respective studies to polyethylene glycol electrolyte gut lavage solution (old, 105; young, 181) or standard prep (old, 71; young, 20). Patient response data were analyzed in two fashions; distribution of response scores and minimal responses. When the distribution of scores were compared, older gut lavage patients had fewer cramps but more overall discomfort than younger patients receiving the lavage preparation. Older standard prep patients had less overall discomfort than younger standard prep subjects. Comparison of responses rated as minimal showed the older lavage patients to have fewer cramps than younger lavage patients and fewer cramps than standard preparation patients of similar age. None of the other assessed symptoms was significantly different between age groups or prep method. Most patients had minimal symptoms regardless of age or prep. Age did not influence adequacy of preparation for gut lavage or standard prep methods.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3740024&dopt=Abstract constipation laxative colon cleansing

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