References: Laxative
Dis Colon Rectum. 1990 Jan;33(1):12-5.
Current preoperative bowel cleansing methods. Results of a survey.
Beck DE, Fazio VW.
Department of General Surgery, Wilford Hall USAF Medical Center, Lackland, AFB, Texas 78236.
A mail survey of 300 members of The American Society of Colon and Rectal Surgeons (ASCRS) was conducted to document the current methods of bowel preparation in use. Two hundred six questionnaires (69 percent) were returned. The majority of respondents (104 or 51 percent) used cathartics and enemas as the primary method of mechanical bowel cleansing. Eighty-nine (43 percent) used a PEG lavage, eight (4 percent) used mannitol, and one physician used a saline lavage method. Almost all the responding surgeons believed that their method of preparation was well tolerated by patients, provided good cleansing, and was associated with few complications. Most patients were admitted one day before surgery. All respondents used perioperative antibiotics, with the most common pattern being a combination of oral and parenteral agents. Surgeons using PEG lavage did more colonic resections per month and were fewer years out of their residency. This current pattern of preoperative bowel preparation has changed from previous surveys.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2104795&dopt=Abstract constipation laxative colon cleansing
Gastrointest Endosc. 1990 Nov-Dec;36(6):580-2.
Colonic concentrations of hydrogen and methane following colonoscopic preparation with an oral lavage solution.
Strocchi A, Bond JH, Ellis C, Levitt MD.
Research Service, Veterans Administration Medical Center, Minneapolis, Minnesota 55417.
Explosions are a rare complication of electrocautery in the colon. The cause of these explosions is ignition of gas containing hydrogen (greater than 4%) or methane (greater than 5%), and oxygen. Hydrogen and methane are products of colonic bacterial metabolism. Oral solutions used for colonoscopy preparation are designed to cleanse the colonic lumen but provide no substrate for fermentation reactions. In 52 patients undergoing colonoscopy, gas samples were collected from the right, transverse, and left colon and analyzed for hydrogen, methane, oxygen, and carbon dioxide. The highest hydrogen and methane concentrations were 0.6% and 0.7%, respectively, less than 16% of the explosive level. Oxygen and carbon dioxide concentrations were close to those of air, suggesting that the bulk of colonic gas was air infused during the procedure. We conclude that the concentrations of explosive gases are well below the hazardous levels when oral colonic cleansing solutions and standard colonoscopic procedures are employed.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2126250&dopt=Abstract constipation laxative colon cleansing
Gastrointest Radiol. 1990 Spring;15(2):164-8.
The assessment of colonic water retention prior to double-contrast enema.
Pietila JA, Bondestam S, Hartel GJ, Suramo IJ.
Department of Diagnostic Radiology, Helsinki University Central Hospital, Finland.
The detection of colonic water retention prior to double-contrast enema (DCE) was studied in 41 outpatients. Ultrasound examination of the cecum (USC) correctly showed 4 of the 5 patients with water retention as well as all 14 cases with dry colon. Changes in patient's weight or in the number of cleansing enemas were not associated with water retention. The USC seems to offer a rapid and accurate method for the detection of colonic water retention prior to DCE. Aspects of the handling of colonic water retention are also discussed.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2180778&dopt=Abstract constipation laxative colon cleansing
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