Intestinal preparation prior to capsule endoscopy administration

In order to have an adequate view of the whole small intestine during capsule endoscopy, the preparation recommended consists of a clear liquid diet and an overnight fast. However, visualization of the small bowel during video capsule endoscopy can be impaired by intestinal contents. To improve mucosal visualization, some authors have evaluated different regimens of preparation. There is no consensus about the necessity of intestinal preparation for capsule endoscopy and it should be interesting to develop adequate guidelines to improve its efficacy and tolerability. Moreover, the effect of preparation type (purgative) on intestinal transit time is not clear. Since a bowel preparation cannot defini-tively improve its visibility (and theoretically the yield of the test), it is not routinely recommended.

Qualitative study of poor intestinal preparation compliance before colonoscopy in elderly patients

Objective:To explore the influencing factors and psychological experience of poor compliance in intestinal preparation before colonoscopy in elderly patients,so as to provide more comprehensive reference for the implementation of targeted nursing intervention measures in the future and to improve the quality of intestinal preparation before colonoscopy in elderly patients.Method:According to the phenomenological research method in the qualitative research,a purposeful sampling selected 11 nursing staff from a digestive endoscopy center of a comprehensive tertiary Class A hospital in Shanxi Province as a research object for a semi-structured interview.Convenience Sampling selected semi-structured interviews with 13 elderly patients who underwent colonoscopy in a comprehensive tertiary Class A hospital in Shanxi Province from July to September 2018 for colonoscopy but had poor bowel preparation results.Colaizzi Phenomenological research methods conduct inductive analysis of data.Results:Through semi-structured interview,the influencing factors of poor compliance of intestinal preparation before colonoscopy in elderly patients were summarized as follows:①nursing staff ignored the individualized education of patients;②in the process of intestinal preparation,elderly patients have insufficient understanding of intestinal preparation,insufficient attention,forgetting the contents of intestinal preparation,intolerance in the process of intestinal preparation,lack of encouragement and professional guidance,etc.Conclusion:In clinical practice,medical staff should strengthen the individualized education of patients undergoing colonoscopy,guide them to correctly understand the intestinal preparation process and understand the importance of intestinal preparation,actively explore more convenient intestinal preparation methods,and actively play the positive role of family members in intestinal preparation of elderly patients.

Hyponatremic encephalopathy due to polyethylene glycol-based bowel preparation for colonoscopy:A case report

BACKGROUND Adequate bowel preparation is critical for colonoscopy screening.At present,the most widely used intestinal cleaner recommended at home and abroad is Polyethylene glycol(PEG).Intestinal cleansers can cause electrolyte disturbances and hyponatremia.However,hyponatremic encephalopathy due to hyponatremia induced by PEG solution,although rare,can lead to serious irreversible sequelae and even death.CASE SUMMARY In this report,we discuss a case of neurological dysfunction due to hyponatremia,also known as hyponatremic encephalopathy,observed in a 63-year-old woman who underwent PEG-based bowel preparation for colonoscopy.She was eventually transferred to our intensive care unit for treatment due to her Glasgow Coma Scale score of 9/15(Eye opening 2;Verbal response 1;Motor response 6)and abnormal laboratory tests.CONCLUSION Physicians should be thoroughly familiarized with the patient’s history before prescribing PEG for bowel preparation,and timely identification of patients with hyponatremic encephalopathy is essential as delayed treatment is associated with poor neurological outcomes.An intravenous infusion of 3%sodium chloride is recommended at the onset of early symptoms.The goal of treatment is to adequately treat cerebral edema while avoiding serum sodium correction beyond 15 to 20 m Eq/L within 48 h of treatment to prevent osmotic demyelination syndrome.

Elenoside increases intestinal motility

AIM： TO study the effects of elenoside, an arylnaphthalene lignan from Justicia hyssopifolia, on gastrointestinal motility in vivo and in vitro in rats. METHODS： Routine in vivo experimental assessments were catharsis index, water percentage of boluses, intestinal transit, and codeine antagonism. The groups included were vehicle control （propylene glycol-ethanolplant oil-tween 80）, elenoside （i.p. 25 and 50 mg/kg）, cisapride （i.p. 10 mg/kg）, and codeine phosphate （intragastric route, 50 mg/kg）. In v/tro approaches used isolated rat intestinal tissues （duodenum, jejunum, and ileum）. The effects of elenoside at concentrations of 3.2 ×10^4, 6.4 ×10^4 and 1.2 ×10^3 mol/L, and cisapride at 10^6 mol/L were investigated. RESULTS： Elenoside in vivo produced an increase in the catharsis index and water percentage of boluses and in the percentage of distance traveled by a suspension of activated charcoal. Codeine phosphate antagonized the effect of 25 mg/kg of elenoside. In vitro, elenoside in duodenum, jejunum and ileum produced an initial decrease in the contraction force followed by an increase. Elenoslde resulted in decreased intestinal frequency in duodenum, jejunum, and ileum. The in vitro and in vivo effects of elenoside were similar to those produced by cisapride. CONCLUSION： Elenoside is a lignan with an action similar to that of purgative and prokinetics drugs. Elenoside, could be an alternative to cisapride in treatment of gastrointestinal diseases as well as a preventive therapy for the undesirable gastrointestinal effects produced by opioids used for mild to moderate pain.