Randomised controlled trial of complete bowel preparation vs distal bowel cleansing in the management of patients referred under fast track guidelines for colorectal cancer
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ABSTRACT:
DISEASE(S): Cancer: Colorectal
PROVIDER: 2418378 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:AimTo evaluate the sensory characteristics of commercial bowel cleansing preparations.MethodsSamples of 4 commercially available bowel cleansing preparations, namely polyethylene glycol electrolyte solution (PEG), PEG + ascorbic acid (PEG-Asc), sodium picosulfate (SPS), and oral sodium sulfate (OSS) were prepared according to the manufacturer's instructions. Descriptive analysis was conducted (n = 14) using a 15-cm line scale with the Compusense at-hand(®) sensory evaluation software. Acceptability testing (n = 80) was conducted using the 9-point hedonic scale. In addition, a Just-About-Right (JAR) scale was included for the four basic tastes to determine their intensity compatibility with acceptability levels in the products.ResultsSamples were significantly different, in descriptive analysis, for all attributes (P < 0.05) except for sweetness. SPS received the highest ratings for turbidity, viscosity appearance, orange odor and orange flavor; PEG-Asc for citrus odor and citrus flavor; OSS for sweetener taste, sweet aftertaste, bitterness, astringency, mouthcoating, bitter aftertaste and throatburn, and along with PEG-Asc, the highest ratings for saltiness, sourness and adhesiveness. Acceptability results showed significant differences between the various samples (P < 0.05). SPS received significantly higher ratings for overall acceptability, acceptability of taste, odor and mouthfeel (P < 0.05). JAR ratings showed that PEG and PEG-Asc were perceived as slightly too salty; SPS and OSS were slightly too sweet, while SPS, PEG-Asc and OSS were slightly too sour and OSS slightly too bitter. While using small sample volumes was necessary to avoid unwanted purgative effects, acceptability ratings do not reflect the true effect of large volumes intake thus limiting the generalization of the results.ConclusionFurther improvements are needed to enhance the sensory profile and to optimize the acceptability for better compliance with these bowel cleansing solutions.
| S-EPMC4980640 | biostudies-literature
Project description:The diagnostic accuracy and safety of colonoscopy highly depends on the quality of the pre-procedural bowel preparation. A past history of poor bowel preparation is the most important risk factor of inadequate bowel cleansing at the next colonoscopy. This study aims to evaluate if an adequate level of bowel cleansing can be achieved with the Pure-Vu System in patients with previous poor bowel preparation, in a single arm international multicenter feasibility study.
| 2363206 | ecrin-mdr-crc
Project description:We conducted a microarray study of sigmoid mucosal gene expression in pilot sample of Rome III+ IBS patients and age and sex-matched HCs. This sample was balanced by sex, free of active psychiatric disease and had limited use of medications. Rome III+ IBS patients and HCs ages 18-55 were recruited primarily by community advertisement. Bowel habit subtypes (IBS with diarrhea (IBS-D), constipation (IBS-C) and mixed pattern (IBS-M)) were based on the Rome III criteria. The diagnosis was confirmed by a clinician with expertise in IBS. Rome III+a IBS patients and HCs ages 18-55 were recruited primarily by community advertisement. Bowel habit subtypes (IBS with diarrhea (IBS-D), constipation (IBS-C) and mixed pattern (IBS-M)) were based on the Rome III criteria. The diagnosis was confirmed by a clinician with expertise in IBS. HCs had no personal or family history of IBS or other chronic pain conditions. Additional exclusion criteria for all subjects included: infectious or inflammatory disorders, active psychiatric illness over the past 6 months as assessed by structured clinical interview for the DSM-IV (MINI),b use of corticosteroids in the past six months, use of narcotics, antidepressants or other medications that could affect neuroendocrine function in the past two months, or current tobacco or alcohol abuse. Participants were compensated. Our goal was to evaluate women during the follicular phase or days 4-14 of their menstrual cycle if on oral contraceptive pills. Phase was determined by date of last menstrual period and progesterone levels. The study was approved by the UCLA Institutional Review Board, and all subjects signed a written informed consent prior to start of study. IBS symptom severity over the prior week was assessed with a numeric rating scale (0-20).c Current anxiety and depression symptoms were measured with the Hospital Anxiety and Depression (HAD) scale.d Sigmoid biopsies (30cm from the anal verge) were obtained by flexible sigmoidoscopy following tap water enemas. Specimens were immediately flash frozen in liquid nitrogen. RNA was extracted with TRIzol. Sigmoid biopsies (30cm from the anal verge) were obtained by flexible sigmoidoscopy following tap water enemas. Specimens were immediately flash frozen in liquid nitrogen. Differential expression analysis was done on mRNA only (\\ormalized_Unfiltered_mRNAonly.txt\\) using limma[1]. Weighted gene coexpression network analysis (WGCNA[2]) was done using all targets after removing those on X and Y chromosomes and filtered by mean raw signal >200. 1. Smyth GK. Linear models and empirical bayes methods for assessing differential expression in microarray experiments. Stat Appl Genet Mol Biol. 2004;3:Article3. 2. Langfelder P, Horvath S. WGCNA: an R package for weighted correlation network analysis. BMC Bioinformatics. 2008;9:559.\
2018-06-03 | E-MTAB-5811 | biostudies-arrayexpress
Project description:Interventions: A:Without mental intervention, bowel preparation routinely, fasting 12 hours before operation, no thermal insulation during operation, without controlling of infusion volume during operation, placing abdominal drainage tube routinely, using analgesia pump after operation, getting out of bed according to patient’s situation, pulling out the gastric tube and Ingestion of water and food after recovery of intestinal function, pulling out the catheter 3 to 4 days, use antibiotics 3-4days;B:Mental intervention, without bowel preparation, drinking 1000 mL of 10% glucose 12 hours before operation, drinking 400 mL of 10% glucose 3 hours before operation, controlling of infusion volume during operation, placing abdominal drainage tube occasionally, abdominal incision infiltration with 20 to 40 mL of 0.5% ropivacaine immediately and 24 hours after operation, taking 200mg of celecoxib orally two times per day for 3 days, getting out of bed for 1 to 2 hours at night on the operation day,
Primary outcome(s): Establish FTS working mode of colorectal cancer
Study Design: Randomized parallel controlled trial
| 2673563 | ecrin-mdr-crc
Project description:Interventions: Group 1: fast bowel preparation:the day before day of surgery be given a normal diet and bowel preparation(oral phosphate-salt 90ml + warm water 1500ml, 99-15:00)and Fasting 8 hours before operation;Group 2: Traditional preparation:Trational routine bowel preparation
Primary outcome(s): The morning of operation and the first day and the third day after surgery taking peripheral blood C - reactive protein and tumor necrosis factor (TNF alpha), interleukin (IL - 6) and interferon (IFN - gamma) 2) The ileum tissue in the operation was determined to determine the concentration of the&#
Study Design: Randomized parallel controlled trial
| 2665841 | ecrin-mdr-crc
Project description:BACKGROUND:The ideal bowel cleansing regimen for colonoscopy has yet to be determined. OBJECTIVE:To compare the cleansing efficacy, and patient tolerability and safety of four bowel preparation regimens. METHODS:A total of 834 patients undergoing outpatient colonoscopy were randomly assigned to one of four regimens: 4 L polyethylene glycol (PEG); 2 L PEG + 20 mg bisacodyl; 90 mL of sodium phosphate (NaP); or two sachets of a commercially available bowel cleansing solution (PSMC) + 300 mL of magnesium citrate (M). The primary outcome measure was cleansing efficacy, which was scored by blinded endoscopists using the Ottawa Bowel Preparation Scale. Secondary outcome measures were bowel preparation quality according to time of colonoscopy, and patient tolerability and safety. RESULTS:The mean total cleansing score was significantly worse in the NaP group compared with the other three groups (P<0.0001). The mean cleansing scores were worse in patients who underwent morning versus afternoon colonoscopy, a finding that was consistent in all four groups. PSMC + M was the best tolerated regimen. No clinically significant mean changes in creatinine or electrolyte levels were identified, although a significantly higher proportion of patients in the NaP group developed hypokelemia (P<0.0001). CONCLUSIONS:2 L PEG + 20 mg bisacodyl, or PSMC + M was as efficacious as 4 L PEG and superior to NaP for bowel cleansing. A short interval between the completion of bowel preparation and the start of colonoscopy (ie, 'runway time'), irrespective of bowel preparation regimen, appeared to be a more important predictor of bowel cleanliness than the cathartic agents used.
| S-EPMC3266156 | biostudies-literature