Probiotics enhance bowel prep for colonoscopy.
Article Type: Brief article
Subject: Colonoscopy (Methods)
Colonoscopy (Patient outcomes)
Probiotics (Health aspects)
Author: Gaby, Alan R.
Pub Date: 04/01/2012
Publication: Name: Townsend Letter Publisher: The Townsend Letter Group Audience: General; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 The Townsend Letter Group ISSN: 1940-5464
Issue: Date: April, 2012 Source Issue: 345
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 286257211
Full Text: One hundred-four patients with constipation and 107 patients without constipation who were scheduled for colonoscopy were randomly assigned to receive, in double-blind fashion, a probiotic preparation (Bacillus subtilis [10.sup.9] colony-forming units], and Streptococcus faecium [9 x [10.sup.9] colony-forming units]) or placebo 3 times per day for 2 weeks prior to the colonoscopy. All patients received oral sodium phosphate for bowel cleansing prior to the procedure. In the group with constipation, the proportion of patients who had a satisfactory bowel preparation was significantly higher in the placebo group than in the placebo group (54.9% vs. 20.8%; p < 0.001). Preparation quality was sighiticantly better in patients without constipation than in those with constipation, and was not affected by probiotics treatment. Among constipation patients, preparation-related adverse events and post-colonoscopy symptoms were less frequent and less severe in the probiotics group than in the placebo group.

Comment: This study demonstrates that, in patients with constipation, pretreatment with a specific probiotic preparation for 2 weeks as part of bowel preparation significantly improved colonic mucosa visualization during colonoscopy and reduced preparation-related and post-colonoscopy gastrointestinal symptoms. Previous research has demonstrated that a wide range of other probiotic strains are beneficial for chronic constipation. It is therefore likely that other strains would also be useful for bowel preparation in constipated patients scheduled for colonoscopy.

Lee H et al. A feasibility study of probiotics pretreatment as a bowel preparation for colonoscopy in constipated patients. Dig Dis Sci. 2010; 55:2344-2351.
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