Document Detail


High-dose senna compared with conventional PEG-ES lavage as bowel preparation for elective colonoscopy: a prospective, randomized, investigator-blinded trial.
MedLine Citation:
PMID:  16393219     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the efficacy and patient acceptance of an oral high dose of senna to conventional polyethylene glycol-electrolyte lavage solution (PEG-ES) in adults undergoing elective colonoscopy. METHODS: Consecutive outpatients referred for elective colonoscopy were prospectively randomly assigned to receive, the day before the procedure, either 24 tablets of 12 mg senna, divided into two doses at 1 p.m. and 9 p.m. (senna group, n=191), or standard 4-L PEG-ES (PEG-ES group, n=92). The overall quality of colon cleansing (primary outcome measure) and cleansing in the right colon were evaluated using the Aronchick scoring scale (1=excellent to 4=inadequate) by the investigator/endoscopist who was blinded to the treatment assignment. Patient acceptance and the safety of the preparation were assessed by a nurse, using a structured questionnaire covering compliance with the dosing, overall tolerance of the preparation (1=none or mild discomfort to 4=severely distressing), and adverse events. RESULTS: The quality of colon cleansing, overall tolerance of the preparation, and compliance were significantly better with senna; overall cleansing was excellent or good in 90.6% of patients in the senna group and in 79.7% in the PEG-ES group (p= 0.003). The percentage of procedures rescheduled because of insufficient colon cleansing was 7.3% in the PEG-ES group and 2.6% in the senna group (p=0.035). Multivariate logistic regression modeling showed the PEG-ES preparation as negative independent predictor of unsuccessful bowel cleansing. The incidence of adverse reactions was similar in the two groups; patients who received senna experienced significantly less nausea and vomiting, but more abdominal pain. CONCLUSIONS: An oral high dose of senna is a valid alternative to standard PEG-ES for outpatient colonoscopy preparation.
Authors:
Franco Radaelli; Gianmichele Meucci; Gianni Imperiali; Giancarlo Spinzi; Enrico Strocchi; Vittorio Terruzzi; Giorgio Minoli
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  100     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-05     Completed Date:  2006-01-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2674-80     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Valduce Hospital, Como, Italy.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Aged
Ambulatory Care
Cathartics / administration & dosage*
Colonoscopy / methods*
Dose-Response Relationship, Drug
Female
Humans
Irrigation / methods
Male
Middle Aged
Patient Satisfaction
Polyethylene Glycols / administration & dosage*
Prospective Studies
Risk Assessment
Senna Extract / administration & dosage*,  adverse effects
Sensitivity and Specificity
Single-Blind Method
Surgical Procedures, Elective
Chemical
Reg. No./Substance:
0/Cathartics; 0/Polyethylene Glycols; 8013-11-4/Senna Extract

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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