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DOI: 10.1055/a-1594-2276
Does the sentence “less is more” apply to bowel preparation?
I read with interest the editorial by Soriani et al [1]. We were happy to see that our experience [2] has been replicated by other Authors. Our belief, in fact, hinges on the timing rather than the type of laxative. Back in 2014, we responded with conviction to the cry, “Split the dose!” convinced that the “golden 5 hours” rule was the right way [3]. Thus, we thought it was more effective to stay within 5 hours from the end of preparation than to administer high-dose laxatives. With this letter, I would also like to thank Prof. Riccardo Marmo, who suggested us to pursue this approach. It should be supported even more, considering that in our studies, we enrolled patients at high risk of complications and who had inadequate preparation. Today, with the advent of very-low-dose intestinal preparations specially designed for colonoscopy bowel preparation, the split-dose approach is particulary safe [4]. Paradoxically, the reported complications, hypernatremia and dehydration [5], are also better managed in hospitalized patients.
Publikationsverlauf
Artikel online veröffentlicht:
14. Dezember 2021
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References
- 1 Soriani P, Biancheri P, Hassan C. et al. Updating the recommendations on bowel preparation for acute lower gastro-intestinal bleeding: The time has come!. Endosc Int Open 2021; 9: E977-E978
- 2 Pontone S, Palma R, Panetta C. et al. Polyethylene glycol-based bowel preparation before colonoscopy for selected inpatients: A pilot study. J Dig Dis 2018; 19: 40-47
- 3 Bucci C, Rotondano G, Hassan C. et al. Optimal bowel cleansing for colonoscopy: split the dose! A series of meta-analyses of controlled studies.. Gastrointest Endosc 2014; 80: 566-576.e2
- 4 Schreiber S, Baumgart DC, Drenth JPH. et al. Colon cleansing efficacy and safety with 1 L NER1006 versus sodium picosulfate with magnesium citrate: a randomized phase 3 trial. Endoscopy 2019; 51: 73-84
- 5 Rex DK. Hyperosmotic low-volume bowel preparations: Is NER1006 safe?. Gastrointest Endosc 2019; 89: 656-658