Bowel Cleansing Preparations Are Associated with Gastroduodenal Lesions

Gastrointestinal Disorders Pub Date : 2024-03-15 DOI:10.3390/gidisord6010024

Anas Khouri, Cesar G. Moreno, J. D. Di Palma

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Abstract

Background: During esophagogastroduodenoscopy performed with colonoscopy, gastric and duodenal erythema, erosions, and ulcerations are often observed. This investigation was designed to review the prevalence of gastroduodenal lesions in patients who have undergone wireless capsule endoscopy using standard bowel cleansing preparations, but no endoscopy or sedation. Methods: A retrospective analysis was conducted on patients referred for capsule endoscopy. Records and capsule reports were reviewed for the patient demographics, preparation prescribed, procedural indications, and gastroduodenal findings. The preparations studied included polyethylene glycol lavage (PEG), PEG plus bisacodyl (PEG + bis), bisacodyl (bis), oral sulfate solution (OSS), and no prep. Results: Among the 1236 records, 498 (40.3%) were men and 738 (59.7%) were women. The mean age was 56 years +/− 18 years SD. The percentage of patients with lesions after any bowel preparation was 52.7% for gastric lesions and 23.6% for duodenal lesions. The percentage of patients with gastroduodenal lesions was 58.3% with prep, compared to 38.2% without prep. These findings were statistically significant, with an RR of 1.53 [1.19–1.94] (p-value = 0.00004). This difference was more pronounced in the OSS group RR of 1.65 [1.29–2.1] and bisacodyl group RR of 1.64 [1.25–2.15] compared to the PEG group RR of 0.95 [0.7–1.3]. Conclusions: This study showed that patients undergoing wireless capsule endoscopy who received bowel preparations had a significant increase in gastric and duodenal lesions. Of the preparations studied, OSS was associated with a greater number of gastroduodenal lesions, while PEG was the least associated with lesions, with an occurrence similar to the non-prep group. The clinical significance of these lesions remains undetermined. Endoscopists should be aware that preparations are associated with gastroduodenal lesions to avoid the misinterpretation and misdiagnosis of these lesions.

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清肠制剂与胃十二指肠病变有关

背景：在与结肠镜同时进行的食管胃十二指肠镜检查中，经常会观察到胃和十二指肠红斑、糜烂和溃疡。本调查旨在审查使用标准肠道清洁制剂但未进行内镜检查或使用镇静剂的无线胶囊内镜检查患者的胃十二指肠病变发生率。方法：对转诊接受胶囊内镜检查的患者进行回顾性分析。对记录和胶囊报告进行了审查，以了解患者的人口统计学特征、处方制剂、手术适应症和胃十二指肠检查结果。研究的制剂包括聚乙二醇灌洗液（PEG）、PEG 加比沙可啶（PEG + bis）、比沙可啶（bis）、硫酸口服溶液（OSS）和无制剂。结果：在 1236 份记录中，男性 498 人（占 40.3%），女性 738 人（占 59.7%）。平均年龄为 56 岁 +/- 18 岁（标清）。在进行任何肠道准备后出现病变的患者中，胃部病变占 52.7%，十二指肠病变占 23.6%。经过肠道准备的胃十二指肠病变患者比例为 58.3%，而未经过肠道准备的患者比例为 38.2%。这些结果具有统计学意义，RR 为 1.53 [1.19-1.94]（P 值 = 0.00004）。与 PEG 组 RR 值 0.95 [0.7-1.3] 相比，OSS 组 RR 值 1.65 [1.29-2.1] 和比沙可啶组 RR 值 1.64 [1.25-2.15] 的差异更为明显。结论：这项研究表明，接受无线胶囊内镜检查并使用肠道制剂的患者的胃和十二指肠病变率显著增加。在所研究的制剂中，OSS与更多的胃十二指肠病变有关，而PEG与病变的相关性最小，其发生率与非制剂组相似。这些病变的临床意义仍未确定。内镜医师应该意识到制剂与胃十二指肠病变有关，以避免对这些病变的误解和误诊。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Gastrointestinal Disorders

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