Yüksek doz senna bağırsak hazırlığında standart rejimler kadar etkin ve tolere edilebilir mi? Senna ile PEG ve sodyum pikosülfat rejimlerinin karşılaştırılması

Öz

Giriş ve Amaç: Bağırsak temizliğinin kalitesi tanısal doğruluğu ve işlem güvenliğini yakından etkiler. Bağırsak temizlik preparatlarının hastaya uygun seçilmesi hasta uyumunu arttırabilir. Bu çalışmada, yüksek doz sennanın etkinlik ve tolere edilebilirliğinin standart preparatlar ile karşılaştırılması amaçlandı. Gereç ve Yöntem: Elektif kolonoskopi yapılması planlanan toplam 150 ayaktan hasta çalışmaya dahil edildi. Hastalar polietilen glikol, senna ve sodyum pikosülfat magnezyum sitrat olacak şekilde 3 gruba ayrıldı. Hastaların tümüne işlemden 2 gün önce düşük lifli diyet, 1 gün önce berrak sıvı diyet verildi. İşlem öncesinde hazırlık sürecine olan tolerans ve yan etkiler kayıt edildi. Tüm işlemler öğleden önce sedoanaljezi altında yapıldı. Kolon temizliği Aronchick bağırsak hazırlık skalası ile derecelendirildi. Bağırsak hazırlık düzeyi, yan etkiler ve hazırlık sürecine olan tolerans gruplar arasında karşılaştırıldı. Bulgular: Senna grubundaki hastaların %74’ünde mükemmel/iyi derecede kolon temizliği sağlandı. Senna, polietilen glikol ve sodyum pikosülfat magnezyum sitratın kolon temizlik düzeyleri benzerdi (p = 0.846). Senna rejiminin en belirgin yan etkisi karın ağrısı idi (p < 0.001). Sodyum pikosülfat magnezyum sitrat en iyi tolere edilen rejimdi (p < 0.001). Senna ve polietilen glikol grubunda tolerans benzerdi. Gruplar arasında adenom tespit oranı, çekal entübasyon oranı ve çekuma ulaşma süresinde fark yoktu. Sonuç: Kolonoskopi hazırlığında yüksek doz senna etkili ve tolere edilebilir bulundu. Standart polietilen glikol ve sodyum pikosülfat magnezyum sitrata alternatif bir rejim olarak düşünülebilir.

Anahtar Kelimeler

• Senna ekstresi
• polietilen glikol
• kolonoskopi

Is high-dose senna as effective and tolerable as standard regimens in bowel preparation? Comparison of senna versus PEG and sodium picosulfate regimen

Öz

Background and Aims: The quality of bowel cleansing closely affects diagnostic accuracy and procedural safety. Appropriate selection of bowel cleansing preparations for the patient may increase patient compliance. In this study, it was aimed to compare the efficacy and tolerance of high-dose senna with standard preparations. Materials and Methods: A total of 150 outpatients scheduled for elective colonoscopy were included in the study. Patients were divided into 3 groups as polyethylene glycol, senna and sodium picosulfate magnesium citrate. All patients were given a low fiber diet 2 days before the procedure and a clear liquid diet 1 day before. All procedures were performed under sedoanalgesia before noon. Colon cleansing was graded with the Aronchick bowel preparation scale. Bowel preparation level, side effects, and tolerance to the preparation process were compared between the groups. Results: Excellent/good colon cleansing was achieved in 74% of the patients in the senna group. Colon cleansing levels of senna, polyethylene glycol, and sodium picosulfate magnesium citrate were similar (p = 0.846). The most obvious side effect of the senna regimen was abdominal pain (p < 0.001). Sodium picosulfate magnesium citrate was the best tolerated regimen (p < 0.001). Tolerability was similar in the senna and polyethylene glycol groups. There was no difference between the groups in adenoma detection rate, cecal intubation rate and time to reach the cecum. Conclusions: High-dose senna was found to be effective and tolerable in colonoscopy preparation. It can be considered as an alternative regimen to standard polyethylene glycol and sodium picosulfate magnesium citrate

Anahtar Kelimeler

• Senna extract
• polyethylene glycol
• colonoscopy

Kaynakça

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