Adding pineapple juice to sennoside A+B calcium for colonoscopy bowel preparation

Year 2016, Volume: 24 Issue: 1, 9 - 12, 28.04.2016

Hüseyin Köseoğlu , Tevfik Solakoğlu Murat Başaran Öykü Tayfur Yürekli Aylin Demirerzer Bolat Mustafa Tahtacı Osman Ersoy

https://doi.org/10.17940/endoskopi.307024

Abstract

Background and Aims: The diagnostic efficacy of colonoscopy depends on the quality of bowel preparation. It was shown in one study that administration of pineapple juice to 2 liter polyethylene glycol improves the quality of bowel cleaning. The aim of this study is to assess the effect of adding pineapple juice to sennoside A+B calcium for colon cleansing. Materials and Methods: One hundred patients admitted to our unit for elective colonoscopy were randomized to control group and pineapple group. Patients were advised to use 300 mg sennoside A+B calcium. In addition to this, the patients in the pineapple group were advised to squeeze one pineapple via a fruit juice extractor, and to drink it at the preprocedural day. The endoscopist scored the cleaning of the colonic segments using the Ottawa Bowel Preparation Scale Results: After exclusion 46 patients in the control group and 44 patients in the pineapple group were included in the analysis. The cleanliness for each segments of the colon and the total OBPS was not statistically significant between groups. The total OBPS for pineapple group and control group were 4.77 and 5.00, respectively. Conclusion: Adding fresh squeezed pineapple juice has no beneficial effect on increasing colon cleansing.

Keywords

Bowel preparation, bromelain, colonoscopy, pineapple juice, sennoside A+B calcium

Kolonoskopi öncesi barsak temizliği için sennosid A+B kalsiyum hazırlık rejimine ananas suyu eklenmesi

Abstract

Giriş ve Amaç: Kolonoskopinin tanısal etkinliği barsak hazırlığı rejiminin başarısına bağlıdır. Daha önce yapılan bir çalışmada polietilen glikol kolonoskopi hazırlık rejimine ananas suyu eklenmesinin barsak temizliğini artırdığı gösterilmiştir. Bu çalışmanın amacı sennosid A+B kalsiyum hazırlık rejimine ananas suyu eklemenin barsak temizliği üzerine olumlu etkisininolup olmadığının değerlendirilmesidir. Gereç ve Yöntem: Kolonoskopi yapılmak üzere ünitemize yönlendirilen hastalar randevu verilmesi esnasında ananas grubu ve kontrol grubu olarak iki gruba ayrıldı. Tüm hastalara barsak hazırlığı için işlemden bir gün önce sennosid A+B kalsiyum 300 mg, bol su ile içmeleri önerildi. Ananas grubunda yer alan hastalara ise buna ek olarakişlemden bir gün önce bir tam ananası katı meyve sıkacağından geçirerek içmesi önerildi. İşlemi yapan endoskopist barsak temizliğini Ottawa barsak temizliği skalası yardımı ile değerlendirdi ve sonuçlar karşılaştırıldı. Bulgular: Çalışma için uygun olmayan hastalar dışlandıktan sonra kontrol grubunda 46, ananas grubunda ise 44 hasta değerlendirmeye alındı. Total Ottawa barsak temizliği skalası skoru ve her kolon segmenti için ayrı ayrı hesaplanan temizlik miktarları açısından iki grup arasında istatistiksel olarak anlamlı fark saptanmadı. Total Ottawa barsak temizliği skalası ananas grubu ve kontrol grubu için sırasıyla 4,77 ve 5,00 olarak hesaplandı. Sonuç: Sennosid A+Bkalsiyum hazırlık rejimine ananas suyu eklemenin barsak temizliği üzerine olumlu katkısı saptanamamıştır. 

Keywords

Ananas suyu, barsak temizliği, bromelain, kolonoskopi, sennoside A+B calcium

References

• Froehlich F, Wietlisbach V, Gonvers JJ, et al. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc 2005;61:378-84.
• Cappell MS, Friedel D. The role of sigmoidoscopy and colonoscopy in the diagnosis and management of lower gastrointestinal disorders: endoscopic findings, therapy, and complications. Med Clin North Am 2002;86:1253-88.
• Leaper M, Johnston MJ, Barclay M, et al. Reasons for failure to diagnose colorectal carcinoma at colonoscopy. Endoscopy 2004;36:499- 503.
• Cheng CL, Kuo YL, Liu NJ, et al. Impact of bowel preparation with low-volume (2-Liter) and intermediate-volume (3-Liter) polyethylene glycol on colonoscopy quality: a prospective observational study. Digestion 2015;92:156-64.
• Hassan C, Bretthauer M, Kaminski MF, et al. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2013;45:142-50.
• Belsey J, Epstein O, Heresbach D. Systematic review: adverse event reports for oral sodium phosphate and polyethylene glycol. Aliment Pharmacol Ther 2009;29:15-28.
• Manukyan MN, Tolan K, Severge U, et al. Prospective randomized comparison of oral sodium phosphate and sennoside A+B calcium lavage for colonoscopy preparation. Surg Laparosc Endosc Percutan Tech 2011;21:90-3.
• Bektas H, Balık E, Bilsel Y. Comparison of sodium phosphate, polyethylen glycol and sena solutions in bowel preparation. A prospective, randomized-controlled clinical study. Dig Endos 2005;17:290-6.,
• Sucullu I, Filiz AI, Okul O, et al. Comparison of sodium phosphate and sennoside solutions in bowel preparation before colonoscopy: prospective randomized trail. Kolon Rektum Hast Derg 2008;3:133-7.
• Feffer JL, Norton RA. Dissolution of phytobezoar using pineapple juice (letter). JAMA 1976;236:1578.
• Simsek Z, Altinbas A, Yuksel I, et al. Effective treatment with pineapple juice in small bowel obstruction due to phytobezoar in a gastrectomized patient. Dig Endosc 2011;23:197.
• Altınbas A, Ekiz F, Yılmaz B, et al. Dissolution of undigested food in a diabetic patient’s stomach by drinking pineapple juice. Endocr Pract 2011;17:522-3.
• Altınbas A, Aktas B, Yılmaz B, et al. Adding pineapple juice to a polyethylene glycol-based bowel cleansing regime improved the quality of colon cleaning. Ann Nutr Metab 2013;63:83-7.
• Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc 2004; 59:482-6.
• Rex DK, Imperiale TF, Latinovich DR, et al. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol 2002;97:1696-700.
• Majid A, Adibah F, Abdul Gani M, et al. Stability of bromelain-polyphenol complex in pineapple juice. Jurnal Teknologi 2008;49:27-38.
• Borrelli F, Capasso R, Severino B, et al. Inhibitory effects of bromelain, a cysteine protease derived from pineapple stem (Ananas comosus), on intestinal motility in mice. Neurogastroenterol Motil 2011;23:745-e331.
• Amato A, Radaelli F, Paggi S, et al. Half doses of PEG-ES and senna vs.high-dose senna for bowel cleansing before colonoscopy: a randomized, investigator-blinded trial. Am J Gastroenterol 2010;105:675-81.