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대장내시경술을 위한 안전하고 적절한 완하제의 사용open accessSafe and appropriate use of laxatives for colonoscopy

Other Titles
Safe and appropriate use of laxatives for colonoscopy
Authors
김원식이범재
Issue Date
Aug-2021
Publisher
대한의사협회
Keywords
장세척액; 완하제; 대장내시경; 폴리에틸렌글라이콜; Bowel preparation solutions; Laxatives; Colonoscopy; Polyethylene glycol
Citation
Journal of the Korean Medical Association, v.64, no.8, pp 561 - 569
Pages
9
Indexed
SCOPUS
ESCI
KCI
Journal Title
Journal of the Korean Medical Association
Volume
64
Number
8
Start Page
561
End Page
569
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54041
DOI
10.5124/jkma.2021.64.8.561
ISSN
1975-8456
2093-5951
Abstract
[한국어 초록 없음]
Background: Appropriate bowel preparation is essential for effective colonoscopy. Inadequate use of bowel preparation solutions reduces patient compliance, makes the detection of lesions such as adenoma difficult, and increases the risk of complication such as perforation. Current Concepts: A 4-L polyethylene glycol (PEG) solution can be safely used for bowel preparation, even in most individuals with underlying diseases. However, it requires a high preparation-volume intake and has poor patient compliance due to its unpleasant taste. Therefore, a 2- or 1- L sulfate-free, PEG-based laxative was developed to, reduce the amount of PEG and improve the taste. Furthermore, simethicon-containing laxative formulation was developed to eliminate gas bubbles. In addition, oral bowel preparation solutions with enema agents and prokinetics were used to improve bowel preparation, but no improvement was observed. Various alternative laxatives are available; however, PEG-based bowel preparation solutions are still recommended in most cases due to their stability. Discussion and Conclusion: Although a 4-L PEG solutions recommended for bowel preparation in most cases, several laxatives have been introduced to overcome its disadvantages. The laxative agent must be selected according to each patient’s specific characteristics. Moreover, the method of taking bowel preparation solutions and additional bowel preparation medications must be carefully chosen. In addition, patient education via various methods, such as using a smartphone, when taking a bowel preparation agent may help improve bowel preparation quality.
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Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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