Bowel preparation for the double-contrast barium enema: How to maintain coating with cleansing?

Cittadini, Giuseppe; Sardanelli, Francesco; Cicco, E. De; Valle, M.; Rosso, E.; Parodi, Roberto

doi:10.1016/s0009-9260(99)91154-6

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…The magnesium-free intestinal preparation we chose is associated with a medium quality, thin but diagnostic, barium coating of the colonic mucosa [7]. This makes it possible to prove both increases and decreases of barium coating.…”

Section: Discussionmentioning

confidence: 99%

“…Lack of magnesium in the colon lumen was considered to be the cause of thin mucosal coating in a comparison of different bowel preparations for DCBE [7]. The potentiality of magnesium ions to improve barium coating of the colonic mucosa was directly demonstrated in vivo by subjecting the patients to bowel preparation with sennosides and magnesium sulphate, or sennosides and sodium sulphate [8].…”

Section: Introductionmentioning

confidence: 99%

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Magnesium ions and barium coating of colonic mucosa: Is it a simple question of viscosity?

et al. 2001

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The aim of the present study was to verify whether magnesium-induced increase of barium coating of the colonic mucosa is specifically due to the increase of barium suspension viscosity. One hundred sixty-one patients scheduled for double-contrast barium enema (DCBE) were randomised in one group of 23 patients (control group, CG), and three groups of 23 pairs (G1, G2 and G3), i.e. 138 patients. The DCBE was performed with standard technique using a barium suspension with dynamic viscosity of 280 cPs (CG), or with viscosity increased to 320 cPs (G1), 2500 cPs (G2) or 3200 cPs (G3), by extemporaneous addition of MgSO4 1, 2 or 3 g in one member of the pair, Na2SO4 1, 4.2 or 8 g in the other one. Three radiologists evaluated on an ordinal scale mucosal coating and free fluid. In all magnesium subgroups barium coating was better than in CG (p < 0.008), the highest value being obtained in G2. No difference was observed as regards free fluid. Inside paired groups, mucosal coating was more effective in magnesium than in sodium members (p < 0.0002). Viscosity of barium suspension being equal inside each group, this effect must be attributed to magnesium-specific interactions with additives of the barium suspension inducing events other than viscosity changes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Magnesium ions and barium coating of colonic mucosa: Is it a simple question of viscosity?

et al. 2001

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“…This is achieved with a 3.2 % concentration compared with the 4 % of magnesium sulphate; thus, the amount of fluid drawn in the intestinal tract is approximately 500 and 400 ml, respectively; however, the usual cleansing level obtained with the combination of sennosides and magnesium sulphate is good. Both combinations are significantly superior to the rapid oral colonic lavage obtained by administration of 4 l of an isotonic electrolyte solution containing polyethylene glycol (PEG-ELS), which in fact has become a standard in some centres [7].…”

Section: Discussionmentioning

confidence: 99%

“…However, a poor barium mucosal coating is frequently the limiting factor [7]. Magnesium ions, as an integral part of a newly designed isotonic PEG-ELS, may play an important role as a correcting factor.…”

Section: Discussionmentioning

confidence: 99%

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Do magnesium ions influence barium mucosal coating of the large bowel?

et al. 1999

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The aim of the present study was to verify whether the presence of magnesium in the colon lumen at the time of the double-contrast barium enema (DCBE) examination changes the quality of barium mucosal coating. The two members of 38 pairs of patients undergoing DCBE with a standardised technique were randomly subjected to bowel preparation with sennosides and magnesium sulphate, or sennosides and sodium sulphate. Mucosal coating, residual fluid and colon cleansing were assessed independently by three radiologists. The null hypothesis was tested by means of Wilcoxon's signed-rank test. Barium mucosal coating was judged to be better in the members to whom magnesium sulphate was administered (p = 0.0007). There was no difference in the amount of residual fluids (p = 0.3198). Colon cleansing was judged to be better in the members to whom sodium sulphate was administered (p = 0.0166). These results demonstrate, in a simple way, that magnesium ions increase barium coating of the colon mucosa in vivo. The underlying mechanisms (increase in viscosity of barium suspension through water subtraction owing to the hydrophilism of magnesium ions, or interactions with the polysaccharide additives) need further investigation. A first clinical application could be the integration of magnesium ions in a newly designed isotonic electrolyte solution containing polyethylene glycol for the oral colon wash-out.

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Revisiting Oral Barium Sulfate Contrast Agents

O’Connor

Summers

2007

Academic Radiology

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Bowel preparation for the double-contrast barium enema: How to maintain coating with cleansing?

Cited by 7 publications

References 21 publications

Magnesium ions and barium coating of colonic mucosa: Is it a simple question of viscosity?

Magnesium ions and barium coating of colonic mucosa: Is it a simple question of viscosity?

Do magnesium ions influence barium mucosal coating of the large bowel?

Revisiting Oral Barium Sulfate Contrast Agents

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