Colostomy irrigation with prostaglandin E2 and bisacodyl. A double-blind cross-over study

Kjærgaard, J; Christensen, Ulrik; Stadil, F.; Anderson, Bradley

doi:10.1002/bjs.1800710728

Cited by 14 publications

(4 citation statements)

References 12 publications

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“…A similar effect was seen by intravenous injection with glyceryl trinitrate [16]. However, in human studies addition of bisacodyl, prostaglandin E 2 [17] , prostaglandin F 2α [18] and foam enema [2] failed to improve the emptying.…”

Section: Discussionmentioning

confidence: 75%

Scintigraphic assessment of colostomy irrigation

et al. 2002

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OBJECTIVE: This study aims to evaluate colonic transport following colostomy irrigation with a new scintigraphic technique. MATERIALS AND METHODS: To label the bowel contents 19 patients (11 uncomplicated colostomy irrigation, 8 complicated colostomy irrigation) took 111In-labelled polystyrene pellets one and two days before investigation. 99mTc-DTPA was mixed with the irrigation fluid to assess its extent within the bowel. Scintigraphy was performed before and after a standardized washout procedure. The colon was divided into three segments 1: the caecum andascending colon; 2: the transverse colon; 3: the descending and sigmoid colon. Assuming ordered evacuation of the colon, the contribution of each colonic segment to the total evacuation was expressed as a percentage of the original segmental counts. These were added to reach a total defaecation score (range: 0-300). RESULTS: In uncomplicated colostomy irrigation, the median defaecation score was 235 (range: 145-289) corresponding to complete evacuation of the descending and transverse colon and 35% evacuation of the caecum/ascending colon. In complicated colostomy irrigation it was possible to distinguish specific emptying patterns. The retained irrigation fluid reached the caecum in all but one patient. CONCLUSION: Scintigraphy can be used to evaluate colonic emptying following colostomy irrigation.

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Section: Discussionmentioning

confidence: 75%

Scintigraphic assessment of colostomy irrigation

et al. 2002

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“…[10][11][12][13][14] Two of these solutions, PEG and GTN, were reported to provide more rapid irrigation than tap water; limitations of these solutions included cost and adverse side effects (cramping, headache) following instillation of GTN. Tap water is usually used for CI, 6-9 but other irrigating solution may be substituted.…”

Section: ■ Proceduresmentioning

confidence: 99%

“…Tap water is usually used for CI, 6-9 but other irrigating solution may be substituted. 13,14 Tap water is typically preferred because it is inexpensive and not commonly associated with clinically relevant adverse side effects. [10][11][12][13][14] Two of these solutions, PEG and GTN, were reported to provide more rapid irrigation than tap water; limitations of these solutions included cost and adverse side effects (cramping, headache) following instillation of GTN.…”

Section: ■ Proceduresmentioning

confidence: 99%

Revisiting Colostomy Irrigation

Kent

Long

Bauer

2015

Journal of Wound, Ostomy &Amp; Continence Nursing

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Colostomy irrigation (CI) is the regular irrigation of the bowel for persons with a permanent colostomy of the descending or sigmoid colon. Although this technique was first described in the 1920s, a recent study of 985 WOC nurses found that almost half (47%) do not routinely teach CI to persons with colostomies. In a systematic review (Evidence-Based Report Card) published in this issue of the Journal, we summarized current best evidence concerning the effect of CI on bowel function and found that irrigation reduces the frequency of bowel elimination episodes and allows some patients to reduce or eliminate ongoing use of a pouching system. This article describes techniques for teaching CI and discussed additional findings associated with CI.

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“…A number of studies have been conducted that have examined a range of other irrigating solutions for CI. Typically, these have involved the use of polyethylene glycol solution (PEG), 8 glyceryl trinitrate solution (GTN) 8 and prostaglandin 10 to assist in obtaining the maximum benefit from irrigation. However, no attempts have been made to systematically summarise the best available evidence on the ideal irrigation fluid to be infused to achieve effective irrigation.…”

Section: Introductionmentioning

confidence: 99%

Fluid regimens for colostomy irrigation: a systematic review

Lizarondo

Gyi

Schultz

2008

International Journal of Evidence-Based Healthcare

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Background Various techniques for managing faecal evacuation have been proposed; however, colostomy irrigation is favoured as it leads to better patient outcomes. Alternative fluid regimens for colostomy irrigation have been suggested to achieve effective evacuation. Aim The objective of this review was to summarise the best available evidence on the most effective fluid regimen for colostomy irrigation. Search strategy Trials were identified by electronic searches of CINAHL, PubMed, MEDLINE, Current Contents, the Cochrane Library and EMBASE. Unpublished articles and references lists from included studies were also searched. Selection criteria Randomised controlled trials and before-and-after studies investigating any fluid regimen for colostomy irrigation were eligible for inclusion. Outcomes measured included fluid inflow time, total wash-out time, haemodynamic changes during irrigation, cramps, leakage episodes, quality of life and level of satisfaction. Data collection and analysis Trial selection, quality appraisal and data extraction were carried out independently by two reviewers. Differences in opinion were resolved by discussion. Main results The systematic literature search strategy identified two cross-over trials that compared water with another fluid regimen. Owing to the differences in irrigating solutions used, the results were not pooled for analysis. Both the polyethylene glycol electrolyte solution and glyceryl trinitrate performed significantly better than water. Conclusion There is some evidence to support the effectiveness of fluid regimens other than water, such as polyethylene glycol electrolyte and glyceryl trinitrate, for colostomy irrigation. Further well-designed clinical trials are required to establish solid evidence on the effectiveness of other irrigating solutions that might enhance colonic irrigation.

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Colostomy irrigation with prostaglandin E2 and bisacodyl. A double-blind cross-over study

Cited by 14 publications

References 12 publications

Scintigraphic assessment of colostomy irrigation

Scintigraphic assessment of colostomy irrigation

Revisiting Colostomy Irrigation

Fluid regimens for colostomy irrigation: a systematic review

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