Combustible colonic gas levels during flexible sigmoidoscopy and colonoscopy

Monahan, David W.; Peluso, Francis E.; Goldner, Fred H.

doi:10.1016/s0016-5107(92)70328-9

Cited by 44 publications

(28 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…(2) During flexible sigmoidoscopy after standard enema preparation, concentrations of H2 or/and CH4 could be at explosive levels [32] . (3) Argon plasma coagulation for post-radiation colitis should be performed only after complete bowel preparation with PEG or NaP, to avoid the risk of explosion [31] .…”

Section: Resultsmentioning

confidence: 99%

“…In a prospective study, sixty patients were evaluated to compare the presence of the combustible gases hydrogen and methane during colonoscopy after a PEG-ELS preparation and flexible sigmoidoscopy after phosphosoda enemas alone [32] . During colonoscopy, the concentrations of hydrogen and methane remained below combustible levels in all patients, whereas 10% of patients had combustible levels of either hydrogen or methane during flexible sigmoidoscopy.…”

Section: Partial Bowel Preparation By Enemasmentioning

confidence: 99%

See 1 more Smart Citation

Colonic gas explosion during therapeutic colonoscopy with electrocautery

Ladas

Karamanolis²,

Ben-Soussan³

2007

WJG

View full text Add to dashboard Cite

Therapeutic colonoscopy with electrocautery is widely used around the world. Adequate colonic cleansing is considered a crucial factor for the safety of this procedure. Colonic gas explosion, although rare, is one of the most frightening iatrogenic complications during colonoscopy with electrocautery. This complication is the result of an accumulation of colonic gases to explosive concentrations, but may be prevented by meticulous bowel preparation. The purpose of this review is to discuss the indications and the types of bowel preparations for therapeutic colonoscopy, and to contribute recommendations for the adequate bowel preparation for colonoscopy with electrocautery. © 2007 WJG . All rights reserved.Key words: Colonic gas explosion; Electrocautery; Therapeutic polypectomy; Argon plasma coagulation; Polypectomy Ladas SD, Karamanolis G, Ben-Soussan E. Colonic gas explosion during therapeutic colonoscopy with electrocautery. World J Gastroenterol 2007; 13(40): 5295-5298

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Partial Bowel Preparation By Enemasmentioning

confidence: 99%

Colonic gas explosion during therapeutic colonoscopy with electrocautery

Ladas

Karamanolis²,

Ben-Soussan³

2007

WJG

View full text Add to dashboard Cite

show abstract

“…Exclusive preparation with enemas is not accepted as a method of preparation for total colonoscopy, both for efficacy and safety reasons related to risk of explosion if electrocautery is applied [71] . Poor palatability leading to nausea or vomiting can impact patient tolerance and eventually the quality of cleansing [16] .…”

Section: To Drinking An Agent To Achieve Good Preparation?mentioning

confidence: 99%

Achieving the best bowel preparation for colonoscopy

Parra‐Blanco¹,

Ruiz²,

Álvarez-Lobos³

et al. 2014

WJG

View full text Add to dashboard Cite

Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. Core tip: Bowel preparation for colonoscopy is a central issue related to the quality of the procedure. There are different agents for bowel preparation that can be administered with different schedules. We review the most commonly used agents, as well as new agents and combinations. Moreover, certain considerations should be taken into account for special populations in order to improve safety, efficacy and tolerance. Regimens for bowel preparation in special situations are discussed, such as for pedi...

show abstract

“…It triggers when three elements are available in the colon lumen: high level of combustible gases such as hydrogen and methane produced by fermentation of non-absorbable carbohydrates by colonic flora, high level of oxygen, and electrical energy that produces heat such as electrocautery and argon plasma coagulation [15,34,35]. High levels of hydrogen and methane are produced in the colonic lumen by fermentation of non-absorbable carbohydrates (lactulose, mannitol) or incompletely absorbed carbohydrates (lactose, fructose, sorbitol) by the colonic bacteria, or the presence of stool in the colonic lumen due to poor cleansing preparation or using enema for sigmoidoscopy [15,[34][35][36][37][38]. In a review in 2007 searching from 1952-2006, there were only ten cases reported in the literature including one case from the reviewer [15,34].…”

Section: Gas Explosionmentioning

confidence: 99%