Clinical Studies

 A new system for preparing the intestine for colonoscopy 

One of the most unpleasant and sometimes difficult elements of a colonoscopy is the preparation of the colon before the examination. Preparing the bowel or cleaning the colon can be so disturbing that for many it is the reason for avoiding a colonoscopy.

During the colonoscopy, patients are usually sedated so that most of the time they do not feel pain and sometimes do not even remember the test. However, the current method of bowel preparation, which is usually performed at home, is associated with limited nutrition in the days before the procedure, abdominal pain, and frequent and urgent bouts of diarrhea. It takes time and often involves missing work. In the case of liquid laxatives, consumption of large amounts of unpalatable products may be required. The specific laxative used varies according to physician or patient preference based on past experience and/or taste. This unpleasant experience is often unsuccessful, and requires repeating the entire process, which adds to the cost of the procedure. The colon may be insufficiently prepared because patients are unable or unwilling to consume the liquid laxatives. Some patients find the preparations tasteless, unpalatable, or nauseating, and some are unable to swallow the large volume of liquid necessary to achieve a good preparation.

Traditional bowel preparation may be troublesome for healthy patients, but for patients with cardiovascular disease, kidney disease, and other disorders, it may even be dangerous due to electrolyte imbalance and large volume intake. Poor preparation impairs the detection of colon neoplasms, especially small lesions, but even large tumors can be missed due to solid material in the colon during the examination.

The main advantage of using liquid laxatives to cleanse the colon is that they flow with the rest of the stool contents of the colon. Mechanical cleansing methods, such as regular enemas and colon hydrotherapy, introduce fluids through the anal opening in the opposite direction to the normal flow, therefore, their ability to reach the uterus is limited. In this retrospective study, we present a new technique by which the entire colon can be cleansed using a cleaning device, the ColonoScoPrep. Conventional bowel preparation begins 6 hours or more before the colonoscopy ("early" preparation), while the ColonoScoPrep cleaning device inserted approximately 30 minutes prior to the procedure.Therefore, we have defined this technique of bowel preparation immediately followed by colonoscopy as "colonoscopy without prior preparation" (CWEP).

The only medication required is two to three bisacodyl tablets the night before. The quality of bowel preparation was rated as excellent, good,

satisfactory, or poor, and patient satisfaction was assessed according to a prospective   protocol.

resultsDuring the period, 125 patients underwent CWEP. Of these, 110 (89.4%) patients had good preparation, allowing a complete colonoscopy examination without interference from fecal matter. In 11 patients the preparation was satisfactory, in 2 it was poor and in 2 the colonoscopy was not completed due to insufficient preparation. None of the patients had abdominal pain or cramping during or after the CWEP and there was no diarrhea after colonoscopy. All patients were satisfied with the process.

conclusionsDespite the fact that the study is retrospective, CWEP appears to be safe and easy to perform.

A new colonic lavage system to prepare the colon for colonoscopy: a retrospective study

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Does the new colon cleansing method change electrolytes and serum creatinine levels?
Introduction: We used a new method to clean the colon before colonoscopy. The new method, which presents a high level of cleanliness, is based on a special rectal device, through which we pass heated water to the large intestine, so that the entire length of the large intestine becomes clean. We wanted to learn if there was a change in electrolytes and creatinine
The serum levels after the cleaning procedure compared to their condition before the procedure.

Material and methods: 20 patients, who needed colonoscopy, (9 men and 11 women, aged 48 to 75 years, Av=59.5), were recruited for the study. They took 3 tablets of Laxadine the night before the colonoscopy and remained on a liquid diet. Just before the colonoscopy, a blood test for Na, Cl, K and creatinine was done, and for 30 to 40 minutes 20 to 35 liters of water were flushed through the special device in the anus, and reached the intestine  through a unique sleeve and colon cleansing. A blood test for those elements was done immediately after the procedure. A regular colonoscopy was performed.

Results: No significant change was observed in all 3 electrolytes. A slight decrease in serum creatinine levels was measured: from an average of 0.93 before cleansing to 0.88 mg/dL immediately after cleansing. The preparation was excellent in 15/20 patients, good in 2/20, sufficient in 1/20 and insufficient in 2/20 patients. without side effects
Notice. All patients were satisfied.

Conclusion: Our new method of cleaning the colon for colonoscopy is not only effective and safe, but may also be considered in patients in whom current methods of cleaning the colon may be dangerous (eg   heart problems or kidney failure)

Does the New Method for Colonic Cleansing Change Electrolytes and Creatinine Serum Levels?