BACKGROUND Colonoscopy quality relies heavily on adequate bowel preparation,yet traditional methods often result in suboptimal compliance.Emerging network-based monitoring systems offer promise for improving both prep...BACKGROUND Colonoscopy quality relies heavily on adequate bowel preparation,yet traditional methods often result in suboptimal compliance.Emerging network-based monitoring systems offer promise for improving both preparation quality and patient cooperation,potentially enhancing clinical outcomes.AIM To evaluate the effectiveness of an intestinal network monitoring system in enhancing the quality of bowel preparation for colonoscopy and its impact on patient psychological and physiological responses,compliance,and adverse event rates.METHODS Between July 2019 and July 2020,800 enteroscopy patients who met the inclusion criteria in the outpatient clinic of the gastroenterology department of our hospital were randomly divided into 400 cases each in the experimental group(network monitoring group)and the control group(verbal+written preaching group),and the psychological and physiological stress response situation,colon Boston Bowel Preparation Scale,enteroscopy to blindness,arrival time to blindness,and polyp detection rate of the patients were compared before and after the intervention,compliance and adverse reactions were compared.RESULTS There was no difference in anxiety and depression scores,heart rate and systolic blood pressure between the groups before the intervention(P>0.05),and after the intervention,the patients’anxiety and depression scores were lower and lower in the study group(P<0.05);heart rate and systolic blood pressure were elevated,but lower in the test group(P<0.05).The left hemicolon,right hemicolon,transverse colon and total Boston Bowel Preparation Scale scores were lower in the test group than in the control group(P<0.05),the colonoscopy arrival rate and polyp detection rate were higher than those in the control group,and the time to arrival and time to exit the scope were shorter than those in the control group(P<0.05),and the dietary preparations,the preparations for taking medications and the total adherence scores were higher than those in the control group(P<0.05).The incidence of adverse reactions in the experimental group was 11.00%,which was lower than that in the control group(P<0.05).CONCLUSION The Bowel Network Monitoring System has potential clinical promotion value in improving the quality of colonoscopic bowel preparation,which can effectively alleviate patient anxiety and depression,improve the quality of colonoscopic bowel preparation and patient compliance,and has a high degree of safety.展开更多
In order to have an adequate view of the whole small intestine during capsule endoscopy, the preparation recommended consists of a clear liquid diet and an overnight fast. However, visualization of the small bowel dur...In order to have an adequate view of the whole small intestine during capsule endoscopy, the preparation recommended consists of a clear liquid diet and an overnight fast. However, visualization of the small bowel during video capsule endoscopy can be impaired by intestinal contents. To improve mucosal visualization, some authors have evaluated different regimens of preparation. There is no consensus about the necessity of intestinal preparation for capsule endoscopy and it should be interesting to develop adequate guidelines to improve its efficacy and tolerability. Moreover, the effect of preparation type (purgative) on intestinal transit time is not clear. Since a bowel preparation cannot defini-tively improve its visibility (and theoretically the yield of the test), it is not routinely recommended.展开更多
Objective:To explore the influencing factors and psychological experience of poor compliance in intestinal preparation before colonoscopy in elderly patients,so as to provide more comprehensive reference for the imple...Objective:To explore the influencing factors and psychological experience of poor compliance in intestinal preparation before colonoscopy in elderly patients,so as to provide more comprehensive reference for the implementation of targeted nursing intervention measures in the future and to improve the quality of intestinal preparation before colonoscopy in elderly patients.Method:According to the phenomenological research method in the qualitative research,a purposeful sampling selected 11 nursing staff from a digestive endoscopy center of a comprehensive tertiary Class A hospital in Shanxi Province as a research object for a semi-structured interview.Convenience Sampling selected semi-structured interviews with 13 elderly patients who underwent colonoscopy in a comprehensive tertiary Class A hospital in Shanxi Province from July to September 2018 for colonoscopy but had poor bowel preparation results.Colaizzi Phenomenological research methods conduct inductive analysis of data.Results:Through semi-structured interview,the influencing factors of poor compliance of intestinal preparation before colonoscopy in elderly patients were summarized as follows:①nursing staff ignored the individualized education of patients;②in the process of intestinal preparation,elderly patients have insufficient understanding of intestinal preparation,insufficient attention,forgetting the contents of intestinal preparation,intolerance in the process of intestinal preparation,lack of encouragement and professional guidance,etc.Conclusion:In clinical practice,medical staff should strengthen the individualized education of patients undergoing colonoscopy,guide them to correctly understand the intestinal preparation process and understand the importance of intestinal preparation,actively explore more convenient intestinal preparation methods,and actively play the positive role of family members in intestinal preparation of elderly patients.展开更多
The role of small bowel capsule endoscopy (CE) in suspected small bowel bleedingis well established and current European and other international guidelinesposition it as the first line test after negative bidirectiona...The role of small bowel capsule endoscopy (CE) in suspected small bowel bleedingis well established and current European and other international guidelinesposition it as the first line test after negative bidirectional endoscopies. Insuspected mid-lower gastrointestinal bleeding (MLGIB) the diagnostic yield ofcolonoscopy is poor and may cause a delay in detecting small bowel disease. Acrucial aspect of small bowel capsule endoscope performance is the timing of theprocedure, the interval between the bleeding episode and capsule ingestion isinversely related to the diagnostic yield as confirmed by a recent meta-analysis.Currently the ongoing advances achieved by video CE in particular to evaluateboth small bowel and colon in a single test using double headed capsules, raisesquestions regarding the position of pan intestinal capsule in the current algorithmto investigate patients presenting with suspected MLGIB ahead of colonoscopy.Early evidence suggests pan intestinal capsule could fit well as a diagnostic“filter” test in this cohort of patients, thereby reserving invasive conventionalcolonoscopy or device assisted enteroscopy as therapeutics options only. The recentdevelopment of magnetically controlled CE and a blood sensing capsule pushthe boundaries of CE even further in patients presenting with suspected gastrointestinalbleeding. This review will discuss the current available evidence andfuture directions of CE in suspected MLGIB.展开更多
BACKGROUND Adequate bowel preparation is critical for colonoscopy screening.At present,the most widely used intestinal cleaner recommended at home and abroad is Polyethylene glycol(PEG).Intestinal cleansers can cause ...BACKGROUND Adequate bowel preparation is critical for colonoscopy screening.At present,the most widely used intestinal cleaner recommended at home and abroad is Polyethylene glycol(PEG).Intestinal cleansers can cause electrolyte disturbances and hyponatremia.However,hyponatremic encephalopathy due to hyponatremia induced by PEG solution,although rare,can lead to serious irreversible sequelae and even death.CASE SUMMARY In this report,we discuss a case of neurological dysfunction due to hyponatremia,also known as hyponatremic encephalopathy,observed in a 63-year-old woman who underwent PEG-based bowel preparation for colonoscopy.She was eventually transferred to our intensive care unit for treatment due to her Glasgow Coma Scale score of 9/15(Eye opening 2;Verbal response 1;Motor response 6)and abnormal laboratory tests.CONCLUSION Physicians should be thoroughly familiarized with the patient’s history before prescribing PEG for bowel preparation,and timely identification of patients with hyponatremic encephalopathy is essential as delayed treatment is associated with poor neurological outcomes.An intravenous infusion of 3%sodium chloride is recommended at the onset of early symptoms.The goal of treatment is to adequately treat cerebral edema while avoiding serum sodium correction beyond 15 to 20 m Eq/L within 48 h of treatment to prevent osmotic demyelination syndrome.展开更多
AIM： TO study the effects of elenoside, an arylnaphthalene lignan from Justicia hyssopifolia, on gastrointestinal motility in vivo and in vitro in rats. METHODS： Routine in vivo experimental assessments were cathars...AIM： TO study the effects of elenoside, an arylnaphthalene lignan from Justicia hyssopifolia, on gastrointestinal motility in vivo and in vitro in rats. METHODS： Routine in vivo experimental assessments were catharsis index, water percentage of boluses, intestinal transit, and codeine antagonism. The groups included were vehicle control （propylene glycol-ethanolplant oil-tween 80）, elenoside （i.p. 25 and 50 mg/kg）, cisapride （i.p. 10 mg/kg）, and codeine phosphate （intragastric route, 50 mg/kg）. In v/tro approaches used isolated rat intestinal tissues （duodenum, jejunum, and ileum）. The effects of elenoside at concentrations of 3.2 ×10^4, 6.4 ×10^4 and 1.2 ×10^3 mol/L, and cisapride at 10^6 mol/L were investigated. RESULTS： Elenoside in vivo produced an increase in the catharsis index and water percentage of boluses and in the percentage of distance traveled by a suspension of activated charcoal. Codeine phosphate antagonized the effect of 25 mg/kg of elenoside. In vitro, elenoside in duodenum, jejunum and ileum produced an initial decrease in the contraction force followed by an increase. Elenoslde resulted in decreased intestinal frequency in duodenum, jejunum, and ileum. The in vitro and in vivo effects of elenoside were similar to those produced by cisapride. CONCLUSION： Elenoside is a lignan with an action similar to that of purgative and prokinetics drugs. Elenoside, could be an alternative to cisapride in treatment of gastrointestinal diseases as well as a preventive therapy for the undesirable gastrointestinal effects produced by opioids used for mild to moderate pain.展开更多
基金Supported by the Changshu Municipal Health Commission Science and Technology Program,No.csws201902。
文摘BACKGROUND Colonoscopy quality relies heavily on adequate bowel preparation,yet traditional methods often result in suboptimal compliance.Emerging network-based monitoring systems offer promise for improving both preparation quality and patient cooperation,potentially enhancing clinical outcomes.AIM To evaluate the effectiveness of an intestinal network monitoring system in enhancing the quality of bowel preparation for colonoscopy and its impact on patient psychological and physiological responses,compliance,and adverse event rates.METHODS Between July 2019 and July 2020,800 enteroscopy patients who met the inclusion criteria in the outpatient clinic of the gastroenterology department of our hospital were randomly divided into 400 cases each in the experimental group(network monitoring group)and the control group(verbal+written preaching group),and the psychological and physiological stress response situation,colon Boston Bowel Preparation Scale,enteroscopy to blindness,arrival time to blindness,and polyp detection rate of the patients were compared before and after the intervention,compliance and adverse reactions were compared.RESULTS There was no difference in anxiety and depression scores,heart rate and systolic blood pressure between the groups before the intervention(P>0.05),and after the intervention,the patients’anxiety and depression scores were lower and lower in the study group(P<0.05);heart rate and systolic blood pressure were elevated,but lower in the test group(P<0.05).The left hemicolon,right hemicolon,transverse colon and total Boston Bowel Preparation Scale scores were lower in the test group than in the control group(P<0.05),the colonoscopy arrival rate and polyp detection rate were higher than those in the control group,and the time to arrival and time to exit the scope were shorter than those in the control group(P<0.05),and the dietary preparations,the preparations for taking medications and the total adherence scores were higher than those in the control group(P<0.05).The incidence of adverse reactions in the experimental group was 11.00%,which was lower than that in the control group(P<0.05).CONCLUSION The Bowel Network Monitoring System has potential clinical promotion value in improving the quality of colonoscopic bowel preparation,which can effectively alleviate patient anxiety and depression,improve the quality of colonoscopic bowel preparation and patient compliance,and has a high degree of safety.
文摘In order to have an adequate view of the whole small intestine during capsule endoscopy, the preparation recommended consists of a clear liquid diet and an overnight fast. However, visualization of the small bowel during video capsule endoscopy can be impaired by intestinal contents. To improve mucosal visualization, some authors have evaluated different regimens of preparation. There is no consensus about the necessity of intestinal preparation for capsule endoscopy and it should be interesting to develop adequate guidelines to improve its efficacy and tolerability. Moreover, the effect of preparation type (purgative) on intestinal transit time is not clear. Since a bowel preparation cannot defini-tively improve its visibility (and theoretically the yield of the test), it is not routinely recommended.
文摘Objective:To explore the influencing factors and psychological experience of poor compliance in intestinal preparation before colonoscopy in elderly patients,so as to provide more comprehensive reference for the implementation of targeted nursing intervention measures in the future and to improve the quality of intestinal preparation before colonoscopy in elderly patients.Method:According to the phenomenological research method in the qualitative research,a purposeful sampling selected 11 nursing staff from a digestive endoscopy center of a comprehensive tertiary Class A hospital in Shanxi Province as a research object for a semi-structured interview.Convenience Sampling selected semi-structured interviews with 13 elderly patients who underwent colonoscopy in a comprehensive tertiary Class A hospital in Shanxi Province from July to September 2018 for colonoscopy but had poor bowel preparation results.Colaizzi Phenomenological research methods conduct inductive analysis of data.Results:Through semi-structured interview,the influencing factors of poor compliance of intestinal preparation before colonoscopy in elderly patients were summarized as follows:①nursing staff ignored the individualized education of patients;②in the process of intestinal preparation,elderly patients have insufficient understanding of intestinal preparation,insufficient attention,forgetting the contents of intestinal preparation,intolerance in the process of intestinal preparation,lack of encouragement and professional guidance,etc.Conclusion:In clinical practice,medical staff should strengthen the individualized education of patients undergoing colonoscopy,guide them to correctly understand the intestinal preparation process and understand the importance of intestinal preparation,actively explore more convenient intestinal preparation methods,and actively play the positive role of family members in intestinal preparation of elderly patients.
文摘The role of small bowel capsule endoscopy (CE) in suspected small bowel bleedingis well established and current European and other international guidelinesposition it as the first line test after negative bidirectional endoscopies. Insuspected mid-lower gastrointestinal bleeding (MLGIB) the diagnostic yield ofcolonoscopy is poor and may cause a delay in detecting small bowel disease. Acrucial aspect of small bowel capsule endoscope performance is the timing of theprocedure, the interval between the bleeding episode and capsule ingestion isinversely related to the diagnostic yield as confirmed by a recent meta-analysis.Currently the ongoing advances achieved by video CE in particular to evaluateboth small bowel and colon in a single test using double headed capsules, raisesquestions regarding the position of pan intestinal capsule in the current algorithmto investigate patients presenting with suspected MLGIB ahead of colonoscopy.Early evidence suggests pan intestinal capsule could fit well as a diagnostic“filter” test in this cohort of patients, thereby reserving invasive conventionalcolonoscopy or device assisted enteroscopy as therapeutics options only. The recentdevelopment of magnetically controlled CE and a blood sensing capsule pushthe boundaries of CE even further in patients presenting with suspected gastrointestinalbleeding. This review will discuss the current available evidence andfuture directions of CE in suspected MLGIB.
文摘BACKGROUND Adequate bowel preparation is critical for colonoscopy screening.At present,the most widely used intestinal cleaner recommended at home and abroad is Polyethylene glycol(PEG).Intestinal cleansers can cause electrolyte disturbances and hyponatremia.However,hyponatremic encephalopathy due to hyponatremia induced by PEG solution,although rare,can lead to serious irreversible sequelae and even death.CASE SUMMARY In this report,we discuss a case of neurological dysfunction due to hyponatremia,also known as hyponatremic encephalopathy,observed in a 63-year-old woman who underwent PEG-based bowel preparation for colonoscopy.She was eventually transferred to our intensive care unit for treatment due to her Glasgow Coma Scale score of 9/15(Eye opening 2;Verbal response 1;Motor response 6)and abnormal laboratory tests.CONCLUSION Physicians should be thoroughly familiarized with the patient’s history before prescribing PEG for bowel preparation,and timely identification of patients with hyponatremic encephalopathy is essential as delayed treatment is associated with poor neurological outcomes.An intravenous infusion of 3%sodium chloride is recommended at the onset of early symptoms.The goal of treatment is to adequately treat cerebral edema while avoiding serum sodium correction beyond 15 to 20 m Eq/L within 48 h of treatment to prevent osmotic demyelination syndrome.
文摘AIM： TO study the effects of elenoside, an arylnaphthalene lignan from Justicia hyssopifolia, on gastrointestinal motility in vivo and in vitro in rats. METHODS： Routine in vivo experimental assessments were catharsis index, water percentage of boluses, intestinal transit, and codeine antagonism. The groups included were vehicle control （propylene glycol-ethanolplant oil-tween 80）, elenoside （i.p. 25 and 50 mg/kg）, cisapride （i.p. 10 mg/kg）, and codeine phosphate （intragastric route, 50 mg/kg）. In v/tro approaches used isolated rat intestinal tissues （duodenum, jejunum, and ileum）. The effects of elenoside at concentrations of 3.2 ×10^4, 6.4 ×10^4 and 1.2 ×10^3 mol/L, and cisapride at 10^6 mol/L were investigated. RESULTS： Elenoside in vivo produced an increase in the catharsis index and water percentage of boluses and in the percentage of distance traveled by a suspension of activated charcoal. Codeine phosphate antagonized the effect of 25 mg/kg of elenoside. In vitro, elenoside in duodenum, jejunum and ileum produced an initial decrease in the contraction force followed by an increase. Elenoslde resulted in decreased intestinal frequency in duodenum, jejunum, and ileum. The in vitro and in vivo effects of elenoside were similar to those produced by cisapride. CONCLUSION： Elenoside is a lignan with an action similar to that of purgative and prokinetics drugs. Elenoside, could be an alternative to cisapride in treatment of gastrointestinal diseases as well as a preventive therapy for the undesirable gastrointestinal effects produced by opioids used for mild to moderate pain.
