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Colonoscopy After Gastric Bypass, Lap Band, Or Sleeve Gastrectomy


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#1 mleolmstead

mleolmstead

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  • LocationEscondido, CA
  • Age:52
  • Surgeon:Dr. Callery
  • Hospital:Pomerado
  • Height (ft-in):5-06
  • Start Weight:251
  • Current Weight:150
  • Goal Weight:151
  • Surgery Date:07/13/2010
  • Surgery Type:Gastric Bypass

Posted 22 August 2011 - 01:18 PM

Hi:

I had my surgery [gastric bypass] a little over a year ago (July 13, 2010). Since I'm over 50 (ugh) I have to have a colonoscopy next month. I have to drink this horrible stuff prior to the colonoscopy - is this ok? Is there anything I need to know or do?

Just wondered. I don't think there's a problem, it'll take me a little longer to drink this stuff, but I wanted to make sure. THANKS :)

#2 Dr. Callery

Dr. Callery

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Posted 24 August 2011 - 04:26 AM

Hi:

I had my surgery a little over a year ago (July 13, 2010). Since I'm over 50 (ugh) I have to have a colonoscopy next month. I have to drink this horrible stuff prior to the colonoscopy - is this ok? Is there anything I need to know or do?

Just wondered. I don't think there's a problem, it'll take me a little longer to drink this stuff, but I wanted to make sure. THANKS :)



As a general rule, a person who is a year out from a weight loss procedure should have no particular problem with a bowel prep. As you point out, you may need to drink the prep more slowly. There are a number of prep formulas to choose from. Each has some pros and cons. Some are fairly low volume, although you may have to consume extra water. Another approach is to split the prep into two smaller portions. These may be better tolerated. You may want to inquire about one of these lower volume formulations or split volume protocols.



_____________________________________________________________________________________


Clin Colon Rectal Surg. 2010 Feb;23(1):10-3.
Bowel preparation for colonoscopy.
Beck DE.
Source

Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana.
Abstract

Colonoscopy is the premier method for colonic evaluation and its diagnostic accuracy and therapeutic safety depends on the quality of the colonic cleansing. Bowel cleansing with polyethylene glycol and sodium phosphate provides cleansing with high-quality preparations with an acceptably low morbidity rate and a high degree of patient satisfaction in a cost-effective manner. Modifications have reduced the volume of the polyethylene glycol preparations. Sodium phosphate has been associated with electrolyte and osmolarity imbalances and nephrocalcinosis; therefore, its clinical use has been questioned. Polyethylene glycol may be safer in patients with a history of significant renal, heart, or liver disease.


Full article


_____________________________________________________________________________________


Gastrointest Endosc. 2011 Jun;73(6):1240-5.
Bowel preparation with split-dose polyethylene glycol before colonoscopy: a meta-analysis of randomized controlled trials.
Kilgore TW, Abdinoor AA, Szary NM, Schowengerdt SW, Yust JB, Choudhary A, Matteson ML, Puli SR, Marshall JB, Bechtold ML.

Division of Gastroenterology, University of Missouri School of Medicine, Columbia, Missouri, USA.
Abstract
BACKGROUND:

Polyethylene glycol (PEG) is a commonly used bowel preparation for colonoscopy. Unfortunately, the standard large-volume solution may reduce patient compliance. Split-dosing of PEG has been studied in various randomized, controlled trials (RCTs). However, results have been conflicting.
OBJECTIVE:

We conducted a meta-analysis to assess the role of split-dose PEG versus full-dose PEG for bowel preparation before colonoscopy.
DESIGN:

Multiple databases were searched (January 2011). RCTs on adults comparing full-dose and split-dose of PEG for bowel preparation before colonoscopy were included and analyzed by calculating pooled estimates of quality of bowel preparation, preparation compliance, willingness to repeat the same preparation, and side effects by using odds ratio (OR) by fixed and random-effects models.
SETTING:

Literature search.
PATIENTS:

Per RCTs.
MAIN OUTCOME MEASUREMENTS:

Satisfactory bowel preparation, willingness to repeat same bowel preparation, patient compliance, and side effects.
RESULTS:

Five trials met inclusion criteria (N = 1232). Split-dose PEG significantly increased the number of satisfactory bowel preparations (OR 3.70; 95% CI, 2.79-4.91; P < .01) and willingness to repeat the same preparation (OR 1.76; 95% CI, 1.06-2.91; P = .03) compared with full-dose PEG. Split-dose PEG also significantly decreased the number of preparation discontinuations (OR 0.53; 95% CI, 0.28-0.98; P = .04) and nausea (OR 0.55; 95% CI, 0.38-0.79; P < .01) compared with full-dose PEG.
LIMITATIONS:

Limited number of studies.
CONCLUSIONS:

The use of a split-dose PEG for bowel preparation before colonoscopy significantly improved the number of satisfactory bowel preparations, increased patient compliance, and decreased nausea compared with the full-dose PEG.

Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

_________________________________________________________________________

Endoscopy. 2011 May;43(5):412-8. Epub 2011 May 4.
Bowel cleansing for colonoscopy: prospective randomized assessment of efficacy and of induced mucosal abnormality with three preparation agents.
Lawrance IC, Willert RP, Murray K.

Centre for Inflammatory Bowel Diseases, Fremantle Hospital, Alma Street, Fremantle 6059, Western Australia. [email protected]
Abstract
BACKGROUND AND STUDY AIMS:

Bowel-cleansing studies are frequently underpowered, poorly designed, and use subjective bowel cleansing assessments. Consensus on efficacy, tolerability, and preparation-induced mucosal abnormalities is lacking. This study aimed to clarify the differences in efficacy and preparation-induced mucosal inflammation of sodium phosphate (NaP), colonLYTLEY, [GoLyte] (PEG), and Picoprep (Pico).
PATIENTS AND METHODS:


This was a prospective randomized single-blinded trial of ambulatory patients to assess the efficacy of bowel preparation and preparation-induced mucosal inflammation. Proceduralists who were blinded to the preparation taken, assessed both bowel cleansing by using the Ottawa bowel preparation assessment tool and preparation-induced mucosal inflammation.
RESULTS:

Of the 634 patients, 98 % ingested more than 75 % of the bowel preparation and data were complete for colonic preparation scoring in 99 %. The preparation used, time of procedure, and patient sex all independently impacted on bowel cleansing. NaP was less efficacious than PEG ( P < 0.001) and Pico ( P < 0.001) for morning procedures whereas all bowel preparations were equally efficacious for afternoon procedures. Preparation-induced mucosal inflammation was 10-fold greater with NaP ( P = 0.03) and Pico ( P = 0.03) compared with PEG.
CONCLUSIONS:

This is the largest published prospective randomized blinded study on this topic and the first to evaluate the three major classes of preparation with a validated tool. The bowel preparation used, time of procedure, and patient sex all independently impacted on bowel cleansing. NaP gave the worst preparation for morning procedures whereas all preparations were equally effective for afternoon procedures. NaP and Pico induced mucosal inflammation 10-fold more frequently than PEG, a finding that requires further investigation.
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This advice is not a substitute for a consultation with your doctor, nutritionist, or other healthcare professional.
As always, if you have a problem or health-related complication (or emergency), please contact the proper authorities immediately.

#3 mleolmstead

mleolmstead

    Newbie

  • Members
  • PipPip
  • 25 posts
  • LocationEscondido, CA
  • Age:52
  • Surgeon:Dr. Callery
  • Hospital:Pomerado
  • Height (ft-in):5-06
  • Start Weight:251
  • Current Weight:150
  • Goal Weight:151
  • Surgery Date:07/13/2010
  • Surgery Type:Gastric Bypass

Posted 26 August 2011 - 04:31 PM

Thanks for the information. I'm feeling a lot better about the procedure.