The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
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Efficacy of Bisacodyl Given as Part of a Polyethylene Glycol-based Bowel Preparation Prior to Colonoscopy in Hospitalized Patients: A Prospective Ramdomized Trial

입원환자에서 Polyethylene Glycol 용액을 이용한 대장내시경 전처치 시 Bisacodyl을 병행하여 복용했을 경우의 효과 비교: 전향적 무작위 비교연구

  • Bang, Ki Bae (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jeong, Eun Haeng (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jeong, Woo Shin (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Chae, Hyun Beom (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Nam Hee (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Tae Hoon (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Ji Yeon (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jung, Yoon Suk (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Jung Ho (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Sohn, Chong Il (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Choi, Kyu Yong (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Dong Il (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 방기배 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 정은행 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 정우신 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 채현범 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 김남희 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 이태훈 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 김지연 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 정윤숙 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 박정호 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 손정일 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 최규용 (성균관대학교 의과대학 강북삼성병원 내과학교실) ;
  • 박동일 (성균관대학교 의과대학 강북삼성병원 내과학교실)
  • Received : 2014.06.25
  • Accepted : 2014.09.17
  • Published : 2014.11.01
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Abstract

Background/Aims: Inpatient status can cause inadequate bowel preparation. The majority of previous studies regarding bowel preparation have focused on comparing the effects of different purgative regimens in outpatients. However, data on bowel preparation for inpatients are lacking. The aim of this study was to investigate whether bisacodyl plus polyethylene glycol (PEG) can improve bowel preparation in hospitalized patients. Methods: A prospective, randomized and observer-blind study was performed. A total of 196 hospitalized patients undergoing colonoscopy were randomized to receive 4 L PEG (PEG only group) or 4 L PEG＋bisacodyl 10 mg (bisacodyl added group). The adequacy of bowel preparation was scored using the Ottawa bowel preparation scale. Results: One hundred and eighty-three subjects completed the study; 96 in the bisacodyl added group and 87 in the PEG only group. There were no significant differences between the bisacodyl added group and the PEG only group with respect to the score of bowel cleansing ($3.59{\pm}2.81$ vs. $3.82{\pm}3.03$, p=0.607), quality of bowel cleansing (adequate preparation 89.6% vs. 85.1%, p=0.380), and overall adverse events (66.7% vs. 52.9%, p=0.057). However, a larger proportion of patients in the PEG only group were able to ingest the entire solution as prescribed than in the bisacodyl added group (98.9% vs. 75.0%, p<0.001). Conclusions: In hospitalized patients, the quality of bowel preparation did not differ depending on whether bisacodyl is added or not. In addition, patient compliance based on consumption of cleansing agent was better in the PEG only group

목적: 입원환자의 경우 외래환자에 비해 장정결이 불충분할 수 있다. 대부분의 이전 연구에서는 외래환자에서 하제에 따른 장정결의 효과를 비교하는 데 중점을 두었으며 입원환자에서 장정결에 대한 자료는 부족한 실정이다. 따라서 이번 연구에서는 입원환자에서 표준 4 L PEG에 병용한 bisacodyl이 장정결도를 개선할 수 있는지 조사하였다. 대상 및 방법: 전향적 무작위 비교연구가 수행되었으며 대장내시경을 시행한 총 196명의 입원환자가 4 L PEG 단독 복용군 혹은 4 L PEG+bisacodyl 10 mg군으로 무작위 배정되었다. 장정결도는 Ottawa 장정결 척도에 의해 평가되었다. 결과: 183명의 환자가 분석에 포함되었으며 4 L PEG군은 87명, 4 L PEG+bisacodyl 10 mg군은 96명이었다. 두 군 간 총 정결도 점수에서 유의한 차이를 보이지 않았으며($3.59{\pm}2.81$ vs. $3.82{\pm}3.03$, p=0.607) 전반적인 장정결 성공률에 있어도 통계적으로 유의한 차이를 보이지 않았다(89.6% vs. 85.1%, p=0.380). 부작용에 있어서도 두 군 간 차이를 보이지 않았다(66.7% vs. 52.9%, p=0.057). 그러나 PEG 단독 복용군에서 bisacodyl이 추가된 군보다 많은 수의 환자에서 PEG 복용을 완료할 수 있었다(98.9% vs. 75.0%, p<0.001). 결론: 입원환자에서 장정결도는 bisacodyl의 부가적 사용 유무에 의존적이지 않았다. 또한 정결제의 복용에 근거한 환자의 순응도는 PEG 단독 투여군에서 더 양호하였다.

Keywords

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