Bowel management for fecal incontinence: Case study
Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt in Pediatric Colorectal and Pelvic Surgery, 2017
This chapter explains the key principles in the management of complex pediatric colorectal diagnoses. It provides case-based presentations, radiographic images, operative images with multiple choice questions to test knowledge. The chapter presents a case study of a 12-year-old female with rectovestibular fistula is receiving daily antegrade enemas via a cecostomy. She has a past medical history of VATER syndrome, Vesicoureteral reflux and Hemivaginas with vaginal septum. This child was initially managed with a change in her antegrade flush regimen to 500 mL normal saline and 20 mg glycerin. This regimen was successful and the flush time reduced to 45–60 minutes. The bisacodyl was likely provoking accidents given its stimulant activity. She was clean with this regimen, which increased her confidence, and she returned for a laxative trial.
BIMATOPROST
Neil Shear, Jerome Z. Litt in Litt's Drug Eruption Reference Manual Including Drug Interactions, 2004
Trade names: Biscolax; Carter’s Little Pills; Dacodyl; Dulcagen; Dulcolax (Novartis); Fleet Laxative (Fleet) Other common trade names: Apo-Bisacodyl; Dulcolan; Laxit Indications: Constipation Category: Irritant/stimulant laxative Onset of action: 6-10 hours Reactions Skin Diaphoresis Exanthems Fixed eruption (1997): Burrow WH, Jackson, MS (from Internet) (observation) (1961): Welsh AL+, Arch Dermatol 84, 1004 Urticaria Trade names: Bismuth subcitrate; Bismuth subgallate (colostomy deodorant); Bismuth subnitrate and Bismuth idoform paraffin paste (BIPP); Bismuth sucralfate; Helidac (Prometheus); Pepto-Bismol (Procter & Gamble) Other common trade names: Bismatrol; Caved-S; Colo-Fresh; De-Nol; Devrom; Diotame; Pepto-Bismol (Procter & Gamble); Pink Bismuth Indications: As part of ‘triple therapy’ (antibiotics+bismuth) for eradication of H. pylori. Bismuth subgallate initiates clotting via activation of factor XII, and is used for bleeding during tonsillectomy and adenoidectomy. BIPP impregnated ribbon gauze is used for packing following ear surgery. Bismuth subsalicylate is in OTC products for gastrointestinal complaints and peptic ulcer disease.
The use of low-volume polyethylene glycol containing ascorbic acid versus 2 L of polyethylene glycol plus bisacodyl as bowel preparation for colonoscopy
Published in Scandinavian Journal of Gastroenterology, 2015
Chung Hyun Tae, Sung-Ae Jung, Sun-Kyung Na, Hye-Kyung Song, Chang Mo Moon, Seong-Eun Kim, Ki-Nam Shim, Hye-Kyung Jung, Il Hwan Moon
Objective. Low-volume polyethylene glycol (PEG) bowel preparations have been developed to improve compliance for colonoscopy. Our study aimed to compare the efficacy and tolerability of low-volume PEG containing ascorbic acid for colonoscopy against 2 L of PEG plus bisacodyl. Methods. We prospectively enrolled consecutive inpatients who had not undergone polypectomy at the index colonoscopy and were subsequently referred for polypectomy at our hospital. A total of 62 patients were randomized to receive either low-volume PEG containing ascorbic acid (n = 31) or 2 L of PEG plus bisacodyl (n = 31) as a split-dose regimen in inpatients. The efficacy of preparation was determined using the Ottawa Bowel Preparation Score (OBPS) and a 4-point scale. Adverse events, tolerability, and willingness were evaluated using a questionnaire. Results. Based on the OBPS and 4-point scale, we determined that the efficacy of low-volume PEG containing ascorbic acid was comparable to that of the 2 L of PEG plus bisacodyl (p = 0.071 for OBPS, p = 0.056 for the 4-point scale). Adverse events were comparable between the two groups (p = 1.000). A greater proportion of patients in the low-volume PEG containing ascorbic acid (90.6%) and the 2L of PEG plus bisacodyl (96.9%) were willing to repeat the same preparation for subsequent colonoscopy.Conclusion. Low-volume PEG containing ascorbic acid had comparable efficacy and tolerability to 2 L of PEG plus bisacodyl, when given as a split dose, for colonoscopy in inpatients. Split-dose low-volume PEG containing ascorbic acid is a good alternative for bowel preparation for colonoscopy in inpatients.
Comparison of bisacodyl and sodium picosulphate in the treatment of chronic constipation
Published in Current Medical Research and Opinion, 2007
Susanne Kienzle-Horn, Jean-Michel Vix, Chris Schuijt, Hubertus Peil, Chris C. Jordan, Michael A. Kamm
Background: Chronic constipation is a widespread condition. Although laxatives are generally accepted as being effective treatments, few studies have made formal comparisons of their efficacy and safety in chronic use. Objective: To compare the safety and efficacy of bisacodyl and sodium picosulphate in the treatment of chronic constipation over a 4-week period. Methods: Patients with chronic constipation (N = 144), recruited from out-patient clinics, were analysed for safety and efficacy in this open-label, randomised, parallel-group study. Patients were treated daily for 4 weeks (bisacodyl, 5–10 mg daily: 70 patients; sodium picosulphate, 5–10 mg daily: 74 patients). Primary efficacy criteria consisted of the number of bowel movements and stool consistency. Secondary efficacy criteria were straining at stool and physicians’ global efficacy assessment. Safety assessments included adverse event monitoring, tolerability and changes in laboratory parameters. Results: Both treatments were equally effective in treating chronic constipation, providing sustained improvement in symptoms. Compared to baseline, there were significant ( p < 0.001) improvements in stool frequency and consistency and in the occurrence of straining at 14 and 28 days for both treatment groups. Based on the physicians’ global assessment, a significant improvement was observed in 74.6% (bisacodyl) and 79.2% (sodium picosulphate) of patients. Neither treatment had significant effects on serum electrolytes. There was a trend for better tolerability in patients receiving bisacodyl treatment based on the number of drug-related adverse events (bisacodyl: 7; sodium picosulphate: 14, two patients withdrawn). Conclusions: Bisacodyl and sodium picosulphate are equally well tolerated and effective in the treatment of chronic constipation over a 4-week period.
Measurement of colonic transit using a delayed-release capsule containing radio-opaque markers
Published in Scandinavian Journal of Gastroenterology, 2008
Jae Myung Park, Myung-Gyu Choi, Hwang Choi, Yu Kyung Cho, Jung Hwan Oh, In Seok Lee, Sang Woo Kim, Kyu Yong Choi, In-Sik Chung
Objective. Colonic transit scintigraphy has several advantages in comparison with radio-opaque marker (ROM) techniques but it is limited to specialized centers. The aim of the study was to validate the ROM technique for measuring colonic transit using delayed-release capsules. Material and methods. Colonic transit is expressed as the sum of the weighted mean marker residence times in the colon (geometric centers). Delayed-release capsules containing radio-opaque markers (DC-ROMs) or scintigraphic methods were compared simultaneously in 10 healthy volunteers. Reproducibility and responsiveness of DC-ROM measurements were evaluated in 10 healthy volunteers at an interval of 2 weeks and after bisacodyl treatment, respectively. Results. The transit profiles between the scintigraphic and DC-ROM methods were highly correlated (r=0.994, p