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 19 February 2018

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News

Physiologic Effects of Bowel Preparation

The physiologic effects of bowel preparations have been assessed for the first time in a paper first published online by the journal Diseases of the Colon & Rectum.

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The study was carried out by Kathrine Holte and colleagues from the Departments of Surgical Gastroenterology and Clinical Physiology at Hvidovre University Hospital in Hvidovre, Denmark.

The group was interested to find that, despite the universal use of bowel preparation before colonoscopy and colorectal surgery, the physiological effects have not been described in a standardized setting.

Twelve healthy volunteers of median age 63 years were enrolled into the prospective study, with each volunteer undergoing bowel preparation with basicodyl and sodium phosphate.

Bowel preparation has significant adverse physiologic effects, which may be attributed to dehydration
Diseases of the Colon & Rectum

Fluid and food intake were standardized according to weight, providing adequate calorie and oral fluid intake.

Before and after bowel preparation, weight, exercise capacity, orthostatic tolerance, plasma and extra-cellular volume, balance function, and biochemical parameters were measured.

The study showed that bowel preparation led to a decrease in exercise capacity (median, 9 %) and weight (median, 1.2 kg).

Plasma osmolality was significantly increased from 287 to 290 mmol kg–1, as well as increased phosphate and urea concentrations, whereas calcium and potassium concentrations decreased significantly after bowel preparation.

There were no differences observed in plasma or extra-cellular volumes and orthostatic tolerance and balance function did not change after bowel preparation.

"Bowel preparation has significant adverse physiologic effects, which may be attributed to dehydration," commented Dr Holte.

"The majority of these findings are small and may not be of clinical relevance in otherwise healthy patients undergoing bowel preparation and following recommendations for oral fluid intake", she added.

Dis Colon Rectum 2004; Published online: 29 June 2004
20 July 2004

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