Effectiveness Of Linalotide Combined With Polyethylene Glycol In Bowel Preparation In Patients With Constipation

OBJECTIVE: To compare the clinical effects of three different protocols for bowel preparation before colonoscopy in patients with constipation,and to discuss relatively safe and effective bowel preparation protocols,which provides a reliable basis for clinicians in the selection of bowel preparation protocols.METHODS: A total of 626 outpatients and inpatients diagnosed with constipation who met the inclusion and exclusion criteria and underwent e-colonoscopy at the Gastroenterology Endoscopy Center of the Second Affiliated Hospital of Dalian Medical University from January 2022 to August 2022 were collected.The patients were randomly divided into three groups:(i)210 cases in the 2L PEG group,(ii)202 cases in the 3LPEG group,and(iii)214 cases in the 2LPEG + 2 capsules of linaclotide group.In the 2LPEG group,2LPEG solution was taken on the day of colonoscopy;in the 3LPEG group,1LPEG solution was taken at 18:00 p.m.on the day before colonoscopy,and 2LPEG solution was taken on the day of colonoscopy;in the 2LPEG+2 linalotide group,1 linalotide capsule was taken orally at 18:00 p.m.on the day before colonoscopy,and 1 linalotide capsule was taken orally on the day of colonoscopy,followed by 2LPEG+2 linalotide capsules.Linalotide capsules followed by 2 LPEG solution on the day of colonoscopy.General information was collected from the three groups of patients: gender,age,BMI,history of underlying diseases(hypertension,diabetes,coronary heart disease),history of abdominal surgery,time of colonoscopy(morning,afternoon),constipation grading(mild,moderate,severe);bowel preparation quality: Boston Bowel Preparation Scale was selected Evaluation of bowelcleanliness;other colonoscopy indicators: time to first bowel movement,number of bowel movements,time to exit,cecum insertion rate,adenoma detection rate.Occurrence of adverse effects: nausea and vomiting,abdominal pain and distension,dizziness and palpitations;tolerance evaluation: willingness to repeat and sleep.The above information was analyzed.RESULTS: 1.There was no statistically significant difference between the general data of patients in the three regimens(p>0.05).2.the number of cases meeting the criteria of good bowel preparation was compared among the three regimens,and the differences were not statistically significant(p>0.05);the total BBPS score,right hemicolectomy score and left hemicolectomy score were higher in the 2LPEG + 2 capsules of linaclotide group than in the 2LPEG group,and the differences were statistically significant(p<0.05),but compared with the 3LPEG group,none of the differences were statistically significant(p>0.05).The differences were not statistically significant when comparing the transverse colon scores of the three regimens(p>0.05);in patients with mild and moderate constipation scores,the total BBPS score,right hemicolectomy score and left hemicolectomy score were higher in the 2LPEG + 2 capsules of linaclotide group than in the 2LPEG group,and the differences were statistically significant(p<0.05),but none of the differences were statistically significant when comparing with the 3LPEG group(p>0.05);the differences in transverse colon scores were not statistically significant when comparing the three regimens(p>0.05);in patients with severe constipation grade,the right hemicolectomy scores were higher in the 3LPEG group than in the 2LPEG group,and the differences were statistically significant(p<0.05);the right hemicolectomy scores were higher in the 2LPEG+2 grain linaclotide group than in the 2LPEG group,but the differences were not statistically significant(p >0.05).The differences were not statistically significant when comparing the total BBPS score,transverse colon score and left hemicolectomy score of the three groups(p > 0.05).3.The time to first bowel movement was greater in the 2LPEG and 3LPEG groups than in the 2LPEG+2 grain linalotide group,and the differences werestatistically significant(p<0.05);the number of bowel movements was greater in the 3LPEG group than in the 2LPEG and 2LPEG+2 grain linalotide groups,and the differences were statistically significant(p<0.05);the cecum insertion rate,ADR,and exit time of the three groups were compared The differences were not statistically significant(p>0.05).4.The total number of adverse reactions and the number of nausea and vomiting in the 3LPEG group were significantly higher than those in the 2LPEG and 2LPEG+2 capsules linaclotide groups,and the difference was statistically significant(p<0.05);the total number of adverse reactions and the number of nausea and vomiting in the 2LPEG and 2LPEG+2 capsules linaclotide groups were not statistically significant(p<0.05).The difference was not statistically significant(p>0.05);and in the occurrence of abdominal pain and bloating and dizziness and palpitation,the difference was not statistically significant in the three groups(p>0.05).5.The differences in tolerability between the 2LPEG and 2LPEG + 2 capsules of linaclotide groups were statistically significant(p<0.05)compared with the 3LPEG group,while the differences in tolerability between the 2LPEG and 2LPEG + 2 capsules of linaclotide groups were not statistically significant(p>0.05).CONCLUSION: The combined regimen of 2LPEG and linaclotide in patients with mild and moderate constipation was more effective than the 2LPEG group in bowel preparation and shortened the time to first bowel movement,while its cleanliness was comparable to that of the 3LPEG group,with a lower incidence of adverse effects and better tolerability than that of the 3LPEG group.