| Objective The quality of bowel preparation plays an important role in colonoscopy.A good quality of bowel preparation is a necessary condition and guarantee for early diagnosis under colonoscopy and endoscopic treatment of early colorectal cancer.In patients with chronic constipation,due to poor intestinal emptying ability,the tradtional bowel preparation method taking polyethylene glycol electrolyte(PEG-ELP)is often unsatisfactory.Studies have shown that taking oral olive oil can stimulate colonic peristalsis via gastrocolic response,and it is beneficial to improve the bowel preparation effect of patients.But whether olive oil combined with PEG-ELP can improve the quality of bowel preparation in patients with chronic constipation remains unclear.This study is to investigate the effect of taking oral olive oil combined with PEG-ELP on bowel preparation in chronic constipation patients before colonoscopy,then explore new method of bowel preparation for patients with chronic constipation to improve the quality of their bowel preparation.Methods 1.Through taking random,single blinded and prospective research method,180 patients with chronic constipation were randomly assigned as group A(60 patients),group B(60 patients)and group C(60 patients).All patients did their colonoscopies from11/2017 to 05/2018.Within each group,patients in group A took 60ml olive oil+3000ml PEG-ELP.Patients in group B took 1500ml PEG-ELP+60ml olive oil+1500ml PEG-ELP.Patients in group C only took PEG-ELP 3000ml.The bowel preparation scores of the right colon,middle colon and left colon were kept by BBPS.The time of first defecation after taking the medication,the total number of defecation before getting sleep,the total number of defecation and the adverse reactions of the three groups were compared.The data of A,B and C were statistically analyzed.The measurement data was compared using the analysis of variance.After the difference was found,the LSD-t test was used to compare the two groups.The enumeration data was compared using the Pearson?~2 test.2.Through taking random,single blinded and prospective research method,320patients with chronic constipation were randomly assigned as group D(160 patients)and group E(160 patients).All patients did their colonoscopies from 11/2017 to 12/2018.Within each group,patients in group D took 60ml olive oil+3000ml PEG-ELP.Patients in group E only took PEG-ELP 3000ml.The two groups of patients were graded according to constipation scores of 1 point,2 point and 3 point,and the degree of constipation was divided into three layers:light,medium and severe.The bowel preparation scores of the right colon,middle colon and left colon were kept by BBPS.The time of first defecation after taking the medication,the total number of defecation before getting sleep,the total number of defecation and the adverse reactions of the two groups were compared.The measurement data was compared using the analysis of variance.For stratified comparison,small samples(n<60 cases)were measured using Kruskal-Wallis H test,and large samples(n?60 cases)were compared using the analysis of variance.The enumeration data was compared using the Pearson?~2 test.Results 1.One patient in group B terminated the examination due to the inability to continue cooperation during the examination.One patient in each of group B and group C was found to have a tumour in the descending colon and was removed.Finally,there were60 cases in group A,58 cases in group B,and 59 cases in group C.There was no statistical difference between three groups based on the general resource(P>0.05).For group A&B&C,the time for the first defecation after taking the medication was(2.25±2.32)h,(2.43±2.39)h and(3.36±2.79)h.The difference between the 3 groups was statistically significant(F=3.36,P=0.037).But there was no statistical meaning between group A&B(P=0.696).For group A&B,the time for their first defecation after taking the medication were both shorter than group C(P=0.016;P=0.046).For group A&B&C,the numbers of defecation before getting sleep was(3.47±2.09),(3.24±1.76)and(2.49±1.58).The difference between the 3 groups was statistically significant(F=4.65,P=0.011).But there was no statistical meaning between group A&B(P=0.503).For group A&B,the numbers of defecation before getting sleep were both higher than group C(P=0.004;P=0.027).For group A&B&C,the total number of defecation was(7.20±2.67),(6.81±2.31)and(5.64±2.22).The difference between the 3 groups was statistically significant(F=6.68,P=0.002).But there was no statistical meaning between group A&B(P=0.381).For group A&B,the total number of defecation were both higher than group C(P=0.001;P=0.010).And there was no statistical meaning between three groups based on the difference of the scores of the left colon,the middle colon and their total BBPS scores(P>0.05).But the scores of the right colon for group A&B were higher than group C(2.03±0.82;1.95±0.87 VS 1.53±0.80,F=6.38,P=0.002).There was no statistical meaning between group A&B(P=0.578).For group A&B,the scores of the right colon were both higher than group C(P=0.001;P=0.006).Adverse reactions after taking the medication include nausea,vomiting,abdominal pain,and bloating.There were 7,3,0 and3 cases in group A.There were 5,3,0 and 6 cases in group B.There were 4,2,1 and 4cases in group C.There was also no statistical meaning between three groups based on the difference of their adverse reactions(P>0.05).2.Two patients in group D terminated the examination due to the inability to continue cooperation during the examination.In group D,2 patients were found with tumors in the descending colon,1 patient and 4 patients were found with tumors in the sigmoid colon and rectum,respectively,and were removed.In group E,1 patient and 3 patients were found with tumors in the descending colon and rectum,respectively,and were removed.Finally,there were 151 cases in group D,156 cases in group E.There was no statistical difference between two groups based on the general resource(P>0.05).For group D&E,the time for the first defecation after taking the medication was(2.15±2.21)h and(2.75±2.46)h.The first defecation time of group D was shorter than that of group E.The difference between the 2 groups was statistically significant(F=5.066,P=0.025);For group D&E,the numbers of defecation before getting sleep was(3.44±1.83)and(2.88±1.64).The numbers of defecation before getting sleep of group D was higher than that of group E.The difference between the 2 groups was statistically significant(F=8.513,P=0.005);For group D&E,the total number of defecation was(7.13±2.53)and(6.34±2.41).The total number of defecation of group D was higher than that of group E.The difference between the 2 groups was statistically significant(F=7.785,P=0.006).And there was no statistical meaning between two groups based on the difference of the scores of the left colon,the middle colon(P>0.05).But the scores of the right colon for group D was higher than group E(2.05±0.83 VS 1.71±0.83,F=12.571,P=0.001).The total BBPS scores for group D was higher than group E(6.67±2.06 VS 6.17±2.11,F=4.333,P=0.038).Adverse reactions after taking the medication include nausea,vomiting,abdominal pain,and bloating.There were 19,11,4 and 17 cases in group D.There were 12,7,2 and 25 cases in group E.There was also no statistical meaning between two groups based on the difference of their adverse reactions(P>0.05).The defecation and bowel preparation scores of patients with constipation scores of 1 point,2 points,and 3 points in the D and E groups were compared.There were 33 cases in group D and 37 cases in group E with constipation score of 1.There were 51 cases in group D and 46 cases in group E with constipation score of 2.After stratified comparative analysis,there was no statistically significant difference between the two groups based on the general resource in the constipation scores of 1 and 2(P>0.05),There was no significant difference in the time for the first defecation after taking the medication,the numbers of defecation before getting sleep,and thetotal number of defecation between the two groups(P>0.05).And there was no significant difference in BBPS between the two groups(P>0.05).There was no statistically significant difference between the two groups based on the general resource in the constipation score of 3(P>0.05).For group D&E,the time for the first defecation after taking the medication was(2.20±2.34)h and(3.33±2.87)h.The difference between the 2groups was statistically significant(P=0.013).For group D,the time for their first defecation after taking the medication was shorter than group E.For group D&E,the numbers of defecation before getting sleep was(3.52±1.94)and(2.55±1.72).The difference between the 2 groups was statistically significant(P=0.002).For group D,the numbers of defecation before getting sleep was higher than group E.For group D&E,the total number of defecation was(7.33±2.49)and(5.81±2.27)).The difference between the3 groups was statistically significant(P=0.001).For group D,the total number of defecation was higher than group E.There were 67 cases in group D and 73 cases in group E with constipation score of 3.The scores of the left colon(2.09±0.75 VS 1.78±0.84;F=5.224,P=0.024),the middle colon(2.60±0.70 VS 2.27±0.93;F=5.316,P=0.023),the right colon(2.06±0.83 VS 1.47±0.85;F=17.368,P=0.001)and their total BBPS scores(6.75±2.00 VS 5.55±2.33;F=10.573,P=0.001)for group D were both higher than group E.Conclusion 1.In the process of bowel preparation,taking oral olive oil combined with PEG-ELP can shorten the first defecation time of patients with chronic constipation,increase the numbers of defecation before getting sleep and the total number of defecation,and effectively improve the right colon cleanliness of patients.In terms of timing,there is no stastifical difference in the effect of bowel preparation and adverse reactions between oral olive oil before taking the first box of PEG-ELP and oral olive oil after taking the first box of PEG-ELP.2.Taking oral olive oil combined with PEG-ELP can significantly improve the cleanliness of the whole colon in patients with serious chronic constipation,whose constipation score were 3.And there is no obvious adverse reaction,meaning that it is worthy of clinical use. |
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