Tıp Fakültesi / Faculty of Medicine

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search.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/openAccessSubject: search.filters.subject.Colonoscopy

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    Gastrointestinal endoscopy in pregnancy
    (2014) Savas, Nurten; 25386072
    Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
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    Adding stewed apricot juice to senna improves quality of colon cleansing in preparation for colonoscopy
    (2017) Yasar, Bulent; Abut, Even; Kayadibi, Huseyin; Akdogan, Fatih; Gonen, Can
    Background: To achieve optimal colonoscopic examination, the bowel must be sufficiently cleansed. However, none of the currently available colonoscopy preparation regimens is safe, efficient, and comfortable. The aim of this study was to determine whether adding stewed apricot juice to senna increased patient comfort and improved bowel cleansing during colonoscopy preparation. Methods: Outpatients of both genders who were over 18 years old and were referred for elective colonoscopy were randomly allocated to drink stewed apricot juice with senna or senna by itself. The quality of the colon cleansing was evaluated using the Ottawa scale. Patient tolerance and adverse events were evaluated through the completion of a questionnaire. Results: The study included a total of 128 patients in the randomization procedure. A significantly greater cleansing effect was observed using stewed apricot juice plus senna in the right and transverse colon (p = 0.038, p = 0.037 respectively). It was also determined that in the stewed apricot juice plus senna group, overall cleansing was superior (p < 0.001), total colonoscopy (17.6 min vs. 22.8 min, p = 0.048) and cecal intubation (7.4 min vs. 11.2 min, p = 0.042) times were shorter, and the colonoscopy procedure was easier (79.4% vs. 49.2%, p < 0.001). No differences were observed between the groups with respect to patient acceptance, compliance, and adverse events. In the stewed apricot juice plus senna group, 91.2% of patients stated their willingness to receive the same regimen in the future compared to 80% of the patients in the senna alone group (p = 0.037). Conclusion: The addition of natural, stewed apricot juice to senna significantly improves cleansing outcomes without additional adverse effects.
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    Ambulatory colonoscopy under sedoanalgesia in adult patients with and without irritable bowel syndrome: A prospective, cross-sectional, and double-blind comparison
    (2018) Tuncali, Bahattin; Araz, Coskun; Celebi, Arzu; 29755018
    Background/Aims: it is unclear whether patients with irritable bowel syndrome (IBS) require a high dose of sedatives during colonoscopy. In this study, we investigated the pre-procedural anxiety levels, sedative consumption, procedure times, complications, and patient's satisfaction between patients with IBS and controls for ambulatory colonoscopy under sedation. Materials and Methods: Rome III criteria were used in the diagnosis of IBS. Anxiety levels were measured using Spielberger's State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BA/). Patients received a fixed dose of midazolam (0.02 mg/kg), fentanyl (1 mu g/kg), ketamine (0.3 mg/kg), and incremental doses of propofol under sedation protocol. Demographic data, heart rate, blood pressure, and oxygen saturation were measured. Procedure times, recovery and discharge times, drug doses used, complications associated with the sedation, and patient's satisfaction scores were also recorded. Results: The mean Trait (p=0.015), State (p=0.029), Beck anxiety scores (p=0.018), the incidence of disruptive movements (p=0.044), and the amount of propofol (p=0.024) used were significantly higher in patients with IBS. There was a decline in mean systolic blood pressure at the 6th minute in patients with IBS (p=0.026). No association was found between the sedative requirement and the anxiety scores. Conclusion: Patients with IBS who underwent elective colonoscopy procedures expressed higher pre-procedural anxiety scores, required more propofol consumption, and experienced more disruptive movements compared with controls. On the contrary, the increased propofol consumption was not associated with the increased pre-procedural anxiety scores.