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Wang D, Liao X, Zhang H, Wang Y, Zhang M, Ren F, Ma X, Sheng J, Jin P, Yu D, Xie H, Wang X. A syrup containing L-arabinose and D-xylose appears superior to PEG-4000 as a bowel cleansing agent. AMB Express 2024; 14:63. [PMID: 38824272 PMCID: PMC11144180 DOI: 10.1186/s13568-024-01715-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 04/28/2024] [Indexed: 06/03/2024] Open
Abstract
Adequate bowel cleansing is crucial for endoscopic diagnosis and treatment, and the recovery of gut microbiota after intestinal cleansing is also important. A hypertonic syrup predominantly comprising L-arabinose and D-xylose (20% xylo-oligosaccharides) can be extracted from the hemicellulose of corn husks and cobs. L-Arabinose and xylo-oligosaccharides have been reported to relieve constipation and improve the gut microbial environment. This study evaluated the bowel cleansing effect of the aforementioned syrup and its influence on the organism and intestinal microbiota after cleansing in comparison with polyethylene glycol-4000 (PEG-4000) in mice. Bowel cleansing was performed using syrup or PEG-4000 in C57BL/6J mice, and the effect of intestinal preparation and its influence on serum electrolytes and gut microbiota after bowel cleansing were evaluated. The volume of intestinal residual feces in the syrup group was significantly lower than that in the PEG-4000 group. Additionally, syrup disturbed serum electrolytes more mildly than PEG-4000. Alpha diversity in the gut microbiota was significantly higher in the syrup group than in the PEG-4000 group on the first day after bowel cleansing. However, no difference in beta diversity was observed between the two groups. Syrup increased the abundance of Bifidobacteria and Christensenella and decreased the abundance of Akkermansia in comparison with PEG-4000 on the first day after bowel cleansing. Thus, this syrup has potential clinical use as a bowel cleansing agent given the above effects, its benefits and safety, and better taste and acceptability.
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Affiliation(s)
- Dezhi Wang
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xingchen Liao
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, 100853, China
| | - Heng Zhang
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yilin Wang
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mingjie Zhang
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
| | - Fangli Ren
- State Key Laboratory of Membrane Biology, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Xianzong Ma
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jianqiu Sheng
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, 100853, China
| | - Peng Jin
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
| | - Dongliang Yu
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China
| | - Hui Xie
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China.
| | - Xin Wang
- Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, #5 Nanmencang, Dongcheng District, Beijing, 100700, China.
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Mistretta F, Damiani N, Campanella D, Mazzetti S, Gulino A, Cappello G, Regge D. Effect of dose splitting of a low-volume bowel preparation macrogol-based solution on CT colonography tagging quality. Radiol Med 2022; 127:809-818. [PMID: 35715681 PMCID: PMC9349139 DOI: 10.1007/s11547-022-01514-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/06/2022] [Indexed: 11/25/2022]
Abstract
Purpose To compare examination quality and acceptability of three different low-volume bowel preparation regimens differing in scheduling of the oral administration of a Macrogol-based solution, in patients undergoing computed tomographic colonography (CTC). The secondary aim was to compare CTC quality according to anatomical and patient variables (dolichocolon, colonic diverticulosis, functional and secondary constipation). Methods One-hundred-eighty patients were randomized into one of three regimens where PEG was administered, respectively: in a single dose the day prior to (A), or in a fractionated dose 2 (B) and 3 days (C) before the examination. Two experienced radiologists evaluated fecal tagging (FT) density and homogeneity both qualitatively and quantitatively by assessing mean segment density (MSD) and relative standard deviation (RSD). Tolerance to the regimens and patient variables were also recorded. Results Compared to B and C, regimen A showed a lower percentage of segments with inadequate FT and a significantly higher median FT density and/or homogeneity scores as well as significantly higher MSD values in some colonic segments. No statistically significant differences were found in tolerance of the preparations. A higher number of inadequate segments were observed in patients with dolichocolon (p < 0.01) and secondary constipation (p < 0.01). Interobserver agreement was high for the assessment of both FT density (k = 0.887) and homogeneity (k = 0.852). Conclusion The best examination quality was obtained when PEG was administered the day before CTC in a single session. The presence of dolichocolon and secondary constipation represent a risk factor for the presence of inadequately tagged colonic segments.
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Affiliation(s)
| | - Nicolò Damiani
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Delia Campanella
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Simone Mazzetti
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessia Gulino
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Giovanni Cappello
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Daniele Regge
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
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Shen H, Liang D, Luo M, Duan C, Cai W, Zhu S, Qiu J, Li W. Pilot study on image quality and radiation dose of CT colonography with adaptive iterative dose reduction three-dimensional. PLoS One 2015; 10:e0117116. [PMID: 25635839 PMCID: PMC4311968 DOI: 10.1371/journal.pone.0117116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 12/17/2014] [Indexed: 12/19/2022] Open
Abstract
Objective To investigate image quality and radiation dose of CT colonography (CTC) with adaptive iterative dose reduction three-dimensional (AIDR3D). Methods Ten segments of porcine colon phantom were collected, and 30 pedunculate polyps with diameters ranging from 1 to 15 mm were simulated on each segment. Image data were acquired with tube voltage of 120 kVp, and current doses of 10 mAs, 20 mAs, 30 mAs, 40 mAs, 50 mAs, respectively. CTC images were reconstructed using filtered back projection (FBP) and AIDR3D. Two radiologists blindly evaluated image quality. Quantitative evaluation of image quality included image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Qualitative image quality was evaluated with a five-score scale. Radiation dose was calculated based on dose-length product. Ten volunteers were examined supine 50 mAs with FBP and prone 20 mAs with AIDR3D, and image qualities were assessed. Paired t test was performed for statistical analysis. Results For 20 mAs with AIDR3D and 50 mAs with FBP, image noise, SNRs and CNRs were (16.4 ± 1.6) HU vs. (16.8 ± 2.6) HU, 1.9 ± 0.2 vs. 1.9 ± 0.4, and 62.3 ± 6.8 vs. 62.0 ± 6.2, respectively; qualitative image quality scores were 4.1 and 4.3, respectively; their differences were all not statistically significant. Compared with 50 mAs with FBP, radiation dose (1.62 mSv) of 20 mAs with AIDR3D was decreased by 60.0%. There was no statistically significant difference in image noise, SNRs, CNRs and qualitative image quality scores between prone 20 mAs with AIDR3D and supine 50 mAs with FBP in 10 volunteers, the former reduced radiation dose by 61.1%. Conclusion Image quality of CTC using 20 mAs with AIDR3D could be comparable to standard 50 mAs with FBP, radiation dose of the former reduced by about 60.0% and was only 1.62 mSv.
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Affiliation(s)
- Hesong Shen
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Dan Liang
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Mingyue Luo
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail:
| | - Chaijie Duan
- Research Center of Biomedical Engineering, Graduate School at Shenzhen, Tsinghua University, Shenzhen, Guangdong, China
| | - Wenli Cai
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Shanshan Zhu
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jianping Qiu
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenru Li
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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