Application effect of linaclotide capsules combined with compound polyethylene glycol in colonoscopy bowel preparation

Abstract

BACKGROUND

In the field of clinical intestinal preparation, compound polyethylene glycol electrolyte solution (SF-PEG) is a commonly used intestinal cleaner. However, practice has shown that using only a single polyethylene glycol formulation often fails to achieve the desired intestinal preparation effect. Linalotide has a unique mechanism of action, which can effectively enhance the secretion of small intestinal fluid and promote intestinal peristalsis. The combination of linaclotide and SF-PEG may provide a better solution for intestinal preparation and improve the quality of intestinal cleaning. Therefore, exploring the application value and clinical efficacy of linaclotide capsules combined with SF-PEG in intestinal preparation is of great clinical significance.

AIM

To explore the effects of the combination of linaclotide capsules and SF-PEG, including its efficacy in intestinal preparation and patient tolerance.

METHODS

To investigate the differences in the effectiveness of different bowel preparation plans in colonoscopy, this article conducted a comprehensive and detailed retrospective analysis of the medical records of patients who underwent colonoscopy from January 2023 to December 2023. In this study, 116 patients were accurately divided into three groups based on the different intestinal preparation drugs used before colonoscopy. Among them, group A consisted of 29 patients who underwent intestinal preparation using 3 liters of SF-PEG combined with linaclotide; group B consists of 50 patients who underwent intestinal preparation using 3 liters of SF-PEG; group C consisted of 37 patients who underwent intestinal preparation using a combination of 2-liter SF-PEC and linaclotide. Subsequently, this article evaluated the quality of intestinal preparation in these three groups of patients, using the Boston bowel preparation scale (BBPS) as a quantitative indicator, while comparing multiple indicators such as intestinal preparation completion rate and detection of positive lesions, providing a strong basis for optimizing clinical intestinal preparation plans.

RESULTS

No statistically significant differences were found in BBPS scores (7.75 ± 1.23, 7.69 ± 1.14, and 7.66 ± 1.31; P = 0.240), bowel preparation completion rates (96.55%, 90.00%, and 97.30%; P = 0.293), adenoma detection rates (20.69%, 38.00%, and 32.43%; P = 0.281), polyp detection rates (34.48%, 50.00%, 37.84%; P = 0.326), insertion time (6.03 ± 4.34, 6.12 ± 3.60, and 5.33 ± 2.42; P = 0.584), and patient satisfaction rates (89.66%, 84.00%, and 97.30%; P = 0.398) among the three groups. However, statistically significant differences were observed in withdrawal time (7.45 ± 2.91, 9.02 ± 3.54, and 6.86 ± 2.66; P = 0.027) and adverse reaction rates (6.90%, 20.00%, and 2.70%; P = 0.029) among the three groups. Multiple comparisons showed that group C had significantly lower withdrawal time and adverse reaction rates than group B (P = 0.013, P = 0.016).

CONCLUSION

Linaclotide capsules show a trend in improving bowel preparation quality and reducing the dosage of SF-PEG.

Keywords: Colonoscopy; Bowel preparation; Compound polyethylene glycol electrolyte solution; Linaclotide; Boston bowel preparation scale; Curative effect

Core Tip: Compound polyethylene glycol electrolyte powder (SF-PEG) is a commonly used intestinal cleaner, but some elderly patients have poor tolerance to it. Linalotide can improve intestinal preparation by increasing small intestinal fluid secretion and intestinal peristalsis. In this study, group C (bowel preparation with 2 L of SF-PEG combined with linaclotide) had significantly lower withdrawal time and incidence of adverse reactions compared to group B (bowel preparation with 3 L of SF-PEG), indicating that linaclotide capsules have a tendency to improve intestinal preparation quality, reduce SF-PEG dosage, help reduce patient discomfort, and make colonoscopy easier for patients.