Colonoscopy 'my way': Preparation, anticoagulants, antibiotics and sedation

被引:8
作者
Waye, JD [1 ]
机构
[1] Mt Sinai Hosp, Mt Sinai Med Ctr, GI Endoscopy Unit, New York, NY USA
关键词
antibiotics; anticoagulants; colonoscopy; endoscopy;
D O I
10.1155/1999/837528
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Colonoscopy was introduced in the 1960s. The facility with which this technique is performed has been enhanced by vast improvements in instrumentation. In spite of this, physician attitudes concerning colonoscopy have changed little over the past several decades. The diet for precolonoscopic preparation has not been altered for 30 years. Colonoscopists have a great reluctance to use a new preparation instead of the 4 L electrolyte solution, perhaps because this was such a significant advance in colonoscopic cleansing, its predecessor being castor oil and enemas. Physicians continue to be wary of the patient who is taking acetylsalicylic acid in the absence of any studies that show that this is detrimental for polypectomy. The management of the patient on warfarin anticoagulation remains a subject for debate. As for antibiotic prophyraxis, mast endoscopy units do not have a standardized approach, although there are good guidelines that, if followed, should decrease the risk of infective endocarditis. Sedation for the endoscopic examination is usually administered by the colonoscopist, although anesthesiologists may, in some countries (and in some defined areas of the United States) be the primary administrators of sedation and analgesia. The present article is a personal approach to the following issues: the preparation of the colon for an examination, current thoughts about anticoagulation and acetylsalicylic acid, antibiotic prophylaxis for colonoscopy and the technique for sedation out of the hospital.
引用
收藏
页码:473 / 476
页数:4
相关论文
共 10 条
[1]  
*AM SOC GASTR END, 1998, GASTROINTEST ENDOSC, V48, P672
[2]  
[Anonymous], 1995, GASTROINTEST ENDOSC, V42, P630
[3]  
Chia Y W, 1995, J R Coll Surg Edinb, V40, P374
[4]   Oral sodium phosphate versus sulfate-free polyethylene glycol electrolyte lavage solution in outpatient preparation for colonoscopy: A prospective comparison [J].
Clarkston, WK ;
Tsen, TN ;
Dies, DF ;
Schratz, CL ;
Vaswani, SK ;
Bjerregaard, P .
GASTROINTESTINAL ENDOSCOPY, 1996, 43 (01) :42-48
[5]   Prevention of bacterial endocarditis - Recommendations by the American Heart Association [J].
Dajani, AS ;
Taubert, KA ;
Wilson, W ;
Bolger, AF ;
Bayer, A ;
Ferrieri, P ;
Gewitz, MH ;
Shulman, ST ;
Nouri, S ;
Newburger, JW ;
Hutto, C ;
Pallasch, TJ ;
Gage, TW ;
Levison, ME ;
Peter, G ;
Zuccaro, G .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 277 (22) :1794-1801
[6]   Cleansing ability and tolerance of three bowel preparations for colonoscopy [J].
Frommer, D .
DISEASES OF THE COLON & RECTUM, 1997, 40 (01) :100-104
[7]   COLONOSCOPIC BOWEL PREPARATIONS - WHICH ONE - A BLINDED, PROSPECTIVE, RANDOMIZED TRIAL [J].
GOLUB, RW ;
KERNER, BA ;
WISE, WE ;
MEESIG, DM ;
HARTMANN, RF ;
KHANDUJA, KS ;
AGUILAR, PS .
DISEASES OF THE COLON & RECTUM, 1995, 38 (06) :594-599
[8]  
LINDEN TB, IN PRESS GASTROINTES
[9]   Bowel preparation for colonoscopy: A randomized prospective trial comparing sodium phosphate and polyethylene glycol in a predominantly elderly population [J].
Thomson, A ;
Naidoo, P ;
Crotty, B .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 1996, 11 (02) :103-107
[10]  
VANNER SJ, 1990, AM J GASTROENTEROL, V85, P422