Abstract | BACKGROUND AND AIMS: PATIENTS AND METHODS: The study was performed on 30 consecutive patients who presented with abdominal distension and radiographic evidence of colonic dilation, with a caecal diameter > or = 10 cm, that resolved conservatively. Patients then were randomised to receive daily 29.5 g of PEG (n = 15) or similar placebo (n = 15). Patients were monitored daily for a seven day period for stool and flatus evacuations, and colonic diameter on abdominal radiographs. Administration of the test solutions and assessment of patient symptoms and x rays were performed in a blinded fashion. A caecal diameter > or = 8 cm with a concomitant > or =10% increase after initial successful therapeutic intervention was considered as a relapse and these patients, after a second therapeutic intervention, were eligible to receive open label PEG. RESULTS: Twenty five patients received neostigmine as the initial therapeutic intervention which resulted in resolution of colonic dilation in 88% of cases. Eight patients had successful endoscopic decompression. Five (33.3%) patients in the placebo group had recurrent caecal dilation compared with none in the PEG group (p = 0.04). Therapy with PEG resulted in a significant increase in stool and flatus evacuations (p = 0.001 and 0.032, respectively) as well as in a significant decrease in the diameter of caecum, ascending and transverse colon, and abdominal circumference (p = 0.017, 0.018, 0.014, and 0.008, respectively). CONCLUSIONS: Administration of PEG in patients with Ogilvie's syndrome after initial resolution of colonic dilation may increase the sustained response rate after initial therapeutic intervention.
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Authors | S N Sgouros, J Vlachogiannakos, K Vassiliadis, C Bergele, G Stefanidis, H Nastos, A Avgerinos, A Mantides |
Journal | Gut
(Gut)
Vol. 55
Issue 5
Pg. 638-42
(May 2006)
ISSN: 0017-5749 [Print] England |
PMID | 16306137
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Cathartics
- Electrolytes
- Parasympathomimetics
- Neostigmine
- Polyethylene Glycols
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Topics |
- Acute Disease
- Aged
- Cathartics
(administration & dosage)
- Colon
(diagnostic imaging)
- Colonic Pseudo-Obstruction
(diagnostic imaging, drug therapy, therapy)
- Colonoscopy
- Decompression, Surgical
- Electrolytes
(administration & dosage)
- Female
- Humans
- Male
- Neostigmine
(therapeutic use)
- Parasympathomimetics
(therapeutic use)
- Polyethylene Glycols
(administration & dosage)
- Prospective Studies
- Radiography
- Recurrence
- Water-Electrolyte Balance
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