PMID- 36761469
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230211
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Advanced intestinal regulation improves bowel preparation quality in patients 
      with constipation: A systematic review and network meta-analysis.
PG  - 964915
LID - 10.3389/fphar.2022.964915 [doi]
LID - 964915
AB  - Background: Inadequate bowel preparation (IBP) has a critical influence on the 
      colonoscopy procedure and is associated with significantly lower rates of 
      detection of colorectal lesions. Constipation is an important risk factor of IBP, 
      and some studies have attempted to address the bowel cleansing for constipated 
      patients. However, there is still lack of consensus to guide the clinical work of 
      bowel preparation (BP) for patients with constipation. Therefore, we aimed to 
      perform a network meta-analysis to compare the overall efficacy of various 
      regimens for BP in constipated patients. Methods: We performed a comprehensive 
      search of PubMed, MEDLINE, EMBASE, Cochrane, and Web of science to identify 
      randomized controlled trials (RCTs) of bowel preparation regimens in constipated 
      patients, update to January 2021. Two investigators independently evaluated 
      articles and extracted data. The odds ratio (OR) with a 95% confidence interval 
      (CI) was used to combine dichotomous data of the primary outcome which was 
      defined as adequate bowel preparation (ABP). Rank probability was used to exhibit 
      the outcome of the network meta-analysis. Results: Eleven studies that included 
      1891 constipated patients were identified as suitable for inclusion. The 
      proportion of ABP was associated with the administration of intensive regimen (OR 
      2.19, 95% CI 1.16-4.17, p = .02, I2 = 84%). Moreover, an intensive regimen had a 
      significant efficacy and light heterogeneity when the same basic laxative program 
      was used (OR 4.06, 95% CI 3.04-5.43, p < .0001, I2 = 0%). In the network 
      meta-analysis, the protocol of a normal regimen + A (normal regimen plus advanced 
      intestinal regulation) had a significant effect for bowel preparation compared 
      with a normal regimen + IR (normal regimen plus irritating laxative regimen) (OR 
      5.21, 95% CI 1.18-24.55), H PEG (4L- polyethylene glycol) (OR 8.70, 95% CI 
      1.75-52.56), and normal regimen (NR) (OR 7.37, 95% CI 2.33-26.39). In the 
      remaining protocols, no significant difference was observed in any comparison. No 
      significant severe adverse events (AEs) associated with bowel preparation were 
      reported in included studies. Conclusion: Intensive regimens could improve bowel 
      cleansing quality for patients with constipation, and advanced intestinal 
      regulation regimens may be superior to others.
CI  - Copyright (c) 2023 Ding, Duan, Yang, Jin, Luo and Ma.
FAU - Ding, Liang
AU  - Ding L
AD  - Department of Gastroenterology, Shaoxing People's Hospital, Shaoxing, Zhejiang, 
      China.
FAU - Duan, JinNan
AU  - Duan J
AD  - Department of Infectious Diseases, Shaoxing People's Hospital, Shaoxing, 
      Zhejiang, China.
FAU - Yang, Tao
AU  - Yang T
AD  - Department of Gastroenterology, Shaoxing People's Hospital, Shaoxing, Zhejiang, 
      China.
FAU - Jin, ChaoQiong
AU  - Jin C
AD  - Department of Gastroenterology, Shaoxing People's Hospital, Shaoxing, Zhejiang, 
      China.
FAU - Luo, Jun
AU  - Luo J
AD  - Department of Gastroenterology, Shaoxing People's Hospital, Shaoxing, Zhejiang, 
      China.
FAU - Ma, Ahuo
AU  - Ma A
AD  - Department of Gastroenterology, Shaoxing People's Hospital, Shaoxing, Zhejiang, 
      China.
LA  - eng
PT  - Systematic Review
DEP - 20230124
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC9904507
OTO - NOTNLM
OT  - bowel preparation
OT  - colonoscopy
OT  - constipation
OT  - network meta-analysis
OT  - regimens
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/02/11 06:00
MHDA- 2023/02/11 06:01
PMCR- 2023/01/24
CRDT- 2023/02/10 03:10
PHST- 2022/06/09 00:00 [received]
PHST- 2022/12/30 00:00 [accepted]
PHST- 2023/02/10 03:10 [entrez]
PHST- 2023/02/11 06:00 [pubmed]
PHST- 2023/02/11 06:01 [medline]
PHST- 2023/01/24 00:00 [pmc-release]
AID - 964915 [pii]
AID - 10.3389/fphar.2022.964915 [doi]
PST - epublish
SO  - Front Pharmacol. 2023 Jan 24;13:964915. doi: 10.3389/fphar.2022.964915. 
      eCollection 2022.