Adamek Henning Ernst, Bergmann Laura, Müssig Karsten
Med. Klinik 2, Klinikum Leverkusen gGmbH, Leverkusen, Germany.
Klinik für Innere Medizin und Gastroenterologie, Niels-Stensen-Kliniken GmbH, Franziskus-Hospital Harderberg, Georgsmarienhütte, Germany.
Z Gastroenterol. 2022 May;60(5):784-789. doi: 10.1055/a-1791-1627. Epub 2022 May 11.
Adequate bowel preparation prior to colonoscopy is the key factor for high quality preparation for colonoscopy. Inadequate preparation can result in prolonged procedure time, incomplete colonoscopy and an increased risk of procedural adverse events. Diabetes mellitus has been identified as a predictor of inadequate colonoscopy bowel preparation. Currently, standard recommendations for diabetes patients before colonoscopy are missing.
This review is based on a selective literature search in PubMed and Google Scholar carried out in June 2021. Systematic reviews, guidelines, expert opinions, and recommendations from German and international societies were also considered.
The currently available preparations comprise two different groups: High-, medium- and low- volume polyethylene glycol (PEG) preparations and hyperosmotic agents. So far, a couple of reviews tried to identify outcome related differencies. Results are heterogeneous. In practise, preparation agents and timing of preparation as well as a thorough patient information before the preparation process are considered the most relevant items. In diabetes patients, preinterventional dietary recommendations are of paramount importance.
Split dosing of PEG preparations are recommended in diabetes patients with expected motility disorders. Extensive counseling about preparation intake and dietary recommendations should be offered.
结肠镜检查前充分的肠道准备是高质量结肠镜检查准备工作的关键因素。准备不充分可能导致检查时间延长、结肠镜检查不完整以及操作不良事件风险增加。糖尿病已被确定为结肠镜检查肠道准备不充分的一个预测因素。目前，缺少针对糖尿病患者结肠镜检查前的标准建议。
本综述基于2021年6月在PubMed和谷歌学术上进行的选择性文献检索。还考虑了德国和国际学会的系统评价、指南、专家意见和建议。
目前可用的肠道准备制剂分为两组：高、中、低容量聚乙二醇（PEG）制剂和高渗剂。到目前为止，已有几项综述试图确定与结果相关的差异。结果参差不齐。在实践中，准备制剂和准备时间以及准备过程前对患者的充分告知被认为是最相关的因素。对于糖尿病患者，干预前的饮食建议至关重要。
对于预期有动力障碍的糖尿病患者，建议采用PEG制剂分次给药。应提供关于制剂服用和饮食建议的广泛咨询。
