PubMed · 4487921
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
E Hjartardóttir. 1973. [Toilax (bisacodyl)].. https://pubmed.ncbi.nlm.nih.gov/4487921/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND: Surreptitious ingestion of laxatives can lead to serious factitious diseases that are difficult to diagnose. Most cases involve ingestion of bisacodyl or senna. Thin layer chromatography (TLC) of urine or stool is the only commercially available test for these laxatives. Such testing is considered highly reliable, but its accuracy in clinical practice is unknown. Our aim was to evaluate the reliability of TLC laxative testing by a clinical reference laboratory in the United States. METHODS: Diarrhea was induced in healthy volunteers by ingestion of bisacodyl, senna, or a control laxative (n = 11 for each laxative group). Samples of urine and diarrheal stool were sent in blinded fashion to the clinical reference laboratory for bisacodyl and senna analysis. RESULTS: TLC testing for bisacodyl-induced diarrhea revealed a sensitivity of 73% and specificity of 91% when urine was tested and sensitivity and specificity of 91% and 96%, respectively, when stool was analyzed. When diarrhea was induced by senna, the TLC assay for senna failed to identify even a single urine or stool specimen as positive (zero% sensitivity). CONCLUSIONS: Considering the expected prevalence of surreptitious laxative abuse in patients with chronic idiopathic diarrhea (2.4%-25%, depending on the clinical setting), TLC of urine or stool for bisacodyl by this reference laboratory would often produce misleading results, and testing for senna would have no clinical value. The major problems are false-positive tests for bisacodyl and false-negative tests for senna.
OBJECTIVE: Comparison of cleansing effects and colonic distension observed with two polyethyleneglycol-solution (PEG) containing bowel preparation techniques prior to CT-colonography (CTC). MATERIALS AND METHODS: One hundred and three patients that received CTC in our institution were retrospectively evaluated. Fifty-one patients received preparation 1 (BP1; based on a GoLytely formulation+bisacodyl), 52 preparation 2 (BP2; based on a NuLytely formulation+bisacodyl). On multi-planar-reformatted (MPR) images, fluid residuals and colon distension were assessed in five colonic segments, from the ascending colon to the rectum. RESULTS: On average, significantly (p<0.001) lower fluid residuals were assesses when using BP2 regardless of the patient position. In prone position, a significantly lower fluid level was observed in the sigmoid using bowel preparation 2. The average maximum diameter measured for the whole colon was 5.2+/-0.6 cm in prone position and 4.8+/-0.6 cm in the supine position in BP1 (p<0.01). In BP2 the average maximum diameter measured for the whole colon was 5.3+/-0.6 cm in prone position and 4.7+/-0.5 cm in supine position, respectively (p<0.001). CONCLUSION: Overall, lower fluid residuals were scored using BP2. In both preparation groups we achieved better colonic distension in prone position. We were not able to distend the sigmoid better when insufflating air during patient repositioning.
Explore the source record for details and available documents.