Effectiveness of Concomitant Use of Green Tea and Polyethylene Glycol in Bowel Preparation for Colonoscopy: a Randomized Controlled Study

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2020 May 15

PMID 32404056

Citations 4

Authors

Zong Hao

Lifeng Gong

Qiang Shen

Huipeng Wang

Shaowen Feng

Xin Wang

Yuankun Cai

Jun Chen

Affiliations

Soon will be listed here.

Abstract

Background: Polyethylene glycol solution (PEG) is widely used for bowel preparation prior to colonoscopies. However, patients often exhibited adverse events as nausea, vomit and distention due to its uncomfortable tastes and potential side affects. This study aimed to evaluate the effectiveness and safety of concomitant use of green tea (GT) with PEG in bowel preparation prior to colonoscopy.

Methods: This was a prospective, randomized controlled study. It was conducted at an outpatient setting of colorectal surgery in a tertiary hospital. Patients aged 18 through 80 who were scheduled to undergo colonoscopy between August 2015 and February 2016 were randomly assigned into two groups, admitting either 2 L-PEG solutions with 1 L GT liquids or 2 L-PEG solutions only for bowel preparation. Admitted doses of PEG solutions, taste evaluation, adverse reactions (nausea and vomiting, distention and abdominal pain) were investigated by questionnaires. The bowel cleanliness of each patient was evaluated according to the Aronchick indicators.

Results: A total of 116 patients were enrolled in this study (PEG+GT 59, PEG 57). Full compliances were achieved in 93.2% patients of group PEG+GT and 59.6% of group PEG (p < 0.001). Mean Aronchick scale between two groups were 2.0 ± 0.9 versus 2.2 ± 0.7 respectively (PEG+GT vs PEG, p = 0.296). Rates of adverse events as nausea and vomiting, abdominal pain in bowel preparation were significantly different between two groups (55.9% vs 77.2%, p = 0.015 and 13.6% vs 33.3%, p = 0.012). Patients in group PEG+GT who have probabilities to receive repeating colonoscopy had a higher willingness to accept PEG+GT again for bowel preparation, compared with PEG group (94.9% vs 57.9%, p < 0.001).

Conclusions: Concomitant use of green tea and polyethylene glycol may effectively reduce incidence of adverse events, increase compliances, with comparable bowel cleanliness in bowel preparation.

Trial Registration: This trial was retrospectively registered on Feb 1st, 2019 (ChiCTR1900021178).

Citing Articles

An abdominal vibration combined with walking exercise (AVCWE) program for older patients with constipation: Development and feasibility study.

Zhang Y, Vimala R, Chui P, Hilmi I Saudi J Gastroenterol. 2024; 30(3):173-180.

PMID: 38629327 PMC: 11198915. DOI: 10.4103/sjg.sjg_387_23.

Colon Bowel Preparation in the Era of Artificial Intelligence: Is There Potential for Enhancing Colon Bowel Cleansing?.

Gimeno-Garcia A, Benitez-Zafra F, Nicolas-Perez D, Hernandez-Guerra M Medicina (Kaunas). 2023; 59(10).

PMID: 37893552 PMC: 10608636. DOI: 10.3390/medicina59101834.

The efficacy and tolerability of sports drink versus water in bowel preparations: a randomised controlled study.

Zhang Z, Gao H, Yuan X, Liu C, Bao Z, Yu S Trials. 2022; 23(1):709.

PMID: 36028915 PMC: 9419325. DOI: 10.1186/s13063-022-06658-2.

Novel frontiers of agents for bowel cleansing for colonoscopy.

Di Leo M, Iannone A, Arena M, Losurdo G, Palamara M, Iabichino G World J Gastroenterol. 2021; 27(45):7748-7770.

PMID: 34963739 PMC: 8661374. DOI: 10.3748/wjg.v27.i45.7748.

References

Rutherford C, Calderwood A . Update on Bowel Preparation for Colonoscopy. Curr Treat Options Gastroenterol. 2018; 16(1):165-181. DOI: 10.1007/s11938-018-0165-3. View

Rahman S, Li Y, Huang Y, Zhu L, Feng S, Wu J . Treatment of inflammatory bowel disease via green tea polyphenols: possible application and protective approaches. Inflammopharmacology. 2018; 26(2):319-330. DOI: 10.1007/s10787-018-0462-4. View

Wan M, Ling K, Wang M, El-Nezami H . Green tea polyphenol epigallocatechin-3-gallate improves epithelial barrier function by inducing the production of antimicrobial peptide pBD-1 and pBD-2 in monolayers of porcine intestinal epithelial IPEC-J2 cells. Mol Nutr Food Res. 2016; 60(5):1048-58. DOI: 10.1002/mnfr.201500992. View

van Duynhoven J, Vaughan E, Jacobs D, Kemperman R, van Velzen E, Gross G . Metabolic fate of polyphenols in the human superorganism. Proc Natl Acad Sci U S A. 2010; 108 Suppl 1:4531-8. PMC: 3063601. DOI: 10.1073/pnas.1000098107. View

Leodolter A, Dominguez-Munoz J, von Arnim U, Malfertheiner P . Citric acid or orange juice for the 13C-urea breath test: the impact of pH and gastric emptying. Aliment Pharmacol Ther. 1999; 13(8):1057-62. DOI: 10.1046/j.1365-2036.1999.00557.x. View

Marshall J, Pineda J, Barthel J, King P . Prospective, randomized trial comparing sodium phosphate solution with polyethylene glycol-electrolyte lavage for colonoscopy preparation. Gastrointest Endosc. 1993; 39(5):631-4. DOI: 10.1016/s0016-5107(93)70213-8. View

Yi L, Tian X, Pi Y, Feng L, Chen H, Liu X . Comparative efficacy of low volume versus traditional standard volume PEG on bowel preparation before colonoscopy: Protocol for an updated meta-analysis with trial sequential analysis. Medicine (Baltimore). 2018; 97(17):e0599. PMC: 5944532. DOI: 10.1097/MD.0000000000010599. View

Lawrance I, Willert R, Murray K . Bowel cleansing for colonoscopy: prospective randomized assessment of efficacy and of induced mucosal abnormality with three preparation agents. Endoscopy. 2011; 43(5):412-8. DOI: 10.1055/s-0030-1256193. View

Fujiki H, Watanabe T, Sueoka E, Rawangkan A, Suganuma M . Cancer Prevention with Green Tea and Its Principal Constituent, EGCG: from Early Investigations to Current Focus on Human Cancer Stem Cells. Mol Cells. 2018; 41(2):73-82. PMC: 5824026. DOI: 10.14348/molcells.2018.2227. View

10.

Henning S, Choo J, Heber D . Nongallated compared with gallated flavan-3-ols in green and black tea are more bioavailable. J Nutr. 2008; 138(8):1529S-1534S. PMC: 2942025. DOI: 10.1093/jn/138.8.1529S. View

11.

Kojecky V, Matous J, Keil R, Dastych M, Kroupa R, Zadorova Z . A head-to-head comparison of 4-L polyethylene glycol and low-volume solutions before colonoscopy: which is the best? A multicentre, randomized trial. Int J Colorectal Dis. 2017; 32(12):1763-1766. DOI: 10.1007/s00384-017-2901-x. View

12.

Perreault G, Goodman A, Larion S, Sen A, Quiles K, Poles M . Split- versus single-dose preparation tolerability in a multiethnic population: decreased side effects but greater social barriers. Ann Gastroenterol. 2018; 31(3):356-364. PMC: 5924859. DOI: 10.20524/aog.2018.0254. View

13.

Rex D, Petrini J, Baron T, Chak A, Cohen J, Deal S . Quality indicators for colonoscopy. Am J Gastroenterol. 2006; 101(4):873-85. DOI: 10.1111/j.1572-0241.2006.00673.x. View

14.

Lee S, Bang C, Park T, Suk K, Baik G, Kim D . Split-dose Bowel Preparation for Colonoscopy: 2 Liters Polyethylene Glycol with Ascorbic Acid versus Sodium Picosulfate versus Oral Sodium Phosphate Tablets. Korean J Gastroenterol. 2017; 70(2):89-95. DOI: 10.4166/kjg.2017.70.2.89. View

15.

Chokshi R, Hovis C, Hollander T, Early D, Wang J . Prevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy. Gastrointest Endosc. 2012; 75(6):1197-203. DOI: 10.1016/j.gie.2012.01.005. View

16.

DellAica I, Niero R, Piazza F, Cabrelle A, Sartor L, Colalto C . Hyperforin blocks neutrophil activation of matrix metalloproteinase-9, motility and recruitment, and restrains inflammation-triggered angiogenesis and lung fibrosis. J Pharmacol Exp Ther. 2007; 321(2):492-500. DOI: 10.1124/jpet.106.116459. View

17.

Yuan J . Cancer prevention by green tea: evidence from epidemiologic studies. Am J Clin Nutr. 2013; 98(6 Suppl):1676S-1681S. PMC: 3831544. DOI: 10.3945/ajcn.113.058271. View

18.

Nogueira L, Nogueira Neto J, Klein M, Sanjuliani A . Short-term Effects of Green Tea on Blood Pressure, Endothelial Function, and Metabolic Profile in Obese Prehypertensive Women: A Crossover Randomized Clinical Trial. J Am Coll Nutr. 2016; 36(2):108-115. DOI: 10.1080/07315724.2016.1194236. View

19.

Kolts B, Lyles W, Achem S, Burton L, GELLER A, MacMath T . A comparison of the effectiveness and patient tolerance of oral sodium phosphate, castor oil, and standard electrolyte lavage for colonoscopy or sigmoidoscopy preparation. Am J Gastroenterol. 1993; 88(8):1218-23. View

20.

Di Febo G, Gizzi G, Calo G, Siringo S, Brunetti G . Comparison of a new colon lavage solution (Iso-Giuliani) with a standard preparation for colonoscopy: a randomized study. Endoscopy. 1990; 22(5):214-6. DOI: 10.1055/s-2007-1012851. View