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David Z. Lubowski - One of the best experts on this subject based on the ideXlab platform.

  • Oral sodium phosphate solution is a superior colonoscopy preparation to polyethylene glycol with Bisacodyl.
    Diseases of The Colon & Rectum, 2000
    Co-Authors: C. J. Young, Richard R. Simpson, Denis W. King, David Z. Lubowski
    Abstract:

    PURPOSE: The aim of this study was to compare the efficacy and patient tolerance of two bowel preparations for colonoscopy. METHODS: Three hundred twenty-three consecutive patients undergoing colonoscopy were randomly assigned to receive either oral sodium phosphate, or 2 liters of polyethylene glycol solution preceded by the stimulant laxative Bisacodyl. Patients were asked to record the effects of the preparation, noting any vomiting, nausea, or abdominal pain, and to determine a discomfort rating on a scale of 1 to 5. One hundred sixty-nine patients were assigned to the oral sodium phosphate solution, and 154 to polyethylene glycol with Bisacodyl. Surgeons were blinded to the preparation used and rated the quality of the bowel preparation on a scale of 1 to 5. RESULTS: Ninety-nine percent of patients in the sodium phosphate group drank all of the solution as opposed to 91 percent of patients in the polyethylene glycol with Bisacodyl group. Patients in the sodium phosphate group reported significantly less discomfort (P = 0.002). No significant difference was reported for vomiting, nausea, or abdominal pain associated with the preparations. The quality of bowel cleansing was considered by the colonoscopists significantly better for the sodium phosphate group than the polyethylene glycol with Bisacodyl group (P < 0.000001). CONCLUSIONS: Colonoscopy preparation with sodium phosphate solution is better tolerated and more effective than polyethylene glycol with Bisacodyl.

  • Oral sodium phosphate solution is a superior colonoscopy preparation to polyethylene glycol with Bisacodyl.
    Diseases of the colon and rectum, 2000
    Co-Authors: C. J. Young, Richard R. Simpson, Denis W. King, David Z. Lubowski
    Abstract:

    PURPOSE: The aim of this study was to compare the efficacy and patient tolerance of two bowel preparations for colonoscopy. METHODS: Three hundred twenty-three consecutive patients undergoing colonoscopy were randomly assigned to receive either oral sodium phosphate, or 2 liters of polyethylene glycol solution preceded by the stimulant laxative Bisacodyl. Patients were asked to record the effects of the preparation, noting any vomiting, nausea, or abdominal pain, and to determine a discomfort rating on a scale of 1 to 5. One hundred sixty-nine patients were assigned to the oral sodium phosphate solution, and 154 to polyethylene glycol with Bisacodyl. Surgeons were blinded to the preparation used and rated the quality of the bowel preparation on a scale of 1 to 5. RESULTS: Ninety-nine percent of patients in the sodium phosphate group drank all of the solution as opposed to 91 percent of patients in the polyethylene glycol with Bisacodyl group. Patients in the sodium phosphate group reported significantly less discomfort (P=0.002). No significant difference was reported for vomiting, nausea, or abdominal pain associated with the preparations. The quality of bowel cleansing was considered by the colonoscopists significantly better for the sodium phosphate group than the polyethylene glycol with Bisacodyl group (P

Min-soo Kim - One of the best experts on this subject based on the ideXlab platform.

  • solubility of Bisacodyl in fourteen mono solvents and n methyl 2 pyrrolidone water mixed solvents at different temperatures and its application for nanosuspension formation using liquid antisolvent precipitation
    Journal of Molecular Liquids, 2020
    Co-Authors: Seon-kwang Lee, Woo-yong Sim, Hee Jun Park, Jeong-soo Kim, Ji-su Jeong, Min-soo Kim
    Abstract:

    Abstract The solubility of Bisacodyl at 288.15–308.15 K was determined by solid-liquid equilibrium in fourteen solvents commonly used in pharmaceutical production. The lowest solubility is in water, and the highest is in N-methyl-2-pyrrolidone (NMP) and other solvents that have high dielectric constants and large dipole moments. According to the Kamlet-Taft linear solvation energy relationship model, the solubility of Bisacodyl decreases with increasing hydrogen bond acidity (α) of the solvent. Experimental solubility data for the fourteen mono solvents and NMP + water binary mixtures were fitted to various theoretical models. In all considered cases, the dissolution of Bisacodyl is endothermic and spontaneous. Based on solubility data in the NMP + water binary mixtures, water and NMP were respectively used as antisolvent and solvent to prepare Bisacodyl nanosuspensions using liquid antisolvent precipitation. A nanosuspension with mean particle size below 100 nm can be prepared by adjusting the concentration of Bisacodyl in NMP and the mass fraction of NMP in the mixed solvent. These solubility data and parametric models established for Bisacodyl in mono solvents and mixtures could be very useful for the purification, crystallization, particle size control, as well as dosage form development of Bisacodyl.

  • Solubility of Bisacodyl in fourteen mono solvents and N-methyl-2-pyrrolidone + water mixed solvents at different temperatures, and its application for nanosuspension formation using liquid antisolvent precipitation
    Journal of Molecular Liquids, 2020
    Co-Authors: Seon-kwang Lee, Woo-yong Sim, Hee Jun Park, Jeong-soo Kim, Ji-su Jeong, Min-soo Kim
    Abstract:

    Abstract The solubility of Bisacodyl at 288.15–308.15 K was determined by solid-liquid equilibrium in fourteen solvents commonly used in pharmaceutical production. The lowest solubility is in water, and the highest is in N-methyl-2-pyrrolidone (NMP) and other solvents that have high dielectric constants and large dipole moments. According to the Kamlet-Taft linear solvation energy relationship model, the solubility of Bisacodyl decreases with increasing hydrogen bond acidity (α) of the solvent. Experimental solubility data for the fourteen mono solvents and NMP + water binary mixtures were fitted to various theoretical models. In all considered cases, the dissolution of Bisacodyl is endothermic and spontaneous. Based on solubility data in the NMP + water binary mixtures, water and NMP were respectively used as antisolvent and solvent to prepare Bisacodyl nanosuspensions using liquid antisolvent precipitation. A nanosuspension with mean particle size below 100 nm can be prepared by adjusting the concentration of Bisacodyl in NMP and the mass fraction of NMP in the mixed solvent. These solubility data and parametric models established for Bisacodyl in mono solvents and mixtures could be very useful for the purification, crystallization, particle size control, as well as dosage form development of Bisacodyl.

Gabrio Bassotti - One of the best experts on this subject based on the ideXlab platform.

  • usefulness of Bisacodyl testing on therapeutic outcomes in refractory constipation
    Digestive Diseases and Sciences, 2018
    Co-Authors: Edda Battaglia, Mario Grassini, Maria Pina Dore, Gabrio Bassotti
    Abstract:

    Although chronically constipated patients usually respond to medical treatment, there is a subgroup with scarce/no response, generally labeled as refractory or intractable. However, whether this lack of response is real or due to ancillary causes (suboptimal dosage, lack of compliance etc.) is unknown. To see whether a pharmacologic test (Bisacodyl colonic intraluminal infusion during manometric assessment) may predict the therapeutic outcome. Data of patients undergoing 24/h colonic manometry for severe intractable constipation in whom the Bisacodyl test (10 ml of drug dissolved into saline and injected through the more proximal recording port) had been carried out were retrieved and analysed, and correlations with the therapeutic outcome made. Overall, charts from 38 patients (5 men) were available; of these, only 21% displayed naive high-amplitude propagated contractions (average, less than 2/24 h), mostly meal-induced, during the recordings. A Bisacodyl response was present in 31.6% patients, with a mean number of events of 1.8 per patient. After Bisacodyl testing, 47.3% patients underwent intensive medical treatment, 44.7% surgery (medical failures), and 8% transanal irrigation, a procedure employed to treat refractory patients. The presence of naive propulsive contractions significantly correlated with the response to Bisacodyl infusion (p < 0.0001), and with a favourable outcome to intensive medical treatment (p < 0.0001). The Bisacodyl test may be clinically useful to better categorize constipated patients erroneously labelled as intractable and to exclude true colonic inertia, thus avoiding surgery in more than 30% of these subjects.

  • Usefulness of Bisacodyl Testing on Therapeutic Outcomes in Refractory Constipation
    Digestive diseases and sciences, 2018
    Co-Authors: Edda Battaglia, Mario Grassini, Maria Pina Dore, Gabrio Bassotti
    Abstract:

    Although chronically constipated patients usually respond to medical treatment, there is a subgroup with scarce/no response, generally labeled as refractory or intractable. However, whether this lack of response is real or due to ancillary causes (suboptimal dosage, lack of compliance etc.) is unknown. To see whether a pharmacologic test (Bisacodyl colonic intraluminal infusion during manometric assessment) may predict the therapeutic outcome. Data of patients undergoing 24/h colonic manometry for severe intractable constipation in whom the Bisacodyl test (10 ml of drug dissolved into saline and injected through the more proximal recording port) had been carried out were retrieved and analysed, and correlations with the therapeutic outcome made. Overall, charts from 38 patients (5 men) were available; of these, only 21% displayed naive high-amplitude propagated contractions (average, less than 2/24 h), mostly meal-induced, during the recordings. A Bisacodyl response was present in 31.6% patients, with a mean number of events of 1.8 per patient. After Bisacodyl testing, 47.3% patients underwent intensive medical treatment, 44.7% surgery (medical failures), and 8% transanal irrigation, a procedure employed to treat refractory patients. The presence of naive propulsive contractions significantly correlated with the response to Bisacodyl infusion (p 

C. J. Young - One of the best experts on this subject based on the ideXlab platform.

  • Oral sodium phosphate solution is a superior colonoscopy preparation to polyethylene glycol with Bisacodyl.
    Diseases of The Colon & Rectum, 2000
    Co-Authors: C. J. Young, Richard R. Simpson, Denis W. King, David Z. Lubowski
    Abstract:

    PURPOSE: The aim of this study was to compare the efficacy and patient tolerance of two bowel preparations for colonoscopy. METHODS: Three hundred twenty-three consecutive patients undergoing colonoscopy were randomly assigned to receive either oral sodium phosphate, or 2 liters of polyethylene glycol solution preceded by the stimulant laxative Bisacodyl. Patients were asked to record the effects of the preparation, noting any vomiting, nausea, or abdominal pain, and to determine a discomfort rating on a scale of 1 to 5. One hundred sixty-nine patients were assigned to the oral sodium phosphate solution, and 154 to polyethylene glycol with Bisacodyl. Surgeons were blinded to the preparation used and rated the quality of the bowel preparation on a scale of 1 to 5. RESULTS: Ninety-nine percent of patients in the sodium phosphate group drank all of the solution as opposed to 91 percent of patients in the polyethylene glycol with Bisacodyl group. Patients in the sodium phosphate group reported significantly less discomfort (P = 0.002). No significant difference was reported for vomiting, nausea, or abdominal pain associated with the preparations. The quality of bowel cleansing was considered by the colonoscopists significantly better for the sodium phosphate group than the polyethylene glycol with Bisacodyl group (P < 0.000001). CONCLUSIONS: Colonoscopy preparation with sodium phosphate solution is better tolerated and more effective than polyethylene glycol with Bisacodyl.

  • Oral sodium phosphate solution is a superior colonoscopy preparation to polyethylene glycol with Bisacodyl.
    Diseases of the colon and rectum, 2000
    Co-Authors: C. J. Young, Richard R. Simpson, Denis W. King, David Z. Lubowski
    Abstract:

    PURPOSE: The aim of this study was to compare the efficacy and patient tolerance of two bowel preparations for colonoscopy. METHODS: Three hundred twenty-three consecutive patients undergoing colonoscopy were randomly assigned to receive either oral sodium phosphate, or 2 liters of polyethylene glycol solution preceded by the stimulant laxative Bisacodyl. Patients were asked to record the effects of the preparation, noting any vomiting, nausea, or abdominal pain, and to determine a discomfort rating on a scale of 1 to 5. One hundred sixty-nine patients were assigned to the oral sodium phosphate solution, and 154 to polyethylene glycol with Bisacodyl. Surgeons were blinded to the preparation used and rated the quality of the bowel preparation on a scale of 1 to 5. RESULTS: Ninety-nine percent of patients in the sodium phosphate group drank all of the solution as opposed to 91 percent of patients in the polyethylene glycol with Bisacodyl group. Patients in the sodium phosphate group reported significantly less discomfort (P=0.002). No significant difference was reported for vomiting, nausea, or abdominal pain associated with the preparations. The quality of bowel cleansing was considered by the colonoscopists significantly better for the sodium phosphate group than the polyethylene glycol with Bisacodyl group (P

Samuel Nurko - One of the best experts on this subject based on the ideXlab platform.

  • characterization of the colonic response to Bisacodyl in children with treatment refractory constipation
    Neurogastroenterology and Motility, 2020
    Co-Authors: Paul T Heitmann, Lukasz Wiklendt, Nikhil Thapar, O Borrelli, Carlo Di Lorenzo, Desalegn Yacob, Desiree F Baaleman, Mana H Vriesman, Samuel Nurko
    Abstract:

    Background: Colonic manometry with intraluminal Bisacodyl infusion can be used to assess colonic neuromuscular function in children with treatment-refractory constipation. If Bisacodyl does not induce high-amplitude propagating contractions (HAPCs), this can be an indication for surgical intervention. A detailed characterization of the colonic response to intraluminal Bisacodyl in children with constipation may help to inform clinical interpretation of colonic manometry studies. Methods: Studies were performed in five pediatric hospitals. Analysis included identification of HAPCs, reporting HAPCs characteristics, and an area under the curve (AUC) analysis. Comparisons were performed between hospitals, catheter type, placement techniques, and site of Bisacodyl infusion. Results: One hundred and sixty-five children were included (median age 10, range 1-17 years; n = 96 girls). One thousand eight hundred and ninety-three HAPCs were identified in 154 children (12.3 ± 8.8 HAPCs per child, 0.32 ± 0.21 HAPCs per min; amplitude 113.6 ± 31.5 mm Hg; velocity 8.6 ± 3.8 mm/s, propagation length 368 ± 175 mm). The mean time to first HAPC following Bisacodyl was 553 ± 669 s. Prior to the first HAPC, there was no change in AUC when comparing pre- vs post-Bisacodyl (Z = −0.53, P =.60). The majority of HAPCs terminated in a synchronous pressurization in the rectosigmoid. Defecation was associated with HAPCs (χ2(1)=7.04, P <.01). Site of Bisacodyl administration, catheter type, and hospital location did not alter the response. Conclusions and Inferences: Intraluminal Bisacodyl induced HAPCs in 93% of children with treatment-refractory constipation. The Bisacodyl response is characterized by ≥1 HAPC within 12 minutes of infusion. The majority of HAPCs terminate in a synchronous pressurization in the rectosigmoid. Optimal clinical management based upon colonic manometry findings is yet to be determined.

  • long term use of Bisacodyl in pediatric functional constipation refractory to conventional therapy
    Journal of Pediatric Gastroenterology and Nutrition, 2020
    Co-Authors: Silvana Bonilla, Samuel Nurko, Leonel Rodriguez
    Abstract:

    OBJECTIVES Standard therapy for pediatric constipation includes osmotic laxatives with stimulant laxatives use only as rescue therapy. Limited information is available on regular and long-term use of Bisacodyl in pediatric population despite its common use in adult and pediatric constipation. METHODS Retrospective review of patients with functional constipation refractory to conventional therapy (regular use of osmotic laxatives and intermittent use of stimulant laxatives only as a rescue therapy) referred to tertiary care children's hospital (January 2007-December 2014). Patients had a bowel movement (BM) frequency of ≤2 per week and were treated with Bisacodyl regularly for longer than 4 weeks. Demographic variables, Bisacodyl dose and treatment duration, number of BM/week before and after treatment, side effects, and length of follow-up were recorded. Response to therapy was successful when frequency of BM increased from baseline to ≥3 BM/wk. RESULTS A total of 164 patients were included, 52% girls, median age 9.45 years (0.9-21 years). Bisacodyl median dose was 5 mg/day, median duration of treatment was 14 months (1-77 months) with 90% of patients taking the medication for <36 months. Median number of BM/wk doubled after initiation of Bisacodyl from 2 to 4 bm/w (P < 0.001). Approximately 57% of patients had successful response. At long-term follow-up 55% of patients were successfully weaned off Bisacodyl (median time of 18 months). Side effects reported in 9% of patients. CONCLUSIONS Bisacodyl is effective and well tolerated in the long-term treatment of pediatric functional constipation refractory to conventional therapy. Most of patients with a favorable response were successfully weaned off the medication.

  • Characterization of the colonic response to Bisacodyl in children with treatment‐refractory constipation
    Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society, 2020
    Co-Authors: Paul T Heitmann, Lukasz Wiklendt, Nikhil Thapar, O Borrelli, Carlo Di Lorenzo, Desalegn Yacob, Desiree F Baaleman, Mana H Vriesman, Samuel Nurko, Khalil El-chammas
    Abstract:

    Background: Colonic manometry with intraluminal Bisacodyl infusion can be used to assess colonic neuromuscular function in children with treatment-refractory constipation. If Bisacodyl does not induce high-amplitude propagating contractions (HAPCs), this can be an indication for surgical intervention. A detailed characterization of the colonic response to intraluminal Bisacodyl in children with constipation may help to inform clinical interpretation of colonic manometry studies. Methods: Studies were performed in five pediatric hospitals. Analysis included identification of HAPCs, reporting HAPCs characteristics, and an area under the curve (AUC) analysis. Comparisons were performed between hospitals, catheter type, placement techniques, and site of Bisacodyl infusion. Results: One hundred and sixty-five children were included (median age 10, range 1-17 years; n = 96 girls). One thousand eight hundred and ninety-three HAPCs were identified in 154 children (12.3 ± 8.8 HAPCs per child, 0.32 ± 0.21 HAPCs per min; amplitude 113.6 ± 31.5 mm Hg; velocity 8.6 ± 3.8 mm/s, propagation length 368 ± 175 mm). The mean time to first HAPC following Bisacodyl was 553 ± 669 s. Prior to the first HAPC, there was no change in AUC when comparing pre- vs post-Bisacodyl (Z = −0.53, P =.60). The majority of HAPCs terminated in a synchronous pressurization in the rectosigmoid. Defecation was associated with HAPCs (χ2(1)=7.04, P 

  • Long-term Use of Bisacodyl in Pediatric Functional Constipation Refractory to Conventional Therapy.
    Journal of pediatric gastroenterology and nutrition, 2020
    Co-Authors: Silvana Bonilla, Samuel Nurko, Leonel Rodriguez
    Abstract:

    OBJECTIVES Standard therapy for pediatric constipation includes osmotic laxatives with stimulant laxatives use only as rescue therapy. Limited information is available on regular and long-term use of Bisacodyl in pediatric population despite its common use in adult and pediatric constipation. METHODS Retrospective review of patients with functional constipation refractory to conventional therapy (regular use of osmotic laxatives and intermittent use of stimulant laxatives only as a rescue therapy) referred to tertiary care children's hospital (January 2007-December 2014). Patients had a bowel movement (BM) frequency of ≤2 per week and were treated with Bisacodyl regularly for longer than 4 weeks. Demographic variables, Bisacodyl dose and treatment duration, number of BM/week before and after treatment, side effects, and length of follow-up were recorded. Response to therapy was successful when frequency of BM increased from baseline to ≥3 BM/wk. RESULTS A total of 164 patients were included, 52% girls, median age 9.45 years (0.9-21 years). Bisacodyl median dose was 5 mg/day, median duration of treatment was 14 months (1-77 months) with 90% of patients taking the medication for