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Cleaning of the gut before endoscopy

I am lung-transplanted since 2010 and had a routine appointment for a gut endoscopy last november. The cleaning phase was unfortunately very difficult, as in spite of drinking of 3 litres endofalk-solution (macrogol) the day before, persisting hard pieces of stool could still be found on parts of the bowel wall. Therefore a final statement could not be made, therefore another attempt was done in December. This time the cleaning phase was intensified. I was told to stop eating two days before and started at 10 o'clock in the mornings with prepacol 70 ml; at 12 o'clock then the tablets that go along with it and at 16 o'clock 3 litres of moviprep solution. On the day of the endoscopy again at 6 o'clock 1 litre moviprep solution. The result was a bit better, however not yet satisfying.
As at the end of April a new attempt should be done and I have since the endoscopy again and again flatulences (probably as an intolerance with longtime effect of the whole gut to endofalk, moviprep or prepacol) my question:
Are there any other substances, with that the cleaning phase could be done better? And what can a transplanted patient take in order to support the gastrointestinal tract?
Many thanks in advance!
Best regards,
an insufficient cleaning of the gut before an endoscopy is frequent in patients with CF. It is improtant to stabilize the gut function in advance.
According to literature and to my personal experience many (not only transplanted) CF patients need a periodic therapy (over months) with a polyethylenglycol preparation for not getting flatulences and changing abdominal pain as a longterm symptom.
For preparation of a gut endoscopy those patients get a higher dosage over 2-3 days; e.g. 8-12 sacs à 13,125g Macrogol 3350 in 125ml of water (total amount 1-1,5 l/d). This treatment should be done by your CF physician/gastro-enterologist, who can decide if a blood sample is necessary to controle a possible change of electrolytes.
You could therefore start now with a lower dosage of polyethylenglycol daily to improve the mentioned symptoms and in order to prepare the next endoscopy in april.

Best regards,
Dr. Helmut Ellemunter

Guidelines for the diagnosis and management of distal intestinal obstruction syndrome in cystic fibrosis patients. Colombo C, Ellemunter H, Houwen R, Munck A, Taylor C, Wilschanski M; ECFS..J Cyst Fibros. 2011 Jun;10 Suppl 2:S24-8. doi: 10.1016/S1569-1993(11)60005-2. Review.