The preparation algorithm and rules are widely presented in available sources. Let's focus on choosing a product most suitable for purification of the object under study. Most often, it is Fortrans (France) which is included in the mandatory “Clinical guidelines”. Its analogues – Lavacol and Moviprep – belong to the same class of laxatives. The main active ingredient of these preparations is macrogol, or polyethylene glycol (PEG), a non-absorbable osmotically acting laxative. What does this mean? Each macrogol molecule binds several water molecules, thereby increasing the fullness of the intestine and causing the urge to empty it. Leaving aside pallatability of these products (each consumer has individual taste preferences), let us focus on the characteristics of solutions containing macrogol and other osmotically active components (for example, sorbitol, mannitol) that are important from the point of view of the methodology and outcomes of using these drugs.
- A long and complex preparatory process (numerous dietary exclusions and limitations);
- Radically increased water intake (not everyone likes it, and some people have contraindications);
- Risk of prolonged effect of unexpected bowel movement;
- Macrogol "collects" all the water in the intestine, and if the volume is not enough, it attracts it from the blood, causing blood thickening, an increase in its viscosity and deterioration of circulation in the bloodstream, which is fraught with clinically significant disorders (pressure drop, heart attack, stroke).
- Because of alkaline composition, Fortrans has an adverse effect on the structure of the gut microbiome.
In cases of incomplete bowel emptying, cloudy “puddles” are formed in it hampering the quality of examination.