Use of the drug Lavacol for high-quality bowel preparation for colonoscopy examination

Preparation for a colonoscopy begins 2-3 days before the examination by following a slag-free diet.

Do not eat:

• vegetables (except potatoes), fresh and dried fruits and berries, as well as dishes containing them, all varieties of greens (dill, parsley, lettuce, etc.)
• all grain-containing products (whole grains, bran, products containing crushed grains, nuts, poppy seeds, coconut flakes, etc.).

Recommended diet: chicken, beef, veal (preferably in the form of cutlets, meatballs); lean fish, skinless potato dishes, eggs, white bread (without additives), pasta, semolina and oatmeal, cheese, butter, cottage cheese, yoghurts (without additives), white flour confectionery, chocolate, ice cream, sweets (sugar, honey, marshmallows, etc.). It is recommended to drink a sufficient amount of fluid (2.0-1.5 l) unless the patient suffers from diseases for which heavy drinking is contraindicated. This can be still water, clarified juices, low-fat broths, tea with honey or sugar, etc.

If the patient suffers from constipation, it is necessary to take laxatives daily as prescribed by a gastroenterologist or endoscopist.

The day before the study

In the morning: light breakfast (semolina, oatmeal), yogurt, white bread, cheese, butter, cottage cheese, confectionery products made from white flour without additives, chocolate, ice cream, etc.).

After breakfast and until the end of the study, you cannot take solid food; you need to drink clear liquids (for example: tea, broth, clarified juices).

Lunch: no later than 15.00 you can drink broth with a small piece of white bread.

From 17.00, you begin taking drugs to cleanse the intestines if the preparation for the study is one-stage (when the entire drug is taken the evening before the study). If the examination is under anesthesia either closer to noon or in the afternoon, then preparation begins at 19.00.

I. PREPARATION SCHEME FOR COLONOSCOPY WITH MOVIPREP

The time for taking MOVIPREP® is adjusted by a specialist

IF YOU ARE PREPARING FOR A STUDY:

Study 08:00 – 10:00 MOVIPREP® dosage regimen: one-stage evening

The day before the study: Breakfast: according to the list of permitted foods and liquids Lunch and dinner: only permitted clear liquids 19:00 – 20:00 take the first liter of MOVIPREP® drug solution 20:00 – 20:30 drink 500 ml of permitted liquid 21:00 – 22:00 take the second liter of MOVIPREP® solution 22:00 – 22:30 drink 500 ml of the approved liquid

Study 10:00 – 14:00 MOVIPREP® dosage regimen: two-stage

The day before the study: Breakfast and light lunch: according to the list of permitted foods and liquids Dinner: only permitted clear liquids 20:00 – 21:00 take the first liter of MOVIPREP® drug solution 21:00 – 21:30 drink 500 ml of permitted liquid Study day: 06:00 – 07:00 take the second liter of MOVIPREP® solution 07:00 – 07:30 drink 500 ml of the approved liquid

Study 14:00 – 19:00 MOVIPREP® dosage regimen: one-stage morning

The day before the study: Breakfast, lunch and light dinner: according to the list of permitted foods and liquids. Day of the study: In the morning: only permitted clear liquids 08:00 – 09:00 take the first liter of MOVIPREP® drug solution 09:00 – 09:30 drink 500 ml of permitted liquid 10:00 – 11:00 take the second liter of MOVIPREP® solution 11:00 – 11:30 drink 500 ml of permitted liquid

IF YOU ARE BEING PREPARED FOR OPERATION

Preparation for surgery is carried out after consultation with a specialist.

MOVIPREP® dosage regimen: one-stage evening only

The day before the operation: Breakfast: according to the list of permitted foods and liquids Lunch and dinner: only permitted clear liquids 19:00 – 20:00 take the first liter of MOVIPREP® solution 20:00 – 20:30 drink 500 ml of permitted liquid 21:00 – 22:00 take the second liter of MOVIPREP® solution 22:00 – 22:30 drink 500 ml of the approved liquid

Preparation with LAVAKOL OR FORTRANS

1.5-2 hours after starting to take the drug, stool will appear. Bowel movements will occur many times while taking Lavacol or Fortrans. The effect of the drug will continue for 1-2 hours after the end of its administration. Colon cleansing ends with the release of a clear or slightly colored liquid.

The study is carried out on an empty stomach. You can't have dinner, breakfast, or drink! In the morning, on the day of the study, visit the toilet in order to evacuate residual fluid from the intestines.

There are patients who cannot take these drugs for some reason, most often it is a taste aversion to such volumes of the drug. More recently, a new group of drugs has appeared, their mechanism of action and quality of preparation is similar to the previously described Levacol and Fortrans, but the volume of the drug is smaller and the taste is better.

The severity of the diet is the same as described above.

Lavacol

Lavacol

® (
Lavacole
) is a Russian-made laxative drug used in bowel preparation before instrumental examinations.

Dosage form and composition of Lavacol

Lavacol is available in the form of sachets containing powder for the preparation of a solution for oral administration. Weight of powder in one sachet is 14.0 g, including:

• polyethylene glycol MM 4000 (macrogol 4000) - 12.0 g
• sodium sulfate anhydrous - 1.0 g
• sodium bicarbonate - 0.6 g
• sodium chloride - 0.2 g
• potassium chloride - 0.2 g

Indications for use of Lavacol

Lavacol is used in the preparation of:

• for instrumental studies of the lower intestine:
• colonoscopy
• X-ray examination of the colon
• anorectal and colonic manometry

Lavacol and colonoscopy. Including economic aspects

High-quality preparation of the colon is the most important factor determining the effectiveness of colonoscopy, its duration and the success of therapeutic procedures, reduces the risk of complications, eliminates the need for repeated examinations, which also affects the economic side.
The condition for ideal preparation of the colon for colonoscopy is the complete absence of contents in the intestine or a moderate amount of residual clear liquid, sometimes mixed with mucus, which does not interfere with a full examination and is freely aspirated. However, in daily clinical practice, endoscopists regularly encounter poor visualization during colonoscopy. Preparing the colon for colonoscopy is a complex process that usually disrupts the patient’s usual rhythm of life. The method of oral intestinal lavage using the drug Lavacol is the method of choice for the combination of safety, effectiveness and comfort for the patient when preparing the colon for examination and surgery. Taking the solution does not lead to disruption of the physiological constants of the body, hemodynamic parameters, and does not change the well-being of patients. Lavacol does not contain flavorings or additives, which makes it easier to take and improves compliance. Experience with the use of the drug Lavacol gives grounds to recommend it for widespread use in clinical practice. It is important that the use of the drug Lavacol is more economically justified for patients: Lavacol costs 170 rubles in pharmacies, Fortrans - 550 rubles. (both drugs are included in the Vital and Essential Drugs list), Endofalk - from 500 rubles, Fleet phospho-soda - from 1500 rubles. Undoubtedly, the classical scheme (using enemas) has the minimum cost, but with this method labor costs increase significantly, and such a scheme is much less comfortable for patients than taking modern means intended for high-quality preparation.*

*The text of the section is based on the article: Shindina T.S., Maksimov M.L. Use of the drug Lavacol for high-quality intestinal preparation for colonoscopic examination // Breast Cancer. 2015. No. 21. pp. 1287–1289.

How to use Lavacol

The contents of 1 sachet of the drug are diluted in 1 glass of water (200 ml) at room temperature.
You can add syrup or jam to the solution to improve the taste. Lavokol solution is taken 200 ml every 20-30 minutes. The solution can be washed down with water or water with lemon. The total amount of solution to drink is 3 liters (15 doses of 14 g each). Defecation begins an hour and a half after starting to take Lavokol and stops 1-3 hours after taking the last dose. Dosage regimens for Lavacol:

• if the study is scheduled for 8-10 am, then Lavacol is taken on an empty stomach from 16:00-17:00 to 21:00-22:00 the night before, after 22:00 food is not taken
• if the study is scheduled for 11-13 hours or later, then the entire dose of Lavacol is divided into 2 doses - from 18:00 to 21:00 and from 6:00 to 7:00 in the morning, after which food is not taken until the study

An examination (colonoscopy) is possible no earlier than 4 hours after the last dose of the drug.
See also the article: “Preparation of the colon for instrumental studies.”

Contraindications to the use of Lavacol

Lavacol is not recommended for severe disturbances in the general condition of the patient, dehydration, heart failure, intestinal obstruction, toxic expansion of the colon, gastric stenosis, perforation of the stomach or intestines, erosive and ulcerative lesions of the gastrointestinal tract, and renal dysfunction.

Side effects of Lavacol

During therapy with Lavokol, the following occasionally occurs: nausea, vomiting, a feeling of heaviness and discomfort when taking the first doses of the drug.

Other medicines containing the active ingredient macrogol

Macrogol, as an active ingredient, is included in the following medications: Osmogol, Realaxan, Tranzipeg, Forlax, Forteza Rompharm, Fortrans. Endofalk is a drug that contains, in addition to macrogol, the following active substances: sodium chloride, sodium bicarbonate, potassium chloride.

general information

According to the pharmacological index, Lavacol belongs to the group “Laxatives”.
According to ATC - to the group “A06 Laxatives”, subgroup “A06AD Osmotic laxatives”, code “A06AD15 Macrogol”. Manufacturer of Lavokol: Moscow Pharmaceutical Factory CJSC. Developer: State Scientific Center for Coloproctology named after A.N. Ryzhikh of the Russian Ministry of Health.

On the website gastroscan.ru in the literature catalog there is a section “Laxatives”, containing medical articles relating to laxatives and their use.

Lavacol has contraindications, application features and side effects. Before using macrogol, you should consult your doctor.

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The principle of action of the medicine

how Lavacol works
The main purpose of Lavacol is to cleanse the gastrointestinal tract of food debris and feces. This procedure is necessary before performing various medical procedures, in particular colonoscopy. The importance of the gastrointestinal tract cleansing procedure is due to the fact that the effectiveness of the diagnostic procedure depends on it. If the intestines are not properly cleansed, there is a risk of complications and infection. Following the instructions for the drug will help achieve the purpose of its use and eliminate the need for an enema.

Preparation for the intestinal colonoscopy procedure with Lavacol has its own characteristics. The main active ingredient of the drug is polyethylene glycol. It holds water molecules and accumulates them. This is necessary to increase the volume of intestinal contents and further its rapid exit. Additional substances such as sodium sulfate, sodium bicarbonate, sodium chloride, potassium chloride will prevent intestinal dehydration and, as a result, water imbalance.

Features of the drug

Features of the drug

In most cases, some discomfort in the body is expected from the use of laxatives. Lavacol in this regard does not cause discomfort in the stomach, there is no pain and no gag reflex. A significant advantage is its relatively low cost, the price varies within 200 rubles for the entire package. There is no need to select measured doses, since the product is packaged in convenient single-use sachets.

Recommendations for the use of various laxatives note their ability to disrupt the intestinal microflora. But according to reviews of people who have used this drug, such an effect is not noticeable.

However, it is necessary to warn that the drug does not have a very pleasant taste. But this is only a temporary and easily removable effect. When used correctly, the drug will help to thoroughly cleanse the intestines and prepare for the upcoming procedure.

Note that bowel cleansing can occur not only with the help of this drug, but also in a more budget-friendly way - an enema.

General recommendations for nutrition before the diagnostic procedure

To ensure that bowel cleansing before the colonoscopy procedure does not cause difficulties, it is advisable to first follow a special diet. This is a slag-free diet 2-3 days before the procedure. During this time, it is necessary to exclude the following foods from the diet:

• Vegetables, excluding potatoes;
• Fruits and berries, both fresh and dried;
• Greenery;
• Products containing grains.

These products are not recommended to be consumed not only on their own, but also as components of dishes. This is due to the fact that they can cause increased gas formation, which will interfere with a full diagnosis.

It is allowed to eat chicken, veal and beef, low-fat fish, boiled potatoes without skin. Pasta and white bread that does not contain additives, oatmeal and semolina porridge, butter, cheese, lactic acid products, and cottage cheese are not excluded from the diet.

On the eve of the study, a light breakfast and lunch and plenty of fluids are recommended. The last meal should be before 17.00. After this time, bowel cleansing with medication begins.

Indications and contraindications

The drug is prescribed not only before colonoscopy, but also during other types of examination of the gastrointestinal tract. Preparation for abdominal surgery is not complete without such a cleansing procedure. The rather simple composition of the drug did not relieve it of contraindications. These are the following states:

1. If the patient has perforation of the intestine or any of its parts, then this drug is not used as a laxative;
2. Intestinal obstruction is a condition in which the use of Lavacol poses a danger to the patient's health. Therefore, this is also a contraindication;
3. Some diseases leading to thickening or thinning of the large intestine exclude the possibility of using the drug in question;
4. For peptic ulcers of the gastrointestinal tract or gastric stenosis;
5. All kidney pathologies;
6. State of dehydration of the body and general weakness;
7. Heart failure;
8. Children's age up to 5 years.

II. PREPARATION SCHEME FOR COLONOSCOPY WITH FORTRANS

3 days before the test, exclude fiber from food (fruits, vegetables, berries, nuts). Avoid taking activated charcoal.

2 days before the study, take a laxative in the evening, regardless of the nature of the stool - Duphalac 60 ml (or Castor oil 60 ml), and Espumisan (5 capsules) at night.

1 day before the test - do not eat, you can drink without restrictions. Instead of lunch, you can take any liquids (juice, broth, compote, etc.), you can eat jelly and drink jelly without berries, candy in any quantity to relieve hunger, sugar, honey.

FORTRANS (4 packets): dilute each packet with 1 liter of water. Water at room temperature, boiled or mineral, but without gases. On the eve of the test, take 2 liters from 18:00 to 20:00 (1 liter per hour). Drink glasses in one gulp at intervals of 15 minutes. The solution can be drunk chilled with lemon juice. Take Espumisan (5 capsules) at night.

On the day of the study, take the remaining 2 liters of Fortrans. The last dose of the drug should be completed no later than 3 hours before the start of the study. Take Espumisan (5 capsules) with the last glass of liquid.

While taking Fortrans, it is recommended to walk, light circular movements of the body, light massage of the anterior abdominal wall.