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A COMPARISON OF TWO BOWEL PREPARATIONS IN A COLORECTAL CANCER SCREENING PROGRAMME USING VIRTUAL COLONOSCOPY
Author(s) -
Edwards John Thomas,
Foster Noellene Mary,
Murray Dianne,
Mendelson Richard Marvin,
Forbes Geoffrey Millar
Publication year - 2001
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2001.ca01-1.x
Subject(s) - medicine , colonoscopy , bloating , gastroenterology , nausea , bowel preparation , vomiting , tolerability , abdominal pain , distension , colorectal cancer , cancer , adverse effect
Aims The ideal bowel preparation for virtual colonoscopy (VC) is not defined. Our aim was to compare a magnesium citrate + sodium picosulfate (picolax) preparation with a picolax + polyethylene glycol (colonlytely) preparation. Methods Asymptomatic average risk subjects aged 50–54 or 65–69 years were invited to participate in a colorectal cancer screening programme using VC. Participants were randomly assigned one of either: ‘X’ prep ( n = 67): Mg citrate at 12.00 h and picolax at 16.00 and 19.00 h or ‘Y’ prep ( n = 80): 1 L colonlytely at 16.30 h and picolax at 17.30 and 19.30 h. Each was preceded by a low residue diet. At VC, segments of bowel were rated for distension, fluid and faeces by a gastroenterologist blinded to the preparation. All subjects completed a written questionnaire regarding the preparation. Results Quality of preparation (each category out of 40)Distension Fluid Faeces TotalX median 38 37 39 113 Y median 37 37 39 112.5 Tolerability (%) Taste (%)X Y X Y Easy/good 38 27 32 14 Tolerable 49 50 59 71 Slight difficulty 8 18 4 15 Extremely difficult 1 4 0 0 Unable to finish 4 1 4 1There was no significant difference between the preparations in reported degree of nausea, pain, bloating and headache. The vast majority (> 90%) of subjects reported either no symptoms or a mild degree of these symptoms. Vomiting occurred in 6 and 1.5% of preparation X and Y subjects, respectively. Three X patients (4.5%) had severe adverse events (two syncopal episodes, one severe vasovagal episode and palpitations) requiring discontinuation of the preparation. Conclusion Both preparations resulted in satisfactory bowel preparation for reading VC and were generally well tolerated. The picolax/colonlytely preparation is safer.