A new approach in bowel preparation before colonoscopy in patients with constipation: A prospective, randomized, investigator-blinded trial
Murat Yıldar, İsmail Yaman, Murat Başbuğ, Faruk Çavdar, Hasan Topfedaisi, Hayrullah Derici
Department of General Surgery, Balıkesir University School of Medicine, Balıkesir, Turkey
Abstract
Objective: Enema administration in the morning of routine colonoscopy is known to be useless. However, the potential bowel cleansing effects of distal colon emptying with enema prior to purgatives are not known. The aim of this study is to investigate the effects of enema use before purgatives in preparation for colonoscopy.
Material and Methods: Two hundred twenty-seven patients were randomly assigned into three groups; enema before purgative use, enema after purgative use, and no enema. Patients were compared in terms of age, sex, BMI, Rome III constipation criteria, history of abdominal surgery, tolerance to the preparation procedure, complications during preparation such as nausea, vomiting, headache and dizziness, cecal insertion time, total duration of colonoscopy, polyp determination rate and colonic cleansing based on the Boston Bowel Preparation Scale.
Results: One hundred two (44.9%) patients were male and 125 (55.1%) female. The mean age and BMI was 55.4±11.8 years and 28.8±4.7, respectively. No difference was observed between the groups in terms of sex, age, or BMI. The number of fulfilled Rome criteria and of previous abdominal surgeries were significantly higher in females than in men. Right colon Boston Bowel Preparation Scale score was higher in the group using enemas before purgatives than the scores of other groups. This improvement was statistically significant in the female patient group with higher constipation rate.
Conclusions: Use of enemas before purgatives in patients with constipation significantly improves adequacy of right colon cleansing.
Keywords: Bowel preparation, colonoscopy, constipation, sennoside A&B, sodium phosphate enema
Ethics committee approval was received for this study from the ethics committee of Çanakkale Onsekiz Mart University Clinical Research Ethical Committee.
Written informed consent was obtained from patients who participated in this study.
Externally peer-reviewed.
Concept - M.Y., İ.Y., M.B.; Design - M.Y., H.D., F.Ç.; Supervision - H.D., İ.Y., M.Y.; Resource - M.Y., H.D., F.Ç.; Materials - M.Y., İ.Y., H.D.; Data Collection and/or Processing - M.Y., İ.Y., M.B.; Analysis and/or Interpretation - M.Y., F.Ç., H.T.; Literature Search - M.Y., İ.Y., H.D.; Writing Manuscript - M.Y., F.Ç., H.D.; Critical Reviews - M.Y., M.B., İ.Y.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.
The authors thank to Emine Sert and Müjgan Çatalçam.