Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy

Virender K. Sharma, Siva Chockalingham, Vivian Clark, Ashok Kapur, Eric N. Steinberg, Eric J. Heinzelmann, Rajeev Vasudeva, Colin Howden

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: There is a paucity of data regarding the optimal form of bowel preparation for flexible sigmoidoscopy. Most endoscopists recommend enemas. A simpler preparation that is easy, acceptable, and that reduces patient encounter time would be desirable, and might be cost-effective. Our objective in this study was to evaluate a simple oral form of preparation for screening flexible sigmoidoscopy. Methods: In this randomized, single-blind, controlled trial, we compared two forms of preparation in consecutive male patients referred for screening flexible sigmoidoscopy. The oral preparation consisted of one bottle of magnesium citrate and two 'Dulcolax' tablets on the evening before flexible sigmoidoscopy. This was compared with the standard form of preparation, namely, two Fleet's enemas given on arrival at the endoscopy suite. Thirty-seven patients received the oral preparation [mean age, 62.8 ± 8.9 (SD) yr]; 33 received enemas (mean age, 65.2 ± 7.3 yr). Endoscopists were blinded to the preparation. Results: Mean time between arrival and starting flexible sigmoidoscopy was 36 ± 22 (SD) min for patients on oral preparation, and 62 ± 25 min for patients receiving enemas (p < 0.0001). Mean times performing flexible sigmoidoscopy were 10 ± 3 min and 13 ± 4 min, respectively (p = 0.004). Mean patient satisfaction score (range 0-13) was higher for patients given the oral preparation (11.4 ± 1.8) than for patients receiving enemas (9.6 ± 2.4) (p = 0.001). Fifteen patients randomized to receive the oral preparation had previous flexible sigmoidoscopy with an enema preparation; all preferred the oral form. Mean technical difficulty (range 1-10) was 3 ± 2.2 for patients given the oral preparation and 4.9 ± 3.1 for patients receiving the enema preparation (p = 0.01). Polyps were identified in 10/37 patients who received the oral preparation and in 3/33 patients who received enemas (p = 0.05). Quality of colon preparation was judged 'good' in 29, 'fair' in four, and 'poor' in four, among the 37 patients given the oral form; corresponding values for 33 patients given enemas were 16, 10, and 7 (p = 0.03). Conclusion: Patient acceptance, encounter time, technical ease, and quality of colon preparation were significantly better with the oral form of colon preparation than with the standard Fleet enema preparation.

Original languageEnglish (US)
Pages (from-to)809-811
Number of pages3
JournalAmerican Journal of Gastroenterology
Volume92
Issue number5
StatePublished - May 1 1997
Externally publishedYes

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Sigmoidoscopy
Enema
Colon
Bisacodyl
Polyps
Patient Satisfaction

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Sharma, V. K., Chockalingham, S., Clark, V., Kapur, A., Steinberg, E. N., Heinzelmann, E. J., ... Howden, C. (1997). Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy. American Journal of Gastroenterology, 92(5), 809-811.

Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy. / Sharma, Virender K.; Chockalingham, Siva; Clark, Vivian; Kapur, Ashok; Steinberg, Eric N.; Heinzelmann, Eric J.; Vasudeva, Rajeev; Howden, Colin.

In: American Journal of Gastroenterology, Vol. 92, No. 5, 01.05.1997, p. 809-811.

Research output: Contribution to journalArticle

Sharma, VK, Chockalingham, S, Clark, V, Kapur, A, Steinberg, EN, Heinzelmann, EJ, Vasudeva, R & Howden, C 1997, 'Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy', American Journal of Gastroenterology, vol. 92, no. 5, pp. 809-811.
Sharma VK, Chockalingham S, Clark V, Kapur A, Steinberg EN, Heinzelmann EJ et al. Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy. American Journal of Gastroenterology. 1997 May 1;92(5):809-811.
Sharma, Virender K. ; Chockalingham, Siva ; Clark, Vivian ; Kapur, Ashok ; Steinberg, Eric N. ; Heinzelmann, Eric J. ; Vasudeva, Rajeev ; Howden, Colin. / Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy. In: American Journal of Gastroenterology. 1997 ; Vol. 92, No. 5. pp. 809-811.
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title = "Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy",
abstract = "Objective: There is a paucity of data regarding the optimal form of bowel preparation for flexible sigmoidoscopy. Most endoscopists recommend enemas. A simpler preparation that is easy, acceptable, and that reduces patient encounter time would be desirable, and might be cost-effective. Our objective in this study was to evaluate a simple oral form of preparation for screening flexible sigmoidoscopy. Methods: In this randomized, single-blind, controlled trial, we compared two forms of preparation in consecutive male patients referred for screening flexible sigmoidoscopy. The oral preparation consisted of one bottle of magnesium citrate and two 'Dulcolax' tablets on the evening before flexible sigmoidoscopy. This was compared with the standard form of preparation, namely, two Fleet's enemas given on arrival at the endoscopy suite. Thirty-seven patients received the oral preparation [mean age, 62.8 ± 8.9 (SD) yr]; 33 received enemas (mean age, 65.2 ± 7.3 yr). Endoscopists were blinded to the preparation. Results: Mean time between arrival and starting flexible sigmoidoscopy was 36 ± 22 (SD) min for patients on oral preparation, and 62 ± 25 min for patients receiving enemas (p < 0.0001). Mean times performing flexible sigmoidoscopy were 10 ± 3 min and 13 ± 4 min, respectively (p = 0.004). Mean patient satisfaction score (range 0-13) was higher for patients given the oral preparation (11.4 ± 1.8) than for patients receiving enemas (9.6 ± 2.4) (p = 0.001). Fifteen patients randomized to receive the oral preparation had previous flexible sigmoidoscopy with an enema preparation; all preferred the oral form. Mean technical difficulty (range 1-10) was 3 ± 2.2 for patients given the oral preparation and 4.9 ± 3.1 for patients receiving the enema preparation (p = 0.01). Polyps were identified in 10/37 patients who received the oral preparation and in 3/33 patients who received enemas (p = 0.05). Quality of colon preparation was judged 'good' in 29, 'fair' in four, and 'poor' in four, among the 37 patients given the oral form; corresponding values for 33 patients given enemas were 16, 10, and 7 (p = 0.03). Conclusion: Patient acceptance, encounter time, technical ease, and quality of colon preparation were significantly better with the oral form of colon preparation than with the standard Fleet enema preparation.",
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AU - Chockalingham, Siva

AU - Clark, Vivian

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AU - Steinberg, Eric N.

AU - Heinzelmann, Eric J.

AU - Vasudeva, Rajeev

AU - Howden, Colin

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