A Prospective Study to Assess the Efficacy and Patient Satisfaction of Three Bowel Preparations for Colonoscopy

Abstract

Purpose: To evaluate the adequacy of bowel cleansing and patient acceptance of a nutritional food package (NutraPrep®) used in combination with polyethylene Glycol electrolyte solution (Colyte®) or Magnesium Citrate/Bisacodyl preparation (LoSo Prep®) versus Magnesium Citrate/Bisacodyl (LoSo Prep®) and a clear liquid diet. Methods: The study population consist of 114 patients, 61 male, 53 female, 33-85 years old, mean age 61 years old. After obtaining informed consent, patients were randomly assigned to one of three bowel preparation groups: Group 1 received Magnesium Citrate, oral Bisacodyl tablets and instructions for a clear liquid diet on the day prior to colonoscopy, and Bisacodyl suppository administered on the day of the procedure at least two hours prior to examination. Group 2 received Magnesium Citrate, oral Bisacodyl tablets and a pre-packaged low residue solid and liquid foods diet on the day prior to colonoscopy, and Bisacodyl suppository administered on the day of the procedure at least two hours prior to examination. Group 3 received Polyethylene glycol electrolyte solution and a pre-packaged low residue solid and liquid foods diet on the day prior to colonoscopy. There were 37 patients in group 1, 38 patients in group 2 and 39 patients in group 3. The characteristics of all patients were similar between the three groups. All procedures were done by the same endoscopist (RCR). The adequacy of bowel preparation was graded by the endoscopist who was blinded to the type of bowel preparation. The preparations were rated by patients for tolerance, compliance, side effects and desire for food. Results: Patients in Group 2 had a superior clean colon as compared to groups 1 and 3, p=.0018. Group 1 patients retained more moderate to large amounts of stool as compared to groups 2 and 3; however only one patient in group 1 had to repeat the procedure due to inadequate visualization of the colon. 87% of patients in group 3 rated the preparation as tolerable or very tolerable as compared to 97% of patients in group 1, and 95% of patients in group 2, p =<.0001. In addition, only 82% patients in group 3 would use the bowel preparation regimen again as compared to 97% of patients in group 1, and 95% patients in group 2, p=.0407. Conclusion: LoSo Prep® and NutraPrep® resulted in superior colon cleansing, as compared to Colyte® and NutraPrep® or LoSo Prep®and a clear liquid diet. In addition, LoSo Prep®preparations were significantly better tolerated and more likely to be used in the future than the Colyte based preparation.