title: Colonic cleansing for radiographic detection of neoplasia: efficacy of the magnesium citrate-castor oil-cleansing enema regimen.
abstract: To optimize detection of colonic polyps, we instituted a cleansing regimen of dietary restriction, hydration, magnesium citrate, castor oil, and a cleansing enema. We then conducted a review of serially performed barium enemas to determine the percentage of patients with clean colons in a mixed population of 500 inpatients and outpatients in whom this regimen had been used. The same regimen also was used before single- and double-contrast barium enemas were performed in 139 patients with 234 polyps, and radiologic-endoscopic correlation was used to determine the percentage of polypoid neoplasms detected. The review indicated that a clean colon had been achieved in 97% of the 500 cases. In an additional 1.4% of patients, fecal residue was limited to small amounts in the cecum or ascending colon. In only two cases (0.4%) did fecal material prevent an examination that was suitable for detection of large polypoid or circumferential lesions. The single- and double-contrast barium enemas detected 80% and 91%, respectively, of polypoid lesions of all sizes. Single-contrast examinations detected 94% of polyps 10 mm or larger and 72% of polyps 5-9 mm. Double-contrast studies detected 96% of polyps 10 mm or larger and 88% of those 5-9 mm. The results of this study indicate that with this regimen, fecal residue does not significantly interfere with the detection of colonic polyps via barium enema examination.
authors.affiliation: Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
authors.forename: D W
authors.initials: DW
authors.lastname: Gelfand
authors.forename: Y M
authors.initials: YM
authors.lastname: Chen
authors.forename: D J
authors.initials: DJ
authors.lastname: Ott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D002368:Castor Oil / Q000008:administration & dosage*; D002400:Cathartics / Q000008:administration & dosage*; D002951:Citrates / Q000008:administration & dosage*; D019343:Citric Acid; D003106:Colon; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D004032:Diet; D004733:Enema; D005243:Feces; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D007507:Therapeutic Irrigation
chemical_list: D002400:Cathartics; D002951:Citrates; D001466:Barium Sulfate; D019343:Citric Acid; D002368:Castor Oil