Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation.
OBJECTIVE
This study was designed to compare the efficacy and patient tolerance of standard orthograde bowel preparation using 4 liters of polyethylene glycol solution with only 2 liters of polyethylene glycol preceded by the stimulant laxative bisacodyl.


METHODS
Three hundred eighty-two consecutive patients undergoing outpatient colonoscopy under two surgeons over a six-month period were randomized to receive one of the two preparations. Patients were asked to record the effects of the preparation and to give it a "discomfort rating" on a scale from 1 to 5. Surgeons were blinded to the preparation used and rated the quality of bowel cleansing on a scale of 1 to 5. One hundred ninety-one patients were randomized to the 4-liter preparation and 191 to the 2-liter preparation.


RESULTS
Ninety-three percent of patients in the 2-liter group drank all of the solution as opposed to only 66 percent of patients in the 4-liter group. Patients in the 4-liter group gave the preparation significantly lower comfort scores than those in the 2-liter group (Fisher's exact test; P = 0.0001). The quality of bowel cleansing was not significantly different between the groups (P = 0.88). A total of 6.8 percent of the 2-liter group and 9.4 percent of the 4-liter group were considered by the surgeon to have had a poor preparation (rating 4 or 5). The quality of the preparation was found to correlate with the patients' age and compliance with the preparation regimen, and was found not to correlate with presenting symptoms, pathology, or a previous colonic resection.


CONCLUSIONS
Bowel preparation with bisacodyl and 2 liters of polyethylene glycol is more acceptable to patients than a 4-liter regimen and is equally effective in cleansing the colon.
Adams
W J
WJ
Colorectal Unit, St. George Hospital, Sydney, Australia.
Meagher
A P
AP
Lubowski
D Z
DZ
King
D W
DW
D000328:Adult; D000368:Aged; D001726:Bisacodyl / Q000627:therapeutic use*; D003106:Colon / Q000187:drug effects* / Q000503:physiopathology; D003113:Colonoscopy / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D012996:Solutions
D012996:Solutions; D001726:Bisacodyl; D011092:Polyethylene Glycols