A blinded clinical trial comparing conventional cleansing enema, Pico-salax and Golytely for barium enema bowel preparation.
An evaluator-blinded randomized clinical trial was undertaken to assess the effectiveness and patient acceptance of three bowel cleansing regimens: conventional cleansing enema, Pico-salax and Golytely.


METHODS
One hundred and fifty patients, referred for barium enema examination, were allocated to one of the three regimens. Both the radiographers and the radiologists did not know the method of preparation. Radiographers were requested to enter the patients' data, the number of bowel openings, the patients' comments of the preparation and side effects. Films were reviewed independently by two experienced radiologists for the degree of bowel cleanliness and quality of barium coating.


RESULTS
The mean (standard deviation) of bowel opening frequency for the cleansing enema, Pico-Salax and Golytely were 3.6(4.4), 8.3(4.8) and 7.1(4.2), respectively, with less bowel opening in the cleansing enema. There was less nausea associated with the cleansing enema (P = 0.006), more vomiting with Golytely (P = 0.008), less abdominal fullness with Pico-salax (P = 0.0006), less anorectal irritation with Golytely (P = 0.025), and no difference in the abdominal pain amongst three groups. There was no statistically significant difference in the number of bowel openings between the groups. Patients found that Pico-salax tasted better than Golytely (P = 0.0094) and Golytely was less accepted in the amount of fluid intake (P = 0.0018 and P < 0.0002 comparing Golytely with the cleansing enema and Pico-salax). Chi-squared testing showed no statistically significant difference in bowel cleanliness and quality of barium coating among the three preparations.


CONCLUSIONS
There was no difference in the effectiveness of the three regimens. Pico-salax seems the most acceptable because it has the fewest side effects.
Lai
A K
AK
Diagnostic Radiology Department, Queen Elizabeth Hospital, Kowloon, Hong Kong.
Kwok
P C
PC
Man
S W
SW
Lau
R S
RS
Chan
S C
SC
D000328:Adult; D001466:Barium Sulfate; D002400:Cathartics / Q000009:adverse effects; D002951:Citrates; D019343:Citric Acid / Q000009:adverse effects; D003672:Defecation / Q000187:drug effects; D004573:Electrolytes / Q000009:adverse effects; D004733:Enema / Q000379:methods; D006801:Humans; D008277:Magnesium Oxide / Q000009:adverse effects; D008875:Middle Aged; D009942:Organometallic Compounds; D010847:Picolines / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000009:adverse effects; D011446:Prospective Studies; D007507:Therapeutic Irrigation
D002400:Cathartics; D002951:Citrates; D004573:Electrolytes; C033608:Golytely; D009942:Organometallic Compounds; C574900:Pico-Salax; D010847:Picolines; D001466:Barium Sulfate; D019343:Citric Acid; D008277:Magnesium Oxide; D011092:Polyethylene Glycols; C005701:picosulfate sodium