title: Bowel preparation comparison: flavored versus unflavored colyte.
abstract: Patients undergoing colonoscopy who have poor bowel cleansing must undergo repeated colon lavage and procedure, resulting in the possibility of additional discomfort and risk. Patient compliance with the necessary 4 liters of colon lavage fluid is essential. At our facility, the current colon lavage solution is unflavored and most patients complain about the taste. These are the patients who are likely to have poorly cleansed bowels. Patient preference for flavor of lavage is not known. A randomized controlled trial of 130 patients was undertaken to learn whether Colyte flavor made a difference in bowel cleansing. Results showed flavor made no difference in bowel cleansing (chi2 = 0.064, p =.96, NS); successful cleansing occurred in 75% (n = 45) of patients who received flavored and 76% (n = 53) who received unflavored Colyte. Results suggest flavor is not a factor in patients' completion of the prep nor cleansing effectiveness. As unflavored Colyte costs less than flavored, cost savings can result from continuing use of unflavored Colyte. While this clinical trial did not answer the dilemma about how to improve colon preparation, the staff's process of conducting nursing research inspired critical thinking and innovative problem-solving. Patients who are undergoing a colonoscopy are required to do a bowel cleansing the day before the procedure. Without proper bowel cleansing, colonic lesions such as polyps, neoplasms, and arteriovenous malformations (AVMs) may go undetected by being covered with small particles of stool ( Cohen et al., 1994). Poor bowel cleansing results in the need for repeat colon preparation and repeat procedure, which pose risk and discomfort for the patient and cost for the staff and institution. Done under moderate sedation, colonoscopy poses potential cardiac risks and respiratory problems for the patient. In addition, the endoscopy procedure itself could cause perforation and bleeding. Avoiding repeat procedures because of failed colonic preparation is, therefore, essential for patient safety and organization cost. Optimally, completing the colon prep solution results in adequate bowel cleansing. Prep flavor was theorized to be a possible cause of noncompliance. The purposes of this study were to determine whether patients' preferred prep solution would yield better compliance with the colon lavage solution and whether the improved compliance results in an adequately prepared bowel.
authors.affiliation: GI Diagnostic Center, Veterans Affairs Medical Center, 4150 Clement Street, 111B1, San Francisco, CA 94121, USA. ann.hayes@med.va.gov
authors.forename: Ann
authors.initials: A
authors.lastname: Hayes
authors.forename: Martha
authors.initials: M
authors.lastname: Buffum
authors.forename: Douglass
authors.initials: D
authors.lastname: Fuller
mesh_terms: D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D004573:Electrolytes / Q000008:administration & dosage*; D005260:Female; D005421:Flavoring Agents / Q000008:administration & dosage*; D005751:Gastric Lavage / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D013649:Taste
chemical_list: D004573:Electrolytes; D005421:Flavoring Agents; C033608:Golytely; D011092:Polyethylene Glycols