Preoperative mechanical preparation of the colon: the patient's experience.
BACKGROUND
Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials.


METHODS
As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 - 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary.


RESULTS
60 patients received mechanical bowel preparation (MBP) and 45 patients did not (No-MBP). In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03.


CONCLUSIONS
Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.
Jung
Barbel
B
University of Umeå and Department of Surgery, Visby Hospital, Visby Sweden. barbel.jung@hsf.gotland.se
Lannerstad
Olof
O
Påhlman
Lars
L
Arodell
Malin
M
Unosson
Mitra
M
Nilsson
Erik
E
D000236:Adenoma / Q000601:surgery*; D000368:Aged; D003110:Colonic Neoplasms / Q000601:surgery*; D003672:Defecation; D004239:Diverticulitis, Colonic / Q000175:diagnosis* / Q000601:surgery*; D017558:Elective Surgical Procedures; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011300:Preoperative Care; D020127:Recovery of Function; D007507:Therapeutic Irrigation