A randomized double-blind controlled trial comparing two forms of enema for flexible sigmoidoscopy.
OBJECTIVE
To compare bowel preparation quality and patient tolerance of two common enema solutions for flexible sigmoidoscopy.


METHODS
Three hundred adults were randomized to receive a hypertonic sodium chloride or hypertonic sodium phosphate enema regime, each consisting of two enemas administered 60 and 30 min before the procedure. Patients completed surveys on preparation comfort. Patients and endoscopist were blinded to the preparation used During the procedure, the endoscopist took pictures of the mucosa and intraluminal content. All pictures were later evaluated by a single doctor who graded the quality of the preparation.


RESULTS
There were no serious complications during or following the procedures. The preparation quality was rated as excellent or good by 76.9% of the hypertonic sodium chloride group and 72.9% of the hypertonic sodium phosphate group (p = 0.423). The hypertonic sodium chloride enema was associated with more abdominal discomfort (p = 0.018).


CONCLUSIONS
Both enemas were safe for all patients with no statistical difference between the qualities of the two bowel preparations. Both preparations performed their bowel-cleaning function well and were suitable for the preparation of patients before flexible sigmoidoscopy. The less expensive hypertonic sodium chloride solution may be an option for hospitals where budgetary considerations are important.
Ruangsin
Sakchai
S
Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. rsakchai@medicine.psu.ac.th
Chowchuvech
Vorapong
V
D002400:Cathartics; D003106:Colon; D004733:Enema / Q000379:methods*; D005260:Female; D006801:Humans; D007038:Hypotonic Solutions; D017616:Magnesium Compounds; D008297:Male; D008875:Middle Aged; D012812:Sigmoidoscopy / Q000379:methods*; D012965:Sodium Chloride / Q000627:therapeutic use
D002400:Cathartics; D007038:Hypotonic Solutions; D017616:Magnesium Compounds; D012965:Sodium Chloride